Exercise Intensity

Boosting Myocardial Preconditioning With High-Intensity Intradialytic Exercise: A Preliminary Study

Patients receiving regular hemodialysis (HD) treatments are at a higher risk of cardiovascular events and death as HD can cause a decrease in the pumping of the heart during treatment called 'stunning'. Intradialytic exercise has emerged as a safe and effective non-drug approach to improve cardiovascular health and is now recommended for patients undergoing HD. It is currently advised that HD patients engage in at least 30 minutes of moderate to vigorous exercise three times per week. This study will evaluate the impact of exercise intensity in the HD population and determine if high impact exercise can offer better protection to the heart against HD-induced myocardial stunning.

This will be the first randomized, cross-controlled trial evaluating the impact of exercise intensity in the HD population. If the efficacy of cardiovascular protection is proven, it could be developed as a therapeutic option in the dialysis population.

Inclusion Criteria:

• Must be on chronic hemodialysis for at least 3 months
• Age ≥ 18 years of age
• Willing and able to provide informed consent

Exclusion Criteria:

• Regular vigorous exercise outside hemodialysis
• > 79 years of age
• Intradialytic exercise in the past 3 months
• Poor echogenicity
• Acute coronary syndrome in the past 3 months
• Unstable arrhythmia/angina
• Shortness of breath at rest or with minimal activity
• Symptomatic hypoglycemia (>2x/week in the week prior to enrolment)
• Symptomatic peripheral arterial disease
• Unable or deemed unsafe to exercise for any reason
• Severe musculoskeletal or orthopedic conditions
• Aortic stenosis
• Hypertrophic cardiopathy
• Severe pulmonary hypertension
• Symptomatic hypertension