Issue №5-21, 2022

https://doi.org/10.38025/2078-1962-2022-21-5-78-86

Hypoxic Conditioning in Rehabilitation and Secondary Prevention Programs in Cardiac Patients with Multimorbidity: a Review

View article (Download PDF file)



Download XML file

1 ORCIDNadezhda P. Lyamina, 2 ORCIDGalina K. Spirina, 3 ORCIDOleg S. Glazachev

1 Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine, Moscow, Russian Federation
2 LLC “AsFor Group”, Moscow, Russian Federation
3 I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation


ABSTRACT

INTORDUCTION. Patients with multiple chronic diseases are at higher risk of premature death, hospitalization, longer hospital stays, and reduced health-related quality of life compared to patients with a single disease. On the other hand, the presence of comorbid conditions limits the enrolment of traditional exercise-based cardiac rehabilitation programs. It is predicted that as life expectancy increases, the level of multimorbidity will increase, making it even more important to find new additional methods and technologies for the rehabilitation of cardiac patients with comorbidities.

AIM. To analyze the data from the current publications or to define the validity and effectiveness of using different hypoxic conditioning regimens in cardiac patients with concomitant chronic pathology (arterial hypertension, obesity, diabetes mellitus, and chronic bronchopulmonary diseases) as well as in multimorbid elderly patients.

MATERIAL AND METHODS. The search for relevant papers was carried out using the Medline, e-library, and Web of Science Core Collection databases, as well as the following keywords: “hypoxic conditioning”, “hypoxic training”, “hypoxic therapy”, “interval hypoxic therapy”, “intermittent hypoxia”, “hypoxic conditioning”, “interval hypoxia training”, and “hypoxic exposure”. The analysis included publications regarding the use of the hypoxic conditioning method in cardiac and elderly patients with multimorbid pathology, as well as publications on the use of the method in the rehabilitation of patients with certain nosologies to identify potential mechanisms in correcting bronchopulmonary violations and lipid and carbohydrate metabolism disorders. The last search date was April 05, 2022.

RESULTS. Most of the analyzed studies proved that the hypoxic conditioning technology in passive interval exposure regimes is an effective method for non-pharmacological correction of cardiometabolic risks in cardiac patients with multimorbid pathology and can increase exercise tolerance, optimize hemodynamic parameters (HR, SBP and DBP), reduce the manifestations of bronchial obstruction and respiratory failure, and improve cognitive function and metabolic indicators. Personalized physical activity doses in oxygen-depleted ambient air appear to be promising, but require additional studies to establish optimal application protocols.

CONCLUSION. The data presented may recommend hypoxic conditioning technologies for wider implementation in cardiac rehabilitation programs for patients with multimorbid pathologies.


KEYWORDS: Cardiac rehabilitation, comorbidity, hypoxic conditioning, interval hypoxic training

For citation: Lyamina N.P., Spirina G.K., Glazachev O.S. Hypoxic Conditioning in Rehabilitation and Secondary Prevention Programs in Cardiac Patients with Multimorbidity: a Review. Bulletin of Rehabilitation Medicine. 2022; 21 (5): 78-86. https://doi.org/10.38025/2078-1962-2022-21-5-78-86



References:

  1. Sawan M.A., Calhoun A.E., Fatade Y.A., Wenger N.K. Cardiac rehabilitation in women, challenges and opportunities. Progress in Cardiovascular Diseases. 2022; (70): 111-118. https://doi.org/10.1016/j.pcad.2022.01.007
  2. Ades P.A., Khadanga S., Savage P.D., Gaalema D.E. Enhancing participation in cardiac rehabilitation: Focus on underserved populations. Progress in Cardiovascular Diseases. 2022; (70): 102-110. https://doi.org/10.1016/j.pcad.2022.01.003
  3. Taylor R.D., Dalal H.M., McDonagh S. The role of cardiac rehabilitation in improving cardiovascular outcomes. Nature Reviews Cardiology. 2022; 19(3): 180-194. https://doi.org/10.1038/s41569-021-00611-7
  4. Chockalingam A., Chan A., Kanaley J.A., Aggarwal K. Home-Based Arm Cardiac Rehabilitation in Disabled Veterans: A Pilot Study. Mo Med. 2021; 118(4): 387-392.
  5. Bauldoff G.S., Carlin B.W. Pulmonary comorbidities in cardiac rehabilitation. Progress in Cardiovascular Diseases. 2022; (70): 190-194. https://doi.org/10.1016/j.pcad.2022.01.009
  6. Tang L.H., Harrison A., Skou S.T., Doherty P. To what extent are comorbidity profiles associated with referral and uptake to cardiac rehabilitation. International Journal of Cardiology. 2021; (15): 343:85-91. https://doi.org/10.1016/j.ijcard.2021.09.016
  7. Glazachev O.S., Lyamina N.P., Spirina G.K. Intermittent hypoxic conditioning: experience and potential in cardiac rehabilitation programs. Russian Journal of Cardiology. 2021; 26(5): 4426 p. https://doi.org/10.15829/1560-4071-2021-4426
  8. Burtscher M. Effects of living at higher altitudes on mortality: a narrative review. Aging and Disease. 2013; 5(4): 274-280. https://doi.org/10.14336/AD.2014.0500274
  9. Faeh D., Gutzwiller F., Bopp M. Swiss National Cohort Study Group. Lower mortality from coronary heart disease and stroke at higher altitudes in Switzerland. Circulation. 2009; 120(6): 495-501. https://doi.org/10.1161/CIRCULATIONAHA.108.819250
  10. Serebrovskaya T., Lei Xi. Intermittent hypoxia training as non-pharmacologic therapy for cardiovascular diseases: Practical analysis on methods and equipment. Experimental Biology and Medicine. 2016; 241(15): 1708-1823. https://doi.org/10.1177/1535370216657614
  11. Tobin B., Costalat G., Renshaw G.M.C. Intermittent not continuous hypoxia provoked haematological adaptations in healthy seniors: hypoxic pattern may hold the key. European Journal of Applied Physiology. 2020; 120(3): 707-718. https://doi.org/10.1007/s00421-020-04310-y
  12. Glazachev O.S., Kryzhanovskaya S.Y., Zapara M.A., Dudnik E.N., Samartseva V.G., Susta D. Safety and Efficacy of Intermittent Hypoxia Conditioning as a New Rehabilitation/ Secondary Prevention Strategy for Patients with Cardiovascular Diseases: A Systematic Review and Meta-analysis. Current Cardiology Reviews. 2021; 17(6): e051121193317. https://doi.org/10.2174/1573403X17666210514005235
  13. Ignatenko G.A., Mukhin I.V., Gavrilyak V.G., Chebotareva E.N., Dzuban A.S., Panieva N.J., Paniev D.S. Hypoxia Hyperoxitherapy in the treatment of patients with comorbid cardiac pathology. University Clinic. 2019; 1(30): 5-10. https://doi.org/10.26435/UC.V0I1(30).219
  14. Muangritdech N., Hamlin M.J., Sawanyawisuth K. et al. Hypoxic training improves blood pressure, nitric oxide and hypoxia-inducible factor-1 alpha in hypertensive patients. European Journal of Applied Physiology. 2020; 120(8): 1815-1826. https://doi.org/10.1007/s00421-020-04410-9
  15. Lyamina N.P., Lyamina S.V., Senchiknin V.N. et al. Normobaric hypoxia conditioning reduces blood pressure and normalizes nitric oxide synthesis in patients with arterial hypertension. Journal of Hypertension. 2011; 29(11): 2265-2272. https://doi.org/10.1097/HJH.0b013e32834b5846
  16. Zhernakova Y.V., Zheleznova E.A., Chazova I.E., Oshchepkova E.V., Dolgusheva Yu.A., YArovaya E.B., Blinova N.V., Orlovskij A.A., Konosova I.D., Shalnova S.A., Rotar' O.P., Konradi A.O., Shlyahto E.V., Bojcov S.A. The prevalence of abdominal obesity and the association with socioeconomic status in regions of the Russian Federation, the results of the epidemiological study-ESSE-RF. Terapevticheskii Arkhiv. 2018; 90(10): 14-22.
  17. Glazachev O.S., Zvenigorodskaia L.A., Dudnik E.N., Iartseva L.A., Mishchenkova T.V., Platonenko A.V., Spirina G.K. Interval hypoxic-hyperoxic training in the treatment of the metabolic syndrome. Eksperimental'naia i klinicheskaia gastroenterologiia. 2010; (7): 51-6.
  18. Lizamore C.A., Hamlin M.J. The Use of Simulated Altitude Techniques for Beneficial Cardiovascular Health Outcomes in Nonathletic, Sedentary, and Clinical Populations: A Literature Review. High Altitude Medicine & Biolology. 2017; 18(4): 305-321. https://doi.org/10.1089/ham.2017.0050
  19. Chacaroun S., Borowik A., Doutreleau S., Belaidi E., Wuyam B., Tamisier R., Pépin J.L., Flore P., Verges S. Cardiovascular and metabolic responses to passive hypoxic conditioning in overweight and mildly obese individuals. American Journal of Physiology – Regulatory, Integrative and Comparative Physiology. 2020; 319(2): 211-222. https://doi.org/10.1152/ajpregu.00311.2019
  20. Bestavashvili A., Glazachev O., Suvorov A, Zhang Y., Zhang X., Rozhkov A., Kuznetsova N., Pavlov C., Glushenkov D., Kopylov P. Intermittent Hypoxic-Hyperoxic Exposures Effects in Patients with Metabolic Syndrome: Correction of Cardiovascular and Metabolic Profile. Biomedicines. 2022; 10(3): 566 p. https://doi.org/10.3390/biomedicines10030566
  21. Balestra C., Lambrechts K., Mrakic-Sposta S., Vezzoli A., Levenez M., Germonpré P., Virgili F., Bosco G., Lafère P. Hypoxic and Hyperoxic Breathing as a Complement to Low-Intensity Physical Exercise Programs: A Proof-of-Principle Study. International Journal of Molecular Sciences. 2021; 22(17): 9600 p. https://doi.org/10.3390/ijms22179600
  22. Brinkmann C., Bloch W., Brixius K. Exercise during short-term exposure to hypoxia or hyperoxia - novel treatment strategies for type 2 diabetic patients? Scandinavian Journal of Medicine and Science in Sports. 2018; 28(2): 549-564. https://doi.org/10.1111/sms.12937
  23. Park H.Y., Jung W.S., Kim J., Lim K. Twelve weeks of exercise modality in hypoxia enhances health-related function in obese older Korean men: A randomized controlled trial. Geriatrics and Gerontology International. 2019; (19): 311-316. https://doi.org/10.1111/ggi.13625
  24. Ramos-Campo D.J., Girard O., Pérez A., Rubio-Arias J.Á. Additive stress of normobaric hypoxic conditioning to improve body mass loss and cardiometabolic markers in individuals with overweight or obesity: A systematic review and meta-analysis. Physiology & Behavior. 2019; (207): 28-40. https://doi.org/10.1016/j.physbeh.2019.04.027
  25. Jung K., Kim J., Park H.Y., Jung W.S., Lim K. Hypoxic Pilates Intervention for Obesity: A Randomized Controlled Trial. International Journal of Environ-mental Research and Public Health. 2020; 17(19): 7186 p. https://doi.org/10.3390/ijerph17197186
  26. De Groote E., Deldicque L. Is Physical Exercise in Hypoxia an Interesting Strategy to Prevent the Development of Type 2 Diabetes? A Narrative Review. Diabetes, Metabolic Myndrome and Obesity: Targets and Therapy. 2021; (14): 3603-3616. https://doi.org/10.2147/DMSO.S322249
  27. Gunton J.E. Hypoxia-inducible factors and diabetes. The Journal of Clinical Investigation. 2020; 130(10): 5063-5073. https://doi.org/10.1172/JCI137556
  28. Serebrovska T.V., Portnychenko A.G., Portnichenko V.I., Xi Lei, Egorov E., Antoniuk-Shcheglova I., Naskalova S., Shatylo V.B. Effects of intermittent hypoxia training on leukocyte pyruvate dehydrogenase kinase 1 (PDK-1) mRNA expression and blood insulin level in prediabetes patients. European Journal of Applied Physiology. 2019; 119(3): 813-823. https://doi.org/10.1007/s00421-019-04072-2
  29. Neuhoff C.G., Zhou S., Broadbent S. Intermittent Hypoxia as an Interventional Strategy for Impaired Fasting Blood Glucose: a Systematic Review. International Journal of Health Sciences. 2018; (6): 17-28.
  30. Kim S.W., Jung W.S., Chung S., Park H.Y. Exercise intervention under hypoxic condition as a new therapeutic paradigm for type 2 diabetes mellitus: A narrative review. World Journal of Diabetes. 2021; 12(4): 331-343. https://doi.org/10.4239/wjd.v12.i4.331
  31. Ignatenko G.A., Kontovsky E.A., Dubovik A.V., Milner I.A., Smirnova Ya.Yu., Bryzhataya Yu.O., Sergienko N.V., Rakitov B.L. Tsyganok T.V. The use of inter-val normobaric hypoxic therapy in patients with cardiopulmonary pathology. Bulletin of Hygiene and Epidemiology. 2018; 22(4): 22-25.
  32. Borukaeva I.K., Abazova Z.K., Ragimbekova M.R., Temirzhanova F.K. Effect of interval hypoxytherapy and entеral oxygenotherapy on immunological reactivity in patients with bronchial asthma. Russian Journal of Immunology. 2019; 13(22): 174-176.
  33. Bayer U., Likar R., Pinter G. et al. Intermittent hypoxic-hyperoxic training on cognitive performance in geriatric patients. Alzheimer’s & Dementia: Translational Research & Clinical Interventions. 2017; 3(1): 114-122. https://doi.org/10.1016/j.trci.2017.01.002
  34. Wang H., Shi X., Schenck H., Hall J.R., Ross S.E., Kline G.P., Chen S., Mallet R.T., Chen P. Intermittent Hypoxia Training for Treating Mild Cognitive Impairment: A Pilot Study. American Journal of Alzheimer's Disease & Other Dementias. 2020; (35): 1533317519896725. https://doi.org/10.1177/1533317519896725
  35. Jung M., Zou L., Yu J.J., Ryu S., Kong Z., Yang L., Kang M., Lin J., Li H., Smith L., Loprinzi P.D. Does exercise have a protective effect on cog-nitive function under hypoxia? A systematic review with meta-analysis. Journal of Sport and Health Science. 2020; 9(6): 562-577. https://doi.org/10.1016/j.jshs.2020.04.004



Creative Commons License
The content is available under the Creative Commons Attribution 4.0 License.

©

Эта статья открытого доступа по лицензии CC BY 4.0. Издательство: ФГБУ «НМИЦ РК» Минздрава России.
This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.

Aссоциация НАЭСКЛ