Individuals with coronary artery calcification exhibited significantly higher systolic blood pressure (235 vs 220 mmHg, P=0.008) and reduced low-frequency HRV during high-intensity endurance exercise.
Observational (n=56)
Do individuals with coronary artery calcification have different haemodynamic and autonomic responses to prolonged high-intensity endurance exercise compared to those without?
Individuals with coronary artery calcification show exaggerated blood pressure responses and reduced low-frequency heart rate variability during high-intensity endurance exercise, indicating an adverse autonomic response.
Absolute Event Rate: 235% vs 220%
p-value: p=0.008
Abstract Endurance exercise is associated with increased life duration and improved life quality. Paradoxically, high exercise intensity is also associated with increased coronary artery calcification (CAC) and a small but significant increased risk of adverse cardiac events during exercise. The mechanisms underlying the development of CAC during prolonged high‐intensity endurance exercise are unknown. This study aims to determine if there are differences in cardiovascular haemodynamic measures and heart rate variability (HRV) in individuals with (CAC + ) and without CAC (CAC − ). Hemodynamic measures from 56 healthy, middle‐aged (median interquartile range 51 43–58 years) individuals (41 men/15 women) participating in a 91 km 251.2 [217.2‐271.6 min] leisure sport mountain bike race were included in this study. Twenty‐five participants (20 men/5 women) were classified as CAC + based on coronary computed tomographic assessment. Haemodynamic measures and HRV were quantified at the top of the hardest hill (THH) during the last quarter of the race. At the top of THH, CAC + individuals had significantly higher systolic blood pressure (SBP) (235 225–245 mmHg vs. 220 193–238 mmHg, P = 0.008), higher diastolic blood pressure (DBP) (105 95–110 mmHg vs. 95 85–110 mmHg, P = 0.006), higher pulse pressure (130 125–140 mmHg vs. 123 110–130 mmHg, P = 0.039), higher mean rate pressure product (33,882 30,872–35,053 bpm × mmHg vs. 31,028 27,392–33,047 bpm × mmHg, P = 0.028), and larger increase in DBP from baseline (20 20–30 mmHg vs. 10 0–20 mmHg, P = 0.001), compared with CAC − individuals. Further, CAC + participants showed a significant reduction in the low‐frequency component of HRV (HRV LF ) (6.3 2.4–11.5 ms 2 vs. 12.4 6.8–20.2 ms 2 , P = 0.044). In multivariable analysis, HRV LF was an independent predictor of the presence of CAC even after adjusting for established risk factors of atherosclerosis: age, sex, body mass index, maximum heart rate, , smoking, resting SBP and resting DBP. CAC + individuals had significant alterations in haemodynamic measures and HRV LF following prolonged high‐intensity endurance exercise compared with individuals without CAC. HRV LF was an independent predictor of CAC, suggesting an adverse autonomic response to high‐intensity endurance exercise in individuals with CAC.
Svane et al. (Tue,) conducted a observational in Coronary artery calcification (n=56). Coronary artery calcification (CAC+) vs. No coronary artery calcification (CAC-) was evaluated on Systolic blood pressure at the top of the hardest hill (p=0.008). Individuals with coronary artery calcification exhibited significantly higher systolic blood pressure (235 vs 220 mmHg, P=0.008) and reduced low-frequency HRV during high-intensity endurance exercise.