{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T02:53:41Z","timestamp":1791600821315,"version":"4.3.4"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2019,12,17]],"date-time":"2019-12-17T00:00:00Z","timestamp":1576540800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Warwickshire NHS trust"},{"name":"Warwickshire NHS trust"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Cardiovascular risk is elevated in end-stage renal disease. Left ventricular (LV) dysfunction is linked to repetitive transient ischaemia occurring during haemodialysis (HD). Cardiomyocyte ischaemia results in \u2018cardiac stunning\u2019, evidenced by regional wall motion abnormalities (RWMAs). Ischaemic RWMA have been documented during HD resulting in maladaptive cardiac remodelling and increased risk of heart failure. Intra-dialytic exercise is well tolerated and can improve quality of life and functional capacity. It may also attenuate HD-induced cardiac stunning.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This exploratory study aimed to assess the effect of intra-dialytic cycle ergometry on cardiac stunning. Twenty exercise-na\u00efve participants on maintenance HD (mean\u2009\u00b1\u2009SD, 59\u2009\u00b1\u200911\u2009years) underwent resting echocardiography and maximal cardiopulmonary exercise testing. Subsequently, cardiac stunning was assessed with myocardial strain-derived RWMAs at four time points during (i) standard HD and (ii) HD with 30\u2009min of sub-maximal intra-dialytic cycle ergometry at a workload equivalent to 90% oxygen uptake at the anaerobic threshold (VO2AT). Central haemodynamics and cardiac troponin I were also assessed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Compared with HD alone, HD with intra-dialytic exercise significantly reduced RWMAs after 2.5\u2009h of HD (total 110\u2009\u00b1\u20094, mean 7\u2009\u00b1\u20094 segments versus total 77\u2009\u00b1\u20093, mean 5\u2009\u00b1\u20093, respectively; P\u2009=\u20090.008). Global cardiac function, intra-dialytic haemodynamics and LV volumetric parameters were not significantly altered with exercise.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Intra-dialytic exercise reduced cardiac stunning. Thirty minutes of sub-maximal exercise at 90% VO2AT was sufficient to elicit acute cardio-protection. These data potentially demonstrate a novel therapeutic effect of intra-dialytic exercise.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ckj\/sfz159","type":"journal-article","created":{"date-parts":[[2019,10,17]],"date-time":"2019-10-17T19:37:57Z","timestamp":1571341077000},"page":"1335-1344","source":"Crossref","is-referenced-by-count":38,"title":["Cardiac stunning during haemodialysis: the therapeutic effect of intra-dialytic exercise"],"prefix":"10.1093","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6060-651X","authenticated-orcid":false,"given":"Scott","family":"McGuire","sequence":"first","affiliation":[{"name":"Faculty of Health and Life Sciences, Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth J","family":"Horton","sequence":"additional","affiliation":[{"name":"Faculty of Health and Life Sciences, Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek","family":"Renshaw","sequence":"additional","affiliation":[{"name":"Faculty of Health and Life Sciences, Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaris","family":"Chan","sequence":"additional","affiliation":[{"name":"Faculty of Health and Life Sciences, Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Faculty of Health and Life Sciences, Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Maddock","sequence":"additional","affiliation":[{"name":"Faculty of Health and Life Sciences, Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nithya","family":"Krishnan","sequence":"additional","affiliation":[{"name":"Faculty of Health and Life Sciences, Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK"},{"name":"Department of Nephrology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8963-9107","authenticated-orcid":false,"given":"Gordon","family":"McGregor","sequence":"additional","affiliation":[{"name":"Faculty of Health and Life Sciences, Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK"},{"name":"Department of Nephrology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK"},{"name":"Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, 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