e240 Journal of Hypertension Vol 34, e-Supplement 2, September 2016
PP.20.04 EFFECT OF ANTECEDENT CIGARETTE SMOKING
ON CARDIOVASCULAR FUNCTION DURING
ISOMETRIC HANDGRIP EXERCISE
P. Anyfanti1, E. Triantafyllidou2, A. Triantafyllou1, A. Kyparos2, M. Nikolaidis2,
I. Vrabas2, A. Zafeiridis2, S. Douma1, K. Dipla2. 1Laboratory of Hypertension,
Micro- and Macrovascular Assessment, Papageorgiou GH, Aristotle University
of Thessaloniki, Thessaloniki, GREECE, 2Exercise Physiology and Biochemistry
Laboratory, Aristotle University of Thessaloniki, Serres, GREECE
Objective: The detrimental effects of long-term smoking on cardiovascular health
have been well established. Surprisingly, the effects of antecedent cigarette smok-
ing on acute cardiovascular adaptations remain by far under-investigated. This
study examined whether acute cardiovascular and neural adaptations during iso-
metric exercise are altered following cigarette smoking.
Design and method: Twelve young, healthy, male habitual smokers performed
randomly two experimental protocols: (i) a smoking protocol, during which the
participant smoked a single cigarette prior to exercise and (ii) a control proto-
col, during which the same participant smoked a sham (nicotine-free) cigarette.
The testing protocol involved a 5-min baseline, a 5-min smoking, a 10-min post-
smoking rest, a 3-min isometric handgrip exercise (at 30% maximum voluntary
contraction), and a 3-min recovery. Beat-to-beat blood pressure (BP) was continu-
ously monitored (Finapres). The double product, an index of myocardial myocar-
dial stress, and spontaneous baroreflex sensitivity (BRS) were assessed.
Results: During baseline, systolic/diastolic BP (SBP/DBP), double product, and
BRS values did not differ between protocols. However, during the post-smoking
rest, both SBP/DBP (140.8 ± 12.1/87.0 ± 6.9 vs. 125.9 ± 7.1/77.3 ± 5.5 mmHg)
and double product (12190.7 ± 2365.9 vs. 8391.5 ± 1226.2 mmHg•bpm) were
higher vs. the respective period in the control protocol (p < 0.001). During hand-
grip, the double product increased compared to baseline in both the smoking
(17240.0 ± 3893.4 vs. 9100.4 ± 1627.7 mmHg•bpm) and the control (15424.3
± 3173.4 vs. 8667.6 ± 1236.7 mmHg•bpm) protocol, with a markedly greater
increase in smoking vs. control protocol (p < 0.001). BRS decreased in the post-
smoking resting period vs. baseline (8.3 ± 4.2 vs. 12.2 ± 5.3 ms/mmHg; p < 0.05),
and was lower than the respective period in the control protocol (13.9 ± 4.7 ms/
mmHg; p < 0.05). A further decrease in BRS was observed during exercise, re-
sulting in lower BRS during handgrip in the smoking vs. control protocol (4.4 ±
2.6 vs. 7.2 ± 4.6 ms/mmHg; p < 0.05). During recovery, delayed BRS and higher
double-product responses were observed in the smoking vs. the control protocol.
Conclusions: Smoking of a single cigarette shortly before exercise, triggers a
greater myocardial stress and an exacerbating BRS response during subsequent
isometric exercise. Even in healthy young men, perceived as free from the long-
term cardiovascular effects of smoking, antecedent smoking induces greater BP
responses during exercise and a delayed recovery.
PP.20.05 THE HEMODYNAMIC CHANGE BY SQUATTING
IS INDUCED BY DIMINISHED VASCULAR
DISTENSIBILITY AND ENHANCED PRESSURE
WAVE REFLECTION
T. Nawa, T. Murakami, M. Shiraishi, S. Fukuoka, K. Higashi, H. Nakajima,
H. Aotsuka. Chiba Children’s Hospital, Chiba, JAPAN
Objective: In patients with tetralogy of Fallot, it is well known that “squatting”
increases the pulmonary blood flow and improves cyanosis. However, the mecha-
nism of these hemodynamic changes has not been fully elucidated. Our hypoth-
esis is that squatting accelerates pressure wave reflection and it increases after
load of systemic circulation. To clarify the mechanism of squatting, the change in
arterial pulsatile property induced by squatting was investigated.
Design and method: 31 healthy young adults were enrolled in this study. 12 were
men and 19 were women, with a mean age of 30 years (range 23 to 43 years).
They had a physical checkup within 6 months, and no abnormality was pointed
out. None of them took any medication. Blood pressure (BP) was measured in the
right brachial artery using an automated oscillometric method during standing
and squatting. Second derivative of photoplethysmogram (SDPTG) was recorded
using the digital photoplethysmograph (DYNA PULSE SDP-100, Fukuda Denshi,
Tokyo, Japan) during standing and squatting. The amplitude of each wave was
measured, and the ratios of the amplitudes of early negative wave (b wave) and late
re-downsloping wave (d-wave) to amplitude of initial positive wave (a wave), b/a
and d/a ratios, were calculated. Baseline measurements in upright position were
obtained after 3 min of quiet standing, including BP and SDPTG. Squatting was
then performed for 3 min, with body weight positioned over the heels. Both BP
and SDPTG were re-examined during squatting.
Results: There was no significant difference about heart rate, systolic BP, diastolic
BP, and pulse pressure between two situations. The b/a ratio during squatting were
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
higher than that during standing (mean ± SEM, –0.83 ± 0.16 vs –0.69 ± 0.13,
P = 0.00037). The d/a ratio during squatting was lower than that during standing
(mean ± SEM, –0.16 ± 0.11 vs –0.31 ± 0.10, P < 0.0001).
Conclusions: Squatting diminishes the vascular distensibility and enhances the
pressure wave reflection. It could improve cyanotic spells in patients with tetral-
ogy of Fallot.
PP.20.06 THE INFLUENCE OF SLOW BREATHING TRAINING
ON PHYSICAL EXERCISE CAPACITY AND SLEEP
DISTURBANCES IN PATIENTS WITH CHRONIC
HEART FAILURE
G. Kielbasa1, T. Drozdz1, D. Debicka-Dabrowska1, K. Styczkiewicz1, M. Klocek1,
G. Malfatto2, A. Bednarek1, A. Olszanecka1, G. Bilo2, D. Czarnecka1, G. Parati2,3,
K. Kawecka-Jaszcz1. 1I Department of Cardiology and Interventional Cardiology
and Hypertension University Hospital, Cracow, POLAND, 2Dept of Cardiovas-
cular, Neural and Metabolic Sciences, S. Luca Hospital, IRCCS Istituto Auxo-
logico Italiano, Milan, ITALY, 3Dept of Medicine and Surgery, University of Milan
Bicocca, Milan, ITALY
Objective: Slow breathing has favorable acute effects in chronic heart failure
(CHF) patients. Aim of this study was to test the feasibility and efficacy of a
new nonpharmacological approach to CHF management based on slow breathing
training (SBT).
Design and method: The study was a cross-over open trial where patients, in
random order, underwent a 10–12 week period of SBT with RESPeRATE device
(InterCure Ltd., Lod, Israel) and a 10–12 week follow-up under usual care. Pa-
tients during SBT were asked to perform each day two separate 15-min sessions
of device-guided SBT at a breathing frequency of 6 breaths per minute. In all
patients, clinical data collection, echocardiography, polysomnography, 6 minute
walking test (6MWT) and laboratory tests were performed at baseline and after
each study phase.
Results: 74 patients completed the study, with the following baseline character-
istics: age 62.9 ± 11.9 years, 59 M/15F, 52 with ischemic CHF, NYHA Class I:7
Class II:51, Class III:16, left ventricular ejection fraction 30.4 ± 8.1 %, hyperten-
sion: 47, history of stroke: 5, diabetes: 28. Compared with values before SBT,
after completion of the SBT phase we observed an increase in 6MWT distance
(from 482.3 ± 118.9 to 499.2 ± 116.9 m; p = 0.008) and in left ventricular ejection
fraction [from 30.0 (25.0–37.0) to 32.0 (27.0–37.0) %; p = 0.047], and a decrease
in apnea-hypopnea index (from 9.9 ± 10.3 to 7.9 ± 8.4; p = 0.015). A trend towards
reduction of pulmonary artery pressure [35 (27–45) vs 32 (25–40) mmHg; p =
0.063] was also seen.
Conclusions: Our data indicate that SBT is feasible in CHF patients and that it is
associated with an improvement in functional capacity, haemodynamic variables
and sleep disordered breathing severity. These results support SBT as a novel and
useful component of cardiorespiratory rehabilitation programs in CHF.
PP.20.07 THE BEHAVIOUR OF PHYSIOLOGICAL
PARAMETERS OF ISOLATED PERFUSED RAT
HEART IN EXPERIMENTALY INDUCED CARDIAC
HYPERTROPHY WITH ISOPROTERENOL
C. Revnic1, S. Voinea1, C. Pena2, F. Revnic2, B. Paltineanu3, A.S. Nica4. 1UMF
Carol Davila, Bucharest, ROMANIA, 2NIGG Ana Aslan, Bucharest, ROMANIA,
3UMF Tg. Mures, Targu-Mures, ROMANIA, 4UMF Carol Davila, Rehabilitation
Department, Bucharest, ROMANIA
Objective: The link between deficiency of endocrine system and cardiovascular
pathology has not been completely elucidated.Aim:To induce cardiac hypertrophy
with Isoproterenol(ISO) and see the effect on coronary flow (C.F). and LVPD,
and to evaluate the redox potential during ischemia and hypertrophy estimating
GGT,GSTand the level of Thyol groups and to see the effects of treatment with
Testosterone (T),Hydrocortisone (Hy),estradiol(Es) associated with ISO on car-
diovascular system in rats of different genders.
Design and method: 40 Wistar rats aged 8 months old:20 male and 20 female
were divided into 4 groups of 10 rats each(5male and 5 female):A Controls treated
with 0.9% saline, B treated for 20 days with ISO i.m.injections for induction of
cardiac hypertrophy,C treated with Hy 1,8 mg/kg,D male treated withT 6,75 mg/
kg, female treated with Es 0,45 mg/kg ..From 8th day of treatment, rats received
also treatment with ISO (0.5 mg/kg. C.F. and LVDP were determined in isolated
perfused rat hearts mounted in Langendorff retrograde perfussion system for all
groups.Cardiac hypertrophy has been evaluated using the hypertrophy index: myo-
cardial weight/body weight, left ventricle weight/ b.w.GGT,GST and Thyol groups
have been evaluated from left ventricle using standard biochemical techniques.