Title: Effects of periodized training regime on vascular and autonomic systems in patients with coronary artery disease: a pilot randomized controlled trial

Abstract:

Background: Periodized exercise training regime in clinical populations have not been well studied until currently days. The purpose of this study was to compare the effects of a periodized training regime to a non-periodized training regime in cardiorespiratory fitness (CRF), heart rate variability (HRV) and pulse wave velocity (PWV) parameters.

Methods: Twenty-four trained patients with stable coronary artery disease (CAD) (64±10 years) were randomized in 2 groups: linear periodized combined exercise training (LPCET) and non-periodized combined exercise training (NPCET) which performed 60 exercise training sessions (3 times per week) for 6 months. Baseline and end-protocol evaluations included: 1) incremental symptom-limited cycling cardiopulmonary exercise test; 2) one-repetition maximum; 3) arterial stiffness; and 4) heart rate variability.

Results: neither of the 2 groups increased VO₂ peak nor overall strength (p>0.05). The LPCET group increased 22% in Central pulse pressure (p=0.04); decreased 16% in upper limb PWV (p=0.009); 7% in Central diastolic blood pressure (p=0.05) and 11% in left ventricular ejection time (LVET) (p=0.05). The NPCET group decreased significantly 10% in upper Limb PWV (p=0.049), 9% in lower limb PWV and 16% in LVET (p=0.015). There were no significant differences between pre-post training in HRV index in both groups. Moderate Pearson´s correlation was found in LPCET: VO₂peak-Aortic PWV and SDNN-Aortic PWV (p<0.05; r=-0.4; r=-0.3 respectively).

Conclusion: Long-term non-periodized training regime in stable CAD patients was more effective to improve peripheral arterial stiffness than the periodized training regime. Both training models were equally effective in maintaining the HRV index. The current study suggests that exercise training may improve arterial stiffness but not autonomic balance independently of exercise type training prescription in trained CAD patients. More studies have to be performed to understand the PWV-HRV and the effects of new training approaches.

Future directions: A gap may exist in exercise protocols when the daily physiological individuality is not considered. As HRV as daily physiological state, both are constant variable. The most appropriate stimulus may be the one that respects the direct and indirect conditions of the organism. Correlating self-perception (i.e. Brums and Borg scale) and physiological variables may be an alternative to enhance the improvement of health and performance.

Biography:

Graduated in Physical Education from the Regional University of Blumenau Foundation (2007); Postgraduate courses related to special groups and biomechanics between 2009-2011 at the Gama Filho University. Postgraduate with emphasis on the improvement in cardiovascular rehabilitation at the Instituto do Coração; Master in Human Movement Sciences from the State University of Santa Catarina (2013). University Teacher (2010-2015) at FURB institutions; UNIDAVI; UNIFEBE; UNIASSELVI; UNIMAX (current job 2022) (Biochemistry of Exercise; Resistance Training; Biomechanics & Kinesiology; Technology in Physical Education). Ph.D scholarship  by CNPQ “Ciências Sem Fronteiras” program (Faculty of Human Motricity, 2015-19); Responsible for the teaching/research/extension process at the Cardiovascular Rehabilitation Center of the University of Lisbon (CRECUL). Dissertation/Thesis theme: Acute Responses and Chronic Effects of Autonomic/Cardiovascular/Cardiopulmonary Systems following exercise training. Research and professional activities in the area of health, training, cardiology, exercise biochemistry, musculoskeletal rehabilitation, cardiovascular rehabilitation, stress, nervous system and vascular system.