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Zhang Y, Wang X, Pathiravasan CH, Spartano NL, Lin H, Borrelli B, Benjamin EJ, McManus DD, Larson MG, Vasan RS, Shah RV, Lewis GD, Liu C, Murabito JM, Nayor M. Association of Smartwatch-Based Heart Rate and Physical Activity With Cardiorespiratory Fitness Measures in the Community: Cohort Study. J Med Internet Res 2024; 26:e56676. [PMID: 38870519 PMCID: PMC11216017 DOI: 10.2196/56676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/11/2024] [Accepted: 03/20/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Resting heart rate (HR) and routine physical activity are associated with cardiorespiratory fitness levels. Commercial smartwatches permit remote HR monitoring and step count recording in real-world settings over long periods of time, but the relationship between smartwatch-measured HR and daily steps to cardiorespiratory fitness remains incompletely characterized in the community. OBJECTIVE This study aimed to examine the association of nonactive HR and daily steps measured by a smartwatch with a multidimensional fitness assessment via cardiopulmonary exercise testing (CPET) among participants in the electronic Framingham Heart Study. METHODS Electronic Framingham Heart Study participants were enrolled in a research examination (2016-2019) and provided with a study smartwatch that collected longitudinal HR and physical activity data for up to 3 years. At the same examination, the participants underwent CPET on a cycle ergometer. Multivariable linear models were used to test the association of CPET indices with nonactive HR and daily steps from the smartwatch. RESULTS We included 662 participants (mean age 53, SD 9 years; n=391, 59% women, n=599, 91% White; mean nonactive HR 73, SD 6 beats per minute) with a median of 1836 (IQR 889-3559) HR records and a median of 128 (IQR 65-227) watch-wearing days for each individual. In multivariable-adjusted models, lower nonactive HR and higher daily steps were associated with higher peak oxygen uptake (VO2), % predicted peak VO2, and VO2 at the ventilatory anaerobic threshold, with false discovery rate (FDR)-adjusted P values <.001 for all. Reductions of 2.4 beats per minute in nonactive HR, or increases of nearly 1000 daily steps, corresponded to a 1.3 mL/kg/min higher peak VO2. In addition, ventilatory efficiency (VE/VCO2; FDR-adjusted P=.009), % predicted maximum HR (FDR-adjusted P<.001), and systolic blood pressure-to-workload slope (FDR-adjusted P=.01) were associated with nonactive HR but not associated with daily steps. CONCLUSIONS Our findings suggest that smartwatch-based assessments are associated with a broad array of cardiorespiratory fitness responses in the community, including measures of global fitness (peak VO2), ventilatory efficiency, and blood pressure response to exercise. Metrics captured by wearable devices offer a valuable opportunity to use extensive data on health factors and behaviors to provide a window into individual cardiovascular fitness levels.
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Affiliation(s)
- Yuankai Zhang
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA, United States
| | - Xuzhi Wang
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA, United States
| | | | - Nicole L Spartano
- Section of Endocrinology, Diabetes, Nutrition, and Weight Management, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
| | - Honghuang Lin
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Belinda Borrelli
- Center for Behavioral Science Research, Department of Health Policy & Health Services Research, Boston University, Henry M. Goldman School of Dental Medicine, Boston, MA, United States
| | - Emelia J Benjamin
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States
- Section of Preventive Medicine and Epidemiology and Cardiovascular Medicine, Departments of Medicine and Epidemiology, Boston University Chobanian & Avedisian School of Medicine and School of Public Health, Boston, MA, United States
| | - David D McManus
- Cardiology Division, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
- Department of Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Martin G Larson
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA, United States
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States
| | - Ramachandran S Vasan
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States
- Section of Preventive Medicine and Epidemiology and Cardiovascular Medicine, Departments of Medicine and Epidemiology, Boston University Chobanian & Avedisian School of Medicine and School of Public Health, Boston, MA, United States
| | - Ravi V Shah
- Cardiology Division, Vanderbilt Translational and Clinical Research Center, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Gregory D Lewis
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- Pulmonary Critical Care Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Chunyu Liu
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA, United States
| | - Joanne M Murabito
- Boston University's and National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States
- Section of General Internal Medicine, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
| | - Matthew Nayor
- Sections of Cardiology and Preventive Medicine and Epidemiology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
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Ghram A, Latiri I, Methnani J, Souissi A, Benzarti W, Toulgui E, Ben Saad H. Effects of cardiorespiratory rehabilitation program on submaximal exercise in patients with long-COVID-19 conditions: a systematic review of randomized controlled trials and recommendations for future studies. Expert Rev Respir Med 2023; 17:1095-1124. [PMID: 38063359 DOI: 10.1080/17476348.2023.2293226] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/06/2023] [Indexed: 02/21/2024]
Abstract
INTRODUCTION Long-COVID-19 patients (LC19Ps) often experience cardiovascular and respiratory complications. Cardiorespiratory rehabilitation programs (CRRPs) have emerged as promising interventions to enhance exercise capacity in this population. This systematic review aimed to assess the impact of CRRPs on submaximal exercise performance, specifically the 6-minute walk test (6MWT) outcomes, in LC19Ps through an analysis of available randomized controlled trials (RCTs). METHODS A systematic search was conducted in PubMed/Medline and Scopus to identify relevant RCTs. Six RCTs meeting inclusion criteria were included in this review, investigating the effects of CRRPs on 6MWT outcomes in LC19Ps. RESULTS The findings from the included RCTs provide compelling evidence supporting the effectiveness of CRRPs in improving submaximal exercise performance in LC19Ps. These results underscore the potential of CRRPs to enhance submaximal exercise capacity and overall functional well-being in this population. However, future research is imperative to determine optimal CRRPs, including duration, intensity, and specific intervention components. Additionally, the long-term sustainability and durability of CRRP-induced improvements warrant further exploration. Future studies should prioritize patient-centric outcomes and address potential implementation barriers. CONCLUSION CRRPs show promise in ameliorating submaximal exercise performance among LC19Ps. Further research is needed to refine these programs and ensure their lasting impact on this patient group. SYSTEMATIC REVIEW REGISTRATION https://doi.org/10.17605/OSF.IO/HMN38. [Figure: see text].
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Affiliation(s)
- Amine Ghram
- Department of Cardiac Rehabilitation, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Imed Latiri
- Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED Hospital, Sousse, Tunisia
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Jabeur Methnani
- LR19ES09, Laboratoire de Physiologie de l'Exercice et Physiopathologie: de l'Intégré au Moléculaire 10 « Biologie, Médecine et Santé », Faculty of Medicine of Sousse, Sousse, Tunisia
| | - Amine Souissi
- Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED Hospital, Sousse, Tunisia
| | - Wafa Benzarti
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Emna Toulgui
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Helmi Ben Saad
- Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED Hospital, Sousse, Tunisia
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
- Department of Physiology and Functional Exploration, Farhat HACHED Hospital, Sousse, Tunisia
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3
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Olshansky B, Ricci F, Fedorowski A. Importance of resting heart rate. Trends Cardiovasc Med 2023; 33:502-515. [PMID: 35623552 DOI: 10.1016/j.tcm.2022.05.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/20/2022] [Accepted: 05/20/2022] [Indexed: 11/30/2022]
Abstract
Resting heart rate is a determinant of cardiac output and physiological homeostasis. Although a simple, but critical, parameter, this vital sign predicts adverse outcomes, including mortality, and development of diseases in otherwise normal and healthy individuals. Temporal changes in heart rate can have valuable predictive capabilities. Heart rate can reflect disease severity in patients with various medical conditions. While heart rate represents a compilation of physiological inputs, including sympathetic and parasympathetic tone, aside from the underlying intrinsic sinus rate, how resting heart rate affects outcomes is uncertain. Mechanisms relating resting heart rate to outcomes may be disease-dependent but why resting heart rate in otherwise healthy, normal individuals affects outcomes remains obscure. For specific conditions, physiologically appropriate heart rate reductions may improve outcomes. However, to date, in the normal population, evidence that interventions aimed at reducing heart rate improves outcomes remains undefined. Emerging data suggest that reduction in heart rate via vagal activation and/or sympathetic inhibition is propitious.
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Affiliation(s)
- Brian Olshansky
- Division of Cardiology, Department of Internal Medicine, University of Iowa, Iowa City, IA 52242, USA.
| | - Fabrizio Ricci
- Department of Neuroscience, Imaging and Clinical Sciences, "G.d'Annunzio" University of Chieti-Pescara, Via dei Vestini, 33, Chieti 66100, Italy; Department of Clinical Sciences, Lund University, 214 28 Malmö, Sweden
| | - Artur Fedorowski
- Department of Clinical Sciences, Lund University, 214 28 Malmö, Sweden; Department of Cardiology, Karolinska University Hospital, and Department of Medicine, Karolinska Institute, 171 76 Stockholm, Sweden
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Chiu YH, Tsai SC, Lin CS, Wang LY, Huang KC. Effects of a 12-week walking intervention on circulating lipid profiles and adipokines in normal weight and abdominal obese female college students. J Exerc Sci Fit 2023; 21:253-259. [PMID: 37180765 PMCID: PMC10173777 DOI: 10.1016/j.jesf.2023.04.001] [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: 10/21/2022] [Revised: 03/11/2023] [Accepted: 04/19/2023] [Indexed: 05/16/2023] Open
Abstract
Background/objectives Regular exercise such as aerobic exercise has been shown to reduce the risk of some diseases such as cardiovascular disease (CVD). However, only few studies have investigated the impact of regular aerobic exercise on non-obese and overweight/obese persons. Therefore, this study was designed to compare the effect of a 12-week 10,000 steps a day walking intervention on the body composition, serum lipids, adipose tissue function, and obesity-associated cardiometabolic risk between normal weight and overweight/obese female college students. Methods Ten normal weight (NWCG) and 10 overweight/obese (AOG) individuals were recruited in this study. Both groups performed a regular 10,000 steps a day walk for 12 weeks. Their blood pressure, body mass index, waist-to-hip ratio, and blood lipid profiles were evaluated. Moreover, serum leptin and adiponectin levels were measured using an enzyme-linked immunosorbent assay. Results Our results revealed that triglyceride (TG), TG/high-density lipoprotein cholesterol (HDL-C) ratio and leptin were significantly reduced in the AOG group after the 12-week walking intervention. However, total cholesterol, HDL-C, and adiponectin/leptin ratio were significantly increased in the AOG group. There was little or no change in these variables in the NWCG group after the 12-week walking intervention. Conclusions Our study demonstrated that a 12-week walking intervention may help improve cardiorespiratory fitness and obesity-associated cardiometabolic risk by decrease resting heart rate, modulating blood lipid profiles, and inducing adipokine alterations in obese individuals. Therefore, our research encourages obese young adults to improve their physical health by participating in a 12-week walking program of 10,000 steps a day.
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Affiliation(s)
- Yi Han Chiu
- Department of Microbiology, Soochow University, Taipei, 111, Taiwan
| | - Shiow-Chwen Tsai
- Institute of Sports Science, University of Taipei, Taipei, 111, Taiwan
| | - Chen-Si Lin
- Department of Veterinary Medicine, National Taiwan University, Taipei, 111, Taiwan
| | - Li-Yu Wang
- Department of Medicine, MacKay Medical College, New Taipei City, 252, Taiwan
| | - Kuo-Chin Huang
- Holistic Education Center, MacKay Medical College, New Taipei City, 252, Taiwan
- Corresponding author. Holistic Education Center, MacKay Medical College, 25245, New Taipei City, Taiwan.
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Gonzales TI, Jeon JY, Lindsay T, Westgate K, Perez-Pozuelo I, Hollidge S, Wijndaele K, Rennie K, Forouhi N, Griffin S, Wareham N, Brage S. Resting heart rate is a population-level biomarker of cardiorespiratory fitness: The Fenland Study. PLoS One 2023; 18:e0285272. [PMID: 37167327 PMCID: PMC10174582 DOI: 10.1371/journal.pone.0285272] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 04/19/2023] [Indexed: 05/13/2023] Open
Abstract
INTRODUCTION Few large studies have evaluated the relationship between resting heart rate (RHR) and cardiorespiratory fitness. Here we examine cross-sectional and longitudinal relationships between RHR and fitness, explore factors that influence these relationships, and demonstrate the utility of RHR for remote population monitoring. METHODS In cross-sectional analyses (The UK Fenland Study: 5,722 women, 5,143 men, aged 29-65y), we measured RHR (beats per min, bpm) while seated, supine, and during sleep. Fitness was estimated as maximal oxygen consumption (ml⋅min-1⋅kg-1) from an exercise test. Associations between RHR and fitness were evaluated while adjusting for age, sex, adiposity, and physical activity. In longitudinal analyses (6,589 participant subsample), we re-assessed RHR and fitness after a median of 6 years and evaluated the association between within-person change in RHR and fitness. During the coronavirus disease-2019 pandemic, we used a smartphone application to remotely and serially measure RHR (1,914 participant subsample, August 2020 to April 2021) and examined differences in RHR dynamics by pre-pandemic fitness level. RESULTS Mean RHR while seated, supine, and during sleep was 67, 64, and 57 bpm. Age-adjusted associations (beta coefficients) between RHR and fitness were -0.26, -0.29, and -0.21 ml⋅kg-1⋅beat-1 in women and -0.27, -0.31, and -0.19 ml⋅kg-1⋅beat-1 in men. Adjustment for adiposity and physical activity attenuated the RHR-to-fitness relationship by 10% and 50%, respectively. Longitudinally, a 1-bpm increase in supine RHR was associated with a 0.23 ml⋅min-1⋅kg-1 decrease in fitness. During the pandemic, RHR increased in those with low pre-pandemic fitness but was stable in others. CONCLUSIONS RHR is a valid population-level biomarker of cardiorespiratory fitness. Physical activity and adiposity attenuate the relationship between RHR and fitness.
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Affiliation(s)
- Tomas I. Gonzales
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Justin Y. Jeon
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
- Department of Sport Industry Studies, Exercise Medicine Center for Diabetes and Cancer Patients (ICONS), Yonsei University, Seoul, Korea
| | - Timothy Lindsay
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Kate Westgate
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | | | - Stefanie Hollidge
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Katrien Wijndaele
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Kirsten Rennie
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Nita Forouhi
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Simon Griffin
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Nick Wareham
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
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Riddell MC, Li Z, Gal RL, Calhoun P, Jacobs PG, Clements MA, Martin CK, Doyle III FJ, Patton SR, Castle JR, Gillingham MB, Beck RW, Rickels MR. Examining the Acute Glycemic Effects of Different Types of Structured Exercise Sessions in Type 1 Diabetes in a Real-World Setting: The Type 1 Diabetes and Exercise Initiative (T1DEXI). Diabetes Care 2023; 46:704-713. [PMID: 36795053 PMCID: PMC10090894 DOI: 10.2337/dc22-1721] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/27/2022] [Indexed: 02/10/2023]
Abstract
OBJECTIVE Maintenance of glycemic control during and after exercise remains a major challenge for individuals with type 1 diabetes. Glycemic responses to exercise may differ by exercise type (aerobic, interval, or resistance), and the effect of activity type on glycemic control after exercise remains unclear. RESEARCH DESIGN AND METHODS The Type 1 Diabetes Exercise Initiative (T1DEXI) was a real-world study of at-home exercise. Adult participants were randomly assigned to complete six structured aerobic, interval, or resistance exercise sessions over 4 weeks. Participants self-reported study and nonstudy exercise, food intake, and insulin dosing (multiple daily injection [MDI] users) using a custom smart phone application and provided pump (pump users), heart rate, and continuous glucose monitoring data. RESULTS A total of 497 adults with type 1 diabetes (mean age ± SD 37 ± 14 years; mean HbA1c ± SD 6.6 ± 0.8% [49 ± 8.7 mmol/mol]) assigned to structured aerobic (n = 162), interval (n = 165), or resistance (n = 170) exercise were analyzed. The mean (± SD) change in glucose during assigned exercise was -18 ± 39, -14 ± 32, and -9 ± 36 mg/dL for aerobic, interval, and resistance, respectively (P < 0.001), with similar results for closed-loop, standard pump, and MDI users. Time in range 70-180 mg/dL (3.9-10.0 mmol/L) was higher during the 24 h after study exercise when compared with days without exercise (mean ± SD 76 ± 20% vs. 70 ± 23%; P < 0.001). CONCLUSIONS Adults with type 1 diabetes experienced the largest drop in glucose level with aerobic exercise, followed by interval and resistance exercise, regardless of insulin delivery modality. Even in adults with well-controlled type 1 diabetes, days with structured exercise sessions contributed to clinically meaningful improvement in glucose time in range but may have slightly increased time below range.
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Affiliation(s)
| | - Zoey Li
- Jaeb Center for Health Research, Tampa, FL
| | | | | | - Peter G. Jacobs
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR
| | | | - Corby K. Martin
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
| | - Francis J. Doyle III
- Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA
| | | | - Jessica R. Castle
- Harold Schnitzer Diabetes Health Center, Oregon Health & Science University, Portland, OR
| | - Melanie B. Gillingham
- Department of Molecular and Medical Genetics, Oregon Health & Science University, Portland, OR
| | | | - Michael R. Rickels
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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7
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Toulgui E, Benzarti W, Rahmani C, Aissa S, Ghannouchi I, Knaz A, Sayhi A, Sellami S, Mahmoudi K, Jemni S, Gargouri I, Hayouni A, Ouanes W, Ammar A, Ben saad H. Impact of cardiorespiratory rehabilitation program on submaximal exercise capacity of Tunisian male patients with post-COVID19: A pilot study. Front Physiol 2022; 13:1029766. [PMID: 36246110 PMCID: PMC9555273 DOI: 10.3389/fphys.2022.1029766] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 09/12/2022] [Indexed: 12/12/2022] Open
Abstract
Post-COVID19 patients suffer from persistent respiratory, cardiovascular, neurological, and musculoskeletal health complaints such as dyspnea, chest pain/discomfort, and fatigue. In Tunisia, the potential benefits of a cardiorespiratory rehabilitation program (CRRP) after COVID19 remain unclear. The main aim of this study was to evaluate the impact of a CRRP on submaximal exercise capacity, evaluated through the 6-min walk test (6MWT) data in post-COVID19 Tunisian patients. This was a cross-sectional study including 14 moderate to severe COVID19 patients aged from 50 to 70 years. CRRP was performed after the end of patients’ hospitalization in COVID19 units for extensive or severe extents of COVID19. Dyspnea (modified medical research council), spirometry data, handgrip strength values, 6MWT data, and 6-min walk work (i.e., 6-min walk distance x weight) were evaluated 1-week pre-CRRP, and 1-week post-CRRP. CRRP included 12 sessions [3 sessions (70 min each)/week for 4 weeks]. Exercise-training included aerobic cycle endurance, strength training, and educational sessions. Comparing pre- and post- CRRP results showed significant improvements in the means±standard deviations of dyspnea by 1.79 ± 0.80 points (p < 0.001), forced expiratory volume in one second by 110 ± 180 ml (p = 0.04), 6-min walk distance by 35 ± 42 m (p = 0.01), 6-min walk work by 2,448 ± 3,925 mkg (p = 0.048), resting heart-rate by 7 ± 9 bpm (p = 0.02) and resting diastolic blood pressure by 6 ± 10 mmHg (p = 0.045). In Tunisia, CRRP seems to improve the submaximal exercise capacity of post-COVID19 patients, mainly the 6-min walk distance and work.
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Affiliation(s)
- Emna Toulgui
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Wafa Benzarti
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Chiraz Rahmani
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Sana Aissa
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Ines Ghannouchi
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse, Tunisia
| | - Asma Knaz
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Amani Sayhi
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse, Tunisia
| | - Sana Sellami
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse, Tunisia
| | - Khaoula Mahmoudi
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse, Tunisia
| | - Sonia Jemni
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Imene Gargouri
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | | | - Walid Ouanes
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Achraf Ammar
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UPL, Paris Nanterre University, UFR STAPS, Nanterre, France
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- *Correspondence: Achraf Ammar,
| | - Helmi Ben saad
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse, Tunisia
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8
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Mayuga KA, Fedorowski A, Ricci F, Gopinathannair R, Dukes JW, Gibbons C, Hanna P, Sorajja D, Chung M, Benditt D, Sheldon R, Ayache MB, AbouAssi H, Shivkumar K, Grubb BP, Hamdan MH, Stavrakis S, Singh T, Goldberger JJ, Muldowney JAS, Belham M, Kem DC, Akin C, Bruce BK, Zahka NE, Fu Q, Van Iterson EH, Raj SR, Fouad-Tarazi F, Goldstein DS, Stewart J, Olshansky B. Sinus Tachycardia: a Multidisciplinary Expert Focused Review. Circ Arrhythm Electrophysiol 2022; 15:e007960. [PMID: 36074973 PMCID: PMC9523592 DOI: 10.1161/circep.121.007960] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sinus tachycardia (ST) is ubiquitous, but its presence outside of normal physiological triggers in otherwise healthy individuals remains a commonly encountered phenomenon in medical practice. In many cases, ST can be readily explained by a current medical condition that precipitates an increase in the sinus rate, but ST at rest without physiological triggers may also represent a spectrum of normal. In other cases, ST may not have an easily explainable cause but may represent serious underlying pathology and can be associated with intolerable symptoms. The classification of ST, consideration of possible etiologies, as well as the decisions of when and how to intervene can be difficult. ST can be classified as secondary to a specific, usually treatable, medical condition (eg, pulmonary embolism, anemia, infection, or hyperthyroidism) or be related to several incompletely defined conditions (eg, inappropriate ST, postural tachycardia syndrome, mast cell disorder, or post-COVID syndrome). While cardiologists and cardiac electrophysiologists often evaluate patients with symptoms associated with persistent or paroxysmal ST, an optimal approach remains uncertain. Due to the many possible conditions associated with ST, and an overlap in medical specialists who see these patients, the inclusion of experts in different fields is essential for a more comprehensive understanding. This article is unique in that it was composed by international experts in Neurology, Psychology, Autonomic Medicine, Allergy and Immunology, Exercise Physiology, Pulmonology and Critical Care Medicine, Endocrinology, Cardiology, and Cardiac Electrophysiology in the hope that it will facilitate a more complete understanding and thereby result in the better care of patients with ST.
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Affiliation(s)
- Kenneth A. Mayuga
- Section of Cardiac Electrophysiology and Pacing, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH
| | - Artur Fedorowski
- Karolinska Institutet & Karolinska University Hospital, Stockholm, Sweden
| | - Fabrizio Ricci
- Department of Neuroscience, Imaging and Clinical Sciences, “G.d’Annunzio” University of Chieti-Pescara, Chieti Scalo, Italy
| | | | | | | | | | | | - Mina Chung
- Section of Cardiac Electrophysiology and Pacing, Department of Cardiovascular Medicine, Cleveland Clinic, Phoenix, AZ
| | - David Benditt
- University of Minnesota Medical School, Minneapolis, MN
| | | | - Mirna B. Ayache
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Hiba AbouAssi
- Division of Endocrinology, Metabolism, and Nutrition, Duke University Medical Center, Durham, NC
| | | | | | | | | | - Tamanna Singh
- Department of Cardiovascular Medicine, Cleveland Clinic, OH
| | | | - James A. S. Muldowney
- Vanderbilt University Medical Center &Tennessee Valley Healthcare System, Nashville Campus, Department of Veterans Affairs, Nashville, TN
| | - Mark Belham
- Cambridge University Hospitals NHS FT, Cambridge, UK
| | - David C. Kem
- University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Cem Akin
- University of Michigan, Ann Arbor, MI
| | | | - Nicole E. Zahka
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Qi Fu
- Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas & University of Texas Southwestern Medical Center, Dallas, TX
| | - Erik H. Van Iterson
- Section of Preventive Cardiology & Rehabilitation, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Miller Family Heart, Vascular & Thoracic Institute, Cleveland Clinic Cleveland, OH
| | - Satish R Raj
- Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Miller MS, Straight CR, Palmer BM. Inertial artifact in viscoelastic measurements of striated muscle: Modeling and experimental results. Biophys J 2022; 121:1424-1434. [PMID: 35314143 PMCID: PMC9072571 DOI: 10.1016/j.bpj.2022.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/26/2021] [Accepted: 03/15/2022] [Indexed: 11/21/2022] Open
Abstract
Viscoelastic properties of striated muscle are often measured using length perturbation analysis and quantified as a complex modulus, whose elastic and viscous components reflect the energy-storage and energy-absorbing properties of the tissue, respectively. The energy stored as inertia is commonly ignored due to the small size of samples examined, typically <1 mm. Considering recent advances in tissue engineering to generate muscle tissues of larger sizes, we questioned whether ignoring the inertial artifact was still reasonable in these samples. To answer this question, we derived and solved the one-dimensional wave equation that describes the propagation of strain along the length of a sample. The inertial artifact was predicted to contaminate the elastic modulus with (2πf)2L02ρ/6, where f is perturbation frequency, L0 is muscle length, and ρ is muscle density. We then measured viscoelastic properties up to 500 Hz in mouse skeletal muscle fibers at long (4.8 mm) and short (<1 mm) lengths and up to 100 Hz in rat cardiac slices at long (10-12 mm) and short (<2 mm) lengths. We found the elastic modulus of long preparations was elevated as frequency increased and was about half the magnitude of that predicted by the model. While the prediction tended to overestimate the measured inertial artifact, these results provided some validity to the model. We used the predicted artifact as an overly conservative estimate of error that might arise in a mechanics assay of mammalian striated muscle, whose nominal resting stiffness is on the order 100 kN m-2. We found that muscle lengths of <1 mm resulted in negligible inertial artifact (<0.5% error) for perturbation frequencies under 250 Hz. Muscle samples longer than 5 mm, on the other hand, would result in >5% error at frequencies of 200 Hz and higher.
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Affiliation(s)
- Mark S Miller
- Department of Kinesiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts
| | - Chad R Straight
- Department of Kinesiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts
| | - Bradley M Palmer
- Department of Molecular Physiology and Biophysics, Larner College of Medicine, University of Vermont, Burlington, Vermont.
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10
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Macartney MJ, Ghodsian MM, Noel-Gough B, McLennan PL, Peoples GE. DHA-Rich Fish Oil Increases the Omega-3 Index in Healthy Adults and Slows Resting Heart Rate without Altering Cardiac Autonomic Reflex Modulation. J Am Coll Nutr 2021; 41:637-645. [PMID: 34379997 DOI: 10.1080/07315724.2021.1953417] [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: 02/01/2023]
Abstract
Regular fish consumption, a rich source of long-chain omega-3 (ω-3) docosahexaenoic acid (DHA), modifies cardiac electrophysiology. However, human studies investigating fish oil and cardiac electrophysiology have predominantly supplemented therapeutic (high) doses of fish oil (often ω-3 eicosapentaenoic acid (EPA) rich sources). This study examined whether non-therapeutic doses of DHA-rich fish oil modulate cardiac electrophysiology at rest and during cardiovascular reflex challenges to the same extent, if at all, in young healthy adults. Participants (N = 20) were supplemented (double-blinded) with (2x1g.day-1) soy oil (Control n = 9) or DHA-rich tuna fish oil (FO n = 11) providing DHA: 560 mg and EPA: 140 mg. The Omega-3 Index (O3I; erythrocyte membrane % EPA + DHA), heart rate (HR) and HR variability (HRV) were analyzed during rest, maximal isometric handgrip and cold diving reflex challenges at baseline and following 8 weeks. The baseline O3I (Control: 5.1 ± 1.0; FO: 5.4 ± 0.9; P > 0.05), resting HR (Control: 65 ± 12bpm; FO: 66 ± 8bpm; P > 0.05) and HRV metrics did not significantly differ between the groups prior to supplementation. Relative to the control group, the O3I was increased (Control: 5.0 ± 1.1; FO: 7.8 ± 1.2; P < 0.001), and resting HR was slowed in the FO group following supplementation (Control: 66 ± 9bpm; FO: 61 ± 6bpm; P = 0.046). However, no significant (P > 0.05) between-group differences were observed in HR responsiveness or any indices of HRV during reflex challenges. In young healthy adults, dietary achievable doses of ω-3 DHA-rich fish oil exerted a direct slowing effect on resting HR, without compromising the HR response to either dominant sympathetic or parasympathetic modulation.
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Affiliation(s)
- Michael J Macartney
- Graduate Medicine, School of Medicine, University of Wollongong, Wollongong, Australia.,Centre for Medical and Exercise Physiology, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Mathew M Ghodsian
- Graduate Medicine, School of Medicine, University of Wollongong, Wollongong, Australia
| | - Bransen Noel-Gough
- Graduate Medicine, School of Medicine, University of Wollongong, Wollongong, Australia
| | - Peter L McLennan
- Graduate Medicine, School of Medicine, University of Wollongong, Wollongong, Australia.,Centre for Medical and Exercise Physiology, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Gregory E Peoples
- Graduate Medicine, School of Medicine, University of Wollongong, Wollongong, Australia.,Centre for Medical and Exercise Physiology, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, Australia
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11
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Lamooki SR, Tutino VM, Paliwal N, Damiano RJ, Waqas M, Nagesh SSV, Rajabzadeh-Oghaz H, Vakharia K, Siddiqui AH, Meng H. Evaluation of Two Fast Virtual Stenting Algorithms for Intracranial Aneurysm Flow Diversion. Curr Neurovasc Res 2021; 17:58-70. [PMID: 31987021 DOI: 10.2174/1567202617666200120141608] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 11/13/2019] [Accepted: 11/25/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Endovascular treatment of intracranial aneurysms (IAs) by flow diverter (FD) stents depends on flow modification. Patient-specific modeling of FD deployment and computational fluid dynamics (CFD) could enable a priori endovascular strategy optimization. We developed a fast, simplistic, expansion-free balls-weeping algorithm to model FDs in patientspecific aneurysm geometry. However, since such strong simplification could result in less accurate simulations, we also developed a fast virtual stenting workflow (VSW) that explicitly models stent expansion using pseudo-physical forces. METHODS To test which of these two fast algorithms more accurately simulates real FDs, we applied them to virtually treat three representative patient-specific IAs. We deployed Pipeline Embolization Device into 3 patient-specific silicone aneurysm phantoms and simulated the treatments using both balls-weeping and VSW algorithms in computational aneurysm models. We then compared the virtually deployed FD stents against experimental results in terms of geometry and post-treatment flow fields. For stent geometry, we evaluated gross configurations and porosity. For post-treatment aneurysmal flow, we compared CFD results against experimental measurements by particle image velocimetry. RESULTS We found that VSW created more realistic FD deployments than balls-weeping in terms of stent geometry, porosity and pore density. In particular, balls-weeping produced unrealistic FD bulging at the aneurysm neck, and this artifact drastically increased with neck size. Both FD deployment methods resulted in similar flow patterns, but the VSW had less error in flow velocity and inflow rate. CONCLUSION In conclusion, modeling stent expansion is critical for preventing unrealistic bulging effects and thus should be considered in virtual FD deployment algorithms. Also endowed with its high computational efficiency and superior accuracy, the VSW algorithm is a better candidate for implementation into a bedside clinical tool for FD deployment simulation.
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Affiliation(s)
- Saeb R Lamooki
- Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, United States.,Department of Mechanical & Aerospace Engineering, University at Buffalo, Buffalo, NY, United States
| | - Vincent M Tutino
- Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, United States.,Department of Biomedical Engineering, University at Buffalo, Buffalo, NY, United States.,Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States.,Department of Pathology and Anatomical Sciences, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
| | - Nikhil Paliwal
- Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, United States.,Department of Mechanical & Aerospace Engineering, University at Buffalo, Buffalo, NY, United States
| | - Robert J Damiano
- Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, United States.,Department of Mechanical & Aerospace Engineering, University at Buffalo, Buffalo, NY, United States
| | - Muhammad Waqas
- Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, United States.,Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
| | - Setlur S V Nagesh
- Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, United States.,Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States.,Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
| | - Hamidreza Rajabzadeh-Oghaz
- Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, United States.,Department of Mechanical & Aerospace Engineering, University at Buffalo, Buffalo, NY, United States
| | - Kunal Vakharia
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
| | - Adnan H Siddiqui
- Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, United States.,Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States.,Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
| | - Hui Meng
- Canon Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY, United States.,Department of Mechanical & Aerospace Engineering, University at Buffalo, Buffalo, NY, United States.,Department of Biomedical Engineering, University at Buffalo, Buffalo, NY, United States.,Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
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12
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Zhou D, Li Z, Shi G, Zhou J. Effect of heart rate on hospital mortality in critically ill patients may be modified by age: a retrospective observational study from large database. Aging Clin Exp Res 2021; 33:1325-1335. [PMID: 32638341 DOI: 10.1007/s40520-020-01644-7] [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] [Received: 05/09/2020] [Accepted: 06/25/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Heart rate has been found associated with mortality in critically ill patients. However, whether the association differs between the elderly and non-elderly patients was unknown. METHODS We conducted a retrospective observational study of adult patients admitted to the intensive care unit (ICU) in the United States. Demographic, vital signs, laboratory tests, and interventions were extracted and compared between the elderly and non-elderly patients. The main exposure was heart rate, the proportion of time spent in heart rate (PTS-HR) was calculated. The primary outcome was hospital mortality. The multivariable logistic regression model was performed to assess the relationship between PTS-HR and hospital mortality, and interaction between PTS-HR and age categories was explored. RESULTS 104,276 patients were included, of which 52,378 (50.2%) were elderly patients and 51,898 (49.8%) were non-elderly patients. The median age was 66 (IQR 54-76) years. After adjusting for confounders, PTS-HR < 60 beats per minute (bpm) (OR 0.972, 95% CI [0.945, 0.998], p = 0.031, Pinteraction = 0.001) and 60-80 bpm (OR 0.925, 95% CI [0.912, 0.938], p < 0.001, Pinteraction = 0.553) were associated with decreased risk of mortality; PTS-HR 80-100 bpm was associated with decreased mortality in the non-elderly patients (OR 0.955, 95% CI [0.941,0.975], p < 0.001) but was associated with increased mortality in the very elderly patients (OR 1.018, 95% CI [1.003,1.029], p = 0.017, Pinteraction < 0.001). PTS-HR > 100 bpm (OR 1.093, 95% CI [1.081,1.105], p < 0.001, Pinteraction = 0.004) was associated with increased mortality. CONCLUSIONS The effect of heart rate on hospital mortality differs between the elderly and non-elderly critically ill patients.
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13
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Zhang S, Li Z, Lv Y, Sun L, Xiao X, Gang X, Wang G. Cardiovascular effects of growth hormone (GH) treatment on GH-deficient adults: a meta-analysis update. Pituitary 2020; 23:467-475. [PMID: 32166618 DOI: 10.1007/s11102-020-01036-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND It is still unclear whether growth hormone (GH) replacement is able to improve cardiovascular parameters in adults with GH deficiency (AGHD) from the updated clinical trials reported to date. METHODS AND RESULTS We systematically reviewed clinical trials of GH treatment on AGHD patients in recent decade, and evaluated the effects of GH on cardiovascular parameters assessed by echocardiography. 11 clinical trials were identified in 3 bibliographic databases. We conducted a combined analysis of effects on four aspects: General indicators: baseline heart rate (BHR), peak heart rate (PHR), systolic blood pressure (SBP), diastolic blood pressure (DBP); Cardiac structure: left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular interventricular septum (LVIS), left ventricular mass (LVM), left ventricular posterior wall (LVPW); Cardiovascular function: deceleration time of E wave (DT), E/A ratio (E/A), ejection fraction (EF), NT-BNP; Life quality: peak VO2, VE/VCO2 slope. Overall effect size was used to evaluate significance, and weighted mean difference after GH treatment was given to appreciate size of the effect. GH treatment was associated with a significant increase in BHR (3.03[2.00, 4.06]), LVIS (0.50[0.43, 0.57]), LVPW (0.50[0.43, 0.57]), and EF (2.12[1.34, 2.90]). Overall effect sizes were negative significant for DBP (- 1.19[- 2.33, - 0.05]), LVEDV (- 9.84[- 16.53, - 3.15]), NT-BNP (- 206.34[- 308.95, - 103.72]), and VE/VCO2 slope (- 2.31[- 2.92, - 1.71]). CONCLUSIONS As assessed by echocardiography, GH administration may improve the general vital signs and life quality of AGHD patients, based on the positive effect on BHR and negative effects on DBP and VE/VCO2 slope. Also, GH treatment would influence the structure of heart with positive effects on LVIS, LVPW and negative effect on LVEDV, which together with the increase of EF and decrease of NT-BNP, then resulting in improving the systolic function of AGHD patients.
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Affiliation(s)
- Siwen Zhang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, NO.71 Xinmin Street, 130021, Changchun, Jilin, People's Republic of China
| | - Zhuo Li
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, NO.71 Xinmin Street, 130021, Changchun, Jilin, People's Republic of China
| | - You Lv
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, NO.71 Xinmin Street, 130021, Changchun, Jilin, People's Republic of China
| | - Lin Sun
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, NO.71 Xinmin Street, 130021, Changchun, Jilin, People's Republic of China
| | - Xianchao Xiao
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, NO.71 Xinmin Street, 130021, Changchun, Jilin, People's Republic of China
| | - Xiaokun Gang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, NO.71 Xinmin Street, 130021, Changchun, Jilin, People's Republic of China.
| | - Guixia Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, NO.71 Xinmin Street, 130021, Changchun, Jilin, People's Republic of China.
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14
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Introduction to Radar Scattering Application in Remote Sensing and Diagnostics: Review. ATMOSPHERE 2020. [DOI: 10.3390/atmos11050517] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The manuscript reviews the current literature on scattering applications of RADAR (Radio Detecting And Ranging) in remote sensing and diagnostics. This paper gives prime features for a variety of RADAR applications ranging from forest and climate monitoring to weather forecast, sea status, planetary information, and mapping of natural disasters such as the ones caused by earthquakes. Both the fundamental parameters involved in scattering mechanisms of RADAR applications and the factors affecting RADAR performances are also discussed.
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15
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Awotoye J, Fashanu OE, Lutsey PL, Zhao D, O'Neal WT, Michos ED. Resting heart rate and incident venous thromboembolism: the Multi-Ethnic Study of Atherosclerosis. Open Heart 2020; 7:e001080. [PMID: 32153786 PMCID: PMC7046973 DOI: 10.1136/openhrt-2019-001080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 01/07/2020] [Accepted: 01/27/2020] [Indexed: 12/21/2022] Open
Abstract
Objective Venous thromboembolism (VTE) is associated with significant morbidity and mortality. Resting heart rate (RHR), which may be modifiable through lifestyle changes, has been shown to be associated with cardiovascular disease risk and with inflammatory markers that have been predictive of VTE incidence. Methods We examined whether RHR is also associated with VTE incidence independent of these risk factors. We studied 6479 Multi-Ethnic Study of Atherosclerosis participants free from clinical VTE at baseline who had baseline RHR ascertained by 12-lead ECG. VTE events were recorded from hospital records and death certificates using International Classification of Diseases (ICD)-9 and ICD-10 codes. We categorised RHR as <60, 60-69, 70-79 and ≥80 bpm. We used Cox hazard models to determine the association of incident VTE by RHR. Results Participants had mean (SD) age of 62 (10) years and RHR of 63 (10) bpm. RHR was cross-sectionally correlated with multiple inflammatory and coagulation factors. There were 236 VTE cases after a median follow-up of 14 years. Compared with those with RHR<60 bpm, the HR (95% CI) for incident VTE for RHR≥80 bpm was 2.08 (1.31 to 3.30), after adjusting for demographics, physical activity, smoking, diabetes and use of atrioventricular (AV)-nodal blockers, aspirin and anticoagulants, and remained significant after further adjustment for inflammatory markers (2.05 (1.29 to 3.26)). Results were similar after excluding those taking AV-nodal blocker medications. There was no effect modification of these associations by sex or age. Conclusion Elevated RHR was positively associated with VTE incidence after a median of 14 years; this association was independent of several traditional VTE and inflammatory markers.
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Affiliation(s)
- Josephine Awotoye
- Department of Biology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Oluwaseun E Fashanu
- Department of Medicine, Saint Agnes Hospital, Baltimore, Maryland, USA
- The Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Di Zhao
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Wesley T O'Neal
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Erin D Michos
- The Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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16
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Folsom AR, Lutsey PL, Pope ZC, Fashanu OE, Misialek JR, Cushman M, Michos ED. Resting heart rate and incidence of venous thromboembolism. Res Pract Thromb Haemost 2020; 4:238-246. [PMID: 32110754 PMCID: PMC7040544 DOI: 10.1002/rth2.12288] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 10/01/2019] [Accepted: 10/18/2019] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND/OBJECTIVES Higher resting heart rate is a risk factor for arterial cardiovascular diseases. We assessed whether higher heart rate is a risk factor for venous thromboembolism (VTE). METHODS In a prospective epidemiologic cohort, the Atherosclerosis Risk in Communities (ARIC) Study, we associated resting heart rate by electrocardiogram with physician-validated incident hospitalized VTE through 2015. We also examined whether lower heart rate variability (HRV), a marker of cardiac autonomic imbalance, might be a risk factor for VTE. RESULTS Resting heart rate at Visit 1 (1987-1989), when participants were 45 to 64 years old (mean, 54 years), was not associated with incidence of VTE (n = 882 cases). However, heart rate at Visit 4 (1996-1998; mean age, 63 years) was associated positively with VTE (n = 557 cases). The adjusted hazard ratios (95% confidence intervals) of VTE across Visit 4 heart rate categories of <60, 60 to 69, 70 to 79, and ≥80 bpm were 1 (reference), 1.22 (1.01-1.49), 1.39 (1.09-1.78), and 1.44 (1.01-2.06), respectively, and when evaluated continuously 1.11 (1.02-1.21) per 10 bpm greater heart rate. For the most part, HRV indices were not associated with VTE or associations were explained by inverse correlations of HRV indices with heart rate. CONCLUSION We found a significant positive and independent association of resting heart rate at ARIC Visit 4 with incidence of VTE. The reason why high heart rate is a risk marker for VTE warrants further exploration.
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Affiliation(s)
- Aaron R. Folsom
- Division of Epidemiology & Community HealthSchool of Public HealthUniversity of MinnesotaMinneapolisMNUSA
| | - Pamela L. Lutsey
- Division of Epidemiology & Community HealthSchool of Public HealthUniversity of MinnesotaMinneapolisMNUSA
| | - Zachary C. Pope
- Division of Epidemiology & Community HealthSchool of Public HealthUniversity of MinnesotaMinneapolisMNUSA
| | - Oluwaseun E. Fashanu
- The Ciccarone Center for the Prevention of Cardiovascular DiseaseDivision of CardiologyJohns Hopkins School of MedicineBaltimoreMDUSA
- Department of MedicineSaint Agnes HospitalBaltimoreMDUSA
| | - Jeffrey R. Misialek
- Division of Epidemiology & Community HealthSchool of Public HealthUniversity of MinnesotaMinneapolisMNUSA
| | - Mary Cushman
- Department of MedicineUniversity of VermontBurlingtonVTUSA
- Department of Pathology and Laboratory MedicineUniversity of VermontBurlingtonVTUSA
| | - Erin D. Michos
- The Ciccarone Center for the Prevention of Cardiovascular DiseaseDivision of CardiologyJohns Hopkins School of MedicineBaltimoreMDUSA
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17
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Osibogun O, Ogunmoroti O, Spatz ES, Fashanu OE, Michos ED. Ideal cardiovascular health and resting heart rate in the Multi-Ethnic Study of Atherosclerosis. Prev Med 2020; 130:105890. [PMID: 31715219 PMCID: PMC6930349 DOI: 10.1016/j.ypmed.2019.105890] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 09/16/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
Elevated resting heart rate (RHR) is associated with an increased cardiovascular disease (CVD) risk, but little is known about its association with cardiovascular health (CVH), assessed by the Life's Simple 7 (LS7) metrics. We explored whether ideal CVH was associated with RHR in a cohort free from clinical CVD. We conducted a cross-sectional analysis of baseline data (2000-2002) of 6457 Multi-Ethnic Study of Atherosclerosis participants in 2018. Each LS7 metric (smoking, physical activity, diet, body mass index, blood pressure, cholesterol and glucose) was scored 0-2. Total score ranged from 0 to 14. Scores of 0-8 indicate inadequate, 9-10 average, and 11-14 optimal CVH. RHR was categorized as <60, 60-69, 70-79 and ≥80 bpm. We used multinomial logistic regression to determine associations between CVH score and RHR, adjusting for age, sex, race/ethnicity, education, income, health insurance, and atrioventricular nodal blockers. Mean age of participants (standard deviation) was 62 (10) years; 53% were women; 47% had inadequate CVH, 33% average, and 20% optimal. Favorable CVH was associated with lower odds of having higher RHR. Compared to RHR <60 bpm, participants with optimal CVH had adjusted odds ratio (95% CI) of 0.55 (0.46-0.64) for RHR of 60-69 bpm, 0.34 (0.28-0.43) for 70-79 bpm, and 0.14 (0.09-0.22) for ≥80 bpm. A similar pattern was observed in the stratified analysis by sex, race/ethnicity and age. Favorable CVH was less likely to be associated with elevated RHR irrespective of sex, race/ethnicity and age. More research is needed to explore the usefulness of promoting ideal CVH to reduce elevated RHR, a known risk factor for CVD.
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Affiliation(s)
- Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States of America.
| | - Oluseye Ogunmoroti
- The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, United States of America.
| | - Erica S Spatz
- Division of Cardiovascular Medicine, Yale University, New Haven, CT, United States of America.
| | - Oluwaseun E Fashanu
- The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, United States of America; Saint Agnes Healthcare, Baltimore, MD, United States of America.
| | - Erin D Michos
- The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, United States of America.
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Resting Heart Rate and Blood Pressure as Indices of Cardiovascular and Mortality Risk: IS LOWER INVARIABLY BETTER? J Cardiopulm Rehabil Prev 2019; 38:353-357. [PMID: 30371627 DOI: 10.1097/hcr.0000000000000376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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19
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Choi GY, Han CH, Jung YJ, Hwang HJ. A multi-day and multi-band dataset for a steady-state visual-evoked potential-based brain-computer interface. Gigascience 2019; 8:giz133. [PMID: 31765472 PMCID: PMC6876666 DOI: 10.1093/gigascience/giz133] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 08/26/2019] [Accepted: 10/16/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND A steady-state visual-evoked potential (SSVEP) is a brain response to visual stimuli modulated at certain frequencies; it has been widely used in electroencephalography (EEG)-based brain-computer interface research. However, there are few published SSVEP datasets for brain-computer interface. In this study, we obtained a new SSVEP dataset based on measurements from 30 participants, performed on 2 days; our dataset complements existing SSVEP datasets: (i) multi-band SSVEP datasets are provided, and all 3 possible frequency bands (low, middle, and high) were used for SSVEP stimulation; (ii) multi-day datasets are included; and (iii) the EEG datasets include simultaneously obtained physiological measurements, such as respiration, electrocardiography, electromyography, and head motion (accelerator). FINDINGS To validate our dataset, we estimated the spectral powers and classification performance for the EEG (SSVEP) datasets and created an example plot to visualize the physiological time-series data. Strong SSVEP responses were observed at stimulation frequencies, and the mean classification performance of the middle frequency band was significantly higher than the low- and high-frequency bands. Other physiological data also showed reasonable results. CONCLUSIONS Our multi-band, multi-day SSVEP datasets can be used to optimize stimulation frequencies because they enable simultaneous investigation of the characteristics of the SSVEPs evoked in each of the 3 frequency bands, and solve session-to-session (day-to-day) transfer problems by enabling investigation of the non-stationarity of SSVEPs measured on different days. Additionally, auxiliary physiological data can be used to explore the relationship between SSVEP characteristics and physiological conditions, providing useful information for optimizing experimental paradigms to achieve high performance.
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Affiliation(s)
- Ga-Young Choi
- Department of Medical IT Convergence Engineering, Kumoh National Institute of Technology, Daehak-ro 61, Gumi 39177, Republic of Korea
| | - Chang-Hee Han
- Machine Learning Group, Berlin Institute of Technology (TU Berlin), Marchstrasse 23, Berlin 10587, Germany
| | - Young-Jin Jung
- Department of Radiological Science, Dongseo University, Jurye-ro 47, Busan 47011, Republic of Korea
| | - Han-Jeong Hwang
- Department of Medical IT Convergence Engineering, Kumoh National Institute of Technology, Daehak-ro 61, Gumi 39177, Republic of Korea
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20
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Comparison of Motion Artifacts on CT Images Obtained in the Ultrafast Scan Mode and Conventional Scan Mode for Unconscious Patients in the Emergency Department. AJR Am J Roentgenol 2019; 213:W153-W161. [DOI: 10.2214/ajr.19.21456] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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21
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Training and Evaluation of Human Cardiorespiratory Endurance Based on a Fuzzy Algorithm. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132390. [PMID: 31284468 PMCID: PMC6651740 DOI: 10.3390/ijerph16132390] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 07/01/2019] [Accepted: 07/03/2019] [Indexed: 11/17/2022]
Abstract
Cardiorespiratory endurance refers to the ability of the heart and lungs to deliver oxygen to working muscles during continuous physical activity, which is an important indicator of physical health. Cardiorespiratory endurance is typically measured in the laboratory by maximum oxygen uptake (VO2max) which is not a practical method for real-life use. Given the relative difficulty in measuring oxygen consumption directly, we can estimate cardiorespiratory endurance on the basis of heart beat. In this paper, we proposed a fuzzy system based on the human heart rate to provide an effective cardiorespiratory endurance training program and the evaluation of cardiorespiratory endurance levels. Trainers can respond correctly with the help of a smart fitness app to obtain the desired training results and prevent undesirable events such as under-training or over-training. The fuzzy algorithm, which is built for the Android mobile phone operating system receives the resting heart rate (RHR) of the participants via Bluetooth before exercise to determine the suitable training speed mode of a treadmill for the individual. The computer-based fuzzy program takes RHR and heart rate recovery (HRR) after exercise as inputs to calculate the cardiorespiratory endurance level. The experimental results show that after 8 weeks of exercise training, the RHR decreased by an average of 11%, the HRR increased by 51.5%, and the cardiorespiratory endurance evaluation level was also improved. The proposed system can be combined with other methods for fitness instructors to design a training program that is more suitable for individuals.
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22
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Sochacki KR, Dong D, Peterson L, McCulloch PC, Lisman K, Harris JD. Overnight call is associated with poor resting heart rate and heart rate variability in orthopaedic surgeons. J ISAKOS 2019. [DOI: 10.1136/jisakos-2019-000273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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23
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Jensen MT. Resting heart rate and relation to disease and longevity: past, present and future. Scandinavian Journal of Clinical and Laboratory Investigation 2019; 79:108-116. [PMID: 30761923 DOI: 10.1080/00365513.2019.1566567] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Assessment of heart rate has been used for millennia as a marker of health. Several studies have indicated that low resting heart rate (RHR) is associated with health and longevity, and conversely, a high resting heart to be associated with disease and adverse events. Longitudinal studies have shown a clear association between increase in heart rate over time and adverse events. RHR is a fundamental clinical characteristic and several trials have assessed the effectiveness of heart rate lowering medication, for instance beta-blockers and selective sinus node inhibition. Advances in technology have provided new insights into genetic factors related to RHR as well as insights into whether elevated RHR is a risk factor or risk marker. Recent animal research has suggested that heart rate lowering with sinus node inhibition is associated with increased lifespan. Furthermore, genome-wide association studies in the general population using Mendelian randomization have demonstrated a causal link between heart rate at rest and longevity. Furthermore, the development in personal digital devices such as mobile phones, fitness trackers and eHealth applications has made heart rate information and knowledge in this field as important as ever for the public as well as the clinicians. It should therefore be expected that clinicians and health care providers will be met by relevant questions and need of advice regarding heart rate information from patients and the public. The present review provides an overview of the current knowledge in the field of heart rate and health.
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Affiliation(s)
- Magnus T Jensen
- a Department of Cardiology , Rigshospitalet , Copenhagen, Denmark.,b Department of Cardiology , Herlev-Gentofte Hospital , Hellerup , Denmark
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24
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Wang S, Fashanu OE, Zhao D, Guallar E, Gottesman RF, Schneider ALC, McEvoy JW, Norby FL, Aladin AI, Alonso A, Michos ED. Relation of Elevated Resting Heart Rate in Mid-Life to Cognitive Decline Over 20 Years (from the Atherosclerosis Risk in Communities [ARIC] Study). Am J Cardiol 2019; 123:334-340. [PMID: 30424869 PMCID: PMC6309583 DOI: 10.1016/j.amjcard.2018.10.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/28/2018] [Accepted: 10/02/2018] [Indexed: 11/24/2022]
Abstract
Resting heart rate (RHR) is independently associated with cardiovascular disease (CVD) risk. We determined whether RHR, measured in mid-life, is also associated with cognitive decline. We studied 13,720 middle-aged white and black ARIC participants without a history of stroke or atrial fibrillation. RHR was obtained from a 12-lead resting electrocardiogram at the baseline visit (1990 to 1992) and categorized into groups as <60 (reference), 60 to 69, 70 to 79 and ≥80 beats/min. Cognitive scores were obtained at baseline and at up to 2 additional visits (1996 to 1998 and 2011 to 2013). The primary outcome was a global composite cognitive score (Z-score) derived from 3 tests: delayed word recall, digit symbol substitution, and word fluency. The associations of RHR with cognitive decline and incident dementia were examined using linear mixed-effects and Cox hazard models, respectively, adjusting for sociodemographics, CVD risk factors, and AV-nodal blockade use. Multiple imputation methods were used to account for attrition over follow-up. Participants had mean ± SD age of 58 ± 6 years; 56% were women, 24% black. Average RHR was 66 ± 10 beats/min. Over a mean follow-up of 20 years, those with RHR ≥80 beats/min had greater global cognitive decline (average adjusted Z-score difference -0.12 [95% confidence interval -0.21, -0.03]) and increased risk for incident dementia (hazard ratio 1.28 (1.04, 1.57), compared with those with RHR <60 beats/min. In conclusion, elevated RHR is independently associated with greater cognitive decline and incident dementia over 20 years. Further studies are needed to determine whether the associations are causal or secondary to another underlying process, and whether modification of RHR can affect cognitive decline.
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Affiliation(s)
- Stephanie Wang
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Oluwaseun E Fashanu
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Di Zhao
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, Maryland; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Eliseo Guallar
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, Maryland; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Rebecca F Gottesman
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | | | - John W McEvoy
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Faye L Norby
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Amer I Aladin
- Department of Cardiology, Wake Forest University Baptist Health, Winston Salem, North Carolina
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Erin D Michos
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland; Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, Maryland.
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25
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Abbott TEF, Pearse RM, Cuthbertson BH, Wijeysundera DN, Ackland GL. Cardiac vagal dysfunction and myocardial injury after non-cardiac surgery: a planned secondary analysis of the measurement of Exercise Tolerance before surgery study. Br J Anaesth 2018; 122:188-197. [PMID: 30686304 PMCID: PMC6354047 DOI: 10.1016/j.bja.2018.10.060] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/19/2018] [Accepted: 10/20/2018] [Indexed: 12/14/2022] Open
Abstract
Background The aetiology of perioperative myocardial injury is poorly understood and not clearly linked to pre-existing cardiovascular disease. We hypothesised that loss of cardioprotective vagal tone [defined by impaired heart rate recovery ≤12 beats min−1 (HRR ≤12) 1 min after cessation of preoperative cardiopulmonary exercise testing] was associated with perioperative myocardial injury. Methods We conducted a pre-defined, secondary analysis of a multi-centre prospective cohort study of preoperative cardiopulmonary exercise testing. Participants were aged ≥40 yr undergoing non-cardiac surgery. The exposure was impaired HRR (HRR≤12). The primary outcome was postoperative myocardial injury, defined by serum troponin concentration within 72 h after surgery. The analysis accounted for established markers of cardiac risk [Revised Cardiac Risk Index (RCRI), N-terminal pro-brain natriuretic peptide (NT pro-BNP)]. Results A total of 1326 participants were included [mean age (standard deviation), 64 (10) yr], of whom 816 (61.5%) were male. HRR≤12 occurred in 548 patients (41.3%). Myocardial injury was more frequent amongst patients with HRR≤12 [85/548 (15.5%) vs HRR>12: 83/778 (10.7%); odds ratio (OR), 1.50 (1.08–2.08); P=0.016, adjusted for RCRI). HRR declined progressively in patients with increasing numbers of RCRI factors. Patients with ≥3 RCRI factors were more likely to have HRR≤12 [26/36 (72.2%) vs 0 factors: 167/419 (39.9%); OR, 3.92 (1.84–8.34); P<0.001]. NT pro-BNP greater than a standard prognostic threshold (>300 pg ml−1) was more frequent in patients with HRR≤12 [96/529 (18.1%) vs HRR>12 59/745 (7.9%); OR, 2.58 (1.82–3.64); P<0.001]. Conclusions Impaired HRR is associated with an increased risk of perioperative cardiac injury. These data suggest a mechanistic role for cardiac vagal dysfunction in promoting perioperative myocardial injury.
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Affiliation(s)
- T E F Abbott
- William Harvey Research Institute, Queen Mary University of London, London, UK; University College London Hospital, London, UK
| | - R M Pearse
- William Harvey Research Institute, Queen Mary University of London, London, UK; Barts Health NHS Trust, London, UK
| | - B H Cuthbertson
- Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada
| | - D N Wijeysundera
- University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Toronto General Hospital, Toronto, ON, Canada
| | - G L Ackland
- William Harvey Research Institute, Queen Mary University of London, London, UK; Barts Health NHS Trust, London, UK.
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26
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Nabian M, Yin Y, Wormwood J, Quigley KS, Barrett LF, Ostadabbas S. An Open-Source Feature Extraction Tool for the Analysis of Peripheral Physiological Data. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2018; 6:2800711. [PMID: 30443441 PMCID: PMC6231905 DOI: 10.1109/jtehm.2018.2878000] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 09/05/2018] [Accepted: 10/22/2018] [Indexed: 11/09/2022]
Abstract
Electrocardiogram, electrodermal activity, electromyogram, continuous blood pressure, and impedance cardiography are among the most commonly used peripheral physiological signals (biosignals) in psychological studies and healthcare applications, including health tracking, sleep quality assessment, disease early-detection/diagnosis, and understanding human emotional and affective phenomena. This paper presents the development of a biosignal-specific processing toolbox (Bio-SP tool) for preprocessing and feature extraction of these physiological signals according to the state-of-the-art studies reported in the scientific literature and feedback received from the field experts. Our open-source Bio-SP tool is intended to assist researchers in affective computing, digital and mobile health, and telemedicine to extract relevant physiological patterns (i.e., features) from these biosignals semi-automatically and reliably. In this paper, we describe the successful algorithms used for signal-specific quality checking, artifact/noise filtering, and segmentation along with introducing features shown to be highly relevant to category discrimination in several healthcare applications (e.g., discriminating patterns associated with disease versus non-disease). Further, the Bio-SP tool is a publicly-available software written in MATLAB with a user-friendly graphical user interface (GUI), enabling future crowd-sourced modification to these tools. The GUI is compatible with MathWorks Classification Learner app for inference model development, such as model training, cross-validation scheme farming, and classification result computation.
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Affiliation(s)
- Mohsen Nabian
- Augmented Cognition LabElectrical and Computer Engineering DepartmentNortheastern UniversityBostonMA02115USA
- Harvard Medical SchoolBostonMA02115USA
| | - Yu Yin
- Augmented Cognition LabElectrical and Computer Engineering DepartmentNortheastern UniversityBostonMA02115USA
| | | | | | - Lisa F. Barrett
- Department of PsychologyNortheastern UniversityBostonMA02115USA
| | - Sarah Ostadabbas
- Augmented Cognition LabElectrical and Computer Engineering DepartmentNortheastern UniversityBostonMA02115USA
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27
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Abbott TEF, Ackland GL, Archbold RA, Wragg A, Kam E, Ahmad T, Khan AW, Niebrzegowska E, Rodseth RN, Devereaux PJ, Pearse RM. Preoperative heart rate and myocardial injury after non-cardiac surgery: results of a predefined secondary analysis of the VISION study. Br J Anaesth 2018; 117:172-81. [PMID: 27440628 PMCID: PMC4954612 DOI: 10.1093/bja/aew182] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2016] [Indexed: 12/15/2022] Open
Abstract
Background Increased baseline heart rate is associated with cardiovascular risk and all-cause mortality in the general population. We hypothesized that elevated preoperative heart rate increases the risk of myocardial injury after non-cardiac surgery (MINS). Methods We performed a secondary analysis of a prospective international cohort study of patients aged ≥45 yr undergoing non-cardiac surgery. Preoperative heart rate was defined as the last measurement before induction of anaesthesia. The sample was divided into deciles by heart rate. Multivariable logistic regression models were used to determine relationships between preoperative heart rate and MINS (determined by serum troponin concentration), myocardial infarction (MI), and death within 30 days of surgery. Separate models were used to test the relationship between these outcomes and predefined binary heart rate thresholds. Results Patients with missing outcomes or heart rate data were excluded from respective analyses. Of 15 087 patients, 1197 (7.9%) sustained MINS, 454 of 16 007 patients (2.8%) sustained MI, and 315 of 16 037 patients (2.0%) died. The highest heart rate decile (>96 beats min−1) was independently associated with MINS {odds ratio (OR) 1.48 [1.23–1.77]; P<0.01}, MI (OR 1.71 [1.34–2.18]; P<0.01), and mortality (OR 3.16 [2.45–4.07]; P<0.01). The lowest decile (<60 beats min−1) was independently associated with reduced mortality (OR 0.50 [0.29–0.88]; P=0.02), but not MINS or MI. The predefined binary thresholds were also associated with MINS, but more weakly than the highest heart rate decile. Conclusions Preoperative heart rate >96 beats min−1 is associated with MINS, MI, and mortality after non-cardiac surgery. This association persists after accounting for potential confounding factors. Clinical trial registration NCT00512109.
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Affiliation(s)
- T E F Abbott
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - G L Ackland
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | | | - A Wragg
- Barts Health NHS Trust, London, UK
| | - E Kam
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - T Ahmad
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - A W Khan
- Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan
| | | | - R N Rodseth
- Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - P J Devereaux
- Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - R M Pearse
- William Harvey Research Institute, Queen Mary University of London, London, UK
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28
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Giger A, Stadelmann M, Preiswerk F, Jud C, De Luca V, Celicanin Z, Bieri O, Salomir R, Cattin PC. Ultrasound-driven 4D MRI. Phys Med Biol 2018; 63:145015. [PMID: 29864021 DOI: 10.1088/1361-6560/aaca1d] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We present an ultrasound-driven 4D magnetic resonance imaging (US-4DMRI) method for respiratory motion imaging in the thorax and abdomen. The proposed US-4DMRI comes along with a high temporal resolution, and allows for organ motion imaging beyond a single respiratory cycle. With the availability of the US surrogate both inside and outside the MR bore, 4D MR images can be reconstructed for 4D treatment planning and online respiratory motion prediction during radiotherapy. US-4DMRI relies on simultaneously acquired 2D liver US images and abdominal 2D MR multi-slice scans under free respiration. MR volumes are retrospectively composed by grouping the MR slices corresponding to the most similar US images. We present two different US similarity metrics: an intensity-based approach, and a similarity measure relying on predefined fiducials which are being tracked over time. The proposed method is demonstrated on MR liver scans of eight volunteers acquired over a duration of 5.5 min each at a temporal resolution of 2.6 Hz with synchronous US imaging at 14 Hz-17 Hz. Visual inspection of the reconstructed MR volumes revealed satisfactory results in terms of continuity in organ boundaries and blood vessels. In quantitative leave-one-out experiments, both US similarity metrics reach the performance level of state-of-the-art navigator-based approaches.
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Affiliation(s)
- Alina Giger
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland. Center for Medical Image Analysis & Navigation, University of Basel, Allschwil, Switzerland
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29
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Amoakwa K, Fashanu OE, Tibuakuu M, Zhao D, Guallar E, Whelton SP, O'Neal WT, Post WS, Budoff MJ, Michos ED. Resting heart rate and the incidence and progression of valvular calcium: The Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis 2018; 273:45-52. [PMID: 29677630 PMCID: PMC5949274 DOI: 10.1016/j.atherosclerosis.2018.04.004] [Citation(s) in RCA: 10] [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: 12/01/2017] [Revised: 03/05/2018] [Accepted: 04/05/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS Left-sided valvular calcification is associated with cardiovascular disease (CVD) morbidity and mortality. Resting heart rate (RHR) may influence valvular calcium progression through shear stress. Whether RHR, an established CVD risk factor, is associated with valvular calcium progression is unknown. We assessed whether RHR predicts incidence and progression of mitral annular calcium (MAC) and aortic valve calcium (AVC) in a community-based cohort free of CVD at baseline. METHODS RHR was obtained from baseline electrocardiograms of 5498 MESA participants. MAC and AVC were quantified using Agatston scoring from cardiac computed tomography scans obtained at baseline and at a second examination during follow-up. We examined associations of RHR with incident MAC/AVC and annual change in MAC/AVC scores, after adjusting for demographics, CVD risk factors, physical activity, and atrioventricular nodal blocker use. RESULTS At baseline, participants had mean age of 62 ± 10 years and mean RHR of 63 ± 10 bpm; 12.3% and 8.9% had prevalent AVC and MAC, respectively. Over a median of 2.3 years, 4.1% and 4.5% developed incident AVC and MAC, respectively. Each 10 bpm higher RHR was significantly associated with incident MAC [Risk Ratio 1.17 (95% CI 1.03-1.34)], but not incident AVC. However, RHR was associated with AVC progression [β = 1.62 (0.45-2.80) Agatston units/year for every 10 bpm increment], but not MAC progression. CONCLUSIONS Higher RHR was associated with MAC incidence and AVC progression, independent of traditional CVD risk factors. Future studies are needed to determine whether modification of RHR through lifestyle or pharmacologic interventions can reduce valvular calcium incidence or progression.
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Affiliation(s)
| | - Oluwaseun E Fashanu
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Martin Tibuakuu
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Medicine, St. Luke's Hospital, Chesterfield, MO, USA
| | - Di Zhao
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Eliseo Guallar
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Seamus P Whelton
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Wesley T O'Neal
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Wendy S Post
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Matthew J Budoff
- Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Los Angeles, CA, USA
| | - Erin D Michos
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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30
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Al-Mallah MH, Sakr S, Al-Qunaibet A. Cardiorespiratory Fitness and Cardiovascular Disease Prevention: an Update. Curr Atheroscler Rep 2018; 20:1. [PMID: 29340805 DOI: 10.1007/s11883-018-0711-4] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE OF REVIEW Cardiovascular diseases account for nearly one third of all deaths globally. Improving exercise capacity and cardiorespiratory fitness (CRF) has been an important target to reduce cardiovascular events. In addition, the American Heart Association defined decreased physical activity as the fourth risk factor for coronary artery disease. Multiple large cohort studies have evaluated the impact of CRF on outcomes. In this review, we will discuss the role of CRF in reducing cardiovascular morbidity and mortality. RECENT FINDINGS Recent data suggest that CRF has an important role in reducing not only cardiovascular and all-cause mortality, but also incident myocardial infarction, hypertension, diabetes, atrial fibrillation, heart failure, and stroke. Most recently, its role in cancer prevention started to emerge. CRF protective effects have also been seen in patients with prior comorbidities like prior coronary artery disease, heart failure, depression, end-stage renal disease, and stroke. The prognostic value of CRF has been demonstrated in various patient populations and cardiovascular conditions. Higher CRF is associated with improved survival and decreased incidence of cardiovascular diseases (CVD) and other comorbidities including hypertension, diabetes, heart failure, and atrial fibrillation.
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Affiliation(s)
- Mouaz H Al-Mallah
- King Abdulaziz Cardiac Center, Ministry of National Guard-Health Affairs, King Abdulaziz Medical City, P.O. Box 22490, Riyadh, 11426, Kingdom of Saudi Arabia. .,King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia. .,King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia.
| | - Sherif Sakr
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Ada Al-Qunaibet
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia
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31
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Resting heart rate: A physiological predicator of lie detection ability. Physiol Behav 2018; 186:10-15. [PMID: 29305871 DOI: 10.1016/j.physbeh.2018.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 12/20/2017] [Accepted: 01/02/2018] [Indexed: 11/21/2022]
Abstract
This study explored a psychophysiological measure, Resting Heart Rate (RHR), as a predicator of the ability to detect lies. RHR was recorded for 1min and followed by a deception detection task in which participants were required to judge 24 videos of people describing a real-life event (50% truthful, 50% deceptive). Multiple regression analyses showed that, among other individual characteristics, only RHR predicted the ability to distinguish truth from lies. Importantly, the prediction was negative. This result suggests that the higher the RHR, the worse the detection of lies. Since the RHR is considered to be a physiological trait indexing autonomous arousal, and since high-arousal states can lead to restricted attentional resources, we suggest that limited selection and utilization of cues due to restricted attention is the reason why higher RHR leads to poor deception detection.
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32
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Seviiri M, Lynch BM, Hodge AM, Yang Y, Liew D, English DR, Giles GG, Milne RL, Dugué PA. Resting heart rate, temporal changes in resting heart rate, and overall and cause-specific mortality. Heart 2017; 104:1076-1085. [PMID: 29269380 DOI: 10.1136/heartjnl-2017-312251] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 11/14/2017] [Accepted: 11/16/2017] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Most studies investigating the association between resting heart rate (RHR) and mortality have focused on cardiovascular disease (CVD) mortality, and measured RHR at only one time point. We aimed to assess associations of RHR and changes in RHR over approximately a decade with overall and cause-specific mortality. METHODS We used data from participants in the Melbourne Collaborative Cohort Study with RHR measures at baseline (1990-1994; n=41 386; 9846 deaths) and at follow-up (2003-2007; n=21 692; 2818 deaths). RHR measures were taken by trained staff, using Dinamap monitors. Cox models were used to estimate HR and 95% CI for the associations between RHR and mortality. Vital status and cause of death were ascertained until August 2015 and December 2013, respectively. RESULTS After adjustment for confounders, including blood pressure and known medical conditions but not arrhythmias or atrial fibrillation, RHR was associated with a higher risk of death of similar magnitude for CVD (HR per 10 beats per minute (bpm)=1.11, 95% CI 1.07 to 1.16), cancer (HR=1.10, 95% CI 1.06 to 1.13) and other causes (HR=1.20, 95% CI 1.16 to 1.25). Higher mortality was observed for most cancer sites, including breast (HR=1.16, 95% CI 1.03 to 1.31), colorectal (HR=1.18, 95% CI 1.08 to 1.29), kidney (HR=1.27, 95% CI 1.03 to 1.57) and lung cancer (HR=1.19, 95% CI 1.10 to 1.29). Temporal increases in RHR were associated with higher mortality, particularly for individuals whose RHR increased by more than 15 bpm. CONCLUSIONS RHR and changes in RHR over a decade are associated with mortality risk, including from causes other than CVD such as breast, colorectal or lung cancer. Monitoring of RHR may have utility in identifying individuals at higher mortality risk.
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Affiliation(s)
- Mathias Seviiri
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Brigid M Lynch
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.,Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Allison M Hodge
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Yi Yang
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Danny Liew
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Dallas R English
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Graham G Giles
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Roger L Milne
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Pierre-Antoine Dugué
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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33
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Cheeran D, Khan S, Khera R, Bhatt A, Garg S, Grodin JL, Morlend R, Araj FG, Amin AA, Thibodeau JT, Das S, Drazner MH, Mammen PPA. Predictors of Death in Adults With Duchenne Muscular Dystrophy-Associated Cardiomyopathy. J Am Heart Assoc 2017; 6:JAHA.117.006340. [PMID: 29042427 PMCID: PMC5721845 DOI: 10.1161/jaha.117.006340] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Duchenne muscular dystrophy (DMD) is frequently complicated by development of a cardiomyopathy. Despite significant medical advances provided to DMD patients over the past 2 decades, there remains a group of DMD patients who die prematurely. The current study sought to identify a set of prognostic factors that portend a worse outcome among adult DMD patients. Methods and Results A retrospective cohort of 43 consecutive patients was followed in the adult UT Southwestern Neuromuscular Cardiomyopathy Clinic. Clinical data were abstracted from the electronic medical record to generate baseline characteristics. The population was stratified by survival to time of analysis and compared with characteristics associated with death. The DMD population was in the early 20s, with median follow‐up times over 2 years. All the patients had developed a cardiomyopathy, with the majority of the patients on angiotensin‐converting enzyme inhibitors (86%) and steroids (56%), but few other guideline‐directed heart failure medications. Comparison between the nonsurviving and surviving cohorts found several poor prognostic factors, including lower body mass index (17.3 [14.8–19.3] versus 25.8 [20.8–29.1] kg/m2, P<0.01), alanine aminotransferase levels (26 [18–42] versus 53 [37–81] units/L, P=0.001), maximum inspiratory pressures (13 [0–30] versus 33 [25–40] cmH2O, P=0.03), and elevated cardiac biomarkers (N‐terminal pro‐brain natriuretic peptide: 288 [72–1632] versus 35 [21–135] pg/mL, P=0.03]. Conclusions The findings demonstrate a DMD population with a high burden of cardiomyopathy. The nonsurviving cohort was comparatively underweight, and had worse respiratory profiles and elevated cardiac biomarkers. Collectively, these factors highlight a high‐risk cardiovascular population with a worse prognosis.
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Affiliation(s)
- Daniel Cheeran
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX.,Heart Failure, Ventricular Assist Device & Heart Transplant Program, University of Texas Southwestern Medical Center, Dallas, TX
| | - Shaida Khan
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Rohan Khera
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Anish Bhatt
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Sonia Garg
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX.,Heart Failure, Ventricular Assist Device & Heart Transplant Program, University of Texas Southwestern Medical Center, Dallas, TX
| | - Justin L Grodin
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX.,Heart Failure, Ventricular Assist Device & Heart Transplant Program, University of Texas Southwestern Medical Center, Dallas, TX
| | - Robert Morlend
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX.,Heart Failure, Ventricular Assist Device & Heart Transplant Program, University of Texas Southwestern Medical Center, Dallas, TX
| | - Faris G Araj
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX.,Heart Failure, Ventricular Assist Device & Heart Transplant Program, University of Texas Southwestern Medical Center, Dallas, TX
| | - Alpesh A Amin
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX.,Heart Failure, Ventricular Assist Device & Heart Transplant Program, University of Texas Southwestern Medical Center, Dallas, TX
| | - Jennifer T Thibodeau
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX.,Heart Failure, Ventricular Assist Device & Heart Transplant Program, University of Texas Southwestern Medical Center, Dallas, TX
| | - Sandeep Das
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - Mark H Drazner
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX.,Heart Failure, Ventricular Assist Device & Heart Transplant Program, University of Texas Southwestern Medical Center, Dallas, TX
| | - Pradeep P A Mammen
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX .,Heart Failure, Ventricular Assist Device & Heart Transplant Program, University of Texas Southwestern Medical Center, Dallas, TX.,Hamon Center for Regenerative Science and Medicine, University of Texas Southwestern Medical Center, Dallas, TX.,UT Southwestern Senator Paul D. Wellstone Muscular Dystrophy Cooperative Research Center, University of Texas Southwestern Medical Center, Dallas, TX
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34
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van den Berg ME, Warren HR, Cabrera CP, Verweij N, Mifsud B, Haessler J, Bihlmeyer NA, Fu YP, Weiss S, Lin HJ, Grarup N, Li-Gao R, Pistis G, Shah N, Brody JA, Müller-Nurasyid M, Lin H, Mei H, Smith AV, Lyytikäinen LP, Hall LM, van Setten J, Trompet S, Prins BP, Isaacs A, Radmanesh F, Marten J, Entwistle A, Kors JA, Silva CT, Alonso A, Bis JC, de Boer R, de Haan HG, de Mutsert R, Dedoussis G, Dominiczak AF, Doney ASF, Ellinor PT, Eppinga RN, Felix SB, Guo X, Hagemeijer Y, Hansen T, Harris TB, Heckbert SR, Huang PL, Hwang SJ, Kähönen M, Kanters JK, Kolcic I, Launer LJ, Li M, Yao J, Linneberg A, Liu S, Macfarlane PW, Mangino M, Morris AD, Mulas A, Murray AD, Nelson CP, Orrú M, Padmanabhan S, Peters A, Porteous DJ, Poulter N, Psaty BM, Qi L, Raitakari OT, Rivadeneira F, Roselli C, Rudan I, Sattar N, Sever P, Sinner MF, Soliman EZ, Spector TD, Stanton AV, Stirrups KE, Taylor KD, Tobin MD, Uitterlinden A, Vaartjes I, Hoes AW, van der Meer P, Völker U, Waldenberger M, Xie Z, Zoledziewska M, Tinker A, Polasek O, Rosand J, Jamshidi Y, van Duijn CM, Zeggini E, Jukema JW, Asselbergs FW, Samani NJ, Lehtimäki T, Gudnason V, Wilson J, Lubitz SA, Kääb S, Sotoodehnia N, Caulfield MJ, Palmer CNA, Sanna S, Mook-Kanamori DO, Deloukas P, Pedersen O, Rotter JI, Dörr M, O'Donnell CJ, Hayward C, Arking DE, Kooperberg C, van der Harst P, Eijgelsheim M, Stricker BH, Munroe PB. Discovery of novel heart rate-associated loci using the Exome Chip. Hum Mol Genet 2017; 26:2346-2363. [PMID: 28379579 PMCID: PMC5458336 DOI: 10.1093/hmg/ddx113] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 03/18/2017] [Indexed: 01/06/2023] Open
Abstract
Resting heart rate is a heritable trait, and an increase in heart rate is associated with increased mortality risk. Genome-wide association study analyses have found loci associated with resting heart rate, at the time of our study these loci explained 0.9% of the variation. This study aims to discover new genetic loci associated with heart rate from Exome Chip meta-analyses.Heart rate was measured from either elecrtrocardiograms or pulse recordings. We meta-analysed heart rate association results from 104 452 European-ancestry individuals from 30 cohorts, genotyped using the Exome Chip. Twenty-four variants were selected for follow-up in an independent dataset (UK Biobank, N = 134 251). Conditional and gene-based testing was undertaken, and variants were investigated with bioinformatics methods.We discovered five novel heart rate loci, and one new independent low-frequency non-synonymous variant in an established heart rate locus (KIAA1755). Lead variants in four of the novel loci are non-synonymous variants in the genes C10orf71, DALDR3, TESK2 and SEC31B. The variant at SEC31B is significantly associated with SEC31B expression in heart and tibial nerve tissue. Further candidate genes were detected from long-range regulatory chromatin interactions in heart tissue (SCD, SLF2 and MAPK8). We observed significant enrichment in DNase I hypersensitive sites in fetal heart and lung. Moreover, enrichment was seen for the first time in human neuronal progenitor cells (derived from embryonic stem cells) and fetal muscle samples by including our novel variants.Our findings advance the knowledge of the genetic architecture of heart rate, and indicate new candidate genes for follow-up functional studies.
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Affiliation(s)
- Marten E van den Berg
- Department of Medical Informatics Erasmus MC - University Medical Center Rotterdam, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands
| | - Helen R Warren
- Clinical Pharmacology, William Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK.,NIHR Barts Cardiovascular Biomedical Research Unit, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Claudia P Cabrera
- Clinical Pharmacology, William Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK.,NIHR Barts Cardiovascular Biomedical Research Unit, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Niek Verweij
- University Medical Center Groningen, University of Groningen, Department of Cardiology, the Netherlands
| | - Borbala Mifsud
- Clinical Pharmacology, William Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK.,NIHR Barts Cardiovascular Biomedical Research Unit, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Jeffrey Haessler
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Nathan A Bihlmeyer
- Predoctoral Training Program in Human Genetics, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA, 21205
| | - Yi-Ping Fu
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Stefan Weiss
- Interfaculty Institute for Genetics and Functional Genomics; University Medicine and Ernst-Moritz-Arndt-University Greifswald; Greifswald, 17475, Germany.,DZHK (German Centre for Cardiovascular Research); partner site Greifswald; Greifswald, 17475, Germany
| | - Henry J Lin
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA 90502, USA.,Division of Medical Genetics, Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Niels Grarup
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ruifang Li-Gao
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Giorgio Pistis
- Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Monserrato, Italy.,Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, USA
| | - Nabi Shah
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, DD1 9SY, UK.,Department of Pharmacy, COMSATS Institute of Information Technology, Abbottabad, 22060, Pakistan
| | - Jennifer A Brody
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA 98101, USA
| | - Martina Müller-Nurasyid
- Institute of Genetic Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.,Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-Universität, Munich, Germany
| | - Honghuang Lin
- Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, MA
| | - Hao Mei
- Department of Data Science, University of Mississippi Medical Center, Jackson, MI, USA
| | - Albert V Smith
- Icelandic Heart Association, 201 Kopavogur, Iceland.,Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland
| | - Leo-Pekka Lyytikäinen
- Department of Clinical Chemistry, Fimlab Laboratories and University of Tampere School of Medicine, Arvo, D339, P.O. Box 100, FI-33014 Tampere, Finland
| | - Leanne M Hall
- Department of Cardiovascular Sciences, University of Leicester, Cardiovascular Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK.,NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester LE3 9QP, UK
| | - Jessica van Setten
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Stella Trompet
- Department of Cardiology, Leiden University Medical Center, 2300 RC, Leiden, the Netherlands.,Department of Gerontology and Geriatrics, Leiden university Medical Center, Leiden, the Netherlands
| | - Bram P Prins
- Department of Human Genetics, Wellcome Trust Sanger Institute, Hinxton, United Kingdom, CB10 1SA.,Cardiogenetics Lab, Genetics and Molecular Cell Sciences Research Centre, Cardiovascular and Cell Sciences Institute, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Aaron Isaacs
- CARIM School for Cardiovascular Diseases, Maastricht Centre for Systems Biology (MaCSBio), Dept. of Biochemistry, Maastricht University, Universiteitssingel 60, 6229 ER Maastricht, NL
| | - Farid Radmanesh
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114.,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02142
| | - Jonathan Marten
- MRC Human Genetics Unit, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Crewe Road South, Edinburgh, EH4?2XU, UK
| | - Aiman Entwistle
- Clinical Pharmacology, William Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK.,NIHR Barts Cardiovascular Biomedical Research Unit, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Jan A Kors
- Department of Medical Informatics Erasmus MC - University Medical Center Rotterdam, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands
| | - Claudia T Silva
- Genetic Epidemiology Unit, Dept. of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, NL.,Doctoral Program in Biomedical Sciences, Universidad del Rosario, Bogotá, Colombia.,GENIUROS Group, Genetics and Genomics Research Center CIGGUR, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, 30322
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA 98101, USA
| | - Rudolf de Boer
- University Medical Center Groningen, University of Groningen, Department of Cardiology, the Netherlands
| | - Hugoline G de Haan
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - George Dedoussis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens 17671, Greece
| | - Anna F Dominiczak
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Alex S F Doney
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, DD1?9SY, UK
| | - Patrick T Ellinor
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02142.,Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA, USA
| | - Ruben N Eppinga
- University Medical Center Groningen, University of Groningen, Department of Cardiology, the Netherlands
| | - Stephan B Felix
- Department of Internal Medicine B - Cardiology, Pneumology, Infectious Diseases, Intensive Care Medicine; University Medicine Greifswald; Greifswald, 17475, Germany & DZHK (German Centre for Cardiovascular Research); partner site Greifswald; Greifswald, 17475, Germany
| | - Xiuqing Guo
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA 90502, USA
| | - Yanick Hagemeijer
- University Medical Center Groningen, University of Groningen, Department of Cardiology, the Netherlands
| | - Torben Hansen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Intramural Research Program, National Institutes of Health, Bethesda, Maryland, 20892, USA
| | - Susan R Heckbert
- Cardiovascular Health Research Unit and Department of Epidemiology, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA 98101, USA.,Group Health Research Institute, Group Health Cooperative, 1730 Minor Ave, Suite 1600, Seattle, WA, USA
| | - Paul L Huang
- Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA, USA
| | - Shih-Jen Hwang
- Population Sciences Branch, Division of Intramural Research, NHLBI, NIH, Bethesda MD, USA
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and University of Tampere School of Medicine, Finn-Medi 1, 3th floor, P.O. Box 2000, FI-33521 Tampere, Finland
| | - Jørgen K Kanters
- Laboratory of Experimental Cardiology, University of Copenhagen, Copenhagen, Denmark
| | - Ivana Kolcic
- Faculty of Medicine, University of Split, Split, Croatia
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Intramural Research Program, National Institutes of Health, Bethesda, Maryland, 20892, USA
| | - Man Li
- Division of Nephrology & Hypertension, Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT 84109, USA
| | - Jie Yao
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA 90502, USA
| | - Allan Linneberg
- Research Centre for Prevention and Health, Capital Region of Denmark, Copenhagen, Denmark.,Department of Clinical Experimental Research, Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Simin Liu
- Brown University School of Public Health, Providence, Rhode Island 02912, USA
| | | | - Massimo Mangino
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK.,NIHR Biomedical Research Centre at Guy's and St Thomas' Foundation Trust, London SE1 9RT, UK
| | - Andrew D Morris
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8?9AG, UK
| | - Antonella Mulas
- Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Monserrato, Italy
| | - Alison D Murray
- Aberdeen Biomedical Imaging Centre, Lilian Sutton Building, University of Aberdeen, Foresterhill, Aberdeen AB25?2ZD, UK
| | - Christopher P Nelson
- Department of Cardiovascular Sciences, University of Leicester, Cardiovascular Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK.,NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester LE3 9QP, UK
| | - Marco Orrú
- Unita Operativa Complessa di Cardiologia, Presidio Ospedaliero Oncologico Armando Businco Cagliari , Azienda Ospedaliera Brotzu Cagliari, Caglliari, Italy
| | - Sandosh Padmanabhan
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.,Institute of Cardiovascular and Medical Sciences, University of Glasgow, BHF GCRC, Glasgow G12 8TA, UK
| | - Annette Peters
- DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.,Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,German Center for Diabetes Research, Neuherberg, Germany
| | - David J Porteous
- Centre for Genomic & Experimental Medicine, Institute of Genetics & Molecular Medicine, University of Edinburgh, Western General Hospital, Crewe Road South, Edinburgh EH4?2XU, UK
| | - Neil Poulter
- School of Public Health, Imperial College London, W2?1PG, UK
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Department of Health Services, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA 98101, USA.,Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA
| | - Lihong Qi
- University of California Davis, One Shields Ave Ms1c 145, Davis, CA 95616 USA
| | - Olli T Raitakari
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, and Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, P.O. Box 52, FI-20521 Turku, Finland
| | - Fernando Rivadeneira
- Human Genomics Facility Erasmus MC - University Medical Center Rotterdam, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands
| | - Carolina Roselli
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Igor Rudan
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8?9AG, UK
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, BHF GCRC, Glasgow G12?8TA, UK
| | - Peter Sever
- National Heart and Lung Institute, Imperial College London, W2?1PG, UK
| | - Moritz F Sinner
- DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.,Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-Universität, Munich, Germany
| | - Elsayed Z Soliman
- Epidemiological Cardiology Research Center (EPICARE), Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Timothy D Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Alice V Stanton
- Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Kathleen E Stirrups
- Clinical Pharmacology, William Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK.,Department of Haematology, University of Cambridge, Cambridge, UK
| | - Kent D Taylor
- Institute for Translational Genomics and Population Sciences, Los Angeles BioMedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA.,Division of Genomic Outcomes, Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA.,Departments of Pediatrics, Medicine, and Human Genetics, UCLA, Los Angeles, CA, USA
| | - Martin D Tobin
- Department of Health Sciences, University of Leicester, Leicester LE1?7RH, UK
| | - André Uitterlinden
- Human Genotyping Facility Erasmus MC - University Medical Center Rotterdam, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands
| | - Ilonca Vaartjes
- Julius Center for Health Sciences and Primary Care, University Medical Center, PO Box 85500, 3508 GA Utrecht, the Netherlands
| | - Arno W Hoes
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Peter van der Meer
- University Medical Center Groningen, University of Groningen, Department of Cardiology, the Netherlands
| | - Uwe Völker
- Interfaculty Institute for Genetics and Functional Genomics; University Medicine and Ernst-Moritz-Arndt-University Greifswald; Greifswald, 17475, Germany.,DZHK (German Centre for Cardiovascular Research); partner site Greifswald; Greifswald, 17475, Germany
| | - Melanie Waldenberger
- DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.,Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG, UK.,Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Zhijun Xie
- Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, MA
| | | | - Andrew Tinker
- Clinical Pharmacology, William Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK.,NIHR Barts Cardiovascular Biomedical Research Unit, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Ozren Polasek
- Faculty of Medicine, University of Split, Split, Croatia.,Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG, UK
| | - Jonathan Rosand
- Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114.,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02142
| | - Yalda Jamshidi
- Cardiogenetics Lab, Genetics and Molecular Cell Sciences Research Centre, Cardiovascular and Cell Sciences Institute, St George's, University of London, Cranmer Terrace, London, SW17?0RE, UK
| | - Cornelia M van Duijn
- Genetic Epidemiology Unit, Dept. of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, NL
| | - Eleftheria Zeggini
- Department of Human Genetics, Wellcome Trust Sanger Institute, Hinxton, United Kingdom, CB10?1SA
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, 2300 RC, Leiden, the Netherlands
| | - Folkert W Asselbergs
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht, the Netherlands.,Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, the Netherlands.,Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK
| | - Nilesh J Samani
- Department of Cardiovascular Sciences, University of Leicester, Cardiovascular Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK.,NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester LE3 9QP, UK
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and University of Tampere School of Medicine, Arvo, D338, P.O. Box 100, FI-33014 Tampere, Finland
| | - Vilmundur Gudnason
- Icelandic Heart Association, 201 Kopavogur, Iceland.,Faculty of Medicine, University of Iceland, 101 Reykjavik, Iceland
| | - James Wilson
- Physiology & Biophysics, University of Mississippi Medical Center, Jackson, MI, USA
| | - Steven A Lubitz
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA 02142.,Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA, USA
| | - Stefan Kääb
- DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.,Department of Medicine I, University Hospital Munich, Ludwig-Maximilians-Universität, Munich, Germany
| | - Nona Sotoodehnia
- Cardiovascular Health Research Unit, Division of Cardiology, Departments of Medicine and Epidemiology, University of Washington, 1730 Minor Ave, Suite 1360, Seattle, WA 98101, USA
| | - Mark J Caulfield
- Clinical Pharmacology, William Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK.,NIHR Barts Cardiovascular Biomedical Research Unit, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Colin N A Palmer
- Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, DD1?9SY, UK
| | - Serena Sanna
- Istituto di Ricerca Genetica e Biomedica (IRGB), CNR, Monserrato, Italy
| | - Dennis O Mook-Kanamori
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.,Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Panos Deloukas
- Clinical Pharmacology, William Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Oluf Pedersen
- The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jerome I Rotter
- The Institute for Translational Genomics and Population Sciences, Departments of Pediatrics and Medicine, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA 90502, USA
| | - Marcus Dörr
- Department of Internal Medicine B - Cardiology, Pneumology, Infectious Diseases, Intensive Care Medicine; University Medicine Greifswald; Greifswald, 17475, Germany & DZHK (German Centre for Cardiovascular Research); partner site Greifswald; Greifswald, 17475, Germany
| | | | - Caroline Hayward
- MRC Human Genetics Unit, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Crewe Road South, Edinburgh, EH4?2XU, UK
| | - Dan E Arking
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA, 21205 and
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Pim van der Harst
- University Medical Center Groningen, University of Groningen, Department of Cardiology, the Netherlands
| | - Mark Eijgelsheim
- Department of Epidemiology Erasmus MC - University Medical Center Rotterdam, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands
| | - Bruno H Stricker
- Department of Epidemiology Erasmus MC - University Medical Center Rotterdam, P.O. Box 2040, 3000CA, Rotterdam, the Netherlands
| | - Patricia B Munroe
- Clinical Pharmacology, William Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK.,NIHR Barts Cardiovascular Biomedical Research Unit, Queen Mary University of London, London, EC1M 6BQ, UK
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Aune D, Sen A, ó'Hartaigh B, Janszky I, Romundstad PR, Tonstad S, Vatten LJ. Resting heart rate and the risk of cardiovascular disease, total cancer, and all-cause mortality - A systematic review and dose-response meta-analysis of prospective studies. Nutr Metab Cardiovasc Dis 2017; 27:504-517. [PMID: 28552551 DOI: 10.1016/j.numecd.2017.04.004] [Citation(s) in RCA: 156] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 04/06/2017] [Accepted: 04/13/2017] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND AIM Epidemiological studies have reported increased risk of cardiovascular disease, cancer and all-cause mortality with greater resting heart rate, however, the evidence is not consistent. Differences by gender, adjustment for confounding factors, as well as the potential impact of subclinical disease are not clear. A previous meta-analysis missed a large number of studies, and data for atrial fibrillation have not been summarized before. We therefore aimed to clarify these associations in a systematic review and meta-analysis of prospective studies. METHODS AND RESULTS PubMed and Embase were searched up to 29 March 2017. Summary RRs and 95% confidence intervals (CIs) were calculated using random effects models. Eighty seven studies were included. The summary RR per 10 beats per minute increase in resting heart rate was 1.07 (95% CI: 1.05-1.10, I2 = 61.9%, n = 31) for coronary heart disease, 1.09 (95% CI: 1.00-1.18, I2 = 62.3%, n = 5) for sudden cardiac death, 1.18 (95% CI: 1.10-1.27, I2 = 74.5%, n = 8) for heart failure, 0.97 (95% CI: 0.92-1.02, I2 = 91.4%, n = 9) for atrial fibrillation, 1.06 (95% CI: 1.02-1.10, I2 = 59.5%, n = 16) for total stroke, 1.15 (95% CI: 1.11-1.18, I2 = 84.3%, n = 35) for cardiovascular disease, 1.14 (95% CI: 1.06-1.23, I2 = 90.2%, n = 12) for total cancer, and 1.17 (95% CI: 1.14-1.19, I2 = 94.0%, n = 48) for all-cause mortality. There was a positive dose-response relationship for all outcomes except for atrial fibrillation for which there was a J-shaped association. CONCLUSION This meta-analysis found an increased risk of coronary heart disease, sudden cardiac death, heart failure, atrial fibrillation, stroke, cardiovascular disease, total cancer and all-cause mortality with greater resting heart rate.
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Affiliation(s)
- D Aune
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Epidemiology and Public Health, Imperial College, London, UK; Bjørknes University College, Oslo, Norway.
| | - A Sen
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - B ó'Hartaigh
- Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College, New York, USA; Department of Internal Medicine, Section of Geriatrics, Yale School of Medicine, Adler Geriatric Center, New Haven, USA
| | - I Janszky
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - P R Romundstad
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - S Tonstad
- Department of Preventive Cardiology, Oslo University Hospital Ullevål, Oslo, Norway
| | - L J Vatten
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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Aladin AI, Al Rifai M, Rasool SH, Keteyian SJ, Brawner CA, Blumenthal RS, Blaha MJ, Al-Mallah MH, McEvoy JW. Relation of Resting Heart Rate to Incident Atrial Fibrillation (from the Henry Ford Hospital Exercise Testing Project). Am J Cardiol 2017; 119:262-267. [PMID: 28126149 DOI: 10.1016/j.amjcard.2016.09.047] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 09/23/2016] [Accepted: 09/23/2016] [Indexed: 10/20/2022]
Abstract
Autonomic nervous system (ANS) dysfunction plays a role in atrial fibrillation (AF) initiation. Cardiorespiratory fitness modulates ANS function and is inversely associated with resting heart rate (RHR) and risk of AF. Thus, we sought to study the association between RHR, as a surrogate for ANS function, and incident AF independent of exercise capacity (EC). We analyzed 51,436 subjects without previous AF who underwent a clinically indicated exercise stress test. Incident AF was ascertained through claims files. RHR was measured before stress testing, and EC was estimated by peak metabolic equivalents of task. We studied the association between RHR categories (<70, 70 to 85 [reference], and >85 beats/min) and incident AF using Cox models adjusted for risk factors and for EC. We tested for interaction between RHR and age, gender, smoking, and EC. Mean (SD) age was 53 (13) years, 53% were men, and 28% were black. Participants with RHR <70 beats/min were older, more likely to be men, have higher EC, and more likely to smoke but less likely to have diabetes and hypertension. Over a median of 5.5 years, RHR <70 beats/min was associated with 14% increased risk of AF (95 CI 6% to 25%) in fully adjusted models, whereas RHR >85 beats/min was not associated with AF risk after adjusting for EC. Results for RHR analyzed continuously and by quartile were similar. No interaction was seen. In conclusion, subjects with low RHR at all levels of EC are at increased risk of AF and may benefit from heart rhythm surveillance, particularly in the presence of other AF risk factors.
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Zhang D, Wang W, Li F. Association between resting heart rate and coronary artery disease, stroke, sudden death and noncardiovascular diseases: a meta-analysis. CMAJ 2016; 188:E384-E392. [PMID: 27551034 DOI: 10.1503/cmaj.160050] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Resting heart rate is linked to risk of coronary artery disease, stroke, sudden death and noncardiovascular diseases. We conducted a meta-analysis to assess these associations in general populations and in populations of patients with hypertension or diabetes mellitus. METHODS We searched PubMed, Embase and MEDLINE from inception to Mar. 5, 2016. We used a random-effects model to combine study-specific relative risks (RRs). We used restricted cubic splines to assess the dose-response relation. RESULTS We included 45 nonrandomized prospective cohort studies in the meta-analysis. The multivariable adjusted RR with an increment of 10 beats/min in resting heart rate was 1.12 (95% confidence interval [CI] 1.09-1.14) for coronary artery disease, 1.05 (95% CI 1.01-1.08) for stroke, 1.12 (95% CI 1.02-1.24) for sudden death, 1.16 (95% CI 1.12-1.21) for noncardiovascular diseases, 1.09 (95% CI 1.06-1.12) for all types of cancer and 1.25 (95% CI 1.17-1.34) for noncardiovascular diseases excluding cancer. All of these relations were linear. In an analysis by category of resting heart rate (< 60 [reference], 60-70, 70-80 and > 80 beats/min), the RRs were 0.99 (95% CI 0.93-1.04), 1.08 (95% CI 1.01-1.16) and 1.30 (95% CI 1.19-1.43), respectively, for coronary artery disease; 1.08 (95% CI 0.98-1.19), 1.11 (95% CI 0.98-1.25) and 1.08 (95% CI 0.93-1.25), respectively, for stroke; and 1.17 (95% CI 0.94-1.46), 1.31 (95% CI 1.12-1.54) and 1.57 (95% CI 1.39-1.77), respectively, for noncardiovascular diseases. After excluding studies involving patients with hypertension or diabetes, we obtained similar results for coronary artery disease, stroke and noncardiovascular diseases, but found no association with sudden death. INTERPRETATION Resting heart rate was an independent predictor of coronary artery disease, stroke, sudden death and noncardiovascular diseases over all of the studies combined. When the analysis included only studies concerning general populations, resting heart rate was not associated with sudden death.
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Affiliation(s)
- Dongfeng Zhang
- Department of Epidemiology and Health Statistics, Medical College of Qingdao University, Shandong, Qingdao, China
| | - Weijing Wang
- Department of Epidemiology and Health Statistics, Medical College of Qingdao University, Shandong, Qingdao, China
| | - Fang Li
- Department of Epidemiology and Health Statistics, Medical College of Qingdao University, Shandong, Qingdao, China
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Korshøj M, Lidegaard M, Krustrup P, Jørgensen MB, Søgaard K, Holtermann A. Long Term Effects on Risk Factors for Cardiovascular Disease after 12-Months of Aerobic Exercise Intervention - A Worksite RCT among Cleaners. PLoS One 2016; 11:e0158547. [PMID: 27513932 PMCID: PMC4981369 DOI: 10.1371/journal.pone.0158547] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 06/18/2016] [Indexed: 01/09/2023] Open
Abstract
Objectives Occupational groups exposed to high occupational physical activity have an increased risk for cardiovascular disease (CVD). This may be explained by the high relative aerobic workload. Enhanced cardiorespiratory fitness reduces the relative aerobic workload. Thus, the aim was to evaluate the 12-months effects of worksite aerobic exercise on risk factors for CVD among cleaners. Methods One hundred and sixteen cleaners aged 18–65 years were randomized to a group performing aerobic exercise and a reference group receiving lectures. Outcomes were collected at baseline and after 12-months. A repeated measures 2×2 multi-adjusted mixed-model design was applied to compare the between-group differences using intention-to-treat analysis. Results Between-group differences (p<0.05) were found favouring the aerobic exercise group: cardiorespiratory fitness 2.15 (SE 1.03) mlO2/min/kg, aerobic workload -2.15 (SE 1.06) %HRR, resting HR -5.31 (SE 1.61) beats/min, high sensitive C-reactive protein -0.65 (SE 0.24) μg/ml. The blood pressure was unaltered. Stratified analyses on relative aerobic workload at baseline revealed that those with relative aerobic workloads ≥30% of HRR seems to impose a notable adverse effect on resting and ambulatory blood pressure. Conclusion This long-term worksite aerobic exercise intervention among cleaners led to several beneficial effects, but also potential adverse effects among those with high relative aerobic workloads. Trial Registration Controlled-Trials.com ISRCTN86682076
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Affiliation(s)
- Mette Korshøj
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Nørre Allé 51, 2200, Copenhagen N, Denmark
- * E-mail:
| | - Mark Lidegaard
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
| | - Peter Krustrup
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Nørre Allé 51, 2200, Copenhagen N, Denmark
- Sport and Health Sciences, College of Life and Environmental Sciences, St. Luke's Campus, University of Exeter, Exeter, United Kingdom
| | - Marie Birk Jørgensen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
| | - Karen Søgaard
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
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Xuereb R, Magri CJ, Xuereb S, Xuereb M, Mangion MZ, Xuereb RG. Female gender and cardiovascular disease. Br J Hosp Med (Lond) 2016; 77:454-9. [DOI: 10.12968/hmed.2016.77.8.454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Rachel Xuereb
- Third year medical student at the University of Malta, Malta
| | - Caroline J Magri
- Resident Specialist in the Department of Cardiology, Mater Dei Hospital, Tal-Qroqq, Msida MSD 2090, Malta, and Visiting Lecturer, University of Malta, Malta
| | - Sara Xuereb
- Foundation Year 2 Doctor in the Department of Medicine, Mater Dei Hospital, Malta
| | - Mariosa Xuereb
- Consultant Cardiologist in the Department of Cardiology, Mater Dei Hospital, and Visiting Senior Lecturer, University of Malta, Malta
| | | | - Robert G Xuereb
- Chairman and Consultant Cardiologist in the Department of Cardiology, Mater Dei Hospital, and Visiting Senior Lecturer, University of Malta, Malta
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Aladin AI, Al Rifai M, Rasool SH, Keteyian SJ, Brawner CA, Michos ED, Blaha MJ, Al-Mallah MH, McEvoy JW. The Association of Resting Heart Rate and Incident Hypertension: The Henry Ford Hospital Exercise Testing (FIT) Project. Am J Hypertens 2016; 29:251-7. [PMID: 26112864 DOI: 10.1093/ajh/hpv095] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 05/26/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Given that sympathetic tone is associated with hypertension, we sought to determine whether resting heart rate (RHR), as a surrogate for cardiac autonomic function, was associated with incident hypertension. METHODS We analyzed 21,873 individuals without a history of hypertension who underwent a clinically indicated exercise stress test. Baseline RHR was assessed prior to testing and was categorized as <70, 70-85, and >85 beats-per-minute (bpm). Incident hypertension was defined by subsequent diagnosis codes for new-onset hypertension from three or more encounters. We tested for effect modification by age (<60 vs. ≥60 years), sex, race, and history of coronary heart disease (CHD). RESULTS Mean (±SD) age was 49 (±12) years, 55% were men and 21% were Black. Compared to the lowest RHR (<70 bpm) category, patients in the highest category (>85 bpm) were younger, more likely to be female, heavier, diabetic, and achieve lower metabolic equivalents (METS). Over a median of 4 years follow-up, there were 8,179 cases of incident hypertension. Compared to RHR <70 bpm, persons with RHR >85 bpm had increased risk of hypertension after adjustment for CHD risk factors, baseline blood pressure (BP), and METS (hazard ratio = 1.15 (95% confidence interval 1.08-1.23)). Age was an effect modifier (interaction P = 0.02), whereas sex, race, and CHD were not. In age-stratified analyses the relationship remained significant only in those younger than 60 years. CONCLUSION Elevated RHR is an independent risk factor for incident hypertension, particularly in younger persons. Whether lifestyle modification or other strategies to reduce RHR can prevent incident hypertension in high-risk individuals warrants further study.
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Affiliation(s)
- Amer I Aladin
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Mahmoud Al Rifai
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Shereen H Rasool
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Steven J Keteyian
- Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan, USA
| | - Clinton A Brawner
- Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan, USA
| | - Erin D Michos
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Michael J Blaha
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Mouaz H Al-Mallah
- Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan, USA; Division of Cardiology and Imaging, King Abdul-Aziz Cardiac Center, Riyadh, Kingdom of Saudi Arabia
| | - John W McEvoy
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, Maryland, USA;
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Zhang D, Shen X, Qi X. Resting heart rate and all-cause and cardiovascular mortality in the general population: a meta-analysis. CMAJ 2015; 188:E53-E63. [PMID: 26598376 DOI: 10.1503/cmaj.150535] [Citation(s) in RCA: 172] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Data on resting heart rate and risk of all-cause and cardiovascular mortality are inconsistent; the magnitude of associations between resting heart rate and risk of all-cause and cardiovascular mortality varies across studies. We performed a meta-analysis of prospective cohort studies to quantitatively evaluate the associations in the general population. METHODS We searched PubMed, Embase and MEDLINE from inception to Jan. 1, 2015. We used a random-effects model to combine study-specific relative risks and 95% confidence intervals (CIs). We used restricted cubic spline functions to assess the dose-response relation. RESULTS A total of 46 studies were included in the meta-analysis, involving 1 246 203 patients and 78 349 deaths for all-cause mortality, and 848 320 patients and 25 800 deaths for cardiovascular mortality. The relative risk with 10 beats/min increment of resting heart rate was 1.09 (95% CI 1.07-1.12) for all-cause mortality and 1.08 (95% CI 1.06-1.10) for cardiovascular mortality. Compared with the lowest category, patients with a resting heart rate of 60-80 beats/min had a relative risk of 1.12 (95% CI 1.07-1.17) for all-cause mortality and 1.08 (95% CI 0.99-1.17) for cardiovascular mortality, and those with a resting heart rate of greater than 80 beats/min had a relative risk of 1.45 (95% CI 1.34-1.57) for all-cause mortality and 1.33 (95% CI 1.19-1.47) for cardiovascular mortality. Overall, the results did not differ after adjustment for traditional risk factors for cardiovascular disease. Compared with 45 beats/min, the risk of all-cause mortality increased significantly with increasing resting heart rate in a linear relation, but a significantly increased risk of cardiovascular mortality was observed at 90 beats/min. Substantial heterogeneity and publication bias were detected. INTERPRETATION Higher resting heart rate was independently associated with increased risks of all-cause and cardiovascular mortality. This indicates that resting heart rate is a predictor of all-cause and cardiovascular mortality in the general population.
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Affiliation(s)
- Dongfeng Zhang
- Departments of Epidemiology and Health Statistics (Zhang, Shen), and Clinical Medicine (Qi), Medical College of Qingdao University, Shandong, China
| | - Xiaoli Shen
- Departments of Epidemiology and Health Statistics (Zhang, Shen), and Clinical Medicine (Qi), Medical College of Qingdao University, Shandong, China
| | - Xin Qi
- Departments of Epidemiology and Health Statistics (Zhang, Shen), and Clinical Medicine (Qi), Medical College of Qingdao University, Shandong, China
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