The effect of high-intensity interval training (HIIT) and quercetin supplementation on dimension and functional left ventricular adaptations in men with hypertension and CAD after PCI

Authors

Abstract

Objective: The present study investigated the effects of 10-week High Intensity Interval Training (HIIT) and quercetin consumption on dimension and functional left ventricular adaptations in men with hypertension and coronary artery disease (CAD) after percutaneous coronary intervention (PCI).
 
Materials and Methods: In this semi-experimental randomized, placebo‑controlled and double‑blind study, 34 men with hypertension and CAD after PCI aged 40-60 years were randomly divided into 3 groups of quercetin (n=11), HIIT+quercetin (n=12) and HIIT+placebo (n=11), were followed for 8 weeks of HIIT (30 seconds of activity and 30 seconds of rest) and quercetin consumption (250 mg of quercetin supplement or placebo pills daily). Echocardiography was used to investigate morphological factors such as Left Ventricle Diastolic Diameter (LVDD), Left Ventricle Systolic Diameter (LVSD), Ejection Fraction (EF) and left ventricular diastolic function(E/A). Data were analyzed using paired t test and one way ANOVA at a significant level of 0.05.
 
Results: Systolic and diastolic Left Ventricular Dimensions (LVDs and LVDd) increased in the HIIT+quercetin (p<0.05) and Left ventricular systolic and diastolic function increased in the HIIT+quercetin and in the HIIT+ placebo and quercetin group (p<0.05) with no significant difference between the groups regarding these variables (p>0.05).
 
Conclusion: HIIT with quercetin supplementation can improve the dimensions and function of the left ventricle in men with hypertension and CAD after PCI, whereas separate use of exercise and quercetin increases ventricular function without affecting the dimensions of the left ventricle.

Keywords


1. Riyahii S. Sports rehabilitation in heart disease; a systematic review study. Journal of Health Research 2016; 1(4): 246-259. 2. Koohi F, Salehinya H, Mohmmadian A. Trendsin mortalityfromcardiovascular diseasein Iran from 2006-2010. Bimonthly Journal of Sabzevar University of Medical Sciences 2016; 22(4): 630-638. 3. Shafiee H, Ebrahimi M. Accurate Prediction of Coronary Artery Disease Using Bioinformatics Algorithms. Qom University of Medical Sciences journal 2016; 10 (4):22-35. 4. Nouri R, Ali D, Ali A. Quality of Life in Patients with Hypertension and its Relationship with their Socio-Social Variables in Gonabad. Journal of Prevention and Health 2013; 2(4): 31-42. 5. Treat-Jacobson DJ, Lindquist R. Exercise, quality of life, and symptoms in men and women five to six years after coronary artery bypass graft surgery. Journal of Cardiovascular Nursing 2007; 36:387-97. 6. Allahbakhshian A, Hasankhani H, Mohammadi E, Zamanzadeh V, Ghafari S. Second life after angioplasty: a qualitative study. Journal of Cardiovascular Nursing 2014; 2(4): 52-63. 7. Lauck S, Jonson J, Partner P. Self care behaviour and factors associated with patient outcomes following same day discharge percutaneous coronary intervention. European Journal of Cardiovascular Nursing 2009; 8: 190-199. 8. Peterson JC, et al. Living with heart disease after angioplasty: a qualitative study of patients who have been successful or unsuccessful in multiple behavior change. Heart & Lung: The Journal of Acute and Critical Care 2010; 39: 105-115. 9. Bhatnagar P, Wickramasinghe K, Williams J, Rayner M, Townsend N. The epidemiology of cardiovascular disease in the UK 2014. Heart 2015; 101(15):1182-9. 10. Ebadi A, Moradian T, Feizi F, Asiabi M. Comparison of hospital anxiety and depression among patients with coronary artery disease based on proposed treatment. Iranian Journal of Crirical Care Nursing 2011; 4: 97-102. 11. Kargarfard M, Basati F, Sadeghi M, Rozbehani R, Golabchi A. Effects of a cardiac rehabilitation program on diastolic filling properties and functional capacity in patient with myocardial infarction. Journal of Isfahan Medical School 2011; 29(131): 243-252. 12. Zare Karizak S, Kashef M, Gaeini AA, Nejatian M. The Comparison of Two Protocol of Interval and Continues Aerobic Training on Level of Concentric Pathologic Hypertrophy and Cardiac Function in Patients after Coronary Artery Bypass Grafting surgery. Journal of Practical Studies of Biosciences in Sport 2016; 5(9): 9-20. 13. Badawy, M. A. Al Shammari, F. Aleinati, T. Eldin, M. S. Tarazi, R. & Alfadli, J. Deep sternal wound infection after coronary artery bypass: How to manage?Asian Cardiovascular and Thoracic Annals 2014; 22(6): 649-654. 14. Soleimannejad, K. Nouzari, Y. Ahsani, A. Nejatian, M. & Sayehmiri, K. Evaluation of the Effect of Cardiac Rehabilitation on Left Ventricular Diastolic and Systolic Function and Cardiac Chamber Size in Patients Undergoing Percutaneous Coronary Intervention. Journal of Tehran University Heart Center 2014; 9(2): 54-8. 15. Fallahi AA, Nejatian M, Sardari A, Piry H. Comparison of Two Rehabilitate Continuous and Interval Incremental Individualized Exercise Training Methods on Some Structural and Functional Factors of Left Ventricle in Heart Patients after Coronary Artery Bypass Graft Surgery (CABG). Journal of Rehabilitation Medicine 2017; 6(4): 182-191. 16. Ahmadizad S, Nouri-Habashi A, Rahmani H, Maleki M, Naderi N, Lotfian S, Salimian M. Platelet activation and function in response to high intensity interval exercise and moderate continuous exercise in CABG and PCI patients. Clinical Hemorheology and Microcirculation 2016; 64(4):911-919. doi: 10.3233/CH-168010. 17. Guiraud T, Nigam A, Gremeaux V, Meyer P, Juneau M, Bosquet L. High-intensity interval training in cardiac rehabilitation. Sports Medicine 2012; 42(7):587-605. 18. Parastesh M, Yousefvand Z, Moghadasi S. Comparison of the effect of moderate-intensity interval training (MICT) and high-intensity interval training (HIIT) on testicular structure, serum level of malondialdehyde and total antioxidant capacity of male diabetic rats. Daneshvar Medicine 2019; 27 (141):27-40. 19. Hannan AL, Hing W, Simas V, Climstein M, Coombes JS, Jayasinghe R, Byrnes J, Furness J. High-intensity interval training versus moderate-intensity continuous training within cardiac rehabilitation: a systematic review and meta-analysis. Open Access Journal of Sports Medicine 2018; 9: 1-17. 20. Ribeiro PA, Boidin M, Ju eau M, Nigam A, Gayda M. High-intensity interval training in patients with coronary heart disease: Prescription models and perspectives. Annals of Physical and Rehabilitation Medicine 2017; 60(1):50-57. 21. Gayda M, Ribeiro PA, Juneau M, Nigam A. Comparison of Different Forms of Exercise Training in Patients With Cardiac Disease: Where Does High-Intensity Interval Training Fit? Canadian Journal of Cardiology 2016; 32(4):485-94. 22. Kazemi T, Nayebifar S, Afzalpour M E. Effects of High Intensity Interval Training and Ginger on Cardiac Structural and Functional Adaptations. Iranian Journal of Endocrinology and Metabolism 2016; 18 (4):251-259. 23. Suen J, Thomas J, Kranz A, Vun S, Miller M. Effect of Flavonoids on Oxidative Stress and Inflammation in Adults at Risk of Cardiovascular Disease: A Systematic Review. Healthcare 2016; 4(3). 24. Ramezani A, Moonikh K. Effect of Quercetin Supplementation on Oxidative Stress and Exhaustion in Male Soccer Players. Journal of Medicinal Plants 2017; 2 (62):136-144. 25. Rahmani F, Asar N, Najafizadeh P, Mousavi S Z, Rastegar T. Cardioprotective effects of quercetin on doxorubicin induced cardiotoxicity in male rats. Medical Sciences 2018; 28 (1):24-30. 26. Chekalina NI, Shut SV, Trybrat TA, Burmak YH, Petrov YY, Manusha YI, Kazakov YM. Effect of quercetin on parameters of central hemodynamics and myocardial ischemia in patients with stable coronary heart disease. Wiadomości lekarskie 2017; 70(4): 707-711. 27. Garelnabi M, Mahini H, Wilson T. Quercetin intake with exercise modulates lipoprotein metabolism and reduces atherosclerosis plaque formation. International Society of Sports Nutrition 2014; 11: 22. 28. Chrysohoou C, Angelis A, Tsitsinakis G, Spetsioti S, Nasis I, Tsiachris D and et al. Cardiovascular effects of high-intensity interval aerobic training combined with strength exercise in patients with chronic heart failure. A randomized phase III clinical trial. International Journal of Cardiology 2015; 179: 269-74. 29. Storer TW, Davis JA, and Caozzo VJ. Accurete prediction of Vo2max in cycle ergometry. Medicine & Science in Sports & Exercise 1990; 22: 704-712. 30. Sadeghi, M. Garakyaraghi, M. Khosravi, M. Taghavi, M. Sarrafzadegan, N. & Roohafza, H. The impacts of cardiac rehabilitation program on echocardiographic parameters in coronary artery disease patients with left ventricular dysfunction. Cardiology Research and Practice 2013; 15(2): 1112-1121. 31. Ehsani A A, Martin W H, Heath G W, Coyle E F. Cardiac effects of prolonged and intense exercise training in patients with coronary artery disease. The American Journal of Cardiology 1982; 50: 246-254. 32. Hirshleifer J, Crawford M, O'Rourke RA, Karliner JS. Influence of acute alterations of heart rate and systemic atrial pressure on echocardiographic measures of left ventricular performance in normal human subjects. Circulation 1975; 52: 835-41. 33. Ellingsen Ø, Halle M, Conraads VM, Støylen A, Dalen H, Delagardelle C, Larsen AI, Hole T, Mezzani A, Van Craenenbroeck EM, Videm V. High intensity interval training in heart failure patients with reduced ejection fraction. Circulation 2017; 12: 116. 34. Cassidy S, Thoma C, Hallsworth K, Parikh J, Hollingsworth KG, Taylor R, Jakovljevic DG, Trenell MI. High intensity intermittent exercise improves cardiac structure and function and reduces liver fat in patients with type 2 diabetes: a randomised controlled trial. Diabetologia 2016; 59(1):56-66. 35. Yu CM, Li LS, Lam MF, Siu DC, Miu RK, Lau CP. Effect ofcardiac rehabilitation program on left ventricular diastolic functionand its relationship to exercise capacity in patients with coronary heart disease: experience from a randomised controlled study. American Heart Journal 2004; 147: 11–18. 36. Bahremand, M. Salehi, N. Rai, A. Rezaee, M. & Raeisei, A. A. Cardiac rehabilitation program with high intensity aerobic exercise can reverse diastolic impairment in patients undergoing coronary artery bypass surgery. Galen Medical Journal 2014; 3(2): 102-108. 37. Voutilainens S, Jupari M, Hippelainen M, Karppinen K, Ventila M, Heikkila J. Factors influencing Doppler indexes of left ventricular filling in healthy persons. American Journal of Cardiology 1991; 68(6): 653-9. 38. Galderisi M, Benjamin EJ, Evans JC, D’Agostino RB, Fuller DL, Lehman B, Levy D. Impact of heart rate and PR interval on Doppler indexes of left ventricular diastolic filling in an elderly cohort (the Framingham Heart Study). American Journal of Cardiology 1993; 72: 1183–1187. 39. Xu X, Zhao W, Lao S, Wilson BS, Erikson JM,Zhang JQ, Effects of exercise and l-arginine on ventricular remodeling and oxidative stress. Medicine & Science in Sports & Exercise 2010; 346-354. 40. Kondratiuk VE1, Synytsia YP1.Effect of quercetin on the echocardiographic parameters of left ventricular diastolic function in patients with gout and essential hypertension. Wiadomości lekarskie 2018; 71(8): 1554-1559. 41. Yan L, Zhang JD, Wang B, Lv YJ, Jiang H, et al. Quercetin Inhibits Left Ventricular Hypertrophy in Spontaneously Hypertensive Rats and Inhibits Angiotensin II-Induced H9C2 Cells Hypertrophy by Enhancing PPAR-c Expression and Suppressing AP-1 Activity. Plos One 2013; 8(9): 1-14. 42. Fakhrzadeh H, Sharifi F. Cardiovascular diseases in the elderly. Journal of Gorgan University of Medical Sciences 2012; 14 (3):1-9.