ECSS Paris 2023: CP-MH11
INTRODUCTION: Systemic arterial hypertension (SAH) affects pre-and postmenopausal women, and cardiovascular autonomic impairments are often observed. While pharmacological treatment can reduce blood pressure, it does not seem to restore cardiovascular autonomic control fully. In contrast, aerobic physical training may be decisive in this process, but little is known about its effects in these conditions. This study aimed to investigate the effects of aerobic physical training on baroreflex sensitivity (BRS), autonomic modulation of heart rate (HRV), and blood pressure variability (BPV) in hypertensive women, both pre-and post-menopause. METHODS: A non-randomized clinical trial in which hypertensive women (35–65 years) treated with renin-angiotensin system inhibitors (RASi) were allocated to two groups: premenopausal (N=49) and postmenopausal (N=55). Hemodynamic, metabolic, cardiorespiratory, and cardiovascular autonomic modulation (spectral analysis) parameters were assessed before and after 16 weeks of aerobic physical training. RESULTS: Before aerobic physical training, the premenopausal group exhibited a higher BRS gain (9.0±4.8 vs. 5.6±3.0 ms/mmHg) than the postmenopausal group. HRV spectral analysis revealed that the premenopausal group had higher values of low-frequency (LF, 396±377 ms2 vs. 173±157 ms2) and high-frequency oscillations (HF, 593±683 ms2 vs. 142±139 ms2), and a predominance of vagal autonomic modulation (LF/HF, 0.94±0.64 vs. 1.42±0.69). The differences in BRS gain, LF, and HF between the two groups persisted after aerobic physical training. However, significant increases in HRV parameters were observed, particularly in the postmenopausal group, which began to exhibit vagal dominance in cardiac autonomic modulation (LF/HF 0.97±0.48). Additionally, a reduction in low-frequency BPV was observed in both groups. CONCLUSION: SAH affects HRV, causing significant impairments in women, especially after menopause, even when the treatment with RASi is effective in reducing blood pressure values. Physical training is a fundamental therapeutic tool that counteracts cardiovascular autonomic impairments and increases cardiorespiratory fitness. However, its benefits in autonomic modulation of HRV and BRS were limited. The reason for this limitation is unknown and may involve adaptations induced by the genesis of hypertension in different autonomic regulation sites and adverse adaptations in the heart itself.
Read CV Hugo SouzaECSS Paris 2023: CP-MH11
INTRODUCTION: Cardiopulmonary fitness testing (CPET) is recognised as a clinical risk stratification tool. This pilot study examined the relationship between CPET variables and postoperative complications in robot-assisted surgery (RAS). METHODS: Retrospective analysis was conducted on RAS patients (n=80). Anaerobic threshold (AT) (mL/min/kg), Peak ̇VO₂ (Peak) (mL/min/kg), BMI, age, sex, and Clavien-Dindo (CD) classification were analysed. Linear regression assessed relationships between AT, Peak and complications. Groups were compared with the Mann-Whitney U test. RESULTS: The regression model explained 53.9% of the variance in AT (R² = 0.539, p < 0.001). Complications were associated with a lower AT (β = -2.46, 95% CI: -4.18 to -0.74, p = 0.006, d = 0.41). CD classification was also significant (p < 0.001), with Class V patients recording lower AT (-11.49 mL/min/kg, 95% CI: -18.03 to -4.95, p < 0.001, d = 1.12). Small effects were detected in the Mann-Whitney U tests, but these were not significant: Peak was lower in the complication group (U = 634, p = 0.190, d = 0.20, 95% CI: -0.60 to 2.20). AT was also lower in the complication group, (U = 623, p = 0.226, d = 0.33, 95% CI: -0.40 to 1.90). CONCLUSION: Although underpowered, this pilot suggests that lower AT is associated with the presence of complications following RAS and that patients with higher CD classifications were more likely to have a lower threshold. These findings support preoperative fitness assessment via CPET for risk stratification and care optimisation. Larger samples are required to confirm the findings.
Read CV James SaldanhaECSS Paris 2023: CP-MH11
INTRODUCTION: Whole-body cryostimulation (WBC), a non-pharmacological intervention, has been shown to improve cardiovascular and autonomic regulation. This study aimed to investigate the acute and repeated effects of WBC on baroreflex sensitivity (BRS), heart rate variability (HRV), and blood pressure in physically active men. METHODS: Fifty male participants (22 ± 4 years) were randomly assigned to an experimental group (N=25) and a control group (N=25). Within each group, participants were further classified according to BMI categories (normal weight and overweight). The experimental group underwent 10 WBC sessions over two weeks, while cardiovascular responses were assessed before and after the 1st and the 10th session of WBC. Heart rate (HR), BRS, HRV, and blood pressure (SAP, DAP, MAP) were measured. RESULTS: A significant reduction in blood pressure was observed after repeated WBC exposures, with systolic arterial pressure (SAP) and mean arterial pressure (MAP) decreasing by 7% (−8.6 mmHg for SAP and −6.3 mmHg for MAP) (p < 0.05). In addition, acute WBC exposure significantly increased BRS by 42% after the 1st WBC exposure and 44% after the 10th (p < 0.001). Similarly, R-R intervals increased by 11% and 16%, while RMSSD rose by 19% and 34% after the 1st and 10th exposures, respectively (p < 0.001). However, no long-term adaptation was observed in HR, HRV, or BRS. No significant differences were found between normal-weight and overweight participants. CONCLUSION: Our findings demonstrate that WBC induces acute improvements in autonomic regulation, as evidenced by increased BRS and HRV, while significantly lowering systolic and mean arterial pressures at rest. The observed reduction in SAP and MAP suggests beneficial vascular adaptations, potentially mediated by improved endothelial function and enhanced parasympathetic activity. These results align with previous studies highlighting the positive effects of WBC on cardiovascular regulation, supporting its role as a promising non-pharmacological intervention for blood pressure management. The acute increase in BRS and HRV following WBC exposure indicates a transient enhancement in autonomic balance, which could be beneficial for individuals at risk of hypertension or cardiovascular dysregulation. Although WBC provides acute benefits, no long-term autonomic adaptations were observed, indicating that regular exposure may be needed to sustain its effects. The mechanisms behind blood pressure reduction, such as vascular compliance, nitric oxide availability, or sympathetic regulation, require further investigation. WBC shows promise as a non-pharmacological strategy for blood pressure control, but further research is needed to evaluate its long-term effects, clinical applicability, and interactions with lifestyle factors. Future studies should also investigate individual variability based on age, metabolism, and cardiovascular conditions to optimize its therapeutic potential.
Read CV Wafa douziECSS Paris 2023: CP-MH11