Key result
Heat acclimatization combined with modest exercise training for 2 to 3 weeks prior to coronary artery bypass surgery prevented the post-operative decrease in left ventricular diastolic distensibility observed in non-acclimatized patients.
Why the study?
Does heat acclimatization combined with exercise training reduce immediate-post operative diastolic chamber stiffness in patients undergoing coronary artery bypass surgery?
Cohort (n=16)
Single-blind
No
Does heat acclimatization combined with exercise training reduce immediate-post operative diastolic chamber stiffness in patients undergoing coronary artery bypass surgery?
Heat acclimatization combined with exercise training prior to coronary artery bypass surgery may protect against ischemic injury and reduce post-operative diastolic dysfunction.
Answers are grounded in this paper and cite their sources.
May support pre-CABG heat acclimatization to preserve diastolic function; hypothesis-generating and requires randomized confirmation before practice change.
During the period of 1986-1997 the first 4 publications on the mechanical and metabolic properties of heat acclimated rat's heart were published. The outcome of these studies implied that heat acclimation, sedentary as well as combined with exercise training, confers long lasting protection against ischemic/reperfusion insult. These results promoted a clinical study on patients with coronary artery disease scheduled for elective coronary artery bypass operations aiming to elucidate whether exploitation of environmental stress can be translated into human benefits by improving physiological recovery. During the 1998 study, immediate-post operative chamber stiffness was assessed in patients acclimatized to heat and low intensity training in the desert (spring in the Dead Sea, 17-33°C) vs. patients in colder weather (spring in non-desert areas, 6-19°C) via echocardiogram acquisition simultaneous with left atrial pressure measurement during fast intravascular fluid bolus administration. We showed that patients undergoing "heat acclimatization combined with exercise training" were less susceptible to ischemic injury, therefore expressing less diastolic dysfunction after cardiopulmonary bypass compared to non-acclimatized patients. This was the first clinical translational study on cardiac patients, while exploiting environmental harsh conditions for human benefits. The original experimental data are described and discussed in view of the past as well as the present knowledge of the protective mechanisms induced by Heat Acclimation Mediated Cross-tolerance.
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Pollak et al. (2017) conducted a cohort in Coronary artery disease (n=16). Heat acclimatization and exercise training vs. Non-acclimatized usual routine (6-19°C) was evaluated on Change in left ventricular end-diastolic area at comparable left atrial pressures before and after cardiopulmonary bypass. Heat acclimatization combined with modest exercise training for 2 to 3 weeks prior to coronary artery bypass surgery prevented the post-operative decrease in left ventricular diastolic distensibility observed in non-acclimatized patients.
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