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Biomedical subjects

S A Valenti

Publications and source records attributed to S A Valenti.

5 recordsLinked to original sources

Effects of diltiazem or propranolol during exercise training of hypertensive men.

This was a prospective, randomized, double-blind, placebo-controlled trial to establish whether beta blockers or calcium-channel blockers limit exercise capacity and training responses in men with mild hypertension. Circuit weight and aerobic training was used to assess the effects of drugs on cardiovascular fitness and muscle strength. Fifty-two sedentary men, ages 25-59 yr, with a diastolic blood pressure of 90-105 mm Hg off drugs, without significant ST depression during maximal stress testing, received diltiazem, propranolol, or placebo. Maximal oxygen uptake (VO2max) and exercise duration during treadmill testing, as well as one-repetition maximal strength, were assessed on eight weight machines after a single-blind placebo baseline, after 2 wk of drug run-in, and after 10 wk of exercise training. Total daily doses were 240 mg for propranolol and 360 mg for diltiazem. Propranolol decreased VO2max after drug run-in (P less than 0.05). Exercise training increased VO2max (P less than 0.05) in the diltiazem and placebo groups. After training VO2max in the propranolol group increased (P less than 0.05) from run-in but not beyond baseline levels. Thus, the reduction of VO2max consequent to propranolol therapy limited the overall benefits of training. Exercise duration did not change with run-in and increased (P less than 0.05) with training by 22%, 19%, and 10% for the diltiazem, placebo, and propranolol groups, respectively. Strength after run-in was unchanged, and exercise training increased strength (P less than 0.0001) on all weight machines in all groups. The results show an advantage of diltiazem to propranolol, particularly among physically active patients engaged in aerobic exercise who require antihypertensive therapy.

Adolescent↗

Usefulness of self-efficacy in predicting overexertion during programmed exercise in coronary artery disease.

Overexertion during group jogging was evaluated in relation to self-perceived functional capacity and ability to self-monitor exertional heart rate in 40 men, mean age 55 +/- 9 years, with documented coronary artery disease. Patients' confidence in their ability to jog various distances was measured with a jog self-efficacy (SE) scale before a group exercise program was begun. Depression, type A personality, and performance of symptom-limited treadmill exercise were also assessed. Later, each patient was monitored with ambulatory (Holter) electrocardiography during programmed group jogging. Ambulatory monitoring disclosed significant noncompliance with exercise prescriptions: 33% of patients exceeded their prescribed range of 70% to 85% of maximal treadmill heart rate for at least 10 minutes of the 20-minute exercise bout. Another 25% spent 10 minutes or longer exercising below the prescribed range. Pretest jog SE predicted the number of minutes patients exercised above or below the prescribed intensity, but depression, type A and treadmill performance measures did not. Self-monitoring accuracy (the amount of agreement between exercise heart rate recorded by the electrocardiogram and by the patient) was also related to the number of minutes patients exercised outside the prescribed range. Comparison of SE and self-monitoring accuracy variables revealed that "overachievers" were patients who overestimated their ability to jog, while "underachievers" were those who overestimated their heart rate during exercise. Self-perceptions and self-monitoring skills appear to be important independent predictors of behavioral compliance to exercise guidelines.

Adult↗

Circuit weight training in cardiac patients.

This was a prospective, randomized evaluation of the safety and efficacy of 10 weeks of circuit weight training in patients, aged 35 to 70 years, with documented coronary artery disease. Circuit weight training refers to the performance of a series of weight-lifting exercises using a moderate load with frequent repetitions. Patients had participated in a supervised cardiac rehabilitation program for a minimum of 3 months before the study. Control patients (n = 20) continued with their regular exercise consisting of a walk/jog and volleyball program, while the experimental group (n = 20) substituted circuit weight training for volleyball. No sustained arrhythmias or cardiovascular problems occurred. The experimental group significantly increased treadmill time from 619 to 694 seconds while the treadmill time of the control group did not change. Strength in the experimental group increased by an average of 24% while there was no change in the control patients. Circuit weight training appears to be safe, and to result in significant increases in aerobic endurance and musculoskeletal strength compared with traditional exercise used in cardiac rehabilitation programs.

Adult↗

Swallow syncope.

Swallowing (or deglutition) syncope is an uncommon, vagally-mediated etiology for syncope that may be seen in children and adults. The mechanism of syncope involves afferent impulses from the upper gastrointestinal tract and efferent impulses to the heart that can produce a variety of bradyarrhythmias with atrioventricular block. Two cases of swallow syncope are reported, one associated with drinking a cold carbonated beverage, and the other precipitated by eating a large bolus of food (which we have termed "Vaso-Bagel" syncope). In evaluating patients with syncope, a history of a temporal relationship to eating or drinking should be sought. While changes in eating habits may be effective in some cases, permanent pacemaker placement is often indicated and is curative.

Bradycardia↗

Exercise training combined with antihypertensive drug therapy. Effects on lipids, blood pressure, and left ventricular mass.

We studied exercise training combined with the use of antihypertensive drugs and examined the following questions. (1) Are there additive antihypertensive benefits with exercise and drug therapy combined? (2) Does drug therapy limit exercise-induced lipid improvements? (3) Does exercise that includes weight training and walking/jogging affect the left ventricle? Fifty-two hypertensive men were randomly assigned, double-blind, to diltiazem hydrochloride, sustained release (360 mg daily), propranolol hydrochloride (240 mg daily), or placebo and exercised three times per week for 10 weeks. Baseline blood pressure (145/97 mm Hg) fell after training (131/84 mm Hg) in all groups. Exercise decreased total and low-density lipoprotein cholesterol levels in all groups. Increases in the levels of high-density lipoprotein cholesterol were similar in placebo and diltiazem groups, whereas the propranolol group changed in an opposite direction. In all groups, left ventricular mass increased with training, while diastolic function was unchanged. We conclude that (1) drug therapy provided no additive benefit to the antihypertensive effects of exercise, (2) propranolol limited improvements in high-density lipoprotein cholesterol, and (3) exercise did not adversely affect the left ventricle.

Adolescent↗