51
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De Maria B, Lucini D, Gois MDO, Catai AM, Perego F, Malacarne M, Pagani M, Porta A, Dalla Vecchia LA. Improvement of Sympathovagal Balance by Regular Exercise May Counteract the Ageing Process. A Study by the Analysis of QT Variability. Front Physiol 2022; 13:880250. [PMID: 35514344 PMCID: PMC9065681 DOI: 10.3389/fphys.2022.880250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/04/2022] [Indexed: 11/21/2022] Open
Abstract
QT interval (QT) variability analysis provides pathophysiological and prognostic information utilized in cardiac and non-cardiac diseases, complementary to those obtained from the analysis of heart period (HP) variability. An increased QT variability has been associated to a higher risk for cardiac events and poorest prognosis. Autonomic cardiovascular adaptation to internal and external challenges, such those occurring in athletes exposed to high levels of physical stress and in ageing could also be deepen by analyzing QT variability, searching for early prognostic signatures. The aim of the study was to analyze the QT variability and cardiac control complexity in a group of middle-aged half-marathon runners at baseline (B) and at a 10-year follow-up (FU). We found that the overall QT variability decreased at FU, despite the inescapable increase in age (52.3 ± 8.0 years at FU). This change was accompanied by an increase of the HP variability complexity without changes of the QT variability complexity. Of notice, over the years, the group of athletes maintained their regular physical activity by switching to a moderate intensity rather than strenuous. In conclusion, regular and moderate exercise over the years was beneficial for this group of athletes, as reflected by the decreased overall QT variability that is known to be associated to lower cardiovascular risk. The concomitant enhanced cardiac control complexity also suggests a trend opposite to what usually occurs with ageing, resulting in a more flexible cardiac control, typical of younger people.
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Affiliation(s)
| | - Daniela Lucini
- BIOMETRA Department, University of Milan, Milan, Italy.,Exercise Medicine Unit, IRCCS, Istituto Auxologico Italiano, Milan, Italy
| | | | - Aparecida Maria Catai
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | | | - Mara Malacarne
- BIOMETRA Department, University of Milan, Milan, Italy.,Exercise Medicine Unit, IRCCS, Istituto Auxologico Italiano, Milan, Italy
| | - Massimo Pagani
- Exercise Medicine Unit, IRCCS, Istituto Auxologico Italiano, Milan, Italy
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.,Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, Policlinico San Donato, San Donato Milanese, Milan, Italy
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52
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Teas E, Kimiecik J, Ward RM, Timmerman K. Intuitive Eating and Biomarkers Related to Cardiovascular Disease in Older Adults. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2022; 54:412-421. [PMID: 35534099 PMCID: PMC9097336 DOI: 10.1016/j.jneb.2022.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 01/20/2022] [Accepted: 01/28/2022] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Examine whether exercise and diet motivation are associated with 4 biomarkers related to cardiovascular disease. DESIGN Cross-sectional analysis. Data collection involved questionnaires, blood draws, body composition assessments, and accelerometry. SETTING Small, midwestern college town. PARTICIPANTS Community older adults (≥ 58 years of age; n = 79) recruited through convenience sampling; the sample was representative of the population of interest for some demographic characteristics (eg, age and sex) but not representative of other characteristics (eg, level of activity). VARIABLES MEASURED Independent variables comprised self-reported intrinsic exercise motivation (Behavioral Regulation for Exercise Questionnaire-3) and intuitive eating (Intuitive Eating Scale-2). Dependent variables included inflammatory proteins (C-reactive protein and interleukin-6) and lipid levels (low-density lipoprotein/high-density lipoprotein and triglycerides) quantified from blood samples. Covariates included age, body mass index, sex, and objective physical activity measured by accelerometers worn for 7 days. ANALYSIS Multiple linear regression was used to assess the association between diet and exercise motivation and biomarker outcomes; we analyzed 4 regression models (1 for each biomarker). Significance level P < 0.05. RESULTS Greater intuitive eating was associated with a lower low-density lipoprotein/high-density lipoprotein ratio (β = -0.45, P = 0.001) and lower triglycerides (β = -0.37, P = 0.003). Intrinsic exercise motivation was not associated with the biomarkers. CONCLUSIONS AND IMPLICATIONS Intuitive eating may be a key determinant of certain biomarkers and could be a viable target for interventions to help decrease the risk of cardiovascular disease among older adults.
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Affiliation(s)
- Elizabeth Teas
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN; Center for Aging and the Life Course, Purdue University, West Lafayette, IN.
| | - Jay Kimiecik
- Department of Kinesiology, Nutrition, and Health, Miami University, Oxford, OH
| | - Rose Marie Ward
- Department of Kinesiology, Nutrition, and Health, Miami University, Oxford, OH
| | - Kyle Timmerman
- Department of Kinesiology, Nutrition, and Health, Miami University, Oxford, OH
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53
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Redfern J, Gallagher R, O'Neil A, Grace SL, Bauman A, Jennings G, Brieger D, Briffa T. Historical Context of Cardiac Rehabilitation: Learning From the Past to Move to the Future. Front Cardiovasc Med 2022; 9:842567. [PMID: 35571195 PMCID: PMC9091441 DOI: 10.3389/fcvm.2022.842567] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/18/2022] [Indexed: 12/12/2022] Open
Abstract
Contemporary myocardial infarction (MI) care and management has evolved dramatically since the 1950's; yet outpatient rehabilitation remains underutilized. Deepening our understanding of the origins and history of cardiac rehabilitation highlights a contemporary shift required for policy and practice related to secondary prevention of coronary disease in light of societal changes as well as medical, digital and surgical advancements. Contemporary "cardiac rehabilitation" began when bed rest and physical inactivity was recommended and commonplace for MI survivors. Today, most patients who survive an MI, undergo reperfusion therapy, a short inpatient stay and are discharged with minimal physical morbidity. Despite this, the majority of modern day programs continue to be structured in the same way they have been for the past 50 years and this model has become incongruent with the contemporary context, especially in the COVID-19 era. This review aims to describe the historical foundations of cardiac rehabilitation to inform solutions and meet the demands of contemporary MI management. Delivering health systems reform to address modernization is current healthcare challenge where a united and interdisciplinary effort is needed.
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Affiliation(s)
- Julie Redfern
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Robyn Gallagher
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Adrienne O'Neil
- School of Medicine, IMPACT Institute, Deakin University, Geelong, VIC, Australia
| | - Sherry L Grace
- Faculty of Health, York University, Toronto, ON, Canada
- KITE Toronto Rehabilitation Institute and Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Adrian Bauman
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Garry Jennings
- National Heart Foundation of Australia, Melbourne, VIC, Australia
| | - David Brieger
- Department of Cardiology, Concord Hospital, Sydney, NSW, Australia
| | - Tom Briffa
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
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54
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Sabbari M, Mirzababaei A, Shiraseb F, Clark CCT, Mirzaei K. The association between recommended and non-recommended food scores on cardiovascular risk factors in obese and overweight adult women: a cross-sectional study. BMC Public Health 2022; 22:795. [PMID: 35449003 PMCID: PMC9027453 DOI: 10.1186/s12889-021-12404-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 12/10/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Obesity is a highly prevalent, non-communicable, disease associated with numerous comorbid complications, such as cardiovascular disease. Following a healthy diet is known to help reduce the risk of both obesity and cardiovascular disease. This study was conducted to evaluate the association of recommended food score (RFS) and none recommended food score (NRFS) with cardiovascular risk factors in overweight and obese women. METHODS This cross-sectional study was performed on 379 overweight and obese (BMI ≥25 kg/m2) women aged 18-48 years. Anthropometric measurements and body composition analysis were assessed in all participants. Dietary intake was assessed by a valid and reliable food frequency questionnaire (FFQ) containing 147 items, and RFS and NRFS was calculated. Biochemical assessments including TC, HDL, LDL, TG, FBS, insulin, HOMA-IR, and hs-CRP were quantified by ELISA. RESULTS The mean age and BMI of participants were 36.73 ± 9.21 (y) and 31.17 ± 4.22 (kg/m2), respectively. Binary logistic regression showed that participants in the highest tertile of the RFS compared to the lowest tertile had 57% lower odds for hypertriglyceridemia [OR = 0.43, 95%CI = 0.20-0.92, P = 0.03]. Subjects with high adherence to the NRFS had lower HDL [OR = 2.11, 95%CI = 1.08-4.12, P = 0.02] and higher odds for hypertriglyceridemia [OR = 2.95, 95%CI = 1.47-5.94, P = 0.002] compared to low adherence. CONCLUSIONS There was an inverse significant association between adherence to RFS and odds of hypertriglyceridemia. There was a significant association between NRFS and hypertriglyceridemia, in addition to an inverse association between NRFS and HDL. We recommend that people increase their consumption of fruits, vegetables, whole grains, lean meats or meat alternates, and low-fat dairy and avoid red meat, processed meat, chips, high-fat dairy, solid oil, refined grains, and variety of sweetened foods to prevent cardiovascular disease.
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Affiliation(s)
- Maryam Sabbari
- Faculty of Medical Sciences and Technologies, Islamic Azad University, Science and Research Branch of Tehran, Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran
| | - Farideh Shiraseb
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, CV1 5FB, UK
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box: 14155-6117, Tehran, Iran.
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55
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Thijssen DHJ, Uthman L, Somani Y, van Royen N. Short-term exercise-induced protection of cardiovascular function and health: why and how fast does the heart benefit from exercise? J Physiol 2022; 600:1339-1355. [PMID: 35239189 PMCID: PMC9311195 DOI: 10.1113/jp282000#support-information-section] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 12/10/2021] [Indexed: 05/28/2023] Open
Abstract
Regular exercise training has potent and powerful protective effects against the development of cardiovascular disease. These cardioprotective effects of regular exercise training are partly explained through the effects of exercise on traditional cardiovascular risk factors and improvement in cardiac and vascular health, which take several weeks to months to develop. This review focuses on the observation that single bouts of exercise may also possess an underrecognized, clinically useful form of immediate cardioprotection. Studies, performed in both animals and humans, demonstrate that single or short-term exercise-induced protection (SEP) attenuates the magnitude of cardiac and/or vascular damage in response to prolonged ischaemia and reperfusion injury. This review highlights preclinical evidence supporting the hypothesis that SEP activates multiple pathways to confer immediate protection against ischaemic events, reduce the severity of potentially lethal ischaemic myocardial injury, and therefore act as a physiological first line of defence against injury. Given the fact that the extent of SEP could be modulated by exercise-related and subject-related factors, it is important to recognize and consider these factors to optimize future clinical implications of SEP. This review also summarizes potential effector signalling pathways (i.e. communication between exercising muscles to vascular/cardiac tissue) and intracellular pathways (i.e. reducing tissue damage) that ultimately confer protection against cardiac and vascular injury. Finally, we discuss potential future directions for designing adequate human and animal studies that will support developing effective SEP strategies for the (multi-)diseased and aged individual. KEY POINTS: Single or short-term exercise-induced protection (SEP) attenuates the magnitude of cardiac and/or vascular damage in response to prolonged ischaemia and reperfusion injury (IR injury). SEP activates multiple pathways to confer cardiac protection, which develops remotely at the site of the activated muscle by release of circulating molecules, which transfer towards activation of intramyocardial signalling that promotes cell survival during episodes of IR injury. SEP represents an attractive intervention in aged individuals and in those with co-morbidities. The immediate protection, low cost and simplicity to increase the 'dose' of SEP offers unique opportunities in the clinical applications of SEP.
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Affiliation(s)
- Dick H. J. Thijssen
- Radboud Institute for Health SciencesDepartments of PhysiologyNijmegenThe Netherlands
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLeicesterUK
| | - Laween Uthman
- Radboud Institute for Health SciencesDepartments of PhysiologyNijmegenThe Netherlands
- CardiologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Yasina Somani
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLeicesterUK
| | - Niels van Royen
- CardiologyRadboud University Medical CenterNijmegenThe Netherlands
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56
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Tan JLK, Ylä-Kojola AM, Eriksson JG, Salonen MK, Wasenius N, Hart NH, Chivers P, Rantalainen T, Lano A, Piitulainen H. Effect of Childhood Developmental Coordination Disorder on Adulthood Physical Activity; Arvo Ylppö Longitudinal Study. Scand J Med Sci Sports 2022; 32:1050-1063. [PMID: 35178792 PMCID: PMC9306991 DOI: 10.1111/sms.14144] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 01/27/2022] [Accepted: 02/09/2022] [Indexed: 11/28/2022]
Abstract
Individuals at risk of Developmental Coordination Disorder (DCD) have low levels of physical activity in childhood due to impaired motor competence; however, physical activity levels in adulthood have not been established. This study sought to determine the impact of DCD risk on physical activity levels in adults using accelerometry measurement. Participants (n = 656) from the Arvo Ylppö Longitudinal Study cohort had their motor competence assessed at the age of five years, and their physical activity quantified via device assessment at the age of 25 years. Between group differences were assessed to differentiate physical activity measures for individuals based on DCD risk status, with general linear modeling performed to control for the effects of sex, body mass index (BMI), and maternal education. Participants at risk of DCD were found to have a lower total number of steps (d = 0.3, p = 0.022) than those not at risk. Statistical modeling indicated that DCD risk status increased time spent in sedentary light activity (β = 0.1, 95% CI 0.02 to 0.3, p = 0.026) and decreased time spent in vigorous physical activity via interaction with BMI (β = 0.04, 95% CI 0.001 to 0.1, p = 0.025). Sensitivity analysis found that visuomotor impairment did not significantly impact physical activity but did increase the role of DCD risk status in some models. This 20‐year‐longitudinal study indicated that DCD risk status continues to negatively impact on levels of physical activity into early adulthood.
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Affiliation(s)
- Jocelyn L K Tan
- School of Health Sciences, University of Notre Dame Australia, Fremantle, WA, Australia.,Western Australian Bone Research Collaboration, Perth, WA, Australia
| | - Anna-Mari Ylä-Kojola
- Department of Child Neurology, Children's Hospital, University of Helsinki, Finland
| | - Johan G Eriksson
- Folkhälsan Research Center, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki, Finland.,Department of Obstetrics and Gynecology, Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Singapore Institute for Clinical Sciences, A*Star, Singapore, Singapore
| | - Minna K Salonen
- Folkhälsan Research Center, Helsinki, Finland.,Unit of Chronic Disease Prevention, Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Niko Wasenius
- Folkhälsan Research Center, Helsinki, Finland.,Department of General Practice and Primary Health Care, University of Helsinki, Finland
| | - Nicolas H Hart
- Western Australian Bone Research Collaboration, Perth, WA, Australia.,Institute for Health Research, University of Notre Dame Australia, Fremantle, WA, Australia.,School of Medical and Health Science, Edith Cowan University, Joondalup, WA, Australia.,Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Paola Chivers
- Western Australian Bone Research Collaboration, Perth, WA, Australia.,Institute for Health Research, University of Notre Dame Australia, Fremantle, WA, Australia.,School of Medical and Health Science, Edith Cowan University, Joondalup, WA, Australia
| | - Timo Rantalainen
- Western Australian Bone Research Collaboration, Perth, WA, Australia.,Institute for Health Research, University of Notre Dame Australia, Fremantle, WA, Australia.,School of Medical and Health Science, Edith Cowan University, Joondalup, WA, Australia.,Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Aulikki Lano
- Department of Child Neurology, Children's Hospital, University of Helsinki, Finland
| | - Harri Piitulainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Department of Neuroscience and Biomedical Engineering, School of Science, Aalto University, Aalto, Finland
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57
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Barbiellini Amidei C, Trevisan C, Dotto M, Ferroni E, Noale M, Maggi S, Corti MC, Baggio G, Fedeli U, Sergi G. Association of physical activity trajectories with major cardiovascular diseases in elderly people. Heart 2022; 108:360-366. [DOI: 10.1136/heartjnl-2021-320013] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/18/2021] [Indexed: 12/31/2022] Open
Abstract
IntroductionCardiovascular benefits deriving from physical activity are well known, but it is unclear whether physical activity trajectories in late life are associated with different risks of cardiovascular diseases.MethodsProgetto Veneto Anziani (Pro.V.A.) is a cohort study of 3099 Italians aged ≥65 years with baseline assessment in 1995–1997 and follow-up visits at 4 and 7 years. Surveillance was extended to 2018 by linkage with hospital and mortality records. Prevalent and incident cardiovascular diseases (coronary heart disease, heart failure and stroke) were identified through clinical examination, questionnaire, or hospital records. Moderate to vigorous physical activity was considered as a time-varying variable. Physical activity trajectories were categorised as: stable-low, high-decreasing, low-increasing and stable-high. Exposure was also assessed at 70, 75, 80 and 85 years.ResultsOverall, physical activity was associated with lower rates of incident cardiovascular diseases. A significant risk reduction was present among men and was stronger earlier in late life (70–75 years). Trajectories of stable-high physical activity were associated with a significantly lower risk of cardiovascular outcomes among men (HR 0.48, 95% CI 0.27 to 0.86) compared with those with stable-low trajectories (p for trend 0.002). No significant association was found with stroke. The greatest cardiovascular risk reduction was observed for >20 min/day of physical activity, and was more marked at 70 years.ConclusionIncreasingly active trajectories of physical activity were associated with lower rates of cardiovascular diseases and overall mortality. Promoting at least 20 min/day of physical activity early in late life seems to provide the greatest cardiovascular benefits.
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58
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Global thrombosis test for assessing thrombotic status and efficacy of antithrombotic diet and other conditions. Future Sci OA 2022; 8:FSO788. [PMID: 35251699 PMCID: PMC8890116 DOI: 10.2144/fsoa-2021-0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 01/10/2022] [Indexed: 11/23/2022] Open
Abstract
Because of the high mortality from myocardial infarction and stroke, there is a great demand for finding novel methods of diagnosis, prevention and treatment of these diseases. Most of the current tests measure important determinants of thrombosis such as platelet function, coagulation and fibrinolysis in isolation; therefore, a global test measuring the actual thrombotic status would be more useful in clinical conditions. We obtained considerable experience by using the global thrombosis test, which determines the actual thrombotic status by taking into account the measured platelet reactivity, coagulation and fibrinolytic activities. In animal experiments, we found significant correlation between the ex vivo global thrombosis test measurements and the in vivo thrombotic status. The published evidence for the benefit of an antithrombotic diet with regular physical exercise is also described. There is a great concern in the general population how to detect the risk of thrombotic events and prevent the high mortality from stroke, myocardial infarction, sudden death and cancer-associated thrombosis. Our experience on antithrombotic fruits and vegetables intake and regular exercise assessed by the global thrombosis test suggested a potentially unique way of preventing these life-threatening diseases. In addition, global thrombosis testing may offer some benefit in detecting risk of thrombotic of forthcoming thrombotic events in cancer and COVID-19 virus-infected patients.
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59
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Whitehill RD, Balaji S, Kelleman M, Chandler SF, Abrams DJ, Mao C, Fischbach P, Campbell R. Exercise Recommendations in Pediatric HCM: Variation and Influence of Provider Characteristics. Pediatr Cardiol 2022; 43:132-141. [PMID: 34406429 DOI: 10.1007/s00246-021-02703-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 08/04/2021] [Indexed: 11/29/2022]
Abstract
Pediatric Hypertrophic Cardiomyopathy (HCM) is associated with sudden cardiac death (SCD) that can be related to physical activity. Without pediatric specific guidelines, recommendations for activity restriction may be varied. Therefore, our aim is to determine the current practice and variability surrounding exercise clearance recommendations (ER) in pediatric HCM referral centers as well as provider and patient characteristics that influence them. We designed a survey that was distributed to the Pediatric Heart Transplant Study (PHTS) providers and members of the Pediatric and Adult Congenital Electrophysiology Society (PACES) querying provider demographics and patient variables from 2 patient vignettes. The study is a multicenter survey of current practice of specialized providers caring for pediatric HCM patients. Survey of PHTS and PACES providers via email to the respective listservs with a response rate of 28% and 91 overall completing the entire survey after self-identifying as providers for pediatric HCM patients at their center. ER varies for pediatric HCM and is associated with provider training background as well as personal and professional history. Of the 91 providers who completed the survey, 42% (N = 38) trained in pediatric electrophysiology (EP), and 40% (N = 36) in pediatric heart failure (HF). Responses varied and only 53% of providers cleared for mild to moderate activity for the patient in Vignette 1, which is more in line with recent published adult guidelines. ER in both vignettes was significantly associated with type of training background. EP providers were more likely to recommend no restriction (27.8% vs 5.9%) than HF providers even when controlling for provider age and time out of training. Syncope with exercise was deemed "Most Important" by 81% of providers when making ER. ER for pediatric HCM are variable and the majority of providers make ER outside of previously published adult guidelines. Furthermore, ER are influenced by provider background and experience. Further study is needed for risks and benefits of physical activity in this population to inform the development of pediatric specific guidelines.
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Affiliation(s)
- Robert D Whitehill
- Department of Pediatrics, Emory University School of Medicine, Atlanta, USA. .,Department of Cardiology, Children's Healthcare of Atlanta, Atlanta, USA.
| | - Seshadri Balaji
- Department of Pediatrics, Oregon Health and Science University, Portland, USA
| | - Michael Kelleman
- Department of Pediatrics, Emory University School of Medicine, Atlanta, USA.,Department of Cardiology, Children's Healthcare of Atlanta, Atlanta, USA
| | - Stephanie F Chandler
- Division of Cardiology, Ann & Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Dominic J Abrams
- Department of Cardiology, Boston Children's Hospital, Harvard Medical School, Boston, USA
| | - Chad Mao
- Department of Pediatrics, Emory University School of Medicine, Atlanta, USA.,Department of Cardiology, Children's Healthcare of Atlanta, Atlanta, USA
| | - Peter Fischbach
- Department of Pediatrics, Emory University School of Medicine, Atlanta, USA.,Department of Cardiology, Children's Healthcare of Atlanta, Atlanta, USA
| | - Robert Campbell
- Department of Pediatrics, Emory University School of Medicine, Atlanta, USA.,Department of Cardiology, Children's Healthcare of Atlanta, Atlanta, USA
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60
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Thijssen DHJ, Uthman L, Somani Y, Royen N. Short term exercise‐induced protection of cardiovascular function and health: Why and how fast does the heart benefit from exercise? J Physiol 2021; 600:1339-1355. [PMID: 35239189 PMCID: PMC9311195 DOI: 10.1113/jp282000] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 12/10/2021] [Indexed: 11/13/2022] Open
Abstract
Abstract Regular exercise training has potent and powerful protective effects against the development of cardiovascular disease. These cardioprotective effects of regular exercise training are partly explained through the effects of exercise on traditional cardiovascular risk factors and improvement in cardiac and vascular health, which take several weeks to months to develop. This review focuses on the observation that single bouts of exercise may also possess an underrecognized, clinically useful form of immediate cardioprotection. Studies, performed in both animals and humans, demonstrate that single or short‐term exercise‐induced protection (SEP) attenuates the magnitude of cardiac and/or vascular damage in response to prolonged ischaemia and reperfusion injury. This review highlights preclinical evidence supporting the hypothesis that SEP activates multiple pathways to confer immediate protection against ischaemic events, reduce the severity of potentially lethal ischaemic myocardial injury, and therefore act as a physiological first line of defence against injury. Given the fact that the extent of SEP could be modulated by exercise‐related and subject‐related factors, it is important to recognize and consider these factors to optimize future clinical implications of SEP. This review also summarizes potential effector signalling pathways (i.e. communication between exercising muscles to vascular/cardiac tissue) and intracellular pathways (i.e. reducing tissue damage) that ultimately confer protection against cardiac and vascular injury. Finally, we discuss potential future directions for designing adequate human and animal studies that will support developing effective SEP strategies for the (multi‐)diseased and aged individual. Key points Single or short‐term exercise‐induced protection (SEP) attenuates the magnitude of cardiac and/or vascular damage in response to prolonged ischaemia and reperfusion injury (IR injury). SEP activates multiple pathways to confer cardiac protection, which develops remotely at the site of the activated muscle by release of circulating molecules, which transfer towards activation of intramyocardial signalling that promotes cell survival during episodes of IR injury. SEP represents an attractive intervention in aged individuals and in those with co‐morbidities. The immediate protection, low cost and simplicity to increase the ‘dose’ of SEP offers unique opportunities in the clinical applications of SEP.
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Affiliation(s)
- Dick H. J. Thijssen
- Radboud Institute for Health Sciences Departments of Physiology Nijmegen The Netherlands
- Research Institute for Sport and Exercise Sciences Liverpool John Moores University Leicester United Kingdom
| | - Laween Uthman
- Radboud Institute for Health Sciences Departments of Physiology Nijmegen The Netherlands
- Cardiology Radboud University Medical Center Nijmegen The Netherlands
| | - Yasina Somani
- Research Institute for Sport and Exercise Sciences Liverpool John Moores University Leicester United Kingdom
| | - Niels Royen
- Cardiology Radboud University Medical Center Nijmegen The Netherlands
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Qiu Y, Pan X, Chen Y, Xiao J. Hallmarks of exercised heart. J Mol Cell Cardiol 2021; 164:126-135. [PMID: 34914934 DOI: 10.1016/j.yjmcc.2021.12.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 12/08/2021] [Accepted: 12/09/2021] [Indexed: 12/29/2022]
Abstract
The benefits of exercise in humans on the heart have been well recognized for many years. Long-term endurance exercise training can induce physiologic cardiac hypertrophy with normal or enhanced heart function, and provide protective benefits in preventing heart failure. The heart-specific responses that occur during exercise are complex and highly variable. This review mainly focuses on the current understanding of the structural and functional cardiac adaptations to exercise as well as molecular pathways and signaling proteins responsible for these changes. Here, we summarize eight tentative hallmarks that represent common denominators of the exercised heart. These hallmarks are: cardiomyocyte growth, cardiomyocyte fate reprogramming, angiogenesis and lymphangiogenesis, mitochondrial remodeling, epigenetic alteration, enhanced endothelial function, quiescent cardiac fibroblast, and improved cardiac metabolism. A major challenge is to explore the underlying molecular mechanisms for cardio-protective effects of exercise, and to identify therapeutic targets for heart diseases.
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Affiliation(s)
- Yan Qiu
- Institute of Geriatrics (Shanghai University), Affiliated Nantong Hospital of Shanghai University (The Sixth People's Hospital of Nantong), School of Medicine, Shanghai University, Nantong 226011, China; Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, Shanghai Engineering Research Center of Organ Repair, School of Life Science, Shanghai University, Shanghai 200444, China
| | - Xue Pan
- Institute of Geriatrics (Shanghai University), Affiliated Nantong Hospital of Shanghai University (The Sixth People's Hospital of Nantong), School of Medicine, Shanghai University, Nantong 226011, China; Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, Shanghai Engineering Research Center of Organ Repair, School of Life Science, Shanghai University, Shanghai 200444, China
| | - Yiwen Chen
- Institute of Geriatrics (Shanghai University), Affiliated Nantong Hospital of Shanghai University (The Sixth People's Hospital of Nantong), School of Medicine, Shanghai University, Nantong 226011, China; Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, Shanghai Engineering Research Center of Organ Repair, School of Life Science, Shanghai University, Shanghai 200444, China
| | - Junjie Xiao
- Institute of Geriatrics (Shanghai University), Affiliated Nantong Hospital of Shanghai University (The Sixth People's Hospital of Nantong), School of Medicine, Shanghai University, Nantong 226011, China; Cardiac Regeneration and Ageing Lab, Institute of Cardiovascular Sciences, Shanghai Engineering Research Center of Organ Repair, School of Life Science, Shanghai University, Shanghai 200444, China.
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Iop L, Iliceto S, Civieri G, Tona F. Inherited and Acquired Rhythm Disturbances in Sick Sinus Syndrome, Brugada Syndrome, and Atrial Fibrillation: Lessons from Preclinical Modeling. Cells 2021; 10:3175. [PMID: 34831398 PMCID: PMC8623957 DOI: 10.3390/cells10113175] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/03/2021] [Accepted: 11/09/2021] [Indexed: 12/12/2022] Open
Abstract
Rhythm disturbances are life-threatening cardiovascular diseases, accounting for many deaths annually worldwide. Abnormal electrical activity might arise in a structurally normal heart in response to specific triggers or as a consequence of cardiac tissue alterations, in both cases with catastrophic consequences on heart global functioning. Preclinical modeling by recapitulating human pathophysiology of rhythm disturbances is fundamental to increase the comprehension of these diseases and propose effective strategies for their prevention, diagnosis, and clinical management. In silico, in vivo, and in vitro models found variable application to dissect many congenital and acquired rhythm disturbances. In the copious list of rhythm disturbances, diseases of the conduction system, as sick sinus syndrome, Brugada syndrome, and atrial fibrillation, have found extensive preclinical modeling. In addition, the electrical remodeling as a result of other cardiovascular diseases has also been investigated in models of hypertrophic cardiomyopathy, cardiac fibrosis, as well as arrhythmias induced by other non-cardiac pathologies, stress, and drug cardiotoxicity. This review aims to offer a critical overview on the effective ability of in silico bioinformatic tools, in vivo animal studies, in vitro models to provide insights on human heart rhythm pathophysiology in case of sick sinus syndrome, Brugada syndrome, and atrial fibrillation and advance their safe and successful translation into the cardiology arena.
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Affiliation(s)
- Laura Iop
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, Via Giustiniani, 2, I-35124 Padua, Italy; (S.I.); (G.C.)
| | | | | | - Francesco Tona
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, Via Giustiniani, 2, I-35124 Padua, Italy; (S.I.); (G.C.)
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Shi H, Ossip DJ, Mayo NL, Lopez DA, Block RC, Post WS, Bertoni AG, Ding J, Chen S, Yan C, Xie Z, Hoeschele I, Liu Y, Li D. Role of DNA methylation on the association between physical activity and cardiovascular diseases: results from the longitudinal multi-ethnic study of atherosclerosis (MESA) cohort. BMC Genomics 2021; 22:790. [PMID: 34732130 PMCID: PMC8567593 DOI: 10.1186/s12864-021-08108-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 10/14/2021] [Indexed: 12/03/2022] Open
Abstract
Background The complexity of physical activity (PA) and DNA methylation interaction in the development of cardiovascular disease (CVD) is rarely simultaneously investigated in one study. We examined the role of DNA methylation on the association between PA and CVD. Results The Multi-Ethnic Study of Atherosclerosis (MESA) cohort Exam 5 data with 1065 participants free of CVD were used for final analysis. The quartile categorical total PA variable was created by activity intensity (METs/week). During a median follow-up of 4.0 years, 69 participants developed CVD. Illumina HumanMethylation450 BeadChip was used to provide genome-wide DNA methylation profiles in purified human monocytes (CD14+). We identified 23 candidate DNA methylation loci to be associated with both PA and CVD. We used the structural equation modeling (SEM) approach to test the complex relationships among multiple variables and the roles of mediators. Three of the 23 identified loci (corresponding to genes VPS13D, PIK3CD and VPS45) remained as significant mediators in the final SEM model along with other covariates. Bridged by the three genes, the 2nd PA quartile (β = − 0.959; 95%CI: − 1.554 to − 0.449) and the 3rd PA quartile (β = − 0.944; 95%CI: − 1.628 to − 0.413) showed the greatest inverse associations with CVD development, while the 4th PA quartile had a relatively weaker inverse association (β = − 0.355; 95%CI: − 0.713 to − 0.124). Conclusions The current study is among the first to simultaneously examine the relationships among PA, DNA methylation, and CVD in a large cohort with long-term exposure. We identified three DNA methylation loci bridged the association between PA and CVD. The function of the identified genes warrants further investigation in the pathogenesis of CVD. Supplementary Information The online version contains supplementary material available at 10.1186/s12864-021-08108-w.
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Affiliation(s)
- Hangchuan Shi
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, NY, 14642-0708, USA.,Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Deborah J Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Nicole L Mayo
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Daniel A Lopez
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Robert C Block
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Wendy S Post
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Alain G Bertoni
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - Jingzhong Ding
- Department of Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA
| | - Si Chen
- Aab Cardiovascular Research Institute, University of Rochester, School of Medicine and Dentistry, Rochester, NY, 14642, USA.,Department of Pharmacology and Physiology, University of Rochester, School of Medicine and Dentistry, Rochester, NY, 14642, USA
| | - Chen Yan
- Aab Cardiovascular Research Institute, University of Rochester, School of Medicine and Dentistry, Rochester, NY, 14642, USA.,Department of Pharmacology and Physiology, University of Rochester, School of Medicine and Dentistry, Rochester, NY, 14642, USA
| | - Zidian Xie
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, NY, 14642-0708, USA
| | - Ina Hoeschele
- Department of Statistics, Fralin Life Sciences Institute at Virginia Tech, Blacksburg, VA, 24061, USA
| | - Yongmei Liu
- Department of Medicine, Division of Cardiology, Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, 27701, USA.
| | - Dongmei Li
- Department of Clinical and Translational Research, University of Rochester Medical Center, Rochester, NY, 14642-0708, USA.
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Qu CJ, Teng LQ, Liu XN, Zhang YB, Fang J, Shen CY. Dose-Response Relationship Between Physical Activity and the Incidence of Peripheral Artery Disease in General Population: Insights From the National Health and Nutrition Examination Survey 1999-2004. Front Cardiovasc Med 2021; 8:730508. [PMID: 34722663 PMCID: PMC8553979 DOI: 10.3389/fcvm.2021.730508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/09/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: A low ABI, ≦0.9, indicates peripheral artery disease (PAD) and physical activity (PA) represents an important non-surgical treatment for patients with PAD. However, as for the general population, the associations between PA, PAD, and their mutual dependence are not well-defined. Here we aimed to determine whether there is a dose-response relationship between PA and incidence of PAD in the general population using restricted cubic spline (RCS). Patients and methods: This study analyzed 1,370 adults aged ≧40 years who had participated in the National Health and Nutrition Examination Survey (NHANES) during 1999-2004. The ABI of the participants were measured by trained technicians, and PAD was defined as ABI ≦0.9. PA was obtained with a standard questionnaire, and metabolic equivalents (MET) were used to quantify the PA level. Logistic regression was used to assess the association between PA and incidence of PAD, and the dose-response relationship was analyzed with RCS. Results: PAD was present in 6.2% of the participants: 5.6% of males and 6.9% of females. After adjusting for potential confounders, compared with the first quartile (Q1) of MET, the odds ratios (ORs) of PAD for those with Q2, Q3, and Q4 of MET were 0.688 [95% confidence interval (CI) = 0.684-0.692], 0.463 (95% CI = 0.460-0.466), 0.816 (95% CI = 0.812-0.821), respectively (all p < 0.0001). The RCS regression showed that physical activity was related to the incidence of PAD in a non-linear manner (p for non-linearity < 0.0001). For females, the prevalence of PAD decreased as physical activity increased, reaching the minimum for activity at ~5,800 MET-min month-1 (OR = 0.425, 95% CI = 0.424-0.426), and for males, no plateau was found in this study. Conclusion: The prevalence of PAD is inversely associated with PA, and vigorous activities might help decrease PAD risk for general population. The prevalence of PAD reaches the minimum at ~5,800 MET-min month-1, representing a recommended PA value.
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Affiliation(s)
- Cheng-Jia Qu
- Vascular Surgery Center, Chinese Academy of Medical Sciences, Peking Union Medical University Fuwai Hospital, Beijing, China
| | - Le-Qun Teng
- Vascular Surgery Center, Chinese Academy of Medical Sciences, Peking Union Medical University Fuwai Hospital, Beijing, China
| | - Xin-Nong Liu
- Vascular Surgery Department, Peking Union Medical College, Beijing, China
| | - Yong-Bao Zhang
- Vascular Surgery Center, Chinese Academy of Medical Sciences, Peking Union Medical University Fuwai Hospital, Beijing, China
| | - Jie Fang
- Vascular Surgery Center, Chinese Academy of Medical Sciences, Peking Union Medical University Fuwai Hospital, Beijing, China
| | - Chen-Yang Shen
- Vascular Surgery Center, Chinese Academy of Medical Sciences, Peking Union Medical University Fuwai Hospital, Beijing, China
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Fraser MA, Walsh EI, Shaw ME, Anstey KJ, Cherbuin N. Longitudinal Effects of Physical Activity Change on Hippocampal Volumes over up to 12 Years in Middle and Older Age Community-Dwelling Individuals. Cereb Cortex 2021; 32:2705-2716. [PMID: 34671805 DOI: 10.1093/cercor/bhab375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/11/2021] [Accepted: 09/12/2021] [Indexed: 12/17/2022] Open
Abstract
The objectives of this study were to investigate the long-term associations between changes in physical activity levels and hippocampal volumes over time, while considering the influence of age, sex, and APOE-ε4 genotype. We investigated the effects of change in physical activity on hippocampal volumes in 411 middle age (mean age = 47.2 years) and 375 older age (mean age = 63.1 years) adults followed up to 12 years. An annual volume decrease was observed in the left (middle age: 0.46%; older age: 0.51%) but not in the right hippocampus. Each additional 10 metabolic equivalents (METs, ~2 h of moderate exercise) increase in weekly physical activity was associated with 0.33% larger hippocampal volume in middle age (equivalent to ~1 year of typical aging). In older age, each additional MET was associated with 0.05% larger hippocampal volume; however, the effects declined with time by 0.005% per year. For older age APOE-ε4 carriers, each additional MET was associated with a 0.10% increase in hippocampal volume. No sex effects of physical activity change were found. Increasing physical activity has long-term positive effects on hippocampal volumes and appears especially beneficial for older APOE-ε4 carriers. To optimize healthy brain aging, physical activity programs should focus on creating long-term exercise habits.
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Affiliation(s)
- Mark A Fraser
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory 2601, Australia
| | - Erin I Walsh
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory 2601, Australia.,Population Health Exchange, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory 2601, Australia
| | - Marnie E Shaw
- ANU College of Engineering & Computer Science, Australian National University, Canberra, Australian Capital Territory 2600, Australia
| | - Kaarin J Anstey
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory 2601, Australia.,Ageing Futures Institute, University of New South Wales, Sydney, New South Wales 2052, Australia.,Neuroscience Research Australia, Sydney, New South Wales 2031, Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory 2601, Australia
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Lester GR, Abiusi FS, Bodner ME, Mittermaier PM, Cote AT. The Impact of Fitness Status on Vascular and Baroreceptor Function in Healthy Women and Men. J Vasc Res 2021; 59:16-23. [PMID: 34571505 DOI: 10.1159/000518985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 08/10/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chronic endurance exercise training elicits desirable physiological adaptations in the cardiovascular system. The volume of exercise training required to generate healthy adaptations is unclear. This study assessed the effects of differing exercise training levels on arterial stiffness, compliance, and autonomic function. METHODS Eighty healthy adults (38.5 ± 9.7 years; 44% female) defined as endurance-trained (ET, n = 29), normally active (NA, n = 27), or inactive (IN, n = 24) participated. Cardiovascular markers, including hemodynamics, large arterial compliance and small arterial compliance (LAC and SAC), carotid-femoral pulse wave velocity (PWV), and spontaneous baroreceptor sensitivity (BRS) were assessed. RESULTS ET showed significantly greater LAC values (21.4 ± 6.5) than NA (16.9 ± 2.5; p = 0.002) and IN (14.7 ± 3.2 mL × mm Hg × 10; p = 0.028). Values for SAC and BRS were significantly higher in ET than IN (p < 0.001 and p = 0.028, respectively), but not NA. Compared to IN, PWV values for ET and NA were significantly lower (p < 0.003). After adjusting for covariates (age, sex, and SBP), significant associations with cardiovascular fitness status were noted for all markers but BRS. CONCLUSION Endurance exercise increases LAC likely due to high-volume training; however, lower volumes of physical activity may be sufficient to positively benefit vascular health overall.
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Affiliation(s)
- Garth R Lester
- Faculty of Natural & Applied Sciences, Trinity Western University, Langley, British Columbia, Canada
| | - Francesca S Abiusi
- Faculty of Natural & Applied Sciences, Trinity Western University, Langley, British Columbia, Canada
| | - Michael E Bodner
- School of Human Kinetics, Trinity Western University, Langley, British Columbia, Canada
| | - Peter M Mittermaier
- Faculty of Natural & Applied Sciences, Trinity Western University, Langley, British Columbia, Canada
| | - Anita T Cote
- School of Human Kinetics, Trinity Western University, Langley, British Columbia, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Perrone MA, Feola A, Pieri M, Donatucci B, Salimei C, Lombardo M, Perrone A, Parisi A. The Effects of Reduced Physical Activity on the Lipid Profile in Patients with High Cardiovascular Risk during COVID-19 Lockdown. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168858. [PMID: 34444607 PMCID: PMC8393411 DOI: 10.3390/ijerph18168858] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 12/11/2022]
Abstract
Background: The COVID-19 pandemic is a serious global health problem. In Italy, to limit the infections, the government ordered lockdown from March 2020. This measure, designed to contain the virus, led to serious limitations on the daily life of the individuals it affected, and in particular in the limitation of physical exercise. The aim of this study was to evaluate the effects of reduced physical activity on the lipid profile in patients with high cardiovascular risk. Methods: We enrolled 38 dyslipidemic patients, 56% male, with an age range of 44-62 years, considered to be at high cardiovascular risk. All patients were prescribed statin drug therapy (atorvastatin 40 mg) and a vigorous physical activity program four times a week, 1 h per session. In addition, a personalized Mediterranean diet was prescribed to all the patients. Total cholesterol, LDL, HDL and triglycerides were measured in patients at T0 before lockdown and at T1 during lockdown. Results: Data showed a significant increase (p < 0.01) in total cholesterol (+6,8%) and LDL (+15,8%). Furthermore, the analysis of the data revealed a reduction in HDL (-3%) and an increase in triglycerides (+3,2%), although both were not significant (p > 0.05). Conclusions: Our study showed that the reduction in physical activity during lockdown led to an increase in LDL levels, and therefore, in the risk of ischemic heart disease in dyslipidemic patients with high cardiovascular risk.
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Affiliation(s)
- Marco Alfonso Perrone
- Department of Systems Medicine, University of Roma Tor Vergata, 00133 Rome, Italy;
- University Sports Centre, University of Rome Tor Vergata, 00133 Rome, Italy;
- Correspondence:
| | - Alessandro Feola
- Department of Experimental Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Massimo Pieri
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Bruno Donatucci
- University Sports Centre, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Chiara Salimei
- Department of Systems Medicine, University of Roma Tor Vergata, 00133 Rome, Italy;
| | - Mauro Lombardo
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy;
| | - Andrea Perrone
- Department of Management Engineering, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Attilio Parisi
- Department of Movement, Human and Health Science, University of Rome Foro Italico, 00135 Rome, Italy;
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68
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Washburn BD, Ihm JM. Using Step Counts to Prescribe Physical Activity: What Is the Optimal Dose? Curr Sports Med Rep 2021; 20:402-409. [PMID: 34357886 DOI: 10.1249/jsr.0000000000000868] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT An activity goal of 10,000 steps per day is widely known but was not initially developed based on scientific evidence. The last several years have seen an increase in both the availability of consumer-based step counting devices and research examining the link between daily step counts and various health outcomes. Daily step counts are an intuitive metric of physical activity and are useful for goal-setting and motivating behavioral change. This article reviews the current evidence for daily step counts as related to common health conditions to determine activity goals to prescribe to patients, and also discusses factors to consider when counseling patients on physical activity.
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Degroote L, De Paepe A, De Bourdeaudhuij I, Van Dyck D, Crombez G. Effectiveness of the mHealth intervention 'MyDayPlan' to increase physical activity: an aggregated single case approach. Int J Behav Nutr Phys Act 2021; 18:92. [PMID: 34233718 PMCID: PMC8265041 DOI: 10.1186/s12966-021-01163-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 06/25/2021] [Indexed: 11/17/2022] Open
Abstract
Background e- and mHealth interventions using self-regulation techniques like action and coping planning have the potential to tackle the worldwide problem of physical inactivity. However, they often use one-week self-regulation cycles, providing support toward an active lifestyle on a weekly basis. This may be too long to anticipate on certain contextual factors that may fluctuate from day to day and may influence physical activity. Consequently, the formulated action and coping plans often lack specificity and instrumentality, which may decrease effectiveness of the intervention. The aim of this study was to evaluate effectiveness of a self-regulation, app-based intervention called ‘MyDayPlan’. “MyDayPlan’ provides an innovative daily cycle in which users are guided towards more physical activity via self-regulation techniques such as goal setting, action planning, coping planning and self-monitoring of behaviour. Methods An ABAB single-case design was conducted in 35 inactive adults between 18 and 58 years (M = 40 years). The A phases (A1 and A2) were the control phases in which the ‘MyDayPlan’ intervention was not provided. The B phases (B1 and B2) were the intervention phases in which ‘MyDayPlan’ was used on a daily basis. The length of the four phases varied within and between the participants. Each phase lasted a minimum of 5 days and the total study lasted 32 days for each participant. Participants wore a Fitbit activity tracker during waking hours to assess number of daily steps as an outcome. Single cases were aggregated and data were analysed using multilevel models to test intervention effects and possible carry-over effects. Results Results showed an average intervention effect with a significant increase in number of daily steps from the control to intervention phases for each AB combination. From A1 to B1, an increase of 1424 steps (95% CI [775.42, 2072.32], t (1082) = 4.31,p < .001), and from A2 to B2, an increase of 1181 steps (95% CI [392.98, 1968.16], t (1082) = 2.94, p = .003) were found. Furthermore, the number of daily steps decreased significantly (1134 steps) when going from the first intervention phase (B1) to the second control phase (A2) (95% CI [− 1755.60, − 512.38], t (1082) = − 3.58, p < .001). We found no evidence for a difference in trend between the two control (95% CI [− 114.59, 197.99], t (1078) = .52, p = .60) and intervention phases (95% CI [− 128.79,284.22], t (1078) = .74, p = .46). This reveals, in contrast to what was hypothesized, no evidence for a carry-over effect after removing the ‘MyDayPlan’ app after the first intervention phase (B1). Conclusion This study adds evidence that the self-regulation mHealth intervention, ‘MyDayPlan’ has the capacity to positively influence physical activity levels in an inactive adult population. Furthermore, this study provides evidence for the potential of interventions adopting a daily self-regulation cycle in general. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01163-2.
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Affiliation(s)
- L Degroote
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium. .,Research Foundation Flanders, Brussels, Belgium. .,Department of Clinical-Experimental and Health Psychology, Ghent University, Ghent, Belgium.
| | - A De Paepe
- Department of Clinical-Experimental and Health Psychology, Ghent University, Ghent, Belgium
| | - I De Bourdeaudhuij
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - D Van Dyck
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - G Crombez
- Department of Clinical-Experimental and Health Psychology, Ghent University, Ghent, Belgium
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Cardiac Biomarkers and Autoantibodies in Endurance Athletes: Potential Similarities with Arrhythmogenic Cardiomyopathy Pathogenic Mechanisms. Int J Mol Sci 2021; 22:ijms22126500. [PMID: 34204386 PMCID: PMC8235133 DOI: 10.3390/ijms22126500] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/15/2021] [Accepted: 06/15/2021] [Indexed: 12/13/2022] Open
Abstract
The “Extreme Exercise Hypothesis” states that when individuals perform training beyond the ideal exercise dose, a decline in the beneficial effects of physical activity occurs. This is due to significant changes in myocardial structure and function, such as hemodynamic alterations, cardiac chamber enlargement and hypertrophy, myocardial inflammation, oxidative stress, fibrosis, and conduction changes. In addition, an increased amount of circulating biomarkers of exercise-induced damage has been reported. Although these changes are often reversible, long-lasting cardiac damage may develop after years of intense physical exercise. Since several features of the athlete’s heart overlap with arrhythmogenic cardiomyopathy (ACM), the syndrome of “exercise-induced ACM” has been postulated. Thus, the distinction between ACM and the athlete’s heart may be challenging. Recently, an autoimmune mechanism has been discovered in ACM patients linked to their characteristic junctional impairment. Since cardiac junctions are similarly impaired by intense physical activity due to the strong myocardial stretching, we propose in the present work the novel hypothesis of an autoimmune response in endurance athletes. This investigation may deepen the knowledge about the pathological remodeling and relative activated mechanisms induced by intense endurance exercise, potentially improving the early recognition of whom is actually at risk.
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71
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Langland JT, Sathnur N, Wang Q, Olson APJ. Do assessments of cardiorespiratory and muscular fitness influence subsequent reported physical activity? A randomized controlled trial. BMC Sports Sci Med Rehabil 2021; 13:69. [PMID: 34130756 PMCID: PMC8205209 DOI: 10.1186/s13102-021-00295-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 06/02/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Regular physical activity and exercise provide many health benefits. These health benefits are mediated in large part through cardiorespiratory fitness and muscular strength. As most individuals have not had an assessment of their personal cardiorespiratory fitness or muscular strength we investigated if measurements of cardiorespiratory fitness and muscular strength would influence an individual's subsequent self-reported exercise and physical activity. METHODS Volunteer subjects at a State Fair were randomized in 1:1 parallel fashion to control and intervention groups. The baseline Exercise Vital Sign (EVS) and type of physical activity were obtained from all subjects. The intervention group received estimated maximum oxygen uptake (VO2max) using a step test and muscular strength using a hand grip dynamometer along with age-specific norms for both measurements. All subjects were provided exercise recommendations. Follow up surveys were conducted at 3, 6 and 12 months regarding their EVS and physical activity. RESULTS One thousand three hundred fifteen individuals (656 intervention, 659 control) were randomized with 1 year follow up data obtained from 823 subjects (62.5%). Baseline mean EVS was 213 min/week. No change in EVS was found in either group at follow-up (p = 0.99). Subjects who were less active at baseline (EVS < 150) did show an increase in EVS (86 to 146) at 6 months (p < 0.05). At 3 months the intervention group increased resistance training (29.1 to 42.8%) compared to controls (26.3 to 31.4%) (p < 0.05). Lifestyle physical activity increased in the intervention group at 3 months (27.7 to 29.1%) and 6 months (25%) whereas it declined in the control group at 3 months (24.4 to 20.1%) and 6 months (18.7%) (p < 0.05). CONCLUSION Providing VO2max estimates and grip strength did not produce an increase in overall physical activity. The EVS and exercise recommendations did however produce an increase in physical activity in less active individuals. In a very active population the VO2max estimate and measured grip strength did increase lifestyle activity and resistance training. Wider adoption of these measures could be effective in promoting physical activity and resistance training. TRIAL REGISTRATION clinicaltrials.gov NCT03518931 Registered 05/08/2018 -retrospectively registered.
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Affiliation(s)
- James T Langland
- Department of Medicine, Division of General Internal Medicine, University of Minnesota, 420 Delaware St SE, MMC 784, Minneapolis, MN, 55455, USA.
| | - Neeraj Sathnur
- Department of Medicine, Division of Cardiology, University of Minnesota, Minneapolis, MN, USA
| | - Qi Wang
- Clinical/Translational Science Institute, University of Minnesota, Minneapolis, MN, USA
| | - Andrew P J Olson
- Department of Medicine, Division of General Internal Medicine, University of Minnesota, 420 Delaware St SE, MMC 784, Minneapolis, MN, 55455, USA
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Bommasamudram T, Gandhi P, Iype RO, Raj B, Chandrasekaran B. Circadian influence on post-exercise hypotension: a review. COMPARATIVE EXERCISE PHYSIOLOGY 2021. [DOI: 10.3920/cep200051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Circadian rhythm (CR) can influence the physiological and psychological parameters in every individual. There is a sinusoidal response to blood pressure brought about by the CR. A drop in blood pressure response immediately after an exercise is termed as post-exercise hypotension (PEH). The objective of the present paper is to review the influence of CR on PEH. Comparing the types of exercises, aerobic training showed a higher magnitude of the drop in PEH than resistance training. However, the majority of the studies have not considered the CR influence on PEH. With the evidence available, we can conclude that morning exercise shows the higher magnitude of the drop in PEH and could be sustained for a longer duration.
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Affiliation(s)
- T. Bommasamudram
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Marena, Manipal, Udupi 576104, Karnataka, India
| | - P. Gandhi
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Marena, Manipal, Udupi 576104, Karnataka, India
| | - R. Oommen Iype
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Marena, Manipal, Udupi 576104, Karnataka, India
| | - B. Raj
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Marena, Manipal, Udupi 576104, Karnataka, India
| | - B. Chandrasekaran
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Marena, Manipal, Udupi 576104, Karnataka, India
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73
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Clemente-Suárez VJ, Ramos-Campo DJ, Mielgo-Ayuso J, Dalamitros AA, Nikolaidis PA, Hormeño-Holgado A, Tornero-Aguilera JF. Nutrition in the Actual COVID-19 Pandemic. A Narrative Review. Nutrients 2021; 13:1924. [PMID: 34205138 PMCID: PMC8228835 DOI: 10.3390/nu13061924] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 05/27/2021] [Accepted: 05/31/2021] [Indexed: 02/08/2023] Open
Abstract
The pandemic of Coronavirus Disease 2019 (COVID-19) has shocked world health authorities generating a global health crisis. The present study discusses the main finding in nutrition sciences associated with COVID-19 in the literature. We conducted a consensus critical review using primary sources, scientific articles, and secondary bibliographic indexes, databases, and web pages. The method was a narrative literature review of the available literature regarding nutrition interventions and nutrition-related factors during the COVID-19 pandemic. The main search engines used in the present research were PubMed, SciELO, and Google Scholar. We found how the COVID-19 lockdown promoted unhealthy dietary changes and increases in body weight of the population, showing obesity and low physical activity levels as increased risk factors of COVID-19 affection and physiopathology. In addition, hospitalized COVID-19 patients presented malnutrition and deficiencies in vitamin C, D, B12 selenium, iron, omega-3, and medium and long-chain fatty acids highlighting the potential health effect of vitamin C and D interventions. Further investigations are needed to show the complete role and implications of nutrition both in the prevention and in the treatment of patients with COVID-19.
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Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain;
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, 080002 Barranquilla, Colombia
- Studies Centre in Applied Combat (CESCA), 45007 Toledo, Spain;
| | | | - Juan Mielgo-Ayuso
- Department of Health Sciences, Faculty of Health Sciences, University of Burgos, 09001 Burgos, Spain;
| | - Athanasios A. Dalamitros
- Laboratory of Evaluation of Human Biological Performance, School of Physical Education and Sport Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | | | | | - Jose Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain;
- Studies Centre in Applied Combat (CESCA), 45007 Toledo, Spain;
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74
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Schneider CV, Zandvakili I, Thaiss CA, Schneider KM. Physical activity is associated with reduced risk of liver disease in the prospective UK Biobank cohort. JHEP Rep 2021; 3:100263. [PMID: 33898961 PMCID: PMC8056270 DOI: 10.1016/j.jhepr.2021.100263] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/09/2021] [Accepted: 02/23/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND & AIMS Previous studies have identified physical activity as an important lifestyle factor in the pathogenesis of chronic liver diseases (CLD). However, most studies were short in follow-up, and based on self-reported activity. Moreover, it is unknown whether physical activity affects the risk of liver disease development in the general population. Herein, we aimed to clarify the association between physical activity and CLD by examining the risk of liver disease and progression in relation to accelerometer-based physical activity in a large subset of prospectively recruited participants in the UK Biobank. METHODS We analysed data from 96,688 participants that recorded their physical activity through the use of a wrist accelerometer. Relative risks for development of liver diseases were calculated using multivariable-adjusted Cox regression models. In a subgroup of participants without any previously diagnosed liver disease (n = 95,974), a total of 374 liver disease cases were diagnosed during follow-up (mean = 5.5 years). RESULTS Participants in the top compared with the bottom quartile of physical activity had a reduced risk of both overall CLD (hazard ratio [HR]: 0.41 [0.29-0.59]) and NAFLD (HR: 0.39 [0.21-0.70]). An activity increase of an additional 2,500 steps per day, was associated with a 38% reduction in CLD and a 47% reduction in NAFLD development, independent of adiposity. In the subgroup of participants with previously diagnosed liver disease (n = 714), participants in the top compared with the bottom quartile of physical activity had a striking 89% risk reduction in liver-related death (HR: 0.11 [0.02-0.86]), and 85% risk reduction in all-cause mortality (adjusted HR: 0.15 [0.05-0.44]). Walking an additional 2,500 steps per day was associated with 44% reduction in liver disease progression. CONCLUSIONS Greater physical activity is associated with a dose-dependent reduction in liver disease, which appears to be independent of adiposity. LAY SUMMARY In this study, we aimed to clarify the association between accelerometer-measured physical activity and chronic liver disease by examining risk of overall and specific liver diseases and their progression in relation to accelerometer-based physical activity in 96,688 participants in the UK Biobank. Our results show a clear, dose-dependent protective association between accelerometer-measured physical activity and liver disease development and progression. The linkage of device-measured activity could therefore create a framework for using wearables for personalised prevention of liver diseases.
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Affiliation(s)
- Carolin V. Schneider
- The Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Inuk Zandvakili
- Division of Gastroenterology and Hepatology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Christoph A. Thaiss
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Institute for Diabetes, Obesity, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Kai Markus Schneider
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Institute for Immunology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Institute for Diabetes, Obesity, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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75
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Hammond-Haley M, Allen C, Han J, Patterson T, Marber M, Redwood S. Utility of wearable physical activity monitors in cardiovascular disease: a systematic review of 11 464 patients and recommendations for optimal use. EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2021; 2:231-243. [PMID: 36712392 PMCID: PMC9707885 DOI: 10.1093/ehjdh/ztab035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/22/2021] [Indexed: 02/01/2023]
Abstract
Aims Physical activity (PA) plays an important role in primary and secondary prevention of cardiovascular disease (CVD), functioning as a marker of disease progression and response to therapy. Real-world measurement of habitual PA is now possible through wearable activity monitors, however, their use in cardiovascular patients is not well described. Methods and results We performed a systematic review to summarize how wearable activity monitors have been used to measure PA in patients with CVD, with 11 464 patients included across 108 studies. Activity monitors were primarily used in the setting of cardiac rehabilitation (46, 43%). Most often, triaxial accelerometers (70, 65%) were instructed to be worn at the hip (58, 54%) for 7 days (n = 54, 50%). Thirty-nine different activity monitors were used, with a range of accelerometer specific settings for collection and reporting of activity data. Activity was reported most commonly as time spent in metabolic equivalent-defined activity levels (49, 45%), while non-wear time was defined in just 16 (15%) studies. Conclusion The collecting, processing, and reporting of accelerometer-related outcomes were highly heterogeneous. Most validation studies are limited to healthy young adults, while the paucity of methodological information disclosed renders interpretation of results and cross-study comparison challenging. While accelerometers are promising tools to measure real-world PA, we highlight current challenges facing their use in elderly multimorbid cardiology patients. We suggest recommendations to guide investigators using these devices in cardiovascular research. Future work is required to determine optimal methodology and consensus-based development of meaningful outcomes using raw acceleration data.
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Affiliation(s)
- Matthew Hammond-Haley
- British Heart Foundation Centre of Research Excellence, King's College London, Rayne Institute, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EP, UK
- Department of Cardiology, Guys’ and St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, UK
| | - Christopher Allen
- British Heart Foundation Centre of Research Excellence, King's College London, Rayne Institute, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EP, UK
- Department of Cardiology, Guys’ and St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, UK
| | - Jennie Han
- Royal Lancaster Infirmary, Ashton Road Lancaster, LA1 4RP, UK
| | - Tiffany Patterson
- British Heart Foundation Centre of Research Excellence, King's College London, Rayne Institute, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EP, UK
- Department of Cardiology, Guys’ and St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, UK
| | - Michael Marber
- British Heart Foundation Centre of Research Excellence, King's College London, Rayne Institute, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EP, UK
- Department of Cardiology, Guys’ and St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, UK
| | - Simon Redwood
- British Heart Foundation Centre of Research Excellence, King's College London, Rayne Institute, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EP, UK
- Department of Cardiology, Guys’ and St Thomas NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London, UK
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76
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Guía ESC 2020 sobre cardiología del deporte y el ejercicio en pacientes con enfermedad cardiovascular. Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2020.11.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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77
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Li J, Zhang Z, Si S, Xue F. Leisure-Time Physical Activity and Cardiovascular Disease Risk Among Hypertensive Patients: A Longitudinal Cohort Study. Front Cardiovasc Med 2021; 8:644573. [PMID: 34124188 PMCID: PMC8193126 DOI: 10.3389/fcvm.2021.644573] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/10/2021] [Indexed: 12/13/2022] Open
Abstract
Objective: Few studies estimated the effect of leisure-time physical activity (LTPA) on cardiovascular disease (CVD) risk among hypertensive patients in a longitudinal cohort. This study aims to evaluate the association between LTPA and CVD in a longitudinal management cohort of hypertensive patients. Methods: A total of 58,167 hypertensive patients without baseline CVD from a longitudinal cohort were included in this study. LTPA and other covariates were measured at the follow-up four times annually. The primary outcome was CVD events. The association between LTPA and CVD was assessed by the marginal structure model (MSM) and Cox model with adjustment for age, gender, body mass index (BMI), smoking, drinking, diabetes, hyperlipidemia, and antihypertensive medication. The restricted cubic spline and segmented regression were used to assess the dose-response relationship between LTPA and CVD. Results: We recorded 16,332 CVD events; crude incidence of CVD were 89.68, 80.39, 62.64, and 44.04 per 1,000 person-years for baseline 0, 1-150, 151-300, and >300 min/week LTPA, respectively. Compared with inactive LTPA, the adjusted hazard ratios (HRs) estimated by Cox model and MSM-Cox model for CVD associated with 1-150,151-300, and 300 min/week LTPA were 0.85 (95% CI, 0.83-0.88), 0.67 (95% CI, 0.64-0.71), 0.47 (95% CI, 0.44-0.51), and 0.83 (95% CI, 0.76-0.91), 0.58 (95% CI, 0.52-0.63), and 0.39 (95% CI, 0.35-0.44), respectively. Per 60 min/week increase in LTPA was associated with a 13% reduction in CVD risk. LTPA breakpoint was 417 min/week for CVD. Before and after the break-point, the slopes of the piecewise-linear relationship between LTPA and CVD risk were -0.0017 and -0.0003, respectively. Conclusion: LTPA was more strongly associated with the CVD risk than that estimated by conventional analyses based on baseline LTPA; 417 min/week is a breakpoint, after which the incremental health benefits on CVD prevention obtained from the increase in LTPA are much less than before.
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Affiliation(s)
- Jiqing Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Healthcare Big Data Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zhentang Zhang
- Qingdao Huangdao District Center for Disease Control and Prevention, Qingdao, China
| | - Shucheng Si
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Healthcare Big Data Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Fuzhong Xue
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Healthcare Big Data Research Institute, Cheeloo College of Medicine, Shandong University, Jinan, China
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78
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Pelliccia A, Sharma S, Gati S, Bäck M, Börjesson M, Caselli S, Collet JP, Corrado D, Drezner JA, Halle M, Hansen D, Heidbuchel H, Myers J, Niebauer J, Papadakis M, Piepoli MF, Prescott E, Roos-Hesselink JW, Graham Stuart A, Taylor RS, Thompson PD, Tiberi M, Vanhees L, Wilhelm M. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur Heart J 2021; 42:17-96. [PMID: 32860412 DOI: 10.1093/eurheartj/ehaa605] [Citation(s) in RCA: 766] [Impact Index Per Article: 255.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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79
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Fuller A, Okwose N, Scragg J, Eggett C, Luke P, Bandali A, Velicki R, Greaves L, MacGowan GA, Jakovljevic DG. The effect of age on mechanisms of exercise tolerance: Reduced arteriovenous oxygen difference causes lower oxygen consumption in older people. Exp Gerontol 2021; 149:111340. [PMID: 33838218 DOI: 10.1016/j.exger.2021.111340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/15/2021] [Accepted: 04/01/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To assess the effect of age on mechanisms of exercise tolerance. METHODS Prospective observational study recruited 71 healthy individuals divided into two groups according to their age i.e. younger (≤40 years of age, N = 43); and older (≥55 years of age, N = 28). All participants underwent maximal graded cardiopulmonary exercise stress testing using cycle ergometer with simultaneous non-invasive gas-exchange and central haemodynamic measurements. Using the Fick equation, arteriovenous O2 difference was calculated as the ratio between measured O2 consumption and cardiac output. RESULTS The mean age of younger and older participants was 26.0 ± 5.7 years, and 65.1 ± 6.6 years respectively. Peak O2 consumption was significantly lower in older compared to the younger age group (18.8 ± 5.2 vs 34.4 ± 9.8 mL/kg/min, p < 0.01). Peak exercise cardiac output and cardiac index were not significantly different between the younger and older age groups (22.7 ± 5.0 vs 22.1 ± 3.9 L/min, p = 0.59; and 12.4 ± 2.9 vs 11.8 ± 1.9 L/min/m2, p = 0.29). Despite demonstrating significantly lower peak heart rate by 33 beats/min (129 ± 18.3 vs 162 ± 19.9, p < 0.01), older participants demonstrated significantly higher stroke volume and stroke volume index compared to the younger age group (173 ± 41.5 vs 142 ± 34.9 mL/min, p < 0.01; and 92.1 ± 18.1 vs 78.3 ± 19.5 mL/m2, p < 0.01). Arteriovenous O2 difference was significantly lower in older compared to younger age group participants (9.01 ± 3.0 vs 15.8 ± 4.3 mlO2/100 mL blood, p < 0.01). CONCLUSION Ability of skeletal muscles to extract delivered oxygen represented by reduced arteriovenous O2 difference at peak exercise appears to be the key determinant of exercise tolerance in healthy older individuals.
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Affiliation(s)
- Amy Fuller
- Cardiovascular Research Theme, Clinical and Translational Research Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Nduka Okwose
- Cardiovascular Research Theme, Clinical and Translational Research Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Jadine Scragg
- Cardiovascular Research Theme, Clinical and Translational Research Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Christopher Eggett
- Cardiovascular Research Theme, Clinical and Translational Research Institute, Faculty of Medical Sciences, Newcastle University, UK; Department of Cardiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Peter Luke
- Cardiovascular Research Theme, Clinical and Translational Research Institute, Faculty of Medical Sciences, Newcastle University, UK; Department of Cardiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Alykhan Bandali
- Department of Cardiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Radmila Velicki
- Faculty of Medicine, University of Novi Sad, Institute of Public Health of Vojvodina, Novi Sad, Serbia
| | - Laura Greaves
- Welcome Centre for Mitochondrial Research, Newcastle University, Newcastle Upon Tyne, UK; Biosciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Guy A MacGowan
- Cardiovascular Research Theme, Clinical and Translational Research Institute, Faculty of Medical Sciences, Newcastle University, UK; Department of Cardiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Djordje G Jakovljevic
- Cardiovascular Research Theme, Clinical and Translational Research Institute, Faculty of Medical Sciences, Newcastle University, UK; Department of Cardiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; Cardiovascular and Lifestyle Medicine Research Theme (CSELS), Faculty of Health and Life Sciences, Coventry University, UK.
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80
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Kamimura D, Cain-Shields LR, Clark D, Oshunbade AA, Ashley KE, Guild CS, Loprinzi PD, Newton R, Blaha MJ, Suzuki T, Butler J, Hall JE, Correa A, Hall ME. Physical Activity, Inflammation, Coronary Artery Calcification, and Incident Coronary Heart Disease in African Americans: Insights From the Jackson Heart Study. Mayo Clin Proc 2021; 96:901-911. [PMID: 33714604 PMCID: PMC8026689 DOI: 10.1016/j.mayocp.2020.09.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/16/2020] [Accepted: 09/23/2020] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To examine associations between physical activity (PA), inflammation, coronary artery calcification (CAC), and incident coronary heart disease (CHD) in African Americans. METHODS Among Jackson Heart Study participants without prevalent CHD at baseline (n=4295), we examined the relationships between PA and high-sensitivity C-reactive protein, the presence of CAC (Agatston score ≥100), and incident CHD. Based on the American Heart Association's Life's Simple 7 metrics, participants were classified as having poor, intermediate, or ideal PA. RESULTS After adjustment for possible confounding factors, ideal PA was associated with lower high-sensitivity C-reactive protein levels (β, -0.15; 95% CI, -0.15 to -0.002) and a lower prevalence of CAC (odds ratio, 0.70; 95% CI, 0.51-0.96) compared with poor PA. During a median of 12.8 years of follow-up, there were 164 incident CHD events (3.3/1000 person-years). Ideal PA was associated with a lower rate of incident CHD compared with poor PA (hazard ratio, 0.55; 95% CI, 0.31-0.98). CONCLUSION In a large community-based African American cohort, ideal PA was associated with lower inflammation levels, a lower prevalence of CAC, and a lower rate of incident CHD. These findings suggest that promotion of ideal PA may be an important way to reduce the risk of subclinical and future clinical CHD in African Americans.
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Affiliation(s)
- Daisuke Kamimura
- Department of Medicine, University of Mississippi Medical Center, Jackson; Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
| | | | - Donald Clark
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | | | - Kellan E Ashley
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | - Cameron S Guild
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | - Paul D Loprinzi
- Center for Health Behavior Research, University of Mississippi, University
| | - Robert Newton
- PA & Ethnic Minority Health Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for Prevention of Heart Disease, Baltimore, MD
| | - Takeki Suzuki
- Department of Medicine, Indiana University School of Medicine, Indianapolis
| | - Javed Butler
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | - John E Hall
- Department of Physiology and Biophysics, Mississippi Center for Obesity Research, University of Mississippi Medical Center, Jackson
| | - Adolfo Correa
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | - Michael E Hall
- Department of Medicine, University of Mississippi Medical Center, Jackson; Department of Physiology and Biophysics, Mississippi Center for Obesity Research, University of Mississippi Medical Center, Jackson
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Azizi Z, Gisinger T, Bender U, Deischinger C, Raparelli V, Norris CM, Kublickiene K, Herrero MT, Emam KE, Kautzky-Willer A, Pilote L. Sex, Gender, and Cardiovascular Health in Canadian and Austrian Populations. Can J Cardiol 2021; 37:1240-1247. [PMID: 33785367 DOI: 10.1016/j.cjca.2021.03.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 02/09/2021] [Accepted: 03/07/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Evidence differentiating the effect of biological sex from psychosociocultural factors (gender) in different societies and its relation to cardiovascular diseases is scarce. We explored the association between sex, gender, and cardiovascular health (CVH) among Canadian (CAN) and Austrian (AT) populations. METHODS The Canadian Community Health Survey (CCHS) (n = 63,522; 55% female) and Austrian Health Interview Survey (AT-HIS) (n = 15,771; 56% female) were analyzed in a cross-sectional survey design. The CANHEART/ATHEART index, a measure of ideal CVH composed of 6 cardiometabolic risk factors (smoking, physical activity, fruit and vegetable consumption, overweight/obesity, diabetes, and hypertension; range 0-6; higher scores reflecting better CVH) was calculated for both databases. A composite measure of psychosociocultural gender was computed for each country (range 0-1, higher score identifying characteristics traditionally ascribed to women). RESULTS Median CANHEART 4 (interquartile range 3-5) and CAN gender scores 0.55 (0.49-0.60) were similar to median ATHEART 4 (3-5) and AT gender scores 0.55 (0.46-0.64). Although higher gender scores (CCHS: β = -1.33, 95% confidence interval [CI] -1.44 to -1.22; AT-HIS: β = -1.08, 95% CI -1.26 to -0.89)) were associated with worse CVH, female sex (CCHS: β = 0.35, 95% CI (0.33-0.37); AT-HIS: β = 0.60, 95% CI (0.55-0.64)) was associated with better CVH in both populations. In addition, higher gender scores were associated with increased prevalence of heart disease compared with female sex. The magnitude of this risk was higher in Austrians. CONCLUSIONS These results demonstrate that individuals with characteristics typically ascribed to women reported poorer cardiovascular health and higher risk of heart disease, independently from biological sex and baseline CV risk factors, in both countries. Female sex exhibited better CV health and a lower prevalence of heart disease than male in both populations. However, gender factors and magnitude of gender impact varied by country.
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Affiliation(s)
- Zahra Azizi
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montréal, Québec, Canada
| | - Teresa Gisinger
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Vienna, Austria
| | - Uri Bender
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montréal, Québec, Canada
| | - Carola Deischinger
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Vienna, Austria
| | - Valeria Raparelli
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Colleen M Norris
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada; Heart and Stroke Strategic Clinical Networks, Alberta Health Services, Edmonton, Alberta, Canada
| | - Karolina Kublickiene
- Section for Renal Medicine, Department of Clinical Intervention, Science, and Technology, Karolinska Institute and Karolinska University Hospital, Stockholm, Sweden
| | | | - Khaled El Emam
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Replica Analytics, Ottawa, Ontario, Canada
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Vienna, Austria
| | - Louise Pilote
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montréal, Québec, Canada; Divisions of Clinical Epidemiology and General Internal Medicine, McGill University Health Centre Research Institute, Montréal, Québec, Canada.
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82
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Moorman AJ, Dean LS, Yang E, Drezner JA. Cardiovascular Risk Assessment in the Older Athlete. Sports Health 2021; 13:622-629. [PMID: 33733939 DOI: 10.1177/19417381211004877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
CONTEXT Limited data are available to guide cardiovascular screening in adult or masters athletes (≥35 years old). This review provides recommendations and the rationale for the cardiovascular risk assessment of older athletes. EVIDENCE ACQUISITION Review of available clinical guidelines, original investigations, and additional searches across PubMed for articles relevant to cardiovascular screening, risk assessment, and prevention in adult athletes (1990-2020). STUDY DESIGN Clinical review. LEVEL OF EVIDENCE Level 3. RESULTS Atherosclerotic coronary artery disease (CAD) is the leading cause of exercise-induced acute coronary syndromes, myocardial infarction, and sudden cardiac death in older athletes. Approximately 50% of adult patients who experience acute coronary syndromes and sudden cardiac arrest do not have prodromal symptoms of myocardial ischemia. The risk of atherosclerotic cardiovascular disease (ASCVD) can be estimated by using existing risk calculators. ASCVD 10-year risk is stratified into 3 categories: low-risk (≤10%), intermediate-risk (between 10% and 20%), and high-risk (≥20%). Coronary artery calcium (CAC) scoring with noncontrast computed tomography provides a noninvasive measure of subclinical CAD. Evidence supports a significant association between elevated CAC and the risk of future cardiovascular events, independent of traditional risk factors or symptoms. Statin therapy is recommended for primary prevention if 10-year ASCVD risk is ≥10% (intermediate- or high-risk patients) or if the Agatston score is >100 or >75th percentile for age and sex. Routine stress testing in asymptomatic, low-risk patients is not recommended. CONCLUSION We propose a comprehensive risk assessment for older athletes that combines conventional and novel risk factors for ASCVD, a 12-lead resting electrocardiogram, and a CAC score. Available risk calculators provide a 10-year estimate of ASCVD risk allowing for risk stratification and targeted management strategies. CAC scoring can refine risk estimates to improve the selection of patients for initiation or avoidance of pharmacological therapy.
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Affiliation(s)
- Alec J Moorman
- Department of Medicine, Division of Cardiology, University of Washington, Seattle, Washington
| | - Larry S Dean
- Department of Medicine, Division of Cardiology, University of Washington, Seattle, Washington
| | - Eugene Yang
- Department of Medicine, Division of Cardiology, University of Washington, Seattle, Washington
| | - Jonathan A Drezner
- Department of Family Medicine, Sports Medicine Section and UW Medicine Center for Sports Cardiology, University of Washington, Seattle, Washington
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Salgado-Aranda R, Pérez-Castellano N, Núñez-Gil I, Orozco AJ, Torres-Esquivel N, Flores-Soler J, Chamaisse-Akari A, Mclnerney A, Vergara-Uzcategui C, Wang L, González-Ferrer JJ, Filgueiras-Rama D, Cañadas-Godoy V, Macaya-Miguel C, Pérez-Villacastín J. Influence of Baseline Physical Activity as a Modifying Factor on COVID-19 Mortality: A Single-Center, Retrospective Study. Infect Dis Ther 2021; 10:801-814. [PMID: 33715099 PMCID: PMC7955903 DOI: 10.1007/s40121-021-00418-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 02/16/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes a severe respiratory disease with a 3% global mortality. In the absence of effective treatment, controlling of risk factors that predispose to severe disease is essential to reduce coronavirus disease 2019 (COVID-19) mortality. Large observational studies suggest that exercise can reduce the risk of all-cause and disease-specific mortality. The aim of this study was to analyze the influence of the baseline physical activity level on COVID-19 mortality Methods This is a retrospective cohort study that included patients between 18 and 70 years old, diagnosed with COVID-19 and hospitalized in our center between February 15 and April 15, 2020. After discharge all the patients included in the study were contacted by telephone. Baseline physical activity level was estimated using the Rapid Assessment of Physical Activity Scale questionnaire and patients were divided into two groups for comparison: sedentary patients (group 1) and active patients (group 2). Results During the study period 552 patients were admitted to our hospital and met the inclusion criteria. Global mortality in group 1 was significantly higher than in group 2 (13.8% vs 1.8%; p < 0.001). Patients with a sedentary lifestyle had increased COVID-19 mortality independently of other risk factors previously described (hazard ratio 5.91 (1.80–19.41); p = 0.003). Conclusion A baseline sedentary lifestyle increases the mortality of hospitalized patients with COVID-19. This finding may be of great utility in the prevention of severe COVID-19 disease.
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Affiliation(s)
- Ricardo Salgado-Aranda
- Instituto Cardiovascular, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - Nicasio Pérez-Castellano
- Instituto Cardiovascular, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Facultad de Medicina de la Universidad Complutense de Madrid, Madrid, Spain
- Fundación para la Investigación Interhospitalaria Cardiovascular, Madrid, Spain
| | - Ivan Núñez-Gil
- Instituto Cardiovascular, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - A Josué Orozco
- Instituto Cardiovascular, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Norberto Torres-Esquivel
- Instituto Cardiovascular, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Jesús Flores-Soler
- Instituto Cardiovascular, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Ahmed Chamaisse-Akari
- Instituto Cardiovascular, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Angela Mclnerney
- Instituto Cardiovascular, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Carlos Vergara-Uzcategui
- Instituto Cardiovascular, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Lin Wang
- Instituto Cardiovascular, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Juan J González-Ferrer
- Instituto Cardiovascular, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - David Filgueiras-Rama
- Instituto Cardiovascular, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Victoria Cañadas-Godoy
- Instituto Cardiovascular, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Carlos Macaya-Miguel
- Instituto Cardiovascular, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Facultad de Medicina de la Universidad Complutense de Madrid, Madrid, Spain
- Fundación para la Investigación Interhospitalaria Cardiovascular, Madrid, Spain
| | - Julián Pérez-Villacastín
- Instituto Cardiovascular, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Facultad de Medicina de la Universidad Complutense de Madrid, Madrid, Spain
- Fundación para la Investigación Interhospitalaria Cardiovascular, Madrid, Spain
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84
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Marin-Couture E, Pérusse L, Tremblay A. The fit-active profile to better reflect the benefits of a lifelong vigorous physical activity participation: mini-review of literature and population data. Appl Physiol Nutr Metab 2021; 46:763-770. [PMID: 33667123 DOI: 10.1139/apnm-2020-1109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Physical activity is favourably considered for its effect on metabolic fitness and body composition. This observation is generally supported by observational studies and is concordant with endurance-trained individuals' metabolic and morphological profiles. However, in some contexts, the measurement of physical activity habits may not provide an adequate representation of its benefits. In this paper, we review relevant literature on the respective effects of fitness and physical activity on anthropometric and metabolic variables and the informative potential of a classification based on aerobic fitness and activity indicators. The relevance to defining a profile based on both fitness and activity is reinforced by data from the Quebec Family Study showing that, in both men and women, "fit-active" individuals displayed a much more favourable morphological and metabolic profile than "unfit-inactive" individuals. Moreover, these benefits seemed to be more related to variations in fitness than in physical activity. In summary, evidence suggests that a profile combining information on aerobic fitness and physical activity may better reflect the lifelong impact of physical activity on body composition and health. Novelty: The fit-active profile better reflects the long-term benefits of vigorous physical activity participation on health. The reported benefits seem to be more related to variations in aerobic fitness than to those in physical activity.
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Affiliation(s)
- Elisa Marin-Couture
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec City, QC, Canada.,Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Food (INAF), Quebec City, QC, Canada
| | - Louis Pérusse
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec City, QC, Canada.,Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Food (INAF), Quebec City, QC, Canada
| | - Angelo Tremblay
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec City, QC, Canada.,Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Food (INAF), Quebec City, QC, Canada.,Institut universitaire de cardiologie et de pneumologie de Québec, Quebec City, QC, Canada
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85
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Connelly PJ, Azizi Z, Alipour P, Delles C, Pilote L, Raparelli V. The Importance of Gender to Understand Sex Differences in Cardiovascular Disease. Can J Cardiol 2021; 37:699-710. [PMID: 33592281 DOI: 10.1016/j.cjca.2021.02.005] [Citation(s) in RCA: 80] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 01/11/2023] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide. There is robust evidence of heterogeneity in underlying mechanism, manifestation, prognosis, and response to treatment of CVD between male and female patients. Gender, which refers to the socially constructed roles, behaviours, expressions, and identities of individuals, is an important determinant of CV health, and its consideration might help in attaining a broader understanding of the observed sex differences in CVD. Established risk factors such as hypertension, dyslipidemia, diabetes mellitus, obesity, and smoking are well known to contribute to CVD. However, despite the differences in CVD risk between male and female, most studies looking into the magnitude of effect of each risk factor have traditionally focused on male subjects. While biological sex influences disease pathophysiology, the psycho-socio-cultural construct of gender can further interact with this effect. Behavioural, psychosocial, personal, cultural, and societal factors can create, repress, or strengthen underlying biological CV health differences. Although mechanisms of action are largely unclear, it is suggested that gender-related factors can further exacerbate the detrimental effect of established risk factors of CVD. In this narrative review, we explore the current literature investigating the role of gender in CV risk and its impact on established risk factors as a fundamental step toward precision medicine.
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Affiliation(s)
- Paul J Connelly
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Zahra Azizi
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montréal, Québec, Canada
| | - Pouria Alipour
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montréal, Québec, Canada
| | - Christian Delles
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, United Kingdom.
| | - Louise Pilote
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montréal, Québec, Canada; Divisions of Clinical Epidemiology and General Internal Medicine, McGill University Health Centre Research Institute, Montréal, Québec, Canada.
| | - Valeria Raparelli
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; University of Alberta, Faculty of Nursing, Edmonton, Alberta, Canada
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86
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De Maria B, de Oliveira Gois M, Catai AM, Marra C, Lucini D, Porta A, Pagani M, Dalla Vecchia LA. Ten-year follow-up of cardiac function and neural regulation in a group of amateur half-marathon runners. Open Heart 2021; 8:e001561. [PMID: 33563778 PMCID: PMC7875294 DOI: 10.1136/openhrt-2020-001561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE In the last years, a debate exists about type, intensity and frequency of physical exercise that is really indicated to protect healthy subjects from cardiovascular disease. Regular physical training has been associated with an improved cardiovascular risk profile, but it has also been demonstrated that strenuous and uncontrolled physical exercise could be dangerous, in terms of increased cardiovascular morbidity and mortality. In the present study, we evaluated a group of 35 amateur half-marathon runners, who were likewise studied 10 years before (B). The results of B suggested that an increased cardiac sympathetic modulation could potentially represent a negative prognostic factor. The aim of this follow-up was to assess the medium-long-term effects of moderate to vigorous physical training on the cardiovascular neural control, cardiac function and occurrence of cardiovascular diseases. METHODS Each enrolled subject underwent: (1) an interview and physical examination to ascertain the presence of cardiovascular disease; (2) standing test to evaluate the cardiovascular neural control by means of heart rate variability (HRV), arterial blood pressure (AP) variability and baroreflex sensitivity (BRS); (3) transthoracic echocardiography to evaluate cardiac function. RESULTS At 10-year follow-up (FU), in this group of middle-aged athletes the occurrence of cardiovascular diseases was low, not unlike that of the overall population. The results of HRV analysis showed a decreased sympathetic and increased vagal modulation directed to the heart, compared with B. In addition, HRV, AP variability and BRS indices showed a physiological response to active standing. Finally, athletes had normal echocardiographic measures. CONCLUSION We conclude that in our group of athletes a regular moderate-vigorous physical training through the 10 years was quite beneficial as the prevalence of sympathetic cardiac modulation observed at B was not accompanied by increased cardiovascular risk, on the contrary a slight prevalence of vagal indices was observed at FU.
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Affiliation(s)
- Beatrice De Maria
- Department of Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, Milano, Italy
| | | | - Aparecida Maria Catai
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil
| | - Christian Marra
- Department of Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, Milano, Italy
| | - Daniela Lucini
- Dipartimento di Biotecnologie Mediche e Medicina Traslazionale, University of Milan, Milano, Italy
- Exercise Medicine Unit, Humanitas Clinical and Research Center IRCCS, Rozzano, Italy
| | - Alberto Porta
- Department of Biomedical Sciences for Health, University of Milan, Milano, Italy
- Department of Cardiothoracic, Vascular Anesthesia and Intensive Care, Policlinico San Donato, San Donato Milanese, Italy
| | - Massimo Pagani
- Dipartimento di Biotecnologie Mediche e Medicina Traslazionale, University of Milan, Milano, Italy
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87
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Żebrowska A, Hall B, Stolecka-Warzecha A, Stanula A, Sadowska-Krępa E. The Effect of Omega-3 Fatty Acid Supplementation on Serum Adipocytokines, Lipid Profile and Biochemical Markers of Inflammation in Recreational Runners. Nutrients 2021; 13:456. [PMID: 33573042 PMCID: PMC7912656 DOI: 10.3390/nu13020456] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/27/2021] [Accepted: 01/27/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND The study aimed to evaluate the effects of a 3-week ω-3 PUFA supplementation on serum adipocytokines (i.e., adiponectin, leptin), neuregulin-4 (NRG4) and erythrocyte omega-3 (ω-3) fatty acid content, as well as the blood antioxidant defense capacity in non-elite endurance runners. METHODS Twenty-four runners were randomized into two groups: the supplemented group, who received omega free fatty acids extract containing 142 mg of EPA, 267 mg of DHA, 12 mg of vitamin E and 5 µg of vitamin D, each administrated at a dose of six capsules twice a day for three weeks, or the placebo group. Venous blood samples were withdrawn at the start and at the end of the study protocols to estimate serum biochemical variables. RESULTS A significantly higher ω-3 index and lower AA/EPA ratio was observed after ω-3 PUFA compared to pre-supplementation levels (p < 0.001 and p < 0.001, respectively). An increase in baseline adiponectin and NRG4 levels, as well as a decrease of leptin concentration and lipid profile improvement, were observed in subjects after a ω-3 PUFA diet. The increased ω-3 index had a significant effect on TNFα levels and a serum marker of antioxidant defense. CONCLUSIONS The ω-3 PUFA extract with added vitamin E and D supplementation may have a positive effect on the function of the adipocyte tissue, as well as the ability to prevent cardiovascular complications in athletes.
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Affiliation(s)
- Aleksandra Żebrowska
- Institute of Sport Sciences, Academy of Physical Education in Katowice, Mikołowska Street 72a, 40-065 Katowice, Poland; (A.S.); (E.S.-K.)
| | - Barbara Hall
- School of Biological Sciences, The University of Manchester, Manchester M13 9PL, UK;
| | - Anna Stolecka-Warzecha
- Department of Basic Biomedical Sciences, Silesia Medical University, 40-055 Katowice, Poland;
| | - Arkadiusz Stanula
- Institute of Sport Sciences, Academy of Physical Education in Katowice, Mikołowska Street 72a, 40-065 Katowice, Poland; (A.S.); (E.S.-K.)
| | - Ewa Sadowska-Krępa
- Institute of Sport Sciences, Academy of Physical Education in Katowice, Mikołowska Street 72a, 40-065 Katowice, Poland; (A.S.); (E.S.-K.)
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88
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Higher cardiorespiratory fitness is strongly associated with lower cardiovascular risk factors in firefighters: a cross-sectional study in a German fire brigade. Sci Rep 2021; 11:2445. [PMID: 33510237 PMCID: PMC7843993 DOI: 10.1038/s41598-021-81921-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 01/12/2021] [Indexed: 01/01/2023] Open
Abstract
Previous studies have shown significant cardiovascular risks in firefighters and that they suffer from cardiovascular events, especially on duty. Otherwise, adequate cardiorespiratory fitness is considered to have a protective effect in reducing cardiovascular complications. Therefore, the study aimed to evaluate the association between cardiorespiratory fitness and cardiovascular risks factors in firefighters. We enrolled ninety-seven male German firefighters in this cross-sectional study of cardiorespiratory fitness and cardiovascular risk factors. We used spiroergometry testing to estimate oxygen consumption to determine cardiorespiratory fitness and to calculate metabolic equivalents. We evaluated cardiovascular risk factors included nicotine consumption, lipid profiles, body composition, resting blood pressure, and heart rate. We evaluated cardiovascular risk factors included nicotine consumption, lipid profiles, body composition, resting blood pressure and heart rate. The comparison of association between cardiorespiratory fitness and cardiovascular risk factors was performed by using χ2-test, analysis of variance, general linear regression with/without adjustment for age and body mass index (BMI). This study demonstrated a strong association between lower cardiovascular risk factors and higher cardiorespiratory fitness. There were significantly lower values for BMI, waist circumference, body fat percentage and resting systolic blood pressure, triglycerides, and total cholesterol (all p < 0.0443, age-adjusted) with increased cardiorespiratory fitness. Only 19.6% (n = 19) of the examined firefighters were classified as “fit and not obese”, 48.4% (n = 47) were “low fit and not obese” and 30.9% (n = 30) were “low fit and obese”. The results clarify that increasing cardiorespiratory fitness is a fundamental point for the reduction and prevention of cardiovascular complications in firefighters. It could be demonstrated, especially for central risk factors, particularly BMI, waist circumference, sytolic resting blood pressure and triglyceride values. Therefore, firefighters should be motivated to increase their cardiorespiratory fitness for the beneficial effect of decreasing cardiovascular risk profile.
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89
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Xue K, Liu Y, Iversen KN, Mazidi M, Qu Z, Dong C, Jin T, Hallmans G, Åman P, Johansson A, He G, Landberg R. Impact of a Fermented High-Fiber Rye Diet on Helicobacter pylori and Cardio-Metabolic Risk Factors: A Randomized Controlled Trial Among Helicobacter pylori-Positive Chinese Adults. Front Nutr 2021; 7:608623. [PMID: 33521037 PMCID: PMC7844128 DOI: 10.3389/fnut.2020.608623] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/17/2020] [Indexed: 12/12/2022] Open
Abstract
Background: High dietary fiber intake has been associated with reduced risk of Helicobacter pylori infection and co-morbidities such as gastric cancer but also with reduced risk of cardiovascular disease. It has been suggested that fermented rye could affect Helicobacter pylori bacterial load and that high- fiber rye may be superior to wheat for improvement of several cardiometabolic risk factors, but few long-term interventions with high fiber rye foods have been conducted. Objective: To examine the effect of high-fiber wholegrain rye foods with added fermented rye bran vs. refined wheat on Helicobacter pylori infection and cardiometabolic risk markers in a Chinese population with a low habitual consumption of high fiber cereal foods. Design: A parallel dietary intervention was set up and 182 normal- or overweight men and women were randomized to consume wholegrain rye products containing fermented rye bran (FRB) or refined wheat (RW) for 12 weeks. Anthropometric measurements, fasting blood sample collection and 13C-urea breath test (13C-UBT) were performed at baseline and after 6 and 12 weeks of intervention as well as 12 weeks after the end of the intervention. Results: No difference between diets on Helicobacter pylori bacterial load measured by 13C-UBT breath test or in virulence factors of Helicobacter pylori in blood samples were found. Low density lipoprotein cholesterol (LDL-C) and high sensitivity C-reactive protein (hs-CRP) were significantly lower in the FRB group, compared to the RW group after 12 weeks of intervention. The intervention diets did not affect markers of glucose metabolism or insulin sensitivity. Conclusions: While the results of the present study did not support any effect of FRB on Helicobacter pylori bacterial load, beneficial effects on LDL-C and hs-CRP were clearly shown. This suggest that consumption of high fiber rye foods instead of refined wheat could be one strategy for primary prevention of cardiovascular disease. Clinical Trial Registration: The trial was registered at www.clinicaltrials.gov, Identifier: NCT03103386.
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Affiliation(s)
- Kun Xue
- Key Laboratory of Public Health Safety, Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai, China
| | - Yuwei Liu
- Key Laboratory of Public Health Safety, Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai, China
| | - Kia Nøhr Iversen
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Mohsen Mazidi
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Zheng Qu
- Department of Gastroenterology, Shanghai Zhongye Hospital, Shanghai, China
| | - Chenglin Dong
- Department of Clinical Laboratory, Shanghai Zhongye Hospital, Shanghai, China
| | - Tayi Jin
- Key Laboratory of Public Health Safety, Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai, China
| | - Göran Hallmans
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Per Åman
- Department of Molecular Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Anders Johansson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.,Department of Odontology, Section of Cariology, Umeå University, Umeå, Sweden
| | - Gengsheng He
- Key Laboratory of Public Health Safety, Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai, China
| | - Rikard Landberg
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
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90
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Rubio VJ, Sánchez-Iglesias I, Bueno M, Martin G. Athletes' Psychological Adaptation to Confinement Due to COVID-19: A Longitudinal Study. Front Psychol 2021; 11:613495. [PMID: 33584448 PMCID: PMC7873871 DOI: 10.3389/fpsyg.2020.613495] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/07/2020] [Indexed: 12/12/2022] Open
Abstract
Studies of individuals under conditions of confinement or severe social and physical restrictions have consistently shown deleterious mental health effects but also high levels of adaptability when dealing with such conditions. Considering the role of physical activity and sport in psychological adaptation, this paper describes a longitudinal study to explore to what extent the imposed restrictions due to the outbreak of SARS-CoV-2 may have affected athletes' mental health outcomes and how far the process of adaptation to confinement conditions is differentially affected depending on whether the sports activity was practiced individually or in a group, and outdoors, indoors, or both. Two hundred and seventy-four athletes were assessed over 7 weeks using the GHQ-28 and an ad hoc survey exploring the practice of physical activity. A mixed-model fixed effects ANCOVA was used to analyze the effects of time, place, and company in which the sport was practiced, with an index of the amount of physical activity expended as a covariate. Results show a significant effect of time in three out of four of the GHQ-28 subscales, in all cases showing a consistent adaptation to conditions over time. Results also show that playing sport indoors, outdoors, or both, and practicing alone vs. with others differentially affect the somatic symptoms exhibited during confinement: Athletes who practiced sport with others showed higher levels of somatic symptoms at the beginning of the set of data but a quicker rate of adaptation. Differences arising from practicing sport alone or with others were more pronounced in the case of indoor sports, which could be related to the fact that physical activity that can be practiced during confinement is more similar to that practiced indoors alone. Implications relating to what sport psychologists and other health professionals may offer to athletes in stressful situations are discussed.
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Affiliation(s)
- Víctor J. Rubio
- Department of Biological and Health Psychology, Universidad Autónoma de Madrid, Madrid, Spain
| | - Iván Sánchez-Iglesias
- Department of Psychobiology and Behavioral Sciences Methods, Universidad Complutense de Madrid, Madrid, Spain
| | - Marta Bueno
- Sport and Exercise Psychology, Universidad Autónoma de Madrid, Madrid, Spain
| | - Gema Martin
- Sport Psychology Unit, Center for Applied Psychology, Universidad Autónoma de Madrid, Madrid, Spain
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91
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Polenick CA, Birditt KS, Turkelson A, Kales HC. Chronic condition discordance and physical activity among midlife and older couples. Health Psychol 2021; 40:11-20. [PMID: 33370150 PMCID: PMC8097977 DOI: 10.1037/hea0001040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Chronic conditions in middle and later life are associated with lower physical activity. Yet little is known about chronic condition discordance (i.e., the extent to which conditions have nonoverlapping self-management requirements) within older individuals and couples and its implications for physical activity. We determined how the degrees of chronic condition discordance at the individual level and the couple level (i.e., between spouses) were linked to moderate physical activity across an 8-year period. METHOD The U.S. sample included 1,621 couples from five waves of the Health and Retirement Study (2006-2014). Dyadic growth curve models estimated how individual-level and couple-level chronic condition discordance were linked to initial levels of and rates of change in moderate activity. Models controlled for age, minority status, education, and own and partner reports of baseline negative marital quality, time-varying depressive symptoms, and time-varying number of chronic conditions. RESULTS A considerable proportion of wives (25.4%) and husbands (18.9%) reported moderate activity less than once a week. When individuals (wives: β = -0.10; husbands: β = -0.09) or their spouses (wives: β = -0.04; husbands: β = -0.05) had greater individual-level chronic condition discordance, lower initial moderate activity was reported. When husbands had greater individual-level discordance, both wives (β = -0.16) and husbands (β = -0.19) had a faster rate of decline in moderate activity over time. Couple-level chronic condition discordance was not significantly linked to moderate activity. CONCLUSIONS These findings suggest the importance of promoting physical activity among individuals and couples managing complex chronic conditions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Courtney A. Polenick
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI 48109
- Institute for Social Research, University of Michigan, Ann Arbor, MI 48104
| | - Kira S. Birditt
- Institute for Social Research, University of Michigan, Ann Arbor, MI 48104
| | - Angela Turkelson
- Institute for Social Research, University of Michigan, Ann Arbor, MI 48104
| | - Helen C. Kales
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109
- Department of Psychiatry and Behavioral Sciences, UC Davis Health, Sacramento, CA 95817
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92
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Ramakrishnan R, Doherty A, Smith-Byrne K, Rahimi K, Bennett D, Woodward M, Walmsley R, Dwyer T. Accelerometer measured physical activity and the incidence of cardiovascular disease: Evidence from the UK Biobank cohort study. PLoS Med 2021; 18:e1003487. [PMID: 33434193 PMCID: PMC7802951 DOI: 10.1371/journal.pmed.1003487] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 11/26/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Higher levels of physical activity (PA) are associated with a lower risk of cardiovascular disease (CVD). However, uncertainty exists on whether the inverse relationship between PA and incidence of CVD is greater at the highest levels of PA. Past studies have mostly relied on self-reported evidence from questionnaire-based PA, which is crude and cannot capture all PA undertaken. We investigated the association between accelerometer-measured moderate, vigorous, and total PA and incident CVD. METHODS AND FINDINGS We obtained accelerometer-measured moderate-intensity and vigorous-intensity physical activities and total volume of PA, over a 7-day period in 2013-2015, for 90,211 participants without prior or concurrent CVD in the UK Biobank cohort. Participants in the lowest category of total PA smoked more, had higher body mass index and C-reactive protein, and were diagnosed with hypertension. PA was associated with 3,617 incident CVD cases during 440,004 person-years of follow-up (median (interquartile range [IQR]): 5.2 (1.2) years) using Cox regression models. We found a linear dose-response relationship for PA, whether measured as moderate-intensity, vigorous-intensity, or as total volume, with risk of incident of CVD. Hazard ratios (HRs) and 95% confidence intervals for increasing quarters of the PA distribution relative to the lowest fourth were for moderate-intensity PA: 0.71 (0.65, 0.77), 0.59 (0.54, 0.65), and 0.46 (0.41, 0.51); for vigorous-intensity PA: 0.70 (0.64, 0.77), 0.54 (0.49,0.59), and 0.41 (0.37,0.46); and for total volume of PA: 0.73 (0.67, 0.79), 0.63 (0.57, 0.69), and 0.47 (0.43, 0.52). We took account of potential confounders but unmeasured confounding remains a possibility, and while removal of early deaths did not affect the estimated HRs, we cannot completely dismiss the likelihood that reverse causality has contributed to the findings. Another possible limitation of this work is the quantification of PA intensity-levels based on methods validated in relatively small studies. CONCLUSIONS In this study, we found no evidence of a threshold for the inverse association between objectively measured moderate, vigorous, and total PA with CVD. Our findings suggest that PA is not only associated with lower risk for of CVD, but the greatest benefit is seen for those who are active at the highest level.
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Affiliation(s)
- Rema Ramakrishnan
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
- University of New South Wales, Sydney, Australia
| | - Aiden Doherty
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- National Institute of Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
| | - Karl Smith-Byrne
- International Agency for Research on Cancer, Genetic Epidemiology Group, Lyon, France
| | - Kazem Rahimi
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
- National Institute of Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
- Deep Medicine, Oxford Martin School, University of Oxford, United Kingdom
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Derrick Bennett
- National Institute of Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, United Kingdom
- Clinical Trials Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Mark Woodward
- The George Institute for Global Health, Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- Department of Epidemiology, Johns Hopkins University, Baltimore, United States of America
| | - Rosemary Walmsley
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Terence Dwyer
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, United Kingdom
- Murdoch Children’s Research Institute, Melbourne, Australia
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93
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Wijarnpreecha K, Aby ES, Ahmed A, Kim D. Evaluation and management of extrahepatic manifestations of nonalcoholic fatty liver disease. Clin Mol Hepatol 2020; 27:221-235. [PMID: 33317243 PMCID: PMC8046623 DOI: 10.3350/cmh.2020.0239] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 09/23/2020] [Indexed: 12/12/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a multisystemic disease and a rapidly growing cause of chronic liver disease in children and adults worldwide. Diagnosis and management of extrahepatic manifestations of NAFLD, including cardiovascular disease (CVD), type 2 diabetes mellitus, metabolic syndrome, chronic kidney disease, obstructive sleep apnea, polycystic ovarian syndrome, hypothyroidism, psoriasis, and extrahepatic malignancy are crucial for the treatment of patients with NAFLD. The leading cause of death in NAFLD is primarily from CVD, followed by liver-related mortality, extrahepatic cancer, liver cancer, and diabetes-related mortality. Therefore, clinicians need to identify high-risk patients earlier in the disease course and be aware of the extrahepatic manifestations of NAFLD to improve liver disease outcomes. In this review, we focus on the monitoring and management of the extrahepatic manifestations of NAFLD.
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Affiliation(s)
- Karn Wijarnpreecha
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Jacksonville, FL, USA
| | - Elizabeth S Aby
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Aijaz Ahmed
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA
| | - Donghee Kim
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA
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94
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Cortesi PA, Maloberti A, Micale M, Pagliarin F, Antonazzo IC, Mazzaglia G, Giannattasio C, Mantovani LG. Costs and effects of cardiovascular risk reclassification using the ankle-brachial index (ABI) in addition to the Framingham risk scoring in women. Atherosclerosis 2020; 317:59-66. [PMID: 33213858 DOI: 10.1016/j.atherosclerosis.2020.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 10/01/2020] [Accepted: 11/05/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS Ankle brachial index (ABI) is a simple and cheap parameter to assess the presence of atherosclerosis. It could also help correctly reclassify the cardiovascular risk when added to the Framingham risk score (FRS). Recent evidence has demonstrated improvement in prediction performance of ABI when added to FRS, particularly in women. However, no studies have been published yet evaluating the cost-effectiveness of this approach. This study attempts to fill in this gap by assessing the cost-effectiveness of ABI measurements in primary prevention in women. METHODS We developed a Markov model to compare two different strategies for assessing the cardiovascular risk (low, intermediate and high) among women in the general population: 1) FRS strategy, and 2) FRS + ABI strategy; and the relative impact associated with interventions for preventing CV events in intermediate and high-risk categories. RESULTS In the base-case analysis, FRS + ABI reported an additional cost of € 110 and a gain of 0.0039 QALYs per patient, resulting in an ICER of € 27.986/QALY, when compared to FRS alone. The ICER improved to €1.641/QALY when using a lifetime horizon. The effectiveness of preventive CV disease interventions reported also a significant impact. A 32% reduction of CV events was the minimum value estimated to maintain FRS + ABI as a cost-effective strategy. CONCLUSIONS The addition of ABI to FRS is a cost-effective approach in women classified at low and intermediate risk with FRS only. This new approach gives the possibility to reclassify and allocate them into the appropriate risk group and treatment.
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Affiliation(s)
- Paolo Angelo Cortesi
- Research Centre on Public Health (CESP), University of Milan-Bicocca, Monza, Italy
| | - Alessandro Maloberti
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy; Cardiology 4, "A. De Gasperis" Department, Niguarda Ca Granda Hospital, Milan, Italy.
| | - Mariangela Micale
- Research Centre on Public Health (CESP), University of Milan-Bicocca, Monza, Italy
| | - Federica Pagliarin
- Research Centre on Public Health (CESP), University of Milan-Bicocca, Monza, Italy
| | | | - Giampiero Mazzaglia
- Research Centre on Public Health (CESP), University of Milan-Bicocca, Monza, Italy
| | - Cristina Giannattasio
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy; Cardiology 4, "A. De Gasperis" Department, Niguarda Ca Granda Hospital, Milan, Italy
| | - Lorenzo Giovanni Mantovani
- Research Centre on Public Health (CESP), University of Milan-Bicocca, Monza, Italy; IRCCS Multimedica, Sesto San Giovanni, Italy
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95
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Cardiovascular disease risk factors among older people: Data from the National Health and Morbidity Survey 2015. PLoS One 2020; 15:e0240826. [PMID: 33085718 PMCID: PMC7577487 DOI: 10.1371/journal.pone.0240826] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/02/2020] [Indexed: 12/27/2022] Open
Abstract
Study on cardiovascular disease (CVD) risk factors and their prevalence among the older people in Malaysia is limited. We aimed to determine the prevalence and factors associated with CVD risk factors using the non-laboratory Framingham Generalized 10-Year CVD risk score among older people in Malaysia. This was a population-based cross-sectional study using data of 3,375 participants aged ≥60 years from the National Health and Morbidity Survey 2015. Sociodemographic, health factors and clinical assessments (anthropometry and blood pressure) were included. Complex survey analysis was used to obtain prevalence with 95% confidence intervals (CI). We applied ordinal regression to determine the factors associated with CVD risk. The prevalence for the high 10-year CVD risk was 72.1%. Body mass index was higher among those aged 60–69 years in men (25.4kg/m2, 95%CI 25.1–25.8) and women (26.7kg/m2, 95%CI 26.3–27.1) than the other age groups. The factors associated with moderate and high 10-year CVD risk were Malay ethnicity (Odds Ratio(OR) 0.76, 95%CI 0.63–0.92, p = 0.004), unmarried status (OR 1.55, 95%CI 1.22–1.97, p<0.001) and physically inactive (OR 0.72, 95%CI 0.55–0.95, p = 0.020). There is a need for future study to evaluate preventive strategies to improve the health of older people in order to promote healthy ageing.
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96
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Linking adolescent future expectations to health in adulthood: Evidence and mechanisms. Soc Sci Med 2020; 263:113282. [DOI: 10.1016/j.socscimed.2020.113282] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/14/2020] [Accepted: 08/02/2020] [Indexed: 01/15/2023]
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97
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Gilbertson NM, Eichner NZM, Khurshid M, Rexrode EA, Kranz S, Weltman A, Hallowell PT, Malin SK. Impact of Pre-operative Aerobic Exercise on Cardiometabolic Health and Quality of Life in Patients Undergoing Bariatric Surgery. Front Physiol 2020; 11:1018. [PMID: 32982777 PMCID: PMC7479188 DOI: 10.3389/fphys.2020.01018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 07/24/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Examine the effect of aerobic exercise (EX) combined with standard medical care (SC) (EX + SC) compared to SC alone on cardiometabolic health and quality of life in relation to surgical outcomes. METHODS Patients receiving bariatric surgery were match-paired to 30 days of pre-operative SC (n = 7, 1 male, 39.0 ± 5.3 years, body mass index 46.4 ± 3.0 kg/m2; low calorie diet) or EX + SC (n = 7, 0 males, 45.6 ± 4.8 years, body mass index 43.9 ± 4.2 kg/m2; walking 30 min/day, 5 days/week, 65-85% HR peak ). Body mass, waist circumference, cardiorespiratory fitness (VO2peak), high sensitivity C-reactive protein (hs-CRP), cytokeratin 18 (CK18), weight related quality of life (QoL), and a 120 min mixed meal tolerance test (MMTT) was performed to assess arterial stiffness via augmentation index normalized to a heart rate of 75 beats per minute (AIx@75), whole-body insulin sensitivity, and glucose total area under the curve (tAUC) pre- and post-intervention (∼2 days prior to surgery). Length of hospital stay (admission to discharge) was recorded. RESULTS EX + SC had a greater effect for decreased intake of total calories (P = 0.14; ES = 0.86) compared to SC, but no change in body weight or waist circumference was observed in either group. EX + SC had a greater effect for increased VO2peak (P = 0.24; ES = 0.91) and decreased hs-CRP (P = 0.31; ES = 0.69) compared to SC. EX + SC reduced circulating CK18 (P = 0.05; ES = 3.05) and improved QoL (P = 0.02) compared to SC. Although EX + SC had no statistical effect on arterial stiffness compared to SC, we observed a modest effect size for AIx@75 tAUC (P = 0.36; ES = 0.52). EX + SC had a significantly shorter length of hospital stay (P = 0.05; ES = 1.38) than SC, and a shorter length of hospital stay was associated with decreased sugar intake (r = 0.55, P = 0.04). Decreased AIx@75 tAUC significantly correlated with improved whole-body insulin sensitivity (r = -0.59, P = 0.03) and glucose tAUC (r = 0.57, P = 0.04). CONCLUSION EX with SC for 30 days prior to bariatric surgery may be important for cardiometabolic health, quality of life, and surgical outcomes in the bariatric patient.
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Affiliation(s)
- Nicole M. Gilbertson
- Department of Kinesiology, University of Virginia, Charlottesville, VA, United States
| | - Natalie Z. M. Eichner
- Department of Kinesiology, University of Virginia, Charlottesville, VA, United States
| | - Mahnoor Khurshid
- Department of Kinesiology, University of Virginia, Charlottesville, VA, United States
| | - Elizabeth A. Rexrode
- Department of Surgery, University of Virginia, Charlottesville, VA, United States
| | - Sibylle Kranz
- Department of Kinesiology, University of Virginia, Charlottesville, VA, United States
| | - Arthur Weltman
- Department of Kinesiology, University of Virginia, Charlottesville, VA, United States
- Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Peter T. Hallowell
- Department of Surgery, University of Virginia, Charlottesville, VA, United States
| | - Steven K. Malin
- Department of Kinesiology, University of Virginia, Charlottesville, VA, United States
- Department of Medicine, University of Virginia, Charlottesville, VA, United States
- Robert M. Berne Cardiovascular Research Center, University of Virginia, Charlottesville, VA, United States
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98
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Basu J, Malhotra A, Papadakis M. Exercise and hypertrophic cardiomyopathy: Two incompatible entities? Clin Cardiol 2020; 43:889-896. [PMID: 32048747 PMCID: PMC7403677 DOI: 10.1002/clc.23343] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/27/2020] [Accepted: 01/27/2020] [Indexed: 01/02/2023] Open
Abstract
A greater understanding of the pathogenic mechanisms underpinning hypertrophic cardiomyopathy (HCM) has translated to improved medical care and better survival of affected individuals. Historically these patients were considered to be at high risk of sudden cardiac death (SCD) during exercise; therefore, exercise recommendations were highly conservative and promoted a sedentary life style. There is emerging evidence that suggests that exercise in HCM has a favorable effect on cardiovascular remodeling and moderate exercise programs have not raised any safety concerns. Furthermore, individuals with HCM have a similar burden of atherosclerotic risk factors as the general population in whom exercise has been associated with a reduction in myocardial infarction, stroke, and heart failure, especially among those with a high-risk burden. Small studies revealed that athletes who choose to continue with regular competition do not demonstrate adverse outcomes when compared to those who discontinue sport, and active individuals implanted with an implantable cardioverter defibrillator do not have an increased risk of appropriate shocks or other adverse events. The recently published exercise recommendations from the European Association for Preventative Cardiology account for more contemporary evidence and adopt a more liberal stance regarding competitive and high intensity sport in individuals with low-risk HCM. This review addresses the issue of exercise in individuals with HCM, and explores current evidence supporting safety of exercise in HCM, potential caveats, and areas of further research.
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Affiliation(s)
- Joyee Basu
- Cardiac Risk in the Young Clinical Research Fellow, Cardiology Clinical Academic GroupSt George's University of LondonLondonUK
| | - Aneil Malhotra
- Cardiac Risk in the Young Clinical Research Fellow, Cardiology Clinical Academic GroupSt George's University of LondonLondonUK
- Division of Cardiovascular SciencesThe University of ManchesterManchesterUK
| | - Michael Papadakis
- Cardiac Risk in the Young Clinical Research Fellow, Cardiology Clinical Academic GroupSt George's University of LondonLondonUK
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99
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Li H, Fang J, Wei X, Xu D, Zhang T, Xiang Y, Chen HJ, Liu F, Xie X, Wang P, Hu N. Specific recognition of ion channel blocker by high-content cardiomyocyte electromechanical integrated correlation. Biosens Bioelectron 2020; 162:112273. [DOI: 10.1016/j.bios.2020.112273] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/29/2020] [Accepted: 05/02/2020] [Indexed: 12/22/2022]
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100
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Sapp RM, Landers-Ramos RQ, Shill DD, Springer CB, Hagberg JM. Sex-specific alterations in blood-borne factors in physically inactive individuals are detrimental to endothelial cell functions. J Appl Physiol (1985) 2020; 129:664-674. [PMID: 32730175 DOI: 10.1152/japplphysiol.00292.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Mechanisms underlying the protective effects of both habitual endurance exercise and the female sex on vascular function are incompletely understood. Blood-borne circulating factors, such as circulating microRNAs (ci-miRs), may partially explain these effects. Blood samples were obtained from young, healthy men and women who either habitually performed endurance exercise (endurance trained) or were relatively inactive (sedentary). Women were tested during the early follicular phase of the menstrual cycle or the placebo pill phase of oral contraceptive to control for estrogen. Cultured human umbilical vein endothelial cells (HUVECs) were exposed to participants' serum in migration, proliferation, and reactive oxygen species (ROS) assays. Real-time quantitative polymerase chain reaction was used to quantify an initial array of 84 cardiovascular disease (CVD)-related ci-miRs, followed by validation of 10 ci-miRs. All participants were devoid of traditional CVD risk factors, and circulating estradiol concentration was not different between groups. Serum of endurance-trained women induced greater HUVEC migration compared with serum of sedentary women. HUVEC ROS production was greater in response to serum of sedentary men compared with serum of endurance-trained men and sedentary women. There were sex effects on the levels of nine ci-miRs, with greater levels in men, while ci-miRs-140-5p and 145-5p were also higher in sedentary compared with endurance-trained men and/or women. In a sex-specific manner, habitual endurance exercise was associated with beneficial effects of serum on HUVECs. Thus, alterations in circulating factors may contribute to the protective effects of habitual endurance exercise on vascular health. Additionally, sex had a greater impact than habitual activity level on the levels of vascular-related ci-miRs.NEW & NOTEWORTHY Serum from sedentary women caused impaired endothelial migration, whereas serum from sedentary men elicited increased endothelial reactive oxygen species production as compared with serum from their endurance-trained counterparts. Select CVD-related circulating microRNAs (ci-miRs) were higher in men than women, while ci-miRs-140-5p and 145-5p were also higher in sedentary versus trained men and/or women. Our data suggest that alterations in circulating factors may contribute to the protective effects of habitual exercise and sex on vascular health.
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Affiliation(s)
- Ryan M Sapp
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, Maryland
| | | | - Daniel D Shill
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, Maryland
| | - Catherine B Springer
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, Maryland
| | - James M Hagberg
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, Maryland
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