Flynn Brigid, Vitztum Michelle, Miller Joshua, Houchin Abigail, Kim Jaromme, He Jianghua, Geiger Paige
Department of Anesthesiology, University of Kansas Medical Center, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA.
Department of Molecular and Integrative Physiology, University of Kansas Medical Center, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA.
Pilot Feasibility Stud. 2023 May 23;9(1):86. doi: 10.1186/s40814-023-01314-1.
Chronic heat therapy may have beneficial effects on cardiovascular function. These effects may be more pronounced in older adults. We performed a pilot feasibility study of repeated heat therapy sessions in a hot tub (40.5 °C) in older adults while wearing a noninvasive hemodynamic monitor. As part of the protocol, the volunteers underwent cardiovascular performance testing pre- and post-intervention.
Fifteen volunteers > 50 years old underwent 8-10 separate 45-min hot tub session over 14 days in this exploratory and mixed methods trial. The participants had maximal oxygen consumption (VO max) and other cardiovascular data measured via exercise treadmill testing prior to and after all hot tub sessions. The participants also wore noninvasive fingertip volume clamp monitors while immerged in hot water that calculated systemic vascular resistance, heart rate, blood pressure, and cardiac output in order to ascertain the feasibility and utility of this data. Other laboratory studies were obtained pre- and post-intervention. The protocol was determined feasible if the heat therapy and cardiovascular testing was completed by at least 90% (14/15 subjects). Feasibility of the noninvasive monitor was determined by the fidelity of the results. Secondary exploratory outcomes were analyzed for differences to identify if they are acceptable to include in an efficacy trial.
All participants completed the study protocol identifying the feasibility of the protocol. The noninvasive hemodynamic monitors successfully recorded cardiac output, systemic vascular resistance, heart rate, and blood pressure with fidelity based on the analysis of recordings. In the secondary analyses, we found no difference in the pre- to post-intervention measurement of VO max but did find increased exercise duration following hot tub therapy compared with prior to the therapy (571 s versus 551 s).
The current pilot study protocol is feasible for the purpose of analyzing the effects of heat therapy and cardiovascular performance in older adults while wearing a noninvasive hemodynamic monitor and undergoing treadmill stress testing. Secondary analyses found increased exercise tolerance but no differences in VO max following heat sessions.
慢性热疗可能对心血管功能有有益影响。这些影响在老年人中可能更为明显。我们在老年人中进行了一项试点可行性研究,让他们在热水浴缸(40.5°C)中进行重复热疗疗程,同时佩戴无创血流动力学监测仪。作为该方案的一部分,志愿者在干预前后接受心血管功能测试。
在这项探索性混合方法试验中,15名年龄超过50岁的志愿者在14天内进行了8至10次单独的45分钟热水浴缸疗程。所有热水浴缸疗程前后,参与者通过运动跑步机测试测量最大耗氧量(VO max)和其他心血管数据。参与者在浸入热水时还佩戴无创指尖容积钳监测仪,该监测仪可计算全身血管阻力、心率、血压和心输出量,以确定这些数据的可行性和实用性。干预前后还进行了其他实验室研究。如果至少90%(14/15名受试者)完成了热疗和心血管测试,则该方案被确定为可行。无创监测仪的可行性由结果的准确性决定。对次要探索性结果进行差异分析,以确定它们是否适合纳入疗效试验。
所有参与者都完成了研究方案,证明了该方案的可行性。基于记录分析,无创血流动力学监测仪成功准确地记录了心输出量、全身血管阻力、心率和血压。在次要分析中,我们发现干预前后VO max的测量没有差异,但发现与热疗前相比,热疗后运动持续时间增加(571秒对551秒)。
当前的试点研究方案对于分析老年人在佩戴无创血流动力学监测仪并进行跑步机压力测试时热疗和心血管功能的影响是可行且有效的。次要分析发现热疗后运动耐力增加,但VO max没有差异。