Resumen de las evidencias científicas de la eficacia del ejercicio físico en las enfermedades cardiovasculares / / Um resumo da evidência científica da efetividade do exercício físico nas doenças cardiovasculares / A summary of evidence of the effectiveness of physical exercise on cardiovascular disease

Las enfermedades cardiovasculares son las más prevalentes en la sociedad occidental. En las últimas décadas, innumerables publicaciones informan del poder terapéutico del ejercicio físico (EF) en estas patologías. El objetivo de este trabajo ha sido buscar, valorar y resumir los resultados de las mejores pruebas científicas publicadas, sobre el efecto del EF, en la mortalidad y morbilidad de pacientes con enfermedad coronaria, insuficiencia cardiaca, hipertensión arterial, claudicación intermitente e ictus. Se buscaron revisiones sistemáticas en Medline, Embase, Cochrane Database of Systematic Reviews y Database of Abstracts of Reviews of Effects. Se concluye que, tanto el entrenamiento aeróbico, como el de fuerza son seguros y eficaces en la disminución de la mortalidad y morbilidad en la mejora de algunos signos y síntomas, y en el incremento de la función física en enfermos cardiovasculares (AU)

Cardiovascular diseases are among the most widespread in Western culture. In recent decades, numerous publications have assessed the effectiveness of physical exercise (PE) in these pathologies. The aim of this study was to search for, evaluate and summarize the results of the most conclusive scientific evidence published on the effectiveness of PE on mortality and morbidity in patients with coronary artery disease, heart failure, hypertension, intermittent claudication, and stroke. We searched for systematic reviews in Medline, Embase, Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects. In conclusion, both aerobic and strength training are safe and effective in reducing mortality and morbidity, improving signs and symptoms, and increasing physical function in patients with cardiovascular disease (AU)

As doenças cardiovasculares são as mais prevalentes na sociedade ocidental. Nas últimas décadas, inúmeras publicações informaram o poder terapêutico do exercício físico (EF) nestas patologias. O objetivo deste trabalho foi procurar avaliar e resumir os resultados das maiores evidências científicas publicadas sobre o efeito do EF na mortalidade e morbidade de pacientes com doença coronariana, insuficiência cardíaca, hipertensão arterial, claudicação intermitente e ictus. Foi realizada uma busca por revisões sistemáticas nas seguintes bases de dados: Medline, Embase, Cochrane Database of Systematic Reviews y Database of Abstracts of Reviews of Effects. Conclui-se que tanto o treinamento aeróbico como o de força são seguros e eficazes na diminuição da mortalidade e morbidade, na melhora de alguns sinais e sintomas, e no incremento da função física em enfermos cardiovasculares

Heart rate deflection compared to 4 mmol x l(-1) lactate threshold during incremental exercise and to lactate during steady-state exercise on an arm-cranking ergometer in paraplegic athletes.

The deflection point (DP) of the heart rate in relation to the work rate (WR) of 8 male endurance-trained paraplegics and 11 male physically active sports students was investigated during nonsteady-state incremental arm cranking ergometry (IT) and compared to the 4 mmol x l(-1) blood lactate concentration threshold and to blood lactate concentration in steady-state exercise (SST). Heart rate, and lactate concentration from capillary blood, were determined at rest, during IT and SST. The DP was calculated by linear regression analysis of the heart rate during IT. The SST consisted of three consecutive exercise intensities over a period of 8 min at exercise intensities of 10 W below, and at 10 W above the work rate at deflection point (WRDP). No difference was found between the paraplegics and non-handicapped subjects regarding heart rate and blood lactate concentration at rest and during exercise. A DP was established in all the paraplegics and in 72.7% of the non-handicapped subjects, but lactate accumulation was observed in 75% of the paraplegics and in 62.5% of the non-handicapped subjects at the lowest intensity of SST. In summary, endurance-trained paraplegics with an injury level below T5 showed heart rate and blood lactate concentration values comparable to non-handicapped subjects during IT. A linear increase at moderate exercise intensities and a levelling-off at higher to maximal intensities could be identified in all the paraplegics and in 72.7% of non-handicapped subjects. The determination of the anaerobic threshold by DP should be applied with caution, since no causal relationship of DP and the anaerobic threshold was found and the WRDP tended to overestimate threshold values.

[Coronary circulation and metabolic function in endurance trained paraplegics]. / Herz-Kreislauf- und Stoffwechselfunktion bei ausdauertrainierten Paraplegikern.

OBJECTIVE: To determine the effect of physical activity on pulmonary, cardiovascular and metabolic activity in paraplegics. PATIENTS AND METHODS: Eight male paraplegics (average age 35.7 [range 25-47] years) had been selected from a pool of training members of the German Sport Union for the Disabled. They performed graded arm crank training for 8.3 +/- 3.1 h/week. Left ventricular volume (LVV), stroke volume (SV), wall thickness (WT), heart rate (HR) as well as serum lactate concentration were measured after different levels of the graded exercise. Results were compared with those obtained in 11 male sport students (average age 26.4 [23-30] years), who had similarly trained for 5.6 +/- 1.3 h/week. RESULTS: The paraplegics had a significantly smaller LVV than the controls (771 +/- 84 ml vs 976 +/- 84 ml) and smaller SV (83 +/- 13 ml vs 104 +/- 11ml), with comparable WT. Paraplegics achieved significantly lower maximal exercise (145 +/- 23.7 vs 160 +/- 28.2) and maximal HR (177 +/- 12 vs 170 +/- 9) were not significantly different at the various exercise steps. CONCLUSION: Paraplegia decreases cardiac dimensions and function. Long-term physical exercise achieves results comparable with those of untrained but not of trained healthy controls. Physically active paraplegics showed physiological cardiovascular and metabolic reactions to exercise.

Training-overtraining. A prospective, experimental study with experienced middle- and long-distance runners.

Overtraining may be one frequent cause of stagnation or decrease in performance capacity of athletes. Israel (19) differentiates between addisonoid (parasympathetic) and basedowoid (sympathetic) overtraining, characterized by inhibition or excitation. We tried to induce an overtraining syndrome in 8 experienced middle- and long-distance runners, based on an increase in training volume from an average 85.9 km (week 1) to 115.1 km (week 2) and 143.1 km (week 3) to 174.6 km per week (week 4). The influence of this training on cardiovascular, metabolic and hormonal parameters was examined with special respect to plasma and urinary catecholamines. Laboratory testing including graded treadmill running was performed on the days 0, 14 and 28. Training was held six days each week, with nearly 30 km per day in the fourth week. A stagnation in endurance performance capacity (running velocity at the aerobic-anaerobic transition range) and a decrease in maximum working capacity were observed in 6 and a stagnation in 2 of the 8 sportsmen, indicated by a decrease in total running distance from 4719 + 912 m to 4361 + 788 m during incremental treadmill ergometry. The sportsmen could neither improve nor could they even approximately reach their personal records during the subsequent competitive season. Subjective complaints, classified on a four-point scale, increased from 1.2 (week 1) to 3.2 in week 4. Glucose, lactate, ammonia, glycerol, free fatty acids, albumin, LDL, VLDL cholesterol, hemoglobin level (transient), leukocytes, and heart rate (before and during exercise) decreased significantly. Urea, creatinine, uric acid, GOT, GPT, gamma-GT, serum electrolytes (except phosphate and calcium) remained constant at the measuring times, CPK was elevated.(ABSTRACT TRUNCATED AT 250 WORDS)