Cardiovascular responses to cold and submaximal exercise in patients with coronary artery disease

Rasmus I.P. Valtonen, Antti Kiviniemi, Heidi E. Hintsala, Niilo R.I. Ryti, Tuomas Kenttä, Heikki V. Huikuri, Juha Perkiömäki, Craig G Crandall, Wouter van Marken Lichtenbelt, Markku Alén, Hannu Rintamäki, Matti Mäntysaari, Arto Hautala, Jouni J.K. Jaakkola, Tiina M. Ikäheimo

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Regular year-round exercise is recommended for patients with coronary artery disease (CAD). However, the combined effects of cold and moderate sustained exercise, both known to increase cardiac workload, on cardiovascular responses are not known. We tested the hypothesis that cardiac workload is increased, and evidence of ischemia would be observed during exercise in the cold in patients with CAD. Sixteen men (59.3 ± 7.0 yr, means ± SD) with stable CAD each underwent 4, 30 min exposures in a randomized order: seated rest and moderate-intensity exercise [walking, 60%-70% of max heart rate (HR)] performed at +22°C and -15°C. Systolic brachial blood pressure (SBP), HR, electrocardiogram (ECG), and skin temperatures were recorded throughout the intervention. Rate pressure product (RPP) and ECG parameters were obtained. The combined effects of cold and submaximal exercise were additive for SBP and RPP and synergistic for HR when compared with rest in a neutral environment. RPP (mmHg·beats/min) was 17% higher during exercise in the cold (18,080 ± 3540) compared with neutral (15,490 ± 2,940) conditions ( P = 0.001). Only a few ST depressions were detected during exercise but without an effect of ambient temperature. The corrected QT interval increased while exercising in the cold compared with neutral temperature ( P = 0.023). Recovery of postexercise blood pressure was similar regardless of temperature. Whole body exposure to cold during submaximal exercise results in higher cardiac workload compared with a neutral environment. Despite the higher RPP, no signs of myocardial ischemia or abnormal ECG responses were observed. The results of this study are useful for planning year-round exercise-based rehabilitation programs for stable CAD patients.

Original languageEnglish (US)
Pages (from-to)R768-R776
JournalAmerican journal of physiology. Regulatory, integrative and comparative physiology
Volume315
Issue number4
DOIs
StatePublished - Oct 1 2018

Fingerprint

Coronary Artery Disease
Exercise
Workload
Pressure
Electrocardiography
Heart Rate
Blood Pressure
Temperature
Arm
Exercise Therapy
Skin Temperature
Walking
Myocardial Ischemia
Ischemia

Keywords

  • cold temperature
  • coronary artery disease
  • exercise

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

Cite this

Valtonen, R. I. P., Kiviniemi, A., Hintsala, H. E., Ryti, N. R. I., Kenttä, T., Huikuri, H. V., ... Ikäheimo, T. M. (2018). Cardiovascular responses to cold and submaximal exercise in patients with coronary artery disease. American journal of physiology. Regulatory, integrative and comparative physiology, 315(4), R768-R776. https://doi.org/10.1152/ajpregu.00069.2018

Cardiovascular responses to cold and submaximal exercise in patients with coronary artery disease. / Valtonen, Rasmus I.P.; Kiviniemi, Antti; Hintsala, Heidi E.; Ryti, Niilo R.I.; Kenttä, Tuomas; Huikuri, Heikki V.; Perkiömäki, Juha; Crandall, Craig G; van Marken Lichtenbelt, Wouter; Alén, Markku; Rintamäki, Hannu; Mäntysaari, Matti; Hautala, Arto; Jaakkola, Jouni J.K.; Ikäheimo, Tiina M.

In: American journal of physiology. Regulatory, integrative and comparative physiology, Vol. 315, No. 4, 01.10.2018, p. R768-R776.

Research output: Contribution to journalArticle

Valtonen, RIP, Kiviniemi, A, Hintsala, HE, Ryti, NRI, Kenttä, T, Huikuri, HV, Perkiömäki, J, Crandall, CG, van Marken Lichtenbelt, W, Alén, M, Rintamäki, H, Mäntysaari, M, Hautala, A, Jaakkola, JJK & Ikäheimo, TM 2018, 'Cardiovascular responses to cold and submaximal exercise in patients with coronary artery disease', American journal of physiology. Regulatory, integrative and comparative physiology, vol. 315, no. 4, pp. R768-R776. https://doi.org/10.1152/ajpregu.00069.2018
Valtonen, Rasmus I.P. ; Kiviniemi, Antti ; Hintsala, Heidi E. ; Ryti, Niilo R.I. ; Kenttä, Tuomas ; Huikuri, Heikki V. ; Perkiömäki, Juha ; Crandall, Craig G ; van Marken Lichtenbelt, Wouter ; Alén, Markku ; Rintamäki, Hannu ; Mäntysaari, Matti ; Hautala, Arto ; Jaakkola, Jouni J.K. ; Ikäheimo, Tiina M. / Cardiovascular responses to cold and submaximal exercise in patients with coronary artery disease. In: American journal of physiology. Regulatory, integrative and comparative physiology. 2018 ; Vol. 315, No. 4. pp. R768-R776.
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