Kardiovaskuläre Prävention und regelmäßige körperliche Aktivität

Regular aerobic exercise activates PDGF-BB/PDGFR-β signaling and modulates the inflammatory-anti-inflammatory balance in diet-induced obese mice

OBJECTIVE

Regular aerobic exercise induces cardioprotection by counteracting the obesity-associated inflammatory response, dyslipidemia. PDGF-BB/PDGFR-β signaling is established as a crucial mechanism of endothelial cell-cardiomyocyte communication and cardioprotection, but its physiological roles in response to obesity and regular aerobic exercise are unknown.

METHODS

Thirty C57BL/6 mice were divided into three groups: a normal diet group, a high-fat diet group, and a high-fat diet plus aerobic exercise group. Glucose metabolic parameters, inflammation-related indicators, and blood lipids indicators were detected. In addition, gene expression levels of the inflammatory factors, PDGF-BB, PDGFR-β, PI3K, Akt, eNOS, and P53 in cardiac tissue were quantified. Morphological analysis was also used to quantify the magnitude of inflammation.

RESULTS

High-fat diet (HFD) feeding resulted in adiposity, dyslipidemia, and low levels of cardioprotective factors such as APN and eNOS (P < 0.05), which were improved significantly by 8 weeks of aerobic exercise (P < 0.05). HFD feeding increased the gene expression levels of proinflammatory cytokines and decreased the gene expression levels of anti-inflammatory cytokines in cardiac tissue (P < 0.05), which was reversed by regular aerobic exercise (P < 0.05). In addition, HFD feeding suppressed the levels of the cardioprotective factors PDGF-BB and eNOS through PDGF-BB/PDGFR-β/PI3K/Akt/eNOS signaling in cardiac tissue, while regular aerobic exercise activated PDGF-BB/PDGFR-β/PI3K/Akt/eNOS signaling.

CONCLUSION

Regular aerobic exercise improved adiposity, dyslipidemia induced by HFD feeding. Regular aerobic exercise exerted a prominent role in modulating the inflammatory-anti-inflammatory balance and activating the levels of the cardioprotective factors eNOS and PDGF-BB through PDGF-BB/PDGFR-β signaling.

Das Polypill-Modell: Konzeptionelle Überlegungen zu den körperlichen, psychischen und sozialen Wirkungen des Sports

Hintergrund Angesichts seiner mannigfaltigen physiologischen Wirkungen wird Sport in der Literatur zunehmend als „Polypille“ bezeichnet. Sport gleiche demnach einem pleiotrop wirksamen Medikament. Die Sportwissenschaft kritisiert diese eher klinische Sichtweise als zu einseitig und warnt vor einer Medikalisierung des Sports.

Methode Der vorliegende Beitrag greift diesen Einwand auf und fasst die biopsychosozialen Wirkungen des Sports zusammen. Besondere Beachtung finden dabei die psychischen und sozialen Wirkungen sportlicher Aktivität. Die Überlegungen münden in einem konzeptionellen Modellentwurf, dem Polypill-Modell des Sports.

Ergebnisse Der Sport wird zunächst in seine Organisationsformen differenziert. Anschließend werden die individuellen Wirkungen sportlicher Aktivität auf körperliche, psychische und soziale Ressourcen beschrieben: Diese erstrecken sich auf motorische, also konditionelle und koordinative, Fähigkeiten, auf kognitive, emotionale und motivationale Aspekte sowie auf selbstbezogene und fremdbezogene Sozialkompetenzen. Wenngleich – insbesondere regelmäßiger – Sport körperliche, psychische und soziale Ressourcen zu stärken vermag, bergen beispielsweise unphysiologische Belastungen, mangelhafte Betreuung und normative Strukturen dennoch stets ein individuelles latentes Schädigungspotenzial. Darüber hinaus werden die sportspezifischen Sozialisations- und Enkulturationsprozesse unter den Begriffen „Sozialisation in den Sport“, „Sozialisation im Sport“ und „Sozialisation durch den Sport“ in das Modell integriert. So können viele im Sport erlernte – insbesondere psychische und soziale – Kompetenzen auch für andere Lebensbereiche von Bedeutung sein.

Schlussfolgerungen Unter dem Begriff der Polypille werden neben körperlichen auch psychische und soziale Wirkungen des Sports systematisiert. Das hier vorgeschlagene Polypill-Modell des Sports kann in der universitären und außeruniversitären Lehre ebenso eingesetzt werden wie in der konkreten Studien- und Trainingsplanung.

Psychometric Features of the Polish Version of TSK Heart in Elderly Patients with Coronary Artery Disease

Background and objectives: Recommendations for the control of stable patients with coronary artery disease (CAD) related to an adequate level of physical activity (PA). Practical experience shows that the PA level in most people with CAD is definitely too low in relation to the guidelines. The cause may be psychological factors and among them the fear of movement-kinesiophobia. The aim of this project was to examine the evaluation of psychometric features of the Polish version of the Tampa Scale for Kinesiophobia Heart (TSK Heart), used in people with CAD. Materials and methods: The study involved 287 patients with stable CAD: 112 women and 175 men. Age: 63.50 (SD = 11.49) years. Kinesiophobia was assessed using TSK Heart, physical activity (PA)-using the International Physical Activity Questionnaire (IPAQ), and anxiety and depression was examined using the Hospital Anxiety and Depression Scale (HADS). The structure of TSK was examined using principal component analysis (PCA), internal cohesion (Cronbach's alpha, AC), and content validity was calculated by linear regression. Results: PCA showed a three-factor TSK structure. One-dimensionality and satisfactory reliability were found: TSK Heart: AC = 0.878. Kinesiophobia as a predictor of PA: R2 = 0.162 (p = 0.000000). Anxiety and depression-TSK: R2 = 0.093 (p = 0.00000). Conclusions: The Polish version of TSK Heart for cardiac patients is characterized by good psychometric features. The use of it can improve the cooperation of rehabilitation teams for patients with CAD.

Kinesiophobia as a Problem in Adherence to Physical Activity Recommendations in Elderly Polish Patients with Coronary Artery Disease

INTRODUCTION

The most commonly occurring diseases among the elderly people are cardiovascular system ones and among them the coronary artery disease (CAD). It is considered that the age and insufficient level of physical activity (PA) are the crucial risk factors of CAD. The key barrier which prevents elderly people from undertaking physical activity may be the fear of activity, called kinesiophobia.

AIM

The aim of this project was to examine the frequency of kinesiophobia among Polish elderly patients with CAD and its potential conditions: sex, age, CAD duration, other diseases and chosen socio-demographic variables.

REFERENCE AND METHODS

There have been 135 people examined: 59 women and 76 men in the 65-88 age range (average =71.88 years, SD=4.82). They were people diagnosed with stable CAD. The questionnaire form which was used collected information concerning the socio-demographical and physical activity data. And for kinesiophobia, there was Tampa Scale used, which is dedicated to examine cardiac patients - TSK heart.

RESULTS

Over 76% of examined patients had a high level of kinesiophobia (TSK>37 pt). Sex, age, BMI, CAD duration and the number of other diseases did not have any connection with neither PA nor TSK. Education was the only one, among the socio-demographic variables, which differentiated the kinesiophobia. Better educated people had a lower level of it.

CONCLUSION

Kinesiophobia is a common problem among the elderly people suffering from CAD. It is caused by a lack of physical activity which adversely predicts the progression of the disease. People with higher education are more rarely affected by kinesiophobia. CAD patients should be provided with knowledge and training concerning PA and there should be conditions created to enhance it.