Cardiovascular responses to high-intensity stair climbing in individuals with coronary artery disease

Sydney E Valentino; Emily C Dunford; Jonathan Dubberley; Eva M Lonn; Martin J Gibala; Stuart M Phillips; Maureen J MacDonald

doi:10.14814/phy2.15308

Cardiovascular responses to high-intensity stair climbing in individuals with coronary artery disease

Physiol Rep. 2022 May;10(10):e15308. doi: 10.14814/phy2.15308.

Authors

Sydney E Valentino¹, Emily C Dunford¹, Jonathan Dubberley², Eva M Lonn^{2

3

4}, Martin J Gibala¹, Stuart M Phillips¹, Maureen J MacDonald¹

Affiliations

¹ Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada.
² Hamilton Health Sciences, Hamilton, Ontario, Canada.
³ Population Health Research Institute, Hamilton, Ontario, Canada.
⁴ Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

Abstract

Exercise-based cardiac rehabilitation leads to improvements in cardiovascular function in individuals with coronary artery disease. The cardiac effects of coronary artery disease (CAD) can be quantified using clinical echocardiographic measures, such as ejection fraction (EF). Measures of cardiovascular function typically only used in research settings can provide additional information and maybe more sensitive indices to assess changes after exercise-based cardiac rehabilitation. These additional measures include endothelial function (measured by flow-mediated dilation), left ventricular twist, myocardial performance index, and global longitudinal strain. To investigate the cardiovascular response to 12 week of either traditional moderate-intensity (TRAD) or stair climbing-based high-intensity interval (STAIR) exercise-based cardiac rehabilitation using both clinical and additional measures of cardiovascular function in individuals with CAD. Measurements were made at baseline (BL) and after supervised (4wk) and unsupervised (12 week) of training. This study was registered as a clinical trial at clinicaltrials.gov (NCT03235674). Participants were randomized into either TRAD (n = 9, 8M/1F) and STAIR (n = 9, 8M/1F). There was a training-associated increase in one component of left ventricular twist: Cardiac apical rotation (TRAD: BL: 5.6 ± 3.3º, 4 week: 8.0 ± 3.9º, 12 week: 6.2 ± 5.1º and STAIR: BL: 5.1 ± 3.6º, 4 week: 7.4 ± 3.9º, 12 week: 7.8 ± 2.8º, p (time) = 0.03, η² = 0.20; main effect) and post-hoc analysis revealed a difference between BL and 4 week (p = 0.02). There were no changes in any other clinical or additional measures of cardiovascular function. The small increase in cardiac apical rotation observed after 4 weeks of training may indicate an early change in cardiac function. A larger overall training stimulus may be needed to elicit other cardiovascular function changes.

Keywords: HIIT; cardiac function; cardiac rehabilitation; flow-mediated dilation; stair climbing.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Cardiac Rehabilitation*
Coronary Artery Disease*
Exercise Therapy
High-Intensity Interval Training*
Humans
Stair Climbing*

Associated data

ClinicalTrials.gov/NCT03235674

Grants and funding

CIHR/Canada