The Influence of Continuous Exercising on Chronotropic Incompetence in Multi-Episode Schizophrenia
People with schizophrenia die on average 15–20 years earlier than age and gender matched controls in the general population. An essential part of this excess mortality in people with schizophrenia is caused by physical illnesses. Among the physical illnesses, cardiovascular disease (CVD) has been id...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-03-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fpsyt.2019.00090/full |
| _version_ | 1819171242211540992 |
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| author | Marco Herbsleb Marco Herbsleb Katriona Keller-Varady Thomas Wobrock Alkomiet Hasan Andrea Schmitt Andrea Schmitt Peter Falkai Holger Horst Werner Gabriel Karl-Jürgen Bär Berend Malchow |
| author_facet | Marco Herbsleb Marco Herbsleb Katriona Keller-Varady Thomas Wobrock Alkomiet Hasan Andrea Schmitt Andrea Schmitt Peter Falkai Holger Horst Werner Gabriel Karl-Jürgen Bär Berend Malchow |
| author_sort | Marco Herbsleb |
| collection | DOAJ |
| description | People with schizophrenia die on average 15–20 years earlier than age and gender matched controls in the general population. An essential part of this excess mortality in people with schizophrenia is caused by physical illnesses. Among the physical illnesses, cardiovascular disease (CVD) has been identified as the most common natural cause of death in up to 40–45% of the cases. Chronotropic incompetence (CI) is defined as the inability of the heart to increase its beating frequency in proportion to increased physical activity or higher metabolic demand. It is an established independent cardiovascular risk factor for major cardiac events and overall mortality and might explain adaptation intolerance of the cardiovascular system to even minor exercise courses. CI needs objective exercise testing for definitive diagnosis and therefore represents a biological marker indicating the integrity of the cardiovascular system. It was recently described in patients with schizophrenia and might help explain the reduced physical fitness in these patients and the inability of a subgroup of patients to benefit from exercise interventions. In this study, we tried to replicate the occurrence of CI in an independent sample of patients with schizophrenia and evaluated whether CI can be influenced by a continuous endurance training of 12 weeks. Therefore, we re-analyzed the fitness testing data of 43 patients with schizophrenia and 22 aged and gender matched healthy controls. Parameters of aerobic fitness and chronotropic response to exercise were calculated. Patients with schizophrenia were less physically fit than the healthy controls and displayed a significantly higher heart rate at rest. 10 of 43 patients with schizophrenia and no healthy control subject were classified as chronotropically incompetent. Chronotropic response to exercise did not change significantly after 12 weeks of continuous aerobic exercise training. No differences were observed for baseline heart rate and peak heart rate in both subgroups of schizophrenia patients. Aerobic fitness did not improve significantly in the patients with schizophrenia classified as chronotropically incompetent. Our results confirm the occurrence of CI in patients with multi-episode schizophrenia. This should be taken into account when planning an exercise or lifestyle intervention studies in this population. Schizophrenia patients with CI do not seem to benefit as well as schizophrenia patients without CI from aerobic exercise training interventions. Larger, prospective randomized controlled clinical trials with different training interventions are urgently needed to address the topic of schizophrenia patients not responding to exercise and the relationship to the illness itself. |
| first_indexed | 2024-12-22T19:48:10Z |
| format | Article |
| id | doaj.art-78c708801b994e76aef1634f7f4b7c32 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-12-22T19:48:10Z |
| publishDate | 2019-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-78c708801b994e76aef1634f7f4b7c322022-12-21T18:14:37ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402019-03-011010.3389/fpsyt.2019.00090432530The Influence of Continuous Exercising on Chronotropic Incompetence in Multi-Episode SchizophreniaMarco Herbsleb0Marco Herbsleb1Katriona Keller-Varady2Thomas Wobrock3Alkomiet Hasan4Andrea Schmitt5Andrea Schmitt6Peter Falkai7Holger Horst Werner Gabriel8Karl-Jürgen Bär9Berend Malchow10Psychiatric Brain and Body Research Group, Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, GermanyDepartment of Sports Medicine and Health Promotion, Friedrich-Schiller-University of Jena, Jena, GermanyHannover Medical School, Institute of Sports Medicine, Hannover, GermanyDepartment of Psychiatry and Psychotherapy, County Hospitals Darmstadt-Dieburg, Groß-Umstadt, GermanyDepartment of Psychiatry and Psychotherapy, University Hospital LMU, Munich, GermanyDepartment of Psychiatry and Psychotherapy, University Hospital LMU, Munich, GermanyLaboratory of Neuroscience (LIM27), Institute of Psychiatry, University of São Paulo, São Paulo, BrazilDepartment of Psychiatry and Psychotherapy, University Hospital LMU, Munich, GermanyDepartment of Sports Medicine and Health Promotion, Friedrich-Schiller-University of Jena, Jena, GermanyPsychiatric Brain and Body Research Group, Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, GermanyPsychiatric Brain and Body Research Group, Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, GermanyPeople with schizophrenia die on average 15–20 years earlier than age and gender matched controls in the general population. An essential part of this excess mortality in people with schizophrenia is caused by physical illnesses. Among the physical illnesses, cardiovascular disease (CVD) has been identified as the most common natural cause of death in up to 40–45% of the cases. Chronotropic incompetence (CI) is defined as the inability of the heart to increase its beating frequency in proportion to increased physical activity or higher metabolic demand. It is an established independent cardiovascular risk factor for major cardiac events and overall mortality and might explain adaptation intolerance of the cardiovascular system to even minor exercise courses. CI needs objective exercise testing for definitive diagnosis and therefore represents a biological marker indicating the integrity of the cardiovascular system. It was recently described in patients with schizophrenia and might help explain the reduced physical fitness in these patients and the inability of a subgroup of patients to benefit from exercise interventions. In this study, we tried to replicate the occurrence of CI in an independent sample of patients with schizophrenia and evaluated whether CI can be influenced by a continuous endurance training of 12 weeks. Therefore, we re-analyzed the fitness testing data of 43 patients with schizophrenia and 22 aged and gender matched healthy controls. Parameters of aerobic fitness and chronotropic response to exercise were calculated. Patients with schizophrenia were less physically fit than the healthy controls and displayed a significantly higher heart rate at rest. 10 of 43 patients with schizophrenia and no healthy control subject were classified as chronotropically incompetent. Chronotropic response to exercise did not change significantly after 12 weeks of continuous aerobic exercise training. No differences were observed for baseline heart rate and peak heart rate in both subgroups of schizophrenia patients. Aerobic fitness did not improve significantly in the patients with schizophrenia classified as chronotropically incompetent. Our results confirm the occurrence of CI in patients with multi-episode schizophrenia. This should be taken into account when planning an exercise or lifestyle intervention studies in this population. Schizophrenia patients with CI do not seem to benefit as well as schizophrenia patients without CI from aerobic exercise training interventions. Larger, prospective randomized controlled clinical trials with different training interventions are urgently needed to address the topic of schizophrenia patients not responding to exercise and the relationship to the illness itself.https://www.frontiersin.org/article/10.3389/fpsyt.2019.00090/fullschizophreniaexercisechronotropic incompetencecardiac autonomic dysfunctionheart rate response |
| spellingShingle | Marco Herbsleb Marco Herbsleb Katriona Keller-Varady Thomas Wobrock Alkomiet Hasan Andrea Schmitt Andrea Schmitt Peter Falkai Holger Horst Werner Gabriel Karl-Jürgen Bär Berend Malchow The Influence of Continuous Exercising on Chronotropic Incompetence in Multi-Episode Schizophrenia Frontiers in Psychiatry schizophrenia exercise chronotropic incompetence cardiac autonomic dysfunction heart rate response |
| title | The Influence of Continuous Exercising on Chronotropic Incompetence in Multi-Episode Schizophrenia |
| title_full | The Influence of Continuous Exercising on Chronotropic Incompetence in Multi-Episode Schizophrenia |
| title_fullStr | The Influence of Continuous Exercising on Chronotropic Incompetence in Multi-Episode Schizophrenia |
| title_full_unstemmed | The Influence of Continuous Exercising on Chronotropic Incompetence in Multi-Episode Schizophrenia |
| title_short | The Influence of Continuous Exercising on Chronotropic Incompetence in Multi-Episode Schizophrenia |
| title_sort | influence of continuous exercising on chronotropic incompetence in multi episode schizophrenia |
| topic | schizophrenia exercise chronotropic incompetence cardiac autonomic dysfunction heart rate response |
| url | https://www.frontiersin.org/article/10.3389/fpsyt.2019.00090/full |
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