Int J Sports Med 2024; 45(07): 532-542
DOI: 10.1055/a-2253-1807
Clinical Sciences

Determinants of V̇+O2peak Changes After Aerobic Training in Coronary Heart Disease Patients

Axel Girault
1   Preventive medicine and physical activity Center (ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Canada
2   Unit Research Physiological Adaptations to Exercise and Physical Rehabilitation, Université de Picardie Jules Verne, Amiens, France
,
Pierre-Marie Leprêtre
2   Unit Research Physiological Adaptations to Exercise and Physical Rehabilitation, Université de Picardie Jules Verne, Amiens, France
6   Unit of Cardiac Rehabilitation, Hospital Center of Corbie, Corbie, France
,
Lukas-Daniel Trachsel
3   University Clinic for Cardiology, Inselspital University Hospital Bern, Bern, Switzerland
,
Florent Besnier
1   Preventive medicine and physical activity Center (ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Canada
5   Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Canada
,
Maxime Boidin
4   Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom of Great Britain and Northern Ireland
,
Julie Lalongé
1   Preventive medicine and physical activity Center (ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Canada
,
Martin Juneau
1   Preventive medicine and physical activity Center (ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Canada
5   Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Canada
,
Louis Bherer
1   Preventive medicine and physical activity Center (ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Canada
5   Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Canada
,
Anil Nigam
1   Preventive medicine and physical activity Center (ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Canada
5   Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Canada
,
Mathieu Gayda
1   Preventive medicine and physical activity Center (ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Canada
5   Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Canada
› Author Affiliations
Funding Information Mirella and Lino Saputo Research Chair in Cardiovascular Diseases and the Prevention of Cognitive Decline from Université de Montréal at the Montreal Heart Institute — the Montreal Heart Institute Foundation — the Fonds de Recherche du Québec en Santé — the ÉPIC Center Foundation —

Abstract

This study aimed to highlight the ventilatory and circulatory determinants of changes in ˙VO2peak after exercise-based cardiac rehabilitation (ECR) in patients with coronary heart disease (CHD). Eighty-two CHD patients performed, before and after a 3-month ECR, a cardiopulmonary exercise testing (CPET) on a bike with gas exchanges measurements (˙VO2peak, minute ventilation, i. e., ˙VE), and cardiac output (Q˙c). The arteriovenous difference in O2 (C(a-v¯)O2) and the alveolar capillary gradient in O2 (PAi-aO2) were calculated using Fick’s laws. Oxygen uptake efficiency slope (OUES) was calculated. A 5.0% cut off was applied for differentiating non- (NR: ˙VO2<0.0%), low (LR: 0.0≤ ∆˙VO2<5.0%), moderate (MR: 5.0≤∆˙VO2 < 10.0%), and high responders (HR: ∆˙VO2≥10.0%) to ECR. A total of 44% of patients were HR (n=36), 20% MR (n=16), 23% LR (n=19), and 13% NR (n=11). For HR, the ˙VO2peak increase (p<0.01) was associated with increases in ˙VE (+12.8±13.0 L/min, p<0.01), (+1.0±0.9 L/min, p<0.01), and C(a-v¯)O2 (+2.3±2.5 mLO2/100 mL, p<0.01). MR patients were characterized by+6.7±19.7 L/min increase in ˙VE (p=0.04) and+0.7±1.0 L/min of Q˙c (p<0.01). ECR induced decreases in ˙VE (p=0.04) and C(a-v¯)O2 (p<0.01) and a Q˙c increase in LR and NR patients (p<0.01). Peripheral and ventilatory responses more than central adaptations could be responsible for the ˙VO2peak change with ECR in CHD patients.

Supplementary Material



Publication History

Received: 26 September 2023

Accepted: 23 January 2024

Accepted Manuscript online:
24 January 2024

Article published online:
11 March 2024

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