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Cardiovascular responses to low-intensity isometric handgrip exercise in coronary artery disease: effects of posture
Mariana de Oliveira Gois1, Rodrigo Polaquini Simões1, Alberto Porta2
1Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil.
Insights
Posture significantly impacts cardiovascular responses during isometric handgrip exercise, especially in coronary artery disease (CAD) patients. Standing positions induce greater cardiovascular stress compared to sitting or supine positions in individuals with CAD.
Area of Science:
- Cardiovascular Physiology
- Exercise Science
- Clinical Cardiology
Background:
- Coronary artery disease (CAD) is associated with autonomic dysfunction, impairing cardiovascular adjustments during physical activity and postural changes.
- Understanding these responses is crucial for managing exercise tolerance and safety in CAD patients.
Purpose of the Study:
- To investigate the influence of different body postures (supine, sitting, standing) on cardiovascular responses during low-intensity isometric handgrip exercise in CAD patients.
- To determine if CAD exacerbates cardiovascular stress during isometric handgrip exercise compared to healthy controls.
Main Methods:
- Cardiovascular parameters including blood pressure, heart rate, cardiac output, and stroke volume were measured in 15 CAD patients and 15 healthy controls.
- Subjects performed isometric handgrip exercise at 30% of maximum voluntary contraction until exhaustion in supine, sitting, and standing positions.
- Changes in cardiovascular variables (Delta PB, PR1) were calculated from rest, peak exercise, and early recovery.
Main Results:
- Standing posture resulted in significantly higher systolic and mean arterial pressure responses and double product compared to sitting and supine positions.
- CAD patients exhibited elevated systolic and mean arterial pressure responses across all postures compared to controls.
- CAD patients showed a greater stroke volume response in the sitting position.
Conclusions:
- Body posture significantly modulates cardiovascular responses during isometric handgrip exercise, with standing imposing the greatest stress.
- Coronary artery disease leads to heightened arterial pressure responses, which are considered physiological adaptations to the disease and exercise type.
Background:
Coronary artery disease (CAD) lead to cardiovascular autonomic control disfunctions that can worsen exercise and/or posture adjustments.
Objectives:
To verify the cardiovascular responses to low-intensity isometric handgrip exercise performed in different postures in CAD patients. This study tested the hypothesis that the posture influences the cardiovascular responses during isometric handgrip exercise and that the presence of CAD leads to greater cardiovascular stress during this type of exercise.
Methods:
We investigated cardiovascular responses to isometric handgrip exercise in 15 CAD patients (CADG) and 15 health matched-control (CG). The subjects performed isometric handgrip exercise at 30% of maximum voluntary contraction until exhaustion in SUPINE, SITTING and STANDING positions. Systolic arterial pressure, diastolic arterial pressure, mean blood pressure, heart rate, peripheral vascular resistance, cardiac output, stroke volume and double product were measured during rest (baseline), exercise (peak value) and recovery in the 1st minute (REC1). Delta PB (ΔPB, peak minus baseline) and PR1 (ΔPR1, peak minus REC1) were calculated.
Results:
Higher ΔPB and ΔPR1 of systolic and mean arterial pressure and double product were observed in STANDING when compared to SITTING and/or SUPINE. CADG showed higher ΔPB of systolic and mean arterial pressure in all postures and higher ΔPR1 of strove volume in the SITTING.
Conclusion:
We concluded that the posture during isometric handgrip exercise influences the cardiovascular responses with STANDING leading to higher cardiovascular stress. CAD promoted higher arterial pressure responses however these responses were physiological and expected due to the presence of disease and type of exercise.
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