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Post-exercise Hypotension in Patients With Coronary Artery Disease

Background: Blood pressure (BP) and hemodynamic changes occurring in the recovery phase after a single bout of exercise have not been extensively studied in coronary artery patients, despite the potential clinical implications of reducing BP through exercise. This study aimed at investigating the he...

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Autores principales: Iellamo, Ferdinando, Perrone, Marco Alfonso, Caminiti, Giuseppe, Volterrani, Maurizio, Legramante, Jacopo M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8727444/
https://www.ncbi.nlm.nih.gov/pubmed/35002770
http://dx.doi.org/10.3389/fphys.2021.788591
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author Iellamo, Ferdinando
Perrone, Marco Alfonso
Caminiti, Giuseppe
Volterrani, Maurizio
Legramante, Jacopo M.
author_facet Iellamo, Ferdinando
Perrone, Marco Alfonso
Caminiti, Giuseppe
Volterrani, Maurizio
Legramante, Jacopo M.
author_sort Iellamo, Ferdinando
collection PubMed
description Background: Blood pressure (BP) and hemodynamic changes occurring in the recovery phase after a single bout of exercise have not been extensively studied in coronary artery patients, despite the potential clinical implications of reducing BP through exercise. This study aimed at investigating the hemodynamic and arterial baroreflex mechanisms possibly involved in post-exercise hypotension (PEH) in patients with coronary artery disease. Methods: In 42 normotensive coronary artery patients undergone a Cardiac Rehabilitation Program, we evaluated before and after their daily exercise training session: blood pressure (BP) and heart rate (HR). In a subgroup (n = 29), daily BP profile was also evaluated by ambulatory BP monitoring. In those patients showing PEH (n = 15), we evaluated: Cardiac Output (CO), Stroke Volume (SV), total peripheral resistances (TPR), forearm (FVR) and calf (CVR) vascular resistances, and spontaneous baroreflex sensitivity (BRS). Results: After exercise TPR was significantly reduced with a similar contribution from CVR and FVR, whereas CO and SV significantly increased. BRS showed a significant reduction mainly due to a BRS decrease in response to hypertensive stimuli. Systolic BP (SBP) was significantly reduced for 12 h after the end of a single exercise session. Conclusion: These findings indicate that in coronary artery patients, the recovery phase after exercise is characterized by PEH which is mediated mainly by a generalized peripheral vasodilation and appears to influence BP behavior throughout the daily life. Finally, the cardiac component of the arterial baroreflex seems to contribute indirectly to BP reduction occurring after exercise.
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spelling pubmed-87274442022-01-06 Post-exercise Hypotension in Patients With Coronary Artery Disease Iellamo, Ferdinando Perrone, Marco Alfonso Caminiti, Giuseppe Volterrani, Maurizio Legramante, Jacopo M. Front Physiol Physiology Background: Blood pressure (BP) and hemodynamic changes occurring in the recovery phase after a single bout of exercise have not been extensively studied in coronary artery patients, despite the potential clinical implications of reducing BP through exercise. This study aimed at investigating the hemodynamic and arterial baroreflex mechanisms possibly involved in post-exercise hypotension (PEH) in patients with coronary artery disease. Methods: In 42 normotensive coronary artery patients undergone a Cardiac Rehabilitation Program, we evaluated before and after their daily exercise training session: blood pressure (BP) and heart rate (HR). In a subgroup (n = 29), daily BP profile was also evaluated by ambulatory BP monitoring. In those patients showing PEH (n = 15), we evaluated: Cardiac Output (CO), Stroke Volume (SV), total peripheral resistances (TPR), forearm (FVR) and calf (CVR) vascular resistances, and spontaneous baroreflex sensitivity (BRS). Results: After exercise TPR was significantly reduced with a similar contribution from CVR and FVR, whereas CO and SV significantly increased. BRS showed a significant reduction mainly due to a BRS decrease in response to hypertensive stimuli. Systolic BP (SBP) was significantly reduced for 12 h after the end of a single exercise session. Conclusion: These findings indicate that in coronary artery patients, the recovery phase after exercise is characterized by PEH which is mediated mainly by a generalized peripheral vasodilation and appears to influence BP behavior throughout the daily life. Finally, the cardiac component of the arterial baroreflex seems to contribute indirectly to BP reduction occurring after exercise. Frontiers Media S.A. 2021-12-22 /pmc/articles/PMC8727444/ /pubmed/35002770 http://dx.doi.org/10.3389/fphys.2021.788591 Text en Copyright © 2021 Iellamo, Perrone, Caminiti, Volterrani and Legramante. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Physiology
Iellamo, Ferdinando
Perrone, Marco Alfonso
Caminiti, Giuseppe
Volterrani, Maurizio
Legramante, Jacopo M.
Post-exercise Hypotension in Patients With Coronary Artery Disease
title Post-exercise Hypotension in Patients With Coronary Artery Disease
title_full Post-exercise Hypotension in Patients With Coronary Artery Disease
title_fullStr Post-exercise Hypotension in Patients With Coronary Artery Disease
title_full_unstemmed Post-exercise Hypotension in Patients With Coronary Artery Disease
title_short Post-exercise Hypotension in Patients With Coronary Artery Disease
title_sort post-exercise hypotension in patients with coronary artery disease
topic Physiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8727444/
https://www.ncbi.nlm.nih.gov/pubmed/35002770
http://dx.doi.org/10.3389/fphys.2021.788591
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