Exercise training improves cardiovascular and autonomic profiles in HIV
- 178 Downloads
Human immunodeficiency virus (HIV) is associated with cardiovascular (CV) and autonomic dysfunction, however the effects of fitness on vascular and autonomic mechanisms in HIV disease are unknown.
We studied forty-eight subjects (40.4 ± 4.2 years) in a cross-sectional design matched for age, gender, BMI, and fitness. Participants were assigned to 1 in 4 groups: 1) Healthy Unfit (HU), 2) Healthy Fit (HF), 3) HIV Positive Unfit (HPU), and 4) HIV Positive Fit (HPF). Fitness was assessed via open-circuit spirometry; arterial compliance and autonomic modulations were measured via applanation tonometry and power spectral analysis, respectively, and baroreflex sensitivity was obtained using the alpha index.
Arterial compliance was augmented in HPF vs. HPU [7.4 ± 1.9 mmHg × second vs. 4.4 ± 1.7 mmHg × second (P = 0.006)]. Parasympathetic modulation was higher in HPF vs. HPU [2244.5 ± 2997.6 msecond2 vs. 489.1 ± 552.9 msecond2 (P < 0.05)]. Sympathetic modulation was lower in HPF vs. HU [4.7 ± 5.0 mmHg2 vs. 12.9 ± 9.7 mmHg2 (P < 0.05)]. Baroreflex sensitivity was higher in HPF vs. HPU [17.3 ± 10.2 msecond/mmHg vs. 7.4 ± 3.8 msecond/mmHg (P = 0.003)], and HPF vs. HU [17.3 ± 10.2 msecond/mmHg vs. 6.2 ± 3.0 msecond/mmHg (P = 0.004)].
Augmentations in arterial compliance and baroreflex sensitivity associated with fitness portent an improved CV and autonomic profile for HIV-positive individuals. Physical activity may be an adjuvant method to enhance the overall vascular health in HIV-compromised individuals.
Key wordsimmunodeficiency HIV exercise fitness baroreflex autonomic nervous system
The authors gratefully acknowledge the expert assistance of Pamela Clark, editor, and the enthusiastic support of the subjects of Coler Goldwater Specialty Hospital and Nursing facility, who volunteered to participate in this study.
- 5.Billman G, Schwartz P, Stone L, et al. (1984) The effects of daily exercise on susceptibility to sudden cardiac death. Ciculation 69:1182–1189.Google Scholar
- 6.Bloomfield P (1976) Fourier analysis of time series: an introduction. John Wiley Publishing, New York.Google Scholar
- 10.Cheminot N, Gariepy J, Chironi G, et al. (2000) Diagnosis and determinants of sub-clinical arterial disease in HIV-1 infected patients on HAART. In: 7th Conference on Retroviruses and Opportunistic Infections, San Francisco, CA.Google Scholar
- 14.Davey K, Miniciler N, Taylor A, et al. (1996) Elevated heart rate variability in physically active postmenopausal women: a cardioprotective effect? Am J Physiol 271:H455–H460.Google Scholar
- 15.De Castro S, et al. (1992) Heart involvement in AIDS: a prospective study during various stages of the disease. Eur Heart J 11:1452–1459.Google Scholar
- 19.De Souza C, Shapiro L, Clevenger C, et al. (2000) Regular aerobic exercise prevents/restores the age related decline in endothelium-dependent vasodilation in healthy men. Circulation 102:1351–1357.Google Scholar
- 22.Freeman R (1997) Autonomic failure and AIDS. In: Low PA (ed) Clinical autonomic disorders, 2nd edn. Lippincott-Raven, Philadelphia, pp 727–735.Google Scholar
- 24.Gibbons RJ, Balady GJ, Beasley JW, Bricker JT, Duvernoy WF, Froelicher VF, et al. (1997) ACC/AHA guidelines for exercise testing. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Exercise Testing). J Am Coll Cardiol 30(1):260–311.PubMedCrossRefGoogle Scholar
- 32.La Rovere MT, Bigger JT, Marcus Fl, Mortara A, Schwartz PJ, et al. (1998) Baroreflex sensitivity and heart period variability in prediction of total cardiac mortality after myocardial infarction. ATRAMI (Autonomic Tone and Reflexes After Myocardial Infarction) Investigators. Lancet 14:478–484.CrossRefGoogle Scholar
- 34.Lenormand-Welckenaer C, Cazaubon M, Joly V, et al. (2000) Carotid intima media thickness in protease inhibitors-treated HIV-1 infected patients with hyperlipidemia. In: 40th Interscience Conference on Antimicrobial Agents and Chemotherapy, Toronto, Ontario.Google Scholar
- 40.Nichols WW, O’Rourke MF (1998) McDonald’s blood flow in arteries, 4th edn. Arnold, London.Google Scholar
- 46.Raab W, Silva PP, Machet H, Kimura E, YK S (1960) Cardiac adrenergic preponderence due to lack of physical exercise and its pathogenic complications Am J Cardiol 5:300–320.Google Scholar
- 50.Seals DR (2003) Habitual exercise and the age-associated decline in larger artery compliance. Med Sci Sports Exerc 31(2):68–72.Google Scholar
- 52.Shi X, Walter DW, Formes KJ, et al. (2000) Orthostatic hypotension in aging humans. Am J Physiol 279:H1548–H1554.Google Scholar
- 54.TaskForce of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996) Heart rate variability: standards of measurement, physiological interpretation and clinical use Circulation 93(5):1043–1065.Google Scholar
- 55.The different stages of HIV infection. Avert 2002 June 26.Google Scholar