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Hartman, YAW, Konijnenberg, LSF, Dinnissen, DJM, Rodwell, L, Li, WWL, Nijveldt, R, van Royen, N and Thijssen, DHJ (2023) Handgrip exercise in patients scheduled for cardiac surgery to attenuate troponin release: a feasibility study. American Journal of Physiology - Heart and Circulatory Physiology, 325 (5). H1144-H1150. ISSN 0363-6135
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Handgrip exercise in patients scheduled for cardiac surgery to attenuate troponin release A feasibility study .pdf - Accepted Version Download (335kB) | Preview |
Abstract
Cardiac surgery, including surgical aortic valve repair (SAVR) and coronary artery bypass grafting (CABG), are associated with ischemia-reperfusion (I/R) injury. Single bouts of exercise, including handgrip exercise, may protect against I/R injury. This study explored 1) the feasibility of daily handgrip exercise in the week before SAVR and/or CABG and 2) its impact on cardiac I/R injury, measured as postoperative cardiac troponin-T (cTnT) release. Sixty-five patients undergoing elective SAVR and/or CABG were randomized to handgrip exercise þ usual care (intervention, n ¼ 33) or usual care alone (control, n ¼ 32). Handgrip exercise consisted of daily 4 x 5-min handgrip exercise (30% maximal voluntary contraction) for 2–7 days before cardiac surgery. Feasibility was assessed using validated questionnaires. Postoperative cTnT release was assessed at 0, 6, 12, 18, and 24 h [primary outcome area under the curve (cTnTAUC)]. Most patients (93%) adhered to handgrip exercise and 77% was satisfied with this intervention. Handgrip exercise was associated with lower cTnTAUC (402,943 ± 225,206 vs. 473,300 ± 232,682 ng · min/L), which is suggestive of a medium effect size (Cohen’s d 0.31), and lower cTnTpeak (313 [190–623] vs. 379 [254–699] ng/L) compared with controls. We found that preoperative handgrip exercise is safe and feasible for patients scheduled for SAVR and/or CABG and is associated with a medium effect size to reduce postoperative cardiac I/R injury. This warrants future studies to assess the potential clinical impact of exercise protocols before cardiac surgery. NEW & NOTEWORTHY Daily handgrip exercise in the week before elective cardiac surgery is safe and feasible. Handgrip exercise is associated with a medium effect size for less troponin-T release. Future larger-sized studies are warranted to explore the impact of (handgrip) exercise prior to cardiac surgery on clinical outcomes and direct patient benefits.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | elective cardiac surgery; exercise preconditioning; handgrip exercise; ischemia-reperfusion injury; 0606 Physiology; 1116 Medical Physiology; Cardiovascular System & Hematology |
| Subjects: | R Medicine > RC Internal medicine R Medicine > RD Surgery |
| Divisions: | Sport and Exercise Sciences |
| Publisher: | American Physiological Society |
| SWORD Depositor: | A Symplectic |
| Date Deposited: | 18 Oct 2024 09:46 |
| Last Modified: | 18 Oct 2024 09:46 |
| DOI or ID number: | 10.1152/ajpheart.00428.2023 |
| URI: | https://researchonline.ljmu.ac.uk/id/eprint/24552 |
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