TY - JOUR
T1 - Cardiovascular responses to cold and submaximal exercise in patients with coronary artery disease
AU - Valtonen, Rasmus I.P.
AU - Kiviniemi, Antti
AU - Hintsala, Heidi E.
AU - Ryti, Niilo R.I.
AU - Kenttä, Tuomas
AU - Huikuri, Heikki V.
AU - Perkiömäki, Juha
AU - Crandall, Craig
AU - Van Marken Lichtenbelt, Wouter
AU - Alén, Markku
AU - Rintamäki, Hannu
AU - Mäntysaari, Matti
AU - Hautala, Arto
AU - Jaakkola, Jouni J.K.
AU - Ikäheimo, Tiina M.
N1 - Funding Information:
The study was funded through grants from the Finnish Ministry of Education and Culture and Yrjö Jahnsson Foundation [Year-round health enhancing exercise and coronary artery disease: a randomized controlled study (CadColdEx)]. A. Kiviniemi received funding from the Finnish Foundation for Cardiovascular Research, Helsinki, Finland and the Paulo Foundation, Espoo, Finland.
Publisher Copyright:
Copyright © 2018 the American Physiological Society.
PY - 2018/10
Y1 - 2018/10
N2 - 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 moderateintensity 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.
AB - 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 moderateintensity 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.
KW - Cold temperature
KW - Coronary artery disease
KW - Exercise
UR - http://www.scopus.com/inward/record.url?scp=85063717658&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85063717658&partnerID=8YFLogxK
U2 - 10.1152/AJPREGU.00069.2018
DO - 10.1152/AJPREGU.00069.2018
M3 - Article
C2 - 29975565
AN - SCOPUS:85063717658
SN - 0363-6119
VL - 315
SP - R768-R776
JO - American Journal of Physiology - Regulatory Integrative and Comparative Physiology
JF - American Journal of Physiology - Regulatory Integrative and Comparative Physiology
IS - 4
ER -