Exercise training improves cardiovascular and autonomic profiles in HIV
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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
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