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Cardioprotective effect of intradialytic exercise on left atrial mechanics.
Maufrais, Claire; Josse, Matthieu; Patrier, Laure; Grandperrin, Antoine; Isnard, Myriam; Turc-Baron, Cécile; Nottin, Stéphane; Mandigout, Stéphane; Cristol, Jean-Paul; Obert, Philippe.
Affiliation
  • Maufrais C; UPR4278 Laboratoire de Physiologie Expérimentale Cardiovasculaire, Avignon University, Avignon, France.
  • Josse M; UPR4278 Laboratoire de Physiologie Expérimentale Cardiovasculaire, Avignon University, Avignon, France.
  • Patrier L; Fondation Charles Mion-AIDER Santé, Grabels, France.
  • Grandperrin A; Centre Hospitalier Universitaire, Nîmes, France.
  • Isnard M; UPR4278 Laboratoire de Physiologie Expérimentale Cardiovasculaire, Avignon University, Avignon, France.
  • Turc-Baron C; Association pour le Traitement de l'Insuffisance Rénale Avignon, Avignon, France.
  • Nottin S; Fondation Charles Mion-AIDER Santé, Grabels, France.
  • Mandigout S; Centre Hospitalier Universitaire de Montpellier, Montpellier, France.
  • Cristol JP; UPR4278 Laboratoire de Physiologie Expérimentale Cardiovasculaire, Avignon University, Avignon, France.
  • Obert P; HAVAE UR20217, University of Limoges, Limoges, France.
Am J Physiol Renal Physiol ; 326(5): F694-F703, 2024 May 01.
Article in En | MEDLINE | ID: mdl-38511221
ABSTRACT
Left atrial (LA) function plays a pivotal role in cardiac performance by modulating left ventricular (LV) function. Impairments in LV function are commonly reported during hemodialysis (HD), but available data describing changes in LA function are limited. There is growing evidence of the cardioprotective effect of intradialytic exercise (IDE) on LV function, but studies analyzing its effect on LA function are scarce. Our aim was to evaluate whether IDE can limit the severity of HD-induced impairment in LA myocardial function. In this prospective, open-label, two-center randomized crossover trial, 56 stable individuals receiving HD participated in 2 HD sessions in random order standard HD and a session incorporating 30 min of aerobic exercise. LA and LV global longitudinal strains (GLSs) were obtained before and at peak stress of HD (i.e., 30 min before the HD ending). IDE totally eradicated the decline in LA reservoir strain observed during HD (estimated difference 3.1%, 95% confidence interval 0.4/5.8, P = 0.02), whereas it did not affect the other components of LA mechanics. A similar result favoring IDE intervention was also demonstrated on GLS changes over the HD procedure (P < 0.001). Between-session differences of changes in GLS and LA reservoir strain were correlated (r = -0.32, P = 0.03). The cardioprotective effect of IDE disappeared in patients with LA enlargement (i.e., LA volume index >34 mL/m2). In conclusion, even a short duration of IDE at moderate intensity is effective in preventing HD-associated decline in LA reservoir function. Further research is needed to explore the long-term benefits of IDE on LA function.NEW & NOTEWORTHY A single bout of intradialytic exercise (IDE) at moderate intensity can prevent the hemodialysis-associated decline in left atrial (LA) function. This was partially explained by the relative preservation of left ventricular systolic function with IDE. Benefits of IDE on LA function were lost in patients with LA dilation. Further studies are needed to explore the mechanisms behind IDE-induced cardioprotection and evaluate the clinical impacts of the repetitive cardioprotective effects of IDE on LA function.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Atrial Function, Left / Ventricular Function, Left / Renal Dialysis / Cross-Over Studies Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: Am J Physiol Renal Physiol Journal subject: FISIOLOGIA / NEFROLOGIA Year: 2024 Type: Article Affiliation country: France

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Atrial Function, Left / Ventricular Function, Left / Renal Dialysis / Cross-Over Studies Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: Am J Physiol Renal Physiol Journal subject: FISIOLOGIA / NEFROLOGIA Year: 2024 Type: Article Affiliation country: France