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Fonseca HAR, Bittencourt CR, Monteiro AM, Fonseca FA, Sanches LR, Ferreira CEDS, Neto AMF, Gidlund M, Izar MC. Immunometabolic and Vascular Health Responses among High Endurance Trained Subjects. Int J Sports Med 2024; 45:245-252. [PMID: 37793434 DOI: 10.1055/a-2186-2717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
In this study, we aimed to examine the impact of high endurance training on vascular health parameters and immune-endocrine responses against modified low-density lipoprotein (LDL) particles. This observational, cross-sectional study included high endurance-trained and healthy non-trained subjects. Vascular ultrasound was used to assess vascular health parameters based on carotid intima-media thickness and endothelial function (flow-mediated dilation). Enzyme-linked immunosorbent assays were used to measure interleukin (IL)-8 and IL-10, autoantibody isotypes anti-oxidized LDL (oxLDL) and anti-apolipoprotein B (ApoB-D) peptide. Plasma levels of the corticosterone and 17 α-hydroxyprogesterone hormones were analyzed by mass spectrometry. This study enrolled 96 subjects, of whom 44 were high endurance trained and 52 were healthy non-trained individuals. Smaller carotid intima-media thickness values were observed in the high-endurance trained than in the healthy non-trained males, while no differences were observed between female groups. Flow-mediated dilation measurements did not differ by training or sex. The humoral immune responses to IgG anti-oxLDL and IgM anti-ApoB-D autoantibodies showed an isotype imbalance between the high-endurance trained and the non-trained groups. Immunoendocrine parameters showed inverse correlations between 17 α-hydroxyprogesterone concentrations and carotid intima-media thickness measurements. Direct correlations were found between IL-10 concentrations and flow-mediated dilation measurements. Chronic high-endurance exercise modulates immune-endocrine and vascular health parameters, in a sex-dependent manner.
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Affiliation(s)
- Henrique A R Fonseca
- Cardiology Division, Department of Medicine, Federal University of Sao Paulo, São Paulo, SP, Brazil
- Department of Immunology, Institute Biomedical Science IV, University of Sao Paulo, São Paulo, SP, Brazil
- National Institute of Technology in Complex Fluids, Physics Institute, University of Sao Paulo, São Paulo, SP, Brazil
| | - Celia Regina Bittencourt
- Cardiology Division, Department of Medicine, Federal University of Sao Paulo, São Paulo, SP, Brazil
| | - Andrea Moreira Monteiro
- Department of Immunology, Institute Biomedical Science IV, University of Sao Paulo, São Paulo, SP, Brazil
- National Institute of Technology in Complex Fluids, Physics Institute, University of Sao Paulo, São Paulo, SP, Brazil
| | - Francisco Antonio Fonseca
- Cardiology Division, Department of Medicine, Federal University of Sao Paulo, São Paulo, SP, Brazil
- National Institute of Technology in Complex Fluids, Physics Institute, University of Sao Paulo, São Paulo, SP, Brazil
| | | | | | | | - Magnus Gidlund
- Department of Immunology, Institute Biomedical Science IV, University of Sao Paulo, São Paulo, SP, Brazil
| | - Maria Cristina Izar
- Cardiology Division, Department of Medicine, Federal University of Sao Paulo, São Paulo, SP, Brazil
- National Institute of Technology in Complex Fluids, Physics Institute, University of Sao Paulo, São Paulo, SP, Brazil
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Meng G, Liu T, Rayamajhi S, Thapa A, Zhang S, Wang X, Wu H, Gu Y, Zhang Q, Liu L, Sun S, Wang X, Zhou M, Jia Q, Song K, Fang Z, Niu K. Association between soft drink consumption and carotid atherosclerosis in a large-scale adult population: The TCLSIH cohort study. Nutr Metab Cardiovasc Dis 2023; 33:2209-2219. [PMID: 37586920 DOI: 10.1016/j.numecd.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 06/30/2023] [Accepted: 07/04/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND AND AIMS Carotid atherosclerosis indicates an increased risk for cardiac-cerebral vascular disease. Given the pattern of consumption in China, sugar-sweetened beverage is the main type of soft drink consumed. As soft drinks contain a high amount of fructose, they may be a risk factor of carotid atherosclerosis. A prospective cohort study was conducted to investigate the association between soft drink consumption and the incidence of carotid atherosclerosis in a Chinese adult population. METHODS AND RESULTS A total of 3828 participants (men: 2007 and women: 1821) were included. Carotid atherosclerosis was measured by using ultrasonography and was defined by increased carotid intima-media thickness and/or carotid plaques. Soft drink consumption was assessed using a validated food frequency questionnaire. Cox proportional hazards regression analysis was used to assess the association of soft drink consumption categories with the incidence of carotid atherosclerosis. During a mean follow-up of 3.20 years, 1009 individuals of the 3828 eligible participants developed carotid atherosclerosis. After adjusting for potential confounding factors, we compared the higher levels to the lowest level of soft drink consumption in women, and we estimated the multivariable hazard ratios and 95% confidence intervals of incident carotid atherosclerosis to be 1.09 (0.80, 1.50), and 1.56 (1.14, 2.13) (P for trend <0.05). However, there was no significant association between soft drink consumption and the incidence of carotid atherosclerosis in men or total population. CONCLUSION The result indicated that soft drink consumption was associated with a higher incidence of carotid atherosclerosis in women. TRIAL REGISTERED UMIN Clinical Trials Registry. TRIAL REGISTRATION NUMBER UMIN000027174. TRIAL REGISTRATION WEBSITE: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000031137.
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Affiliation(s)
- Ge Meng
- Department of Toxicology and Health Inspection and Quarantine, School of Public Health, Tianjin Medical University, Tianjin, China; Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Tongfeng Liu
- Department of Toxicology and Health Inspection and Quarantine, School of Public Health, Tianjin Medical University, Tianjin, China; Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Sabina Rayamajhi
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, China; School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Amrish Thapa
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, China; School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shunming Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, China; School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xuena Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, China; School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Hongmei Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, China; School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yeqing Gu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Qing Zhang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Shaomei Sun
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Xing Wang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Ming Zhou
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiyu Jia
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Kun Song
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhongze Fang
- Department of Toxicology and Health Inspection and Quarantine, School of Public Health, Tianjin Medical University, Tianjin, China.
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, China; School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China; Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China; Tianjin Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China; National Demonstration Center for Experimental Preventive Medicine Education, Tianjin Medical University, Tianjin, China.
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Pae BJ, Lee SK, Kim S, Siddiquee AT, Hwang YH, Lee MH, Kim REY, Kim SH, Lee M, Shin C. Effect of physical activity on the change in carotid intima-media thickness: An 8-year prospective cohort study. PLoS One 2023; 18:e0287685. [PMID: 37352303 PMCID: PMC10289364 DOI: 10.1371/journal.pone.0287685] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 06/09/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND AND AIMS There is a demand for longitudinal studies that use both objective and subjective measures of physical activity to investigate the association of physical activity with the change in carotid intima-media thickness (CIMT). In order to investigate such association, we conducted an 8-year follow-up study that used both objective and subjective measures of physical activity. METHODS This cohort study used subsamples of the ongoing Korean Genome and Epidemiology Study (KoGES). Included participants were between 49 to 79 years of age at baseline. Exclusion criteria included incomplete assessments of pedometer/accelerometer, international physical activity questionnaire (IPAQ), and baseline CIMT. Participants with a history of cardiovascular diseases were further excluded. Linear regression models were used for the main analysis. Age differences were assessed by stratifying the participants into < 60 years and ≥ 60 years. RESULTS After removing excluded participants, 835 participants were included in the final analysis (age, 59.84 ± 6.53 years; 326 (39.04%) males). 453 participants were < 60 years and 382 participants were ≥ 60 years. The daily total step count was inversely associated with the percent change in overall CIMT over 8-years (β = -0.015, standard error = 0.007, P = 0.034). This association was present among participants in the < 60-year-old group (β = -0.026, standard error = 0.010, P = 0.006), but not among participants in the ≥ 60-year-old group (β = -0.010, standard error = 0.011, P = 0.38). CONCLUSIONS The findings suggest that taking preemptive actions of increasing physical activity may prevent the incidence of atherosclerosis.
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Affiliation(s)
- Byung Joon Pae
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Seung Ku Lee
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Soriul Kim
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Ali T. Siddiquee
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Yoon Ho Hwang
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Min-Hee Lee
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
- Department of Pediatrics, Wayne State University School of Medicine, and the Translational Imaging Laboratory, Children’s Hospital of Michigan, Detroit, MI, United States of America
| | - Regina E. Y. Kim
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Seong Hwan Kim
- Department of Cardiology, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Miyoung Lee
- College of Physical Education and Sport Science, Kookmin University, Seoul, Republic of Korea
| | - Chol Shin
- Institute of Human Genomic Study, College of Medicine, Korea University, Seoul, Republic of Korea
- Biomedical Research Center, Korea University Ansan Hospital, Ansan, Republic of Korea
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Kumar A, Qiao Y, Wasserman B, Gabriel KP, Martinez-Amezcua P, Dooley EE, Diaz KM, Evenson KR, Sharrett AR, Zhang Y, Palta P. Association of leisure-time physical activity and sedentary behavior with carotid atherosclerosis morphology: The ARIC carotid-MRI study. Am J Prev Cardiol 2023; 14:100505. [PMID: 37252440 PMCID: PMC10220308 DOI: 10.1016/j.ajpc.2023.100505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 05/31/2023] Open
Abstract
Objective We evaluated the prospective association of midlife leisure-time physical activity (LTPA) and sedentary behavior (SB), and their temporal patterns, with MRI-measured carotid atherosclerotic morphology. Methods Participants enrolled in the Carotid MRI substudy (2004-2006) of the Atherosclerosis Risk in Communities (ARIC) Study and with self-reported assessments of LTPA and SB at visits 1 (1987-1989) and 3 (1993-1995) were included in this study. LTPA was ascertained using the ARIC/Baecke physical activity questionnaire and categorized according to the American Heart Association's metric of poor, intermediate, or ideal physical activity. SB, measured as TV viewing frequency, was categorized as high, medium, and low. We used multivariable adjusted linear and logistic regression models to examine the associations between midlife (visit 3 only) and persistent (visit 1 to 3) LTPA and TV viewing with carotid artery plaque burden and components. Results Among the 1,582 (mean age: 59 years, 43% male, 18% Black) participants, 45.7%, 21.7%, and 32.6% reported ideal, intermediate, or poor LTPA, respectively. High TV viewing was reported in 33.8% of participants, with 46.4% and 19.8% reporting medium or low TV viewing, respectively. Compared to poor LTPA, ideal LTPA in midlife was not associated with total wall volume (ß=0.01, 95% CI: -0.01, 0.03), maximum carotid wall thickness (ß=0.06, 95% CI: -0.08, 0.21), normalized wall index (ß=-0.01, 95% CI: -0.03, 0.01), or maximum stenosis (ß=-0.11, 95% CI: -1.98, 1.76). Low or middle, compared to high, TV viewing was also not associated with carotid artery measures of plaque burden. Compared to poor LTPA or high TV viewing, ideal LTPA (odds ratio (OR): 0.82, 95% CI: 0.55, 1.23) and low TV viewing (OR=0.90, 95% CI: 0.56, 1.44) was not associated with odds of lipid core presence, respectively. Conclusion Overall, this study does not provide strong evidence for an association between LTPA and SB with carotid plaque measures.
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Affiliation(s)
- Aarti Kumar
- Columbia University Vagelos College of Physicians and Surgeons, United States
| | - Ye Qiao
- Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD, United States
| | - Bruce Wasserman
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Kelley Pettee Gabriel
- Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Pablo Martinez-Amezcua
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Erin E. Dooley
- Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, AL, United States
| | - Keith M. Diaz
- Center for Cardiovascular and Behavioral Health, Columbia University Irving Medical Center, New York, NY, United States
| | - Kelly R. Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - A. Richey Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Yiyi Zhang
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Priya Palta
- Division of General Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, United States
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Papagianni G, Panayiotou C, Vardas M, Balaskas N, Antonopoulos C, Tachmatzidis D, Didangelos T, Lambadiari V, Kadoglou NPE. The anti-inflammatory effects of aerobic exercise training in patients with type 2 diabetes: A systematic review and meta-analysis. Cytokine 2023; 164:156157. [PMID: 36842369 DOI: 10.1016/j.cyto.2023.156157] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/07/2023] [Accepted: 02/03/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a low-grade, chronic inflammatory disease, associated with increased cardiovascular risk. The purpose of this systematic review/ meta-analysis was to evaluate the effects of aerobic exercise training (AET) on inflammatory markers in T2DM patients. METHODS The literature search was conducted utilizing PubMed, Web of Science, Embase, and the Cochrane Library from their inception up to April 2022. We screened only for randomized controlled trials (RCTs) investigating the effects of AET on C-reactive protein (CRP) and adipokines: adiponectin, resistin, interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-a), along with changes in anthropometric indices and glycemic control in adult T2DM patients. Pooled post-exercise weighted mean differences (WMDs) with 95% Confidence Intervals (CIs) were calculated for all outcomes of interest between exercise-treated patients and controls. RESULTS Twenty-six RCTs involving 1239 T2DM patients were retrieved from the databases for meta-analysis. The cumulative results showed that post-AET inflammatory markers were lower in exercise-treated patients compared to controls regarding CRP (mg/L): WMD: -0.91; 95%CIs: -1.43, -0.40; p < 0.001 resistin (mg/ml): (WMD: -2.08; 95%CIs: -3.32, -0.84; p < 0.001); TNF-a (pg/ml): (WMD: -2.70; 95%CIs: -4.26, -1.14; p < 0.001), and IL-6 (pg/ml): (WMD: -1.05; 95%CIs: -1.68, -0.43; p < 0.001). Those effects were accompanied by significant amelioration of fasting glucose (mg/dl) (WMD: -13.02; 95%CIs: -25.39, -0.66; p = 0.04), HbA1c (%) (WMD: -0.51; 95%CIs: -0.73, -0.28, p < 0.001), and fat mass (%) (WMD: -3.14; 95%CI: -4.71, -1.58; p < 0.001). Our meta-analysis demonstrated less-consistent results for adiponectin (μg/ml), (WMD: 1.00; 95%CI: -0.12, 2.12; p = 0.08) and body-mass index (kg/m2) (WMD: -1.34; 95%CI: -2.76, 0.08; p = 0.06) tending to differ between AET and control group. CONCLUSIONS AET can significantly reduce the inflammatory burden in T2DM patients. by ameliorating the circulating levels of CRP, resistin, TNF-a and IL-6, even without accompanied significant weight-loss. The clinical impact of those anti-inflammatory effects of AET needs to be determined.
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Affiliation(s)
- Georgia Papagianni
- Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | | | - Constantinos Antonopoulos
- Department of Vascular Surgery, Athens University Medical School, Attikon University General Hospital, Athens, Greece
| | | | | | - Vaia Lambadiari
- 2nd Department of Internal Medicine, Research Institute and Diabetes Centre, Athens University Medical School, Attikon University General Hospital, Athens, Greece
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Chandran O, Shruthi P, Sukumar S, Kadavigere R, Chakravarthy K, Rao CR, Chandrasekaran B. Effects of physical activity breaks during prolonged sitting on vascular and executive function—A randomised cross-over trial. J Taibah Univ Med Sci 2023; 18:1065-1075. [PMID: 36994221 PMCID: PMC10040888 DOI: 10.1016/j.jtumed.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 01/25/2023] [Accepted: 03/03/2023] [Indexed: 03/15/2023] Open
Abstract
Objectives High sedentary behaviour is associated with adverse effects on central vascular function and cognitive function. Although interventions to mitigate the adverse effects of workplace sitting are intriguing, evidence of the efficacy of such interventions remains lacking. This randomised cross-over trial was aimed at exploring the effectiveness of prolonged sitting, with or without physical activity breaks, on central, peripheral vascular and cognitive function in adults. Methods Twenty one healthy adults completed 4 h of simulated work conditions in three experimental visits: (1) uninterrupted sitting (SIT); (2) sitting interrupted by 3 min of walking every hour (LIT); and (3) sitting interrupted by 3 min of stair climbing every hour (MIT). Carotid (CA) and superficial femoral artery (SFA) diameter, velocity, shear rate and blood flow were measured with Duplex ultrasound at 50 MHz at three time points (hours 0, 2 and 4), and executive function was assessed with the computer based Eriksen Flanker task every hour. Results The decreases in reaction time (-30.59%) and accuracy (-10.56%) during SIT conditions were statistically significant, and less of a decrease was observed under LIT and MIT conditions. No significant differences in CA and SFA function were observed with LIT and MIT interventions. Conclusion Physical activity breaks of varying intensity during prolonged sitting improve reaction time. However, the vascular benefits of physical activity breaks should be confirmed in the future through long term studies in natural environment.
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Yang D, Liu M, Willey JZ, Khasiyev F, Tom SE, Rundek T, Cheung YK, Wright CB, Sacco RL, Elkind MSV, Gutierrez J. Physical Activity Is Inversely Associated With Severe Intracranial Stenosis in Stroke-Free Participants of NOMAS. Stroke 2023; 54:159-166. [PMID: 36416126 PMCID: PMC9780184 DOI: 10.1161/strokeaha.122.039660] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 09/30/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although protective in secondary stroke prevention of intracranial arterial stenosis (ICAS), it is uncertain if the benefits of leisure time physical activity (LTPA) extend to asymptomatic ICAS or extracranial carotid stenosis (ECAS). Therefore, we sought to determine LTPA's relationship with ECAS and ICAS in a stroke-free, race-ethnically diverse cohort. METHODS This cross-sectional study included participants from the magnetic resonance imaging substudy of the Northern Manhattan Study, of whom 1274 had LTPA assessments at enrollment. LTPA was represented continuously as metabolic equivalent score (MET-score) and ordinally as model-based cluster analysis (LTPA-cluster), both based on the same LTPA assessments. We evaluated ECAS sonographically using carotid intima-media thickening and number of carotid plaques. ICAS was assessed with time-of-flight magnetic resonance angiograph and defined as ≥50% or ≥70% stenosis. We applied regression analyses to evaluate the association between LTPA with ECAS and ICAS, adjusting for confounders. RESULTS Of 1274 included participants (mean age 71±9 years; 60% women; 65% Hispanic), the mean MET-score was 10±16 and 60% were in a LTPA-cluster with any activity. Among those with carotid ultrasound (n=1234), the mean carotid intima-media thickening was 0.97±0.09 mm, and 56% of participants had at least one carotid plaque identified. Among those with magnetic resonance angiograph (n=1211), 8% had ≥50% ICAS and 5% had ≥70% ICAS. For ICAS, MET-score was associated with ≥70% ICAS (adjusted odds ratio per unit increase in MET-score [95% CI, 0.97 [0.94-0.99]) but not with ECAS measures (carotid intima-media thickening, adjusted β-estimate per unit increase in MET-score [95% CI], 0.002 [-0.003 to 0.006] or number of plaques, adjusted β-estimate [95% CI], 0.0001 [-0.0001 to 0.0003]). Substituting MET-score with LTPA-clusters replicated the association between ≥70% ICAS and LTPA (adjusted odds ratio per each increased LTPA-cluster [95% CI], 0.83 [0.70-0.99]). CONCLUSIONS In this diverse stroke-free population, we found LTPA most strongly associated with asymptomatic ≥70% ICAS. Given the high-risk nature of ≥70% ICAS, these findings may emphasize the role of LTPA in people at risk for ICAS.
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Affiliation(s)
- Dixon Yang
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Minghua Liu
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Joshua Z Willey
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Farid Khasiyev
- Department of Neurology, Saint Louis University, Saint Louis, MO, USA
| | - Sarah E Tom
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Tatjana Rundek
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
- Evelyn McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ying K Cheung
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Clinton B Wright
- National Institute of Neurologic Disorders and Stroke, Bethesda, MD, USA
| | - Ralph L Sacco
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
- Evelyn McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mitchell S V Elkind
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jose Gutierrez
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
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KİLİNCER BOZGUL SM, ATİLLA FD, AK G, TÜRK UÖ, BARUTCUOĞLU B, SAYDAM G, ŞAHİN F. Evaluation of cardiovascular disease risk factors, inflammatory markers and subclinical atherosclerosis in patients with hemophilia. EGE TIP DERGISI 2022. [DOI: 10.19161/etd.1208982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Aim: To assess and compare the risk factors of cardiovascular disease (CVD) between patients with hemophilia (PwH) and healthy controls in a single center cohort in Turkey.
Material and Methods: Anthropometric parameters including height, weight, and body mass index were recorded. Fasting glucose, HbA1c, high sensitive C-Reactive Protein (hs-CRP), adiponectin, lipid parameters (total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides) were assessed. International Physical Activity Questionnaires (IPAQ) and carotid intima media thickness (CIMT) measurements were performed. The data from PwH (n=80) and healthy controls (n=36) were compared. Independent associates of CIMT value were analyzed.
Results: Hypertension, diabetes mellitus, metabolic syndrome and smoking frequencies were remarkable in PwH. Family history of CVD was significantly more frequent ( p=0.005) and when considered with IPAQ scores; PwH was much more sedentary than controls (p<0.001). Total cholesterol, LDL-cholesterol were significantly higher in the control group (p =0.003,=0.003) while hs-CRP levels were higher in PwH (p=0.009). Age and IPAQ score were significant independent predictors of CIMT (p=0.004 and 0.003, respectively).
Conclusion: As a result of aging; PwH exposure to the same CVD risk factors as the general population. Screening for CVD risk factors in PwH other than hemophilia evaluation will be essential.
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Affiliation(s)
| | - Fatoş Dilan ATİLLA
- Bakircay University, Ciğli Education and Research Hospital, Department of Internal Medicine, Division of Hematology
| | - Güneş AK
- Ege University, Faculty of Medicine, Department of Clinical Biochemistry
| | | | - Burcu BARUTCUOĞLU
- Ege University, Faculty of Medicine, Department of Clinical Biochemistry
| | - Güray SAYDAM
- Ege University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ege Adult Hemophilia and Thrombosis Center,
| | - Fahri ŞAHİN
- Ege University, Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Ege Adult Hemophilia and Thrombosis Center,
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Effect of Exercise on Carotid Artery Intima-Media Thickness in Adults: A Systematic Review and Meta-Analysis. J Phys Act Health 2022; 19:855-867. [PMID: 36257606 DOI: 10.1123/jpah.2022-0372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/22/2022] [Accepted: 09/01/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Carotid intima-media thickness (cIMT) is a validated surrogate marker of atherosclerosis that is independently associated with the risk for cardiovascular disease. Recent studies on the effect of exercise on cIMT have yielded conflicting results. METHODS Studies that were available up until October 30, 2021 from the PubMed, Cochrane Library, Embase, and Web of Science databases were included in the analysis. Subgroup analyses were performed to determine the effects of the type, intensity, and duration of exercise on cIMT. RESULTS This review included 26 studies with 1370 participants. Compared with control participants, those who engaged in exercise showed a decline in cIMT (weighted mean difference [WMD] -0.02; 95% confidence interval [CI], -0.03 to -0.01; I2 = 90.1%). Participants who engaged in aerobic (WMD -0.02; 95% CI, -0.04 to -0.01; I2 = 52.7%) or resistance (WMD -0.01; 95% CI, -0.02 to -0.00; I2 = 38.5%) exercise showed lower cIMT compared with control participants. An exercise duration of >6 months was associated with a 0.02 mm reduction in cIMT. In participants with low cIMT at baseline (<0.7 mm), exercise alone was not associated with a change in cIMT (WMD -0.01; 95% CI, -0.03 to 0.00; I2 = 93.9%). CONCLUSIONS Exercise was associated with reduced cIMT in adults. Aerobic exercise is associated with a greater decline in cIMT than other forms of exercise. Large, multicenter, randomized controlled trials are required to establish optimal exercise protocols for improving the pathological process of atherosclerosis.
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The Role of Physical Activity Status in the Relationship between Obesity and Carotid Intima-Media Thickness (CIMT) in Urban South African Teachers: The SABPA Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106348. [PMID: 35627885 PMCID: PMC9141222 DOI: 10.3390/ijerph19106348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/13/2022] [Accepted: 05/18/2022] [Indexed: 02/01/2023]
Abstract
Globally, the prevalence of physical inactivity and obesity are on the rise, which may increase carotid intima-media thickness (CIMT) as a marker of subclinical atherosclerosis. This study assessed the association between physical activity (PA), obesity, and CIMT. A cross-sectional study design was used, including a sub-sample (n = 216) of teachers who participated in the Sympathetic Activity and Ambulatory Blood Pressure in Africans (SAPBA) study. Measurements included the following: physical activity status (measured with ActiHeart devices over 7 consecutive days), body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), CIMT (measured by SonoSite Micromax ultrasound), blood pressure (BP), fasting C-reactive protein (CRP), and cholesterol and glucose levels. Data were analysed using the Statistical Package for Social Science. One-third of the teachers were physically inactive (33%) and had low-grade inflammation CRP ≥ 3 mg/L (41%). Males were more sedentary and had higher BP and CIMT (p < 0.05). Independent of age and sex, WC or central obesity was 2.63 times more likely (p = 0.02) to contribute to atherosclerosis, especially in females (OR: 4.23, p = 0.04). PA levels were insignificantly and negatively (β −0.034; 0.888; 0.240) related to subclinical atherosclerosis. The cardiovascular disease risk profiles and limited PA status may have curbed the beneficial impact of PA on the obesity and atherosclerosis.
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11
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The Assessment of Maternal and Fetal Intima-Media Thickness in Perinatology. J Clin Med 2022; 11:jcm11051168. [PMID: 35268257 PMCID: PMC8911195 DOI: 10.3390/jcm11051168] [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: 12/05/2021] [Revised: 01/30/2022] [Accepted: 02/17/2022] [Indexed: 12/10/2022] Open
Abstract
Intima-media thickness (IMT) measurement is a non-invasive method of arterial wall assessment. An increased IMT is a common manifestation of atherosclerosis associated with endothelial dysfunction. In the course of pregnancy, various maternal organs, including the endothelium, are prepared for their new role. However, several pre-gestational conditions involving endothelial dysfunction, such as diabetes, chronic hypertension, and obesity, may impair the adaptation to pregnancy, whereas vascular changes may also affect fetal development, thus, influencing the fetal IMT. In the conducted studies, a correlation was found between an increased fetal abdominal aorta IMT (aIMT) and placental dysfunctions, which may subsequently impact both the mother and the fetus, and contribute to gestational hypertension, preeclampsia (PE), and fetal growth restriction (FGR). In fact, data indicate that following the delivery, the endothelial dysfunction persists and influences the future health of the mother and the newborn. Hypertensive disorders in pregnancy increase the maternal risk of chronic hypertension, obesity, and vascular events. Moreover, individuals born from pregnancies complicated by preeclampsia or fetal growth restriction are at high risk of obesity, diabetes, hypertension, and cardiovascular disease. Therefore, understanding the pathomechanism underlying an increased aIMT in preeclampsia and FGR, as well as subsequent placental dysfunctions, is essential for developing targeted therapies. This review summarizes recent publications regarding IMT and demonstrates how IMT measurements affect predicting perinatal complications.
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Chen L, Bi Y, Su J, Cui L, Han R, Tao R, Zhou J, Wu M, Qin Y. Physical activity and carotid atherosclerosis risk reduction in population with high risk for cardiovascular diseases: a cross-sectional study. BMC Public Health 2022; 22:250. [PMID: 35130854 PMCID: PMC8822633 DOI: 10.1186/s12889-022-12582-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 01/14/2022] [Indexed: 12/03/2022] Open
Abstract
Background Decreased physical activity had been reported to be a common causal and modifiable risk factor for major vascular events. However, the relationship of physical activity and sedentary leisure time with carotid atherosclerosis in population with high risk for cardiovascular diseases (CVDs) is still inconclusive. We aimed to evaluate the association of physical activity and sedentary leisure time with the risk of carotid atherosclerosis, and investigate any possible effect modifiers in population with high risk for CVDs. Methods
The study population was drawn from the China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project-Jiangsu project, which is a population-based screening project that included permanent residents aged 35-75 years from 6 surveillance cities in Jiangsu Province. Linear regression models were used to evaluate the association of physical activity and sedentary leisure time with carotid intima-media thickness (CIMT). The risks of abnormal carotid artery and carotid plaque (CP) were estimated by odds ratios (ORs) and 95% confidence intervals (CIs) using logistic regression. Results Overall, a total of 10,920 participants were enrolled in the final analysis. There was a significant inverse association of physical activity level with CIMT (per SD increase: β=-0.0103; 95%CI: -0.0154, -0.0053). The risk of abnormal carotid artery and CP decreased significantly with the increase of physical activity level (per SD increase: OR=0.908, 95%CI: 0.869-0.948; OR=0.900, 95%CI: 0.857-0.945, respectively). When physical activity level was categorized as quartiles, a significantly lower risk of abnormal carotid artery and CP was found in quartiles 2-4 with quartile 1 as reference (P<0.05 for all). Furthermore, the inverse association were stronger in participants with age ≥60 years (vs. <60 years, Pinteraction<0.001 for both). However, there were no significant association of sedentary leisure time with CIMT, abnormal carotid artery and CP. Conclusions In population with high risk for CVDs, physical activity was inversely associated with CIMT, abnormal carotid artery and CP, particularly among the elders. Sedentary leisure time was not associated with them. These results suggested that physical activity is important for carotid vascular health, and perhaps especially in elder population. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12582-6.
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Affiliation(s)
- Lulu Chen
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yuan Bi
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China.,Shanghai Municipal Center for Health Promotion, Shanghai, China
| | - Jian Su
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Lan Cui
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Renqiang Han
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Ran Tao
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Jinyi Zhou
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Ming Wu
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yu Qin
- Department of Non-communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.
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Narasimhan M, Schwartz R, Halliday G. Parkinsonism and cerebrovascular disease. J Neurol Sci 2021; 433:120011. [PMID: 34686356 DOI: 10.1016/j.jns.2021.120011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/01/2021] [Accepted: 09/29/2021] [Indexed: 11/27/2022]
Abstract
The relationship between cerebrovascular disease and parkinsonism is commonly seen in everyday clinical practice but remains ill-defined and under-recognised with little guidance for the practising neurologist. We attempt to define this association and to illustrate key clinical, radiological and pathological features of the syndrome of Vascular Parkinsonism (VaP). VaP is a major cause of morbidity in the elderly associated with falls, hip fractures and cognitive impairment. Although acute parkinsonism is reported in the context of an acute cerebrovascular event, the vast majority of VaP presents as an insidious syndrome usually in the context of vascular risk factors and radiological evidence of small vessel disease. There may be an anatomic impact on basal ganglia neuronal networks, however the effect of small vessel disease (SVD) on these pathways is not clear. There are now established reporting standards for radiological features of SVD on MRI. White matter hyperintensities and lacunes have been thought to be the representative radiological features of SVD but other features such as the perivascular space are gaining more importance, especially in context of the glymphatic system. It is important to consider VaP in the differential diagnosis of Parkinson disease (PD) and in these situations, neuroimaging may offer diagnostic benefit especially in those patients with atypical presentations or refractoriness to levodopa. Proactive management of vascular risk factors, monitoring of bone density and an exercise program may offer easily attainable therapeutic targets in PD and VaP. Levodopa therapy should be considered in patients with VaP, however the dose and effect may be different from use in PD. This article is part of the Special Issue "Parkinsonism across the spectrum of movement disorders and beyond" edited by Joseph Jankovic, Daniel D. Truong and Matteo Bologna.
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Affiliation(s)
- Manisha Narasimhan
- Brain and Mind Centre and Faculty of Health and Medical Sciences, School of Medical Sciences, University of Sydney, Sydney, NSW, Australia.
| | - Raymond Schwartz
- Brain and Mind Centre and Faculty of Health and Medical Sciences, School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
| | - Glenda Halliday
- Brain and Mind Centre and Faculty of Health and Medical Sciences, School of Medical Sciences, University of Sydney, Sydney, NSW, Australia
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14
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Lee J, Chen B, Kohl HW, Barlow CE, do Lee C, Radford NB, DeFina LF, Gabriel KP. The Association of Physical Activity With Carotid Intima Media Thickening in a Healthy Older Population: Cooper Center Longitudinal Study. J Aging Phys Act 2020; 28:448-454. [PMID: 31801110 PMCID: PMC7266725 DOI: 10.1123/japa.2019-0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 09/30/2019] [Accepted: 10/01/2019] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to examine the association between self-reported physical activity (PA) and mean common carotid artery intima-media thickness (CCA IMT) among older adults. The data are from 1,811 Cooper Center Longitudinal Study participants, who were aged ≥60 years, with no history of cardiovascular disease. A medical history questionnaire was used to assess PA. Carotid ultrasound was performed to measure CCA IMT and the presence of plaque and stenosis. Logistic regression models were constructed to estimate the association between PA and CCA IMT after adjustment for covariates. The participants were aged 69.2 ± 5.9 years, and the majority were male (73.3%) and White (96.7%). The odds ratio of abnormal thickening of CCA IMT was 0.72 (95% confidence interval [0.54, 0.96]) in physically active participants (≥500 metabolic equivalent·min/week) after adjustment for covariates. In the current study, meeting PA guidelines in older adulthood was associated with lower odds of abnormal thickening of CCA IMT.
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15
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Wu WQ, Peng S, Wan XQ, Lin S, Li LY, Song ZY. Physical exercise inhibits atherosclerosis development by regulating the expression of neuropeptide Y in apolipoprotein E-deficient mice. Life Sci 2019; 237:116896. [DOI: 10.1016/j.lfs.2019.116896] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/14/2019] [Accepted: 09/20/2019] [Indexed: 01/01/2023]
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16
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Walker TJ, Heredia NI, Lee M, Laing ST, Fisher-Hoch SP, McCormick JB, Reininger BM. The combined effect of physical activity and sedentary behavior on subclinical atherosclerosis: a cross-sectional study among Mexican Americans. BMC Public Health 2019; 19:161. [PMID: 30727990 PMCID: PMC6366018 DOI: 10.1186/s12889-019-6439-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 01/14/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activity and sedentary behavior are considered independent risk factors for chronic disease. However, we do not fully understand their interrelation with key health outcomes such as subclinical atherosclerosis. This study examines the combined effects of sedentary behavior and physical activity on carotid intima-media thickness (cIMT) and presence of carotid plaque in a Mexican American population on the Texas-Mexico border. METHODS This cross-sectional study was conducted using retrospective data from a sample (n = 612) of participants from the Cameron County Hispanic Cohort. Carotid ultrasound was used to measure cIMT and presence of carotid plaque. Self-reported questionnaires were used to assess leisure time physical activity and sedentary behavior (TV/movie sitting and total sitting). A series of multivariable regression models were used to assess study aims. An interaction term between physical activity and sedentary behavior was included in models for each respective outcome. Models were controlled for demographic and health-related variables. RESULTS There were no significant associations found between physical activity, sedentary behavior and mean cIMT, or cIMT thickness ≥ 75th percentile for age and gender. However, there was a significant interaction between physical activity and TV/movie sitting with presence of carotid plaque. Participants who reported moderate levels of physical activity had significantly lower odds for presence of plaque compared to participants with no activity when TV/movie sitting time was ≤3 h per day. However, there was no significant difference in odds for presence of plaque between physical activity groups when TV/movie sitting exceeded 3 h/day. These results were consistent with models examining total sitting time. CONCLUSIONS Our results indicate that for Mexican Americans, there is a combined effect of sedentary behavior and physical activity on presence of carotid plaque. Participating in moderate physical activity is optimal for having lower levels of carotid plaque in addition to avoiding excessive levels of TV/movie sitting (≥3 h/day) and/or total sitting (≥8.5 h/day).
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Affiliation(s)
- Timothy J. Walker
- Department of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, The University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin St, Houston, TX 77030 USA
| | - Natalia I. Heredia
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler, Houston, TX 77030 USA
| | - MinJae Lee
- Division of Clinical and Translational Sciences, Department of Internal Medicine, The University of Texas McGovern Medical School; Biostatistics/Epidemiology/Research Design (BERD) Core, Center for Clinical and Translational Sciences (CCTS), The University of Texas Health Science Center at Houston, 6410 Fannin St, Houston, TX 77030 USA
| | - Susan T. Laing
- Division of Cardiology, Department of Internal Medicine, McGovern Medical School at the University of Texas Health Science Center at Houston, 6431 Fannin St, Houston, TX 77030 USA
| | - Susan P. Fisher-Hoch
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Brownsville Regional Campus, 1 W University Blvd, Brownsville, TX 78520 USA
| | - Joseph B. McCormick
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Brownsville Regional Campus, 1 W University Blvd, Brownsville, TX 78520 USA
| | - Belinda M. Reininger
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston School of Public Health, Brownsville Regional Campus, 1 W University Blvd, Brownsville, TX 78520 USA
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17
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Changes in vascular structure in diabetic patients after 8 weeks aerobic physical exercise: a randomized controlled trial. Int J Diabetes Dev Ctries 2017. [DOI: 10.1007/s13410-017-0579-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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18
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Gando Y. Carotid Artery Parameters After Combined Exercise Training in Women with Sarcopenic Obesity. J Atheroscler Thromb 2017; 24:1090-1091. [PMID: 28835581 PMCID: PMC5684474 DOI: 10.5551/jat.ed085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Yuko Gando
- Department of Physical Activity Research, National Institute of Health and Nutrition
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19
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Park J, Kwon Y, Park H. Effects of 24-Week Aerobic and Resistance Training on Carotid Artery Intima-Media Thickness and Flow Velocity in Elderly Women with Sarcopenic Obesity. J Atheroscler Thromb 2017; 24:1117-1124. [PMID: 28674320 PMCID: PMC5684477 DOI: 10.5551/jat.39065] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Aim: Sarcopenic obesity (SO) is closely associated with cardiovascular disease (CVD) in elderly women. Increases in body fat and decreases in muscle mass are closely associated with increased carotid intima-media thickness (CIMT). The aim of this study was to examine the influence of a 24-week aerobic and resistance training program on carotid parameters in SO. Methods: Fifty elderly women (74.1 ± 6.1 years) with SO were randomly divided into an exercise group and a control group. The exercise group performed combined exercise over 24 weeks, consisting of resistance and aerobic training for 50–80 min, 5 times a week. Carotid variables were measured using B-mode ultrasound. The differences in the carotid variables and the relative changes between baseline and after 24 weeks were evaluated. Results: In the analysis of variance (ANOVA) results, CIMT (p = 0.013), systolic flow velocity (p = 0.007), diastolic flow velocity (p = 0.006), and wall shear rate (p = 0.010) showed significant interactions. In paired t-test results of the exercise group, CIMT significantly decreased (p < 0.01) and systolic flow velocity (p < 0.01), diastolic flow velocity (p < 0.001), and wall shear rate (p < 0.05) significantly increased after 24 weeks. Conclusion: The 24-week combined exercise effectively decreased CIMT and increased carotid flow velocity and wall shear ratio. Therefore, combined exercise is thought to contribute to the improvement of the risk of CVD in elderly women with SO.
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Affiliation(s)
- Jinkee Park
- Department of Sport Rehabilitation, Dong Ju College, Busan
| | - Yoochan Kwon
- Institute of Taekwondo for Health and Culture, Dong-A University.,Department of Taekwondo, Dong-A University
| | - Hyuntea Park
- Department of Health Care & Science, Dong-A University.,Institute of Convergence Bio-Health, Dong-A University
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20
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Mazidi M, Vadadian P, Rezaie P, Azarpazhooh MR, Esmaeili H, Ghayour-Mobarhan M, Kengne AP, Ferns GA. Levels of physical activity are correlated with intima media ratio in subjects without but not with metabolic syndrome: A study of Iranians without a history of cardiovascular events. Diabetes Metab Syndr 2017; 11:99-102. [PMID: 27697535 DOI: 10.1016/j.dsx.2016.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 08/22/2016] [Indexed: 10/21/2022]
Abstract
AIM We aimed to investigate the relationship between carotid Intima Media Thickness (CIMT) and physical activity levels (PAL), in subjects with and without metabolic syndrome (MetS) and in indidiviuals with and without carotid artery plaque (CAP) defined using high-resolution ultrasound. METHOD A sample of 506 subjects [215 (42.5%) males], aged 35-64 years was recruited from an urban population in Mashhad, Iran, using a stratified-cluster method as part of the Mashhad Stroke Heart Atherosclerosis Disorder (MASHAD) study cohort. This sub-sample was selected randomly from a cohort of 9765 individuals for carotid duplex ultrasound. Comparisons were made between individuals with and without CAP on the one hand, and between participants with and without MetS on the other hand with regard to physical activity and cardiometabolic risk level, as well as their correlation with CIMT. RESULT PAL was positively and significantly correlated with CIMT in the total sample (r=0.132, p<0.001). The correlation coefficient was 0.132 (p=0.426) in the MetS+ participants and 0.440 (p<0.001) in the MetS- participants. The correlation of PAL with CIMT was also positive and significant in CAP+ participants (r=0.150, p<0.001), but not in the CAP- participants (r=-0.001, p=0.621), with however a non-significant difference between the two estimates (p=0.374). Hip circumference was correlated with CIMT in MetS- but not MetS+ participants. CONCLUSION physical activity in the current study appeared to be a correlate of infraclinical CVD risk in participants without metabolic syndrome, but not in those without.
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Affiliation(s)
- Mohsen Mazidi
- Institute of Genetics and Developmental Biology. International College, University of Chinese Academy of Science (IC-UCAS), West Beichen Road, Chaoyang, China; Key State Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Chaoyang, Beijing, China
| | - Peymane Vadadian
- Cardiovascular Research centre, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Peyman Rezaie
- Biochemistry and Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Mahmoud Reza Azarpazhooh
- Cardiovascular Research centre, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Habib Esmaeili
- Department of Statistics, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- Biochemistry and Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
| | - Andre Pascal Kengne
- Non-Communicable Disease Research Unit, South African Medical Research Council and University of Cape Town, Cape Town, South Africa
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Rm 342, Mayfield House, University of Brighton, BN1 9PH, UK
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Katsimpoulas M, Kadoglou NE, Moustardas P, Kapelouzou A, Dede E, Kostomitsopoulos N, Karayannacos PE, Kostakis A, Liapis CD. The role of exercise training and the endocannabinoid system in atherosclerotic plaque burden and composition in Apo-E-deficient mice. Hellenic J Cardiol 2017; 57:417-425. [PMID: 28254386 DOI: 10.1016/j.hjc.2016.11.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 09/01/2016] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION We investigated the effect of combining exercise training and treatment with an endocannabinoid receptor 1 inhibitor (Rimonabant) on atherosclerosis burden and composition. METHODS Forty-eight apolipoprotein E-deficient (ApoE-/-) mice were kept on a 16-week high-fat diet. Mice were then placed on a normal diet and were randomized to the following groups with n=12 mice for 6 more weeks: 1) Control (Co) - no intervention; 2) Exercise (Ex) - exercise training on treadmill; 3) Rimonabant (Ri) - oral administration of rimonabant (10 mg/kg/day); or 4) Rimonabant+Exercise (RiEx) - combination of Ri and Ex groups treatment. At the end, all animals were sacrificed, and blood samples, as well as aortic root specimens, were obtained for histomorphometric analysis and quantification of the serum and plaque content of matrix metalloproteinases (MMPs). RESULTS The mean plaque area was significantly smaller (RiEx: 43.18±1.72%, Ri: 44.66±3.1%, Ex: 49±4.10%, Co: 70.43±2.83%) in all active treatment groups relative to the Co group (p<0.01). Conversely, the relative concentrations of collagen and elastin were increased significantly across all treatment groups compared to Co (p<0.05). Immunohistochemical analysis revealed significantly reduced macrophage content within plaques after all interventions, with the most pronounced effect observed after combined treatment (RiEx: 9.4±3.92%, Ri: 15±2.45%, Ex: 19.78±2.79%, Co: 34.25±4.99%; p<0.05). Within plaques, the TIMP-1 concentration was significantly upregulated in exercise-treated groups. MMP-3 and MMP-9 concentrations were equivalently decreased in all three active treatment groups compared to controls (p<0.001). DISCUSSION Both exercise and rimonabant treatments induced plaque regression and promoted plaque stability. The combined treatment failed to show additive or synergistic benefits relative to either intervention alone.
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Affiliation(s)
- Michalis Katsimpoulas
- Department of Vascular Surgery, Medical School, University of Athens, Greece; Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation, Academy of Athens, Greece.
| | - Nikolaos E Kadoglou
- Department of Vascular Surgery, Medical School, University of Athens, Greece; Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation, Academy of Athens, Greece
| | - Petros Moustardas
- Department of Vascular Surgery, Medical School, University of Athens, Greece; Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation, Academy of Athens, Greece
| | - Alkistis Kapelouzou
- Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation, Academy of Athens, Greece
| | - Eleni Dede
- Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation, Academy of Athens, Greece
| | - Nikolaos Kostomitsopoulos
- Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation, Academy of Athens, Greece
| | - Panayotis E Karayannacos
- Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation, Academy of Athens, Greece
| | - Alkiviadis Kostakis
- Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation, Academy of Athens, Greece
| | - Christos D Liapis
- Department of Vascular Surgery, Medical School, University of Athens, Greece
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22
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Abstract
Carotid artery atherosclerosis (CAA) represents a significant form of atherosclerosis with stroke as a major consequence. Whether it is a unique form of atherosclerosis is not established. However, this is not of major clinical relevance as no specific preventive measures over and above the established ones for cardiovascular risk are well established. Major risk factors for CAA are elevated low-density lipoprotein cholesterol (LDL-C), diabetes mellitus, tobacco use, hypertension, and increased inflammation. Identification of CAA prior to a clinical event centers on imaging studies. Studies with magnetic resonance imaging result in the best definition of CAA plaque morphology. Medical measures that result in prevention are especially centered on statins (marked reduction of the LDL-C) and hypertension control. Nonprocedural therapeutic measures to avoid and delay complications involve antiplatelet medications. Benefits from other measures such as increasing high-density lipoprotein cholesterol and increased exercise appear desirable but require more clinical evidence. In conclusion, there are enough evidence-based medicine results to demand intensive medical preventive measures and not just relegate the patient with asymptomatic or symptomatic CAA to decision-making only involving the surgeon and interventionalist.
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Affiliation(s)
- Thomas F. Whayne
- Gill Heart Institute, University of Kentucky, Lexington, KY, USA
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Parsons TJ, Sartini C, Ellins EA, Halcox JPJ, Smith KE, Ash S, Lennon LT, Wannamethee SG, Lee IM, Whincup PH, Jefferis BJ. Objectively measured physical activity, sedentary time and subclinical vascular disease: Cross-sectional study in older British men. Prev Med 2016; 89:194-199. [PMID: 27261410 PMCID: PMC4976831 DOI: 10.1016/j.ypmed.2016.05.031] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 05/23/2016] [Accepted: 05/28/2016] [Indexed: 11/30/2022]
Abstract
Low physical activity (PA) and high levels of sedentary time (ST) are associated with higher cardiovascular disease (CVD) risk among older people. However, their independent contribution and importance of duration of PA and ST bouts remain unclear. We investigated associations between objectively measured PA, ST and non-invasive vascular measures, markers of CVD risk. Cross-sectional study of 1216 men from the British Regional Heart Study, mean age 78.5years, measured in 2010-2012. Carotid intima thickness (CIMT), distensibility coefficient (DC) and plaque presence were measured using ultrasound; pulse wave velocity (cfPWV) and augmentation index (AIx) using a Vicorder. PA and ST were measured using hip-worn ActiGraph GT3X accelerometers. After adjusting for covariates, each additional 1000 steps per day was associated with a 0.038m/s lower cfPWV (95% CI=-0.076, 0.0003), 0.095 10(-3) kPa(-1) higher DC (95% CI=0.006, 0.185), 0.26% lower AIx (95% CI=-0.40, -0.12) and a 0.005mm lower CIMT (95% CI=-0.008, -0.001). Moderate and vigorous PA (MVPA) was associated with lower AIx and CIMT, light PA (LPA) with lower cfPWV and CIMT and ST with higher cfPWV, AIx and CIMT and lower DC. LPA and ST were highly correlated (r=-0.62). The independence of MVPA and ST or MVPA and LPA was inconsistent across vascular measures. Bout lengths for both PA and ST were not associated with vascular measures. In our cross-sectional study of older men, all PA regardless of intensity or bout duration was beneficially associated with vascular measures, as was lower ST. LPA was particularly relevant for cfPWV and CIMT.
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Affiliation(s)
- Tessa J Parsons
- UCL Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK; UCL Physical Activity Research Group, University College London, London, UK.
| | - Claudio Sartini
- UCL Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK; UCL Physical Activity Research Group, University College London, London, UK
| | - Elizabeth A Ellins
- Institute of Life Sciences, Swansea University, Singleton Park, Swansea SA2 8PP, UK
| | - Julian P J Halcox
- Institute of Life Sciences, Swansea University, Singleton Park, Swansea SA2 8PP, UK
| | - Kirsten E Smith
- Institute of Life Sciences, Swansea University, Singleton Park, Swansea SA2 8PP, UK
| | - Sarah Ash
- UCL Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK
| | - Lucy T Lennon
- UCL Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK
| | - S Goya Wannamethee
- UCL Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK
| | - I-Min Lee
- Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Peter H Whincup
- Population Health Research Institute, St George's University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Barbara J Jefferis
- UCL Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK; UCL Physical Activity Research Group, University College London, London, UK
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Sherwood A, Blumenthal JA, Smith PJ, Watkins LL, Hoffman BA, Hinderliter AL. Effects of Exercise and Sertraline on Measures of Coronary Heart Disease Risk in Patients With Major Depression: Results From the SMILE-II Randomized Clinical Trial. Psychosom Med 2016; 78:602-9. [PMID: 26867076 PMCID: PMC4905719 DOI: 10.1097/psy.0000000000000301] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To assess the effects of supervised and home-based aerobic exercise training, and antidepressant pharmacotherapy (sertraline) on coronary heart disease (CHD) risk factors in a sample of participants with major depressive disorder (MDD). METHODS The Standard Medical Intervention versus Long-term Exercise (SMILE)-II study randomized 202 adults (153 women, 49 men) diagnosed as having MDD to one of four interventions, each of 4-month duration: supervised exercise, home-based exercise, antidepressant medication (sertraline, 50-200 mg daily), or placebo pill. Patients underwent a structured clinical interview for depression and completed the Hamilton Depression Rating Scale. CHD risk factors included brachial artery flow-mediated dilation, carotid intima-media thickness, serum lipids, and 10-year atherosclerotic cardiovascular disease (ASCVD) risk. RESULTS Compared with placebo, active treatment of depression (supervised exercise, home-based exercise, sertraline therapy) was associated with an improvement in CHD risk factors (improved flow-mediated dilation [p = .032], reduced progression of intima-media thickness [p = .037], and a reduction in 10-year ASCVD [p = .049]). The active treatments did not differ from each other in their effects on the CHD risk outcomes. CONCLUSIONS Both exercise and antidepressant medication improved CHD risk factors and lowered ASCVD risk in patients with MDD. Because MDD is associated with increased risk for CHD events, treatment of depression with exercise or sertraline may reduce the risk of developing CHD in patients with MDD. TRIAL REGISTRATION Clinical Trials Government Identifier: NCT-00331305.
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Affiliation(s)
- Andrew Sherwood
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA
| | - James A. Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA
| | - Patrick J. Smith
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA
| | - Lana L. Watkins
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA
| | - Benson A. Hoffman
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA
| | - Alan L. Hinderliter
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Fonseca HAR, Bittencourt CR, Fonseca FA, Monteiro AM, Santos PR, Camargo L, Costa LAR, Murad A, Gidlund M, Figueiredo-Neto AM, Izar MCO. Non-linear Optical Responses of Low-Density Lipoprotein are Associated with Intima-Media Thickness of Carotid Artery in Athletes. Cell Biochem Biophys 2016; 74:253-62. [PMID: 27126056 DOI: 10.1007/s12013-016-0720-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 01/18/2016] [Indexed: 12/20/2022]
Abstract
We investigated the association between the degree of oxidative modification of LDL particles by non-linear optical response of LDL (Z-scan technique) and the presence of subclinical atherosclerosis in different segments of the carotid artery. We recruited high-intensity athlete runners (n = 44) and controls (n = 51) to participate in the study. The carotid intima-media thickness (cIMT), interleukin 10 (IL-10), TNF-alpha, and the non-linear optical responses of LDL particle (Z-scan) were assessed. In athletes, the mean cIMT differed between genders, with higher values observed in female athletes compared to male athletes (P < 0.05). Higher mean values for cIMT were seen in the right carotid arteries of female athletes as compared to female controls (P < 0.05). Higher levels of TNF-alpha and IL-10 were found in athletes (P < 0.05). Yet, ΔΓpv (transmittance curve) of Z-scan in athletes was higher than in the non-athletes, indicating less oxidation in LDL particles of athletes (P < 0.05). There was an inverse association between the ΔΓpv and cIMT in the right internal carotid segments (β = -0.163, P < 0.05) in all subjects, and between the VO2max and the mean cIMT (β = -0.003, P < 0.05) in male subjects. The present study shows that the Z-scan technique enabled to detect less oxidative modifications in LDL particles from athletes. This effect was associated with cIMT in a gender-dependent mode.
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Affiliation(s)
- Henrique Andrade R Fonseca
- Cardiology Division, Department of Medicine, Federal University of Sao Paulo, Rua Loefgren, 1350, 04040-001, São Paulo, SP, Brazil
| | - Célia R Bittencourt
- Cardiology Division, Department of Medicine, Federal University of Sao Paulo, Rua Loefgren, 1350, 04040-001, São Paulo, SP, Brazil
| | - Francisco A Fonseca
- Cardiology Division, Department of Medicine, Federal University of Sao Paulo, Rua Loefgren, 1350, 04040-001, São Paulo, SP, Brazil
| | - Andrea M Monteiro
- Institute of Physics, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Priscila R Santos
- Institute of Physics, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Luciano Camargo
- Cardiology Division, Department of Medicine, Federal University of Sao Paulo, Rua Loefgren, 1350, 04040-001, São Paulo, SP, Brazil
| | | | | | - Magnus Gidlund
- Department of Immunology, Institute of Biomedical Science IV, University of Sao Paulo, Sao Paulo, SP, Brazil
| | | | - Maria Cristina O Izar
- Cardiology Division, Department of Medicine, Federal University of Sao Paulo, Rua Loefgren, 1350, 04040-001, São Paulo, SP, Brazil.
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26
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Eijsvogels TMH, Fernandez AB, Thompson PD. Are There Deleterious Cardiac Effects of Acute and Chronic Endurance Exercise? Physiol Rev 2016; 96:99-125. [PMID: 26607287 PMCID: PMC4698394 DOI: 10.1152/physrev.00029.2014] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Multiple epidemiological studies document that habitual physical activity reduces the risk of atherosclerotic cardiovascular disease (ASCVD), and most demonstrate progressively lower rates of ASCVD with progressively more physical activity. Few studies have included individuals performing high-intensity, lifelong endurance exercise, however, and recent reports suggest that prodigious amounts of exercise may increase markers for, and even the incidence of, cardiovascular disease. This review examines the evidence that extremes of endurance exercise may increase cardiovascular disease risk by reviewing the causes and incidence of exercise-related cardiac events, and the acute effects of exercise on cardiovascular function, the effect of exercise on cardiac biomarkers, including "myocardial" creatine kinase, cardiac troponins, and cardiac natriuretic peptides. This review also examines the effect of exercise on coronary atherosclerosis and calcification, the frequency of atrial fibrillation in aging athletes, and the possibility that exercise may be deleterious in individuals genetically predisposed to such cardiac abnormalities as long QT syndrome, right ventricular cardiomyopathy, and hypertrophic cardiomyopathy. This review is to our knowledge unique because it addresses all known potentially adverse cardiovascular effects of endurance exercise. The best evidence remains that physical activity and exercise training benefit the population, but it is possible that prolonged exercise and exercise training can adversely affect cardiac function in some individuals. This hypothesis warrants further examination.
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Affiliation(s)
- Thijs M H Eijsvogels
- Department of Cardiology, Hartford Hospital, Hartford, Connecticut; and Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Antonio B Fernandez
- Department of Cardiology, Hartford Hospital, Hartford, Connecticut; and Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Paul D Thompson
- Department of Cardiology, Hartford Hospital, Hartford, Connecticut; and Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
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Paraskevas KI, Mikhailidis DP, Veith FJ, Spence JD. Definition of Best Medical Treatment in Asymptomatic and Symptomatic Carotid Artery Stenosis. Angiology 2015; 67:411-9. [PMID: 26721504 DOI: 10.1177/0003319715624526] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Implementation of best medical treatment (BMT) is the cornerstone of the management of patients with either asymptomatic or symptomatic carotid artery stenosis. We review the literature to define the components of BMT. Smoking cessation, maintaining a healthy body weight, moderate exercise, and a Mediterranean diet are essential lifestyle measures. Moderate alcohol consumption may also be beneficial but recommending it to patients may be hazardous if they consume too much. The importance of lifestyle measures is largely underestimated by both physicians and patients. Blood pressure and diabetes control, antiplatelet agents, and lipid-lowering treatment with statins/ezetimibe comprise the pharmacological components of BMT. Initiation of an intensive regimen of BMT is a sine qua non for patients with carotid artery stenosis whether or not they are offered or undergo an invasive revascularization procedure.
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Affiliation(s)
- Kosmas I Paraskevas
- Department of Vascular Surgery, Southampton University Hospital, Southampton, United Kingdom
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital Campus, University College London Medical School, University College London (UCL), London, United Kingdom
| | - Frank J Veith
- Division of Vascular Surgery, New York University Langone Medical Center, New York, NY, USA Division of Vascular Surgery, The Cleveland Clinic, Cleveland, OH, USA
| | - J David Spence
- Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, Western University, London, Ontario, Canada
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28
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Abstract
Aerobic exercise training leads to cardiovascular changes that markedly increase aerobic power and lead to improved endurance performance. The functionally most important adaptation is the improvement in maximal cardiac output which is the result of an enlargement in cardiac dimension, improved contractility, and an increase in blood volume, allowing for greater filling of the ventricles and a consequent larger stroke volume. In parallel with the greater maximal cardiac output, the perfusion capacity of the muscle is increased, permitting for greater oxygen delivery. To accommodate the higher aerobic demands and perfusion levels, arteries, arterioles, and capillaries adapt in structure and number. The diameters of the larger conduit and resistance arteries are increased minimizing resistance to flow as the cardiac output is distributed in the body and the wall thickness of the conduit and resistance arteries is reduced, a factor contributing to increased arterial compliance. Endurance training may also induce alterations in the vasodilator capacity, although such adaptations are more pronounced in individuals with reduced vascular function. The microvascular net increases in size within the muscle allowing for an improved capacity for oxygen extraction by the muscle through a greater area for diffusion, a shorter diffusion distance, and a longer mean transit time for the erythrocyte to pass through the smallest blood vessels. The present article addresses the effect of endurance training on systemic and peripheral cardiovascular adaptations with a focus on humans, but also covers animal data.
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Affiliation(s)
- Ylva Hellsten
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Michael Nyberg
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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29
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Gómez-Sánchez L, García-Ortiz L, Recio-Rodríguez JI, Patino-Alonso MC, Agudo-Conde C, Gómez-Marcos MA. [Relationship between physical activity and hemodynamic parameters in adults]. HIPERTENSION Y RIESGO VASCULAR 2015; 32:113-8. [PMID: 26180035 DOI: 10.1016/j.hipert.2015.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Revised: 03/06/2015] [Accepted: 03/10/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To analyze the relationship between physical activity, as assessed by accelerometer, with central and peripheral augmentation index and carotid intima media thickness (IMT) in adults. METHODS This study analyzed 263 subjects who were included in the EVIDENT study. Physical activity was assessed during 7 days using the ActigraphGT3X accelerometer (counts/min). Carotid ultrasound was used to measure carotid IMT. The Sphygmo Cor System was used to measure central and peripheral augmentation index (CAIx and PAIx). RESULTS Mean age 55.85±12 years; 59.30% female; 26.7 body mass index and blood pressure 120/77mmHg. Mean physician activity counts/min was 244.37 and 2.63±10.26min/day of vigorous or very vigorous activity. Physical activity showed an inverse correlation with PAIx (r=-0.179; P<.01) and vigorous activity day time with IMT(r=-0.174; P<.01), CAIx (r=-0.217; P<.01) and PAIx (r=-0.324; P<.01). After adjusting for confounding factors in the multiple regression analysis, the inverse association of CAIx with counts/min and the time spent in vigorous/very vigorous activity was maintained. CONCLUSION The results suggest that both physical activity and time spent in vigorous or vigorous activity are associated with the central augmentation index in adults.
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Affiliation(s)
- L Gómez-Sánchez
- Unidad de Investigación de la Alamedilla, Medicina de Familia, Centro de Salud Monovar, Atención Primaria, Servicio Madrileño de Salud, Madrid, España
| | - L García-Ortiz
- Unidad de Investigación de la Alamedilla, Medicina de Familia, Centro de Salud de la Alamedilla, Servicio de Salud de Castilla y León, Salamanca, España; Departamento de Medicina de la Universidad de Salamanca, IBSAL, Salamanca, España
| | | | - M C Patino-Alonso
- Departamento de Estadística, Universidad de Salamanca, IBSAL, Salamanca, España
| | - C Agudo-Conde
- Departamento de Estadística, Universidad de Salamanca, IBSAL, Salamanca, España
| | - M A Gómez-Marcos
- Unidad de Investigación de la Alamedilla, Medicina de Familia, Centro de Salud de la Alamedilla, Servicio de Salud de Castilla y León, Salamanca, España.
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Shimabukuro M, Hasegawa Y, Higa M, Amano R, Yamada H, Mizushima S, Masuzaki H, Sata M. Subclinical Carotid Atherosclerosis Burden in the Japanese: Comparison between Okinawa and Nagano Residents. J Atheroscler Thromb 2015; 22:854-68. [PMID: 26133316 DOI: 10.5551/jat.26674] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM The prevalence of overweight and a change in atherosclerotic lipid profiles may be linked to region-specific differences in atherosclerotic diseases. We evaluated whether the lipid phenotype could be linked to region- and sex-specific differences in the degree of atherosclerosis. METHODS Non-diabetic subjects included Okinawa (n=1674) and Nagano (n=1392) residents aged 30-75 years who underwent carotid ultrasonography for the measurement of maximum intima-media thickness (max IMT). RESULTS Average max IMT was higher in Okinawa men and women, and the increase in max IMT with age was enhanced in men. Multiple regression analysis showed that in addition to age and systolic blood pressure, low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol were IMT determinants only in men for both Okinawa and Nagano. Meanwhile, HDL-cholesterol was a determinant for Okinawa men and women, but not for Nagano men and women. CONCLUSIONS This is the first report to show region- and sex-specific differences in the determinants for max IMT in a Japanese population. The evaluation of the relationship between lipid profile patterns and region- and sex-specific differences in carotid atherosclerosis burden may be required.
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Affiliation(s)
- Michio Shimabukuro
- Department of Cardio-Diabetes Medicine, Institute of Biomedical Sciences, The University of Tokushima Graduate School
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31
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Huang C, Wang J, Deng S, She Q, Wu L. The effects of aerobic endurance exercise on pulse wave velocity and intima media thickness in adults: A systematic review and meta-analysis. Scand J Med Sci Sports 2015; 26:478-87. [PMID: 26059748 DOI: 10.1111/sms.12495] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2015] [Indexed: 11/29/2022]
Affiliation(s)
- C. Huang
- Department of Cardiology; The Second Affiliated Hospital of Chongqing Medical University; Chongqing China
| | - J. Wang
- Department of Cardiology; The Second Affiliated Hospital of Chongqing Medical University; Chongqing China
- Department of Cardiology; The Medical Emergency Center of Chongqing; Chongqing China
| | - S. Deng
- Department of Cardiology; The Second Affiliated Hospital of Chongqing Medical University; Chongqing China
| | - Q. She
- Department of Cardiology; The Second Affiliated Hospital of Chongqing Medical University; Chongqing China
| | - L. Wu
- Department of Cardiology; The Second Affiliated Hospital of Chongqing Medical University; Chongqing China
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Scholl J, Bots ML, Peters SAE. Contribution of cardiorespiratory fitness, relative to traditional cardiovascular disease risk factors, to common carotid intima-media thickness. J Intern Med 2015; 277:439-46. [PMID: 24844122 DOI: 10.1111/joim.12271] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Studies have suggested that being slightly overweight but fit is better for cardiovascular health than being somewhat leaner but unfit. Here, we sought to determine the contribution of cardiorespiratory fitness (CRF), relative to the presence of risk factors, to common carotid intima-media thickness (CIMT), a measurement of atherosclerosis and cardiovascular disease risk. METHODS Data were analysed from a cohort of 7300 German employed individuals aged 46 (±7) years who participated in a preventive health check-up at a specialized prevention centre. In addition to traditional cardiovascular disease risk factor assessment, participants performed an exercise test with spirometry to exhaustion, and common CIMT was measured. Individuals were defined as being fit or unfit based on the median age- and sex-specific relative maximum oxygen consumption. RESULTS In a multivariable analysis, there was a strong inverse association between CRF and common CIMT. Individuals who were considered fit and did not have any cardiovascular disease risk factors had the lowest common CIMT values (reference group). Those who were unfit and had an increased risk factor level always had the highest common CIMT values. Good CRF partly compensated for the increased common CIMT due to a risk factor. However, unfit individuals without increased risk factor levels had a common CIMT that was not significantly different from that of the reference group, whereas fit individuals who smoked, had a high body mass index, a low HDL cholesterol concentration or a high systolic blood pressure had an increase in common CIMT. CONCLUSION Cardiorespiratory fitness is a major determinant of common CIMT. Improved CRF does slightly, but not completely, abolish the adverse consequences of cardiovascular disease risk factors on common CIMT.
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Affiliation(s)
- J Scholl
- Dr. Scholl Prevention First GmbH, Private Practice for Preventive Medicine, Ruedesheim am Rhein, Germany
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García-Hermoso A, Martínez-Vizcaíno V, Recio-Rodríguez JI, Sánchez-López M, Gómez-Marcos MÁ, García-Ortiz L. Sedentary behaviour patterns and carotid intima-media thickness in Spanish healthy adult population. Atherosclerosis 2015; 239:571-6. [PMID: 25733329 DOI: 10.1016/j.atherosclerosis.2015.02.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 12/26/2014] [Accepted: 02/16/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to analyze the association between sedentary behaviour, as assessed by an accelerometer, and mean carotid intima-media thickness (IMT). METHODS The study included 263 healthy subjects belonging to the EVIDENT study (59.3% women). Carotid IMT was measured by carotid ultrasonography. Sedentary behaviour was measured objectively over 7 days using ActiGraph accelerometers. Thresholds of 10 consecutive minutes were used to establish sedentary bouts, and assess the number (n/day), and length ≥10 min (min/day). RESULTS Total sedentary time and sedentary time in bouts ≥10 min was higher in participants with a larger mean carotid IMT (>P75). Otherwise, this sedentary time in bouts ≥10 min parameter was weakly associated with augmented carotid IMT injury in the logistic regression model. CONCLUSION Total sedentary time and sedentary time in bouts ≥10 min, as assessed by accelerometer, was positively but weakly associated with carotid IMT. Equally, this sedentary time in bouts ≥10 min was associated with carotid injury, but disappears after adjusting for potential confounders. These findings support that reducing sedentary time and increasing breaks in bouts of sedentary time might represent a useful additional strategy in the cardiovascular disease prevention. TRIAL REGISTRATION Clinical Trials.gov Identifier: NCT01083082.
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Affiliation(s)
- Antonio García-Hermoso
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, USACH, Chile
| | | | | | - Mairena Sánchez-López
- Social and Health Care Research Center, University of Castilla-La Mancha, Cuenca, Spain
| | | | - Luis García-Ortiz
- The Alamedilla Health Center, Castilla y León Health Service-SACYL, USAL, IBSAL, Salamanca, Spain
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Moustardas P, Kadoglou NPE, Katsimpoulas M, Kapelouzou A, Kostomitsopoulos N, Karayannacos PE, Kostakis A, Liapis CD. The complementary effects of atorvastatin and exercise treatment on the composition and stability of the atherosclerotic plaques in ApoE knockout mice. PLoS One 2014; 9:e108240. [PMID: 25264981 PMCID: PMC4180453 DOI: 10.1371/journal.pone.0108240] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 08/26/2014] [Indexed: 12/02/2022] Open
Abstract
Aim This study aimed to investigate the effects of combined atorvastatin and exercise treatment on the composition and stability of the atherosclerotic plaques in apolipoproteinE (apoE) knockout mice. Methods Forty male, apoE−/− mice were fed a high-fat diet for 16 weeks. Thereafter, while maintained on high-fat diet, they were randomized into four (n = 10) groups for 8 additional weeks: Group CO: Control. Group AT: Atorvastatin treatment (10 mg/Kg/day). Group EX: Exercise-training on treadmill. Group AT+EX: Atorvastatin and simultaneous exercise training. At the study’s end, plasma cholesterol levels, lipids and triglycerides were measured, along with the circulating concentrations of matrix-metalloproteinases (MMP-2,3,8,9) and their inhibitors (TIMP-1,2,3). Plaque area and the relative concentrations of collagen, elastin, macrophages, smooth muscle cells, MMP-2,3,8,9 and TIMP-1,2,3 within plaques were determined. Lastly, MMP activity was assessed in the aortic arch. Results All intervention groups showed a lower degree of lumen stenosis, with atheromatous plaques containing more collagen and elastin. AT+EX group had less stenosis and more elastin compared to single intervention groups. MMP-3,-8 -9 and macrophage intra-plaque levels were reduced in all intervention groups. EX group had increased TIMP-1 levels within the lesions, while TIMP-2 was decreased in all intervention groups. The blood levels of the above molecules increased during atherosclerosis development, but they did not change after the therapeutic interventions in accordance to their intra-plaque levels. Conclusion The two therapeutic strategies act with synergy regarding the extent of the lesions and lumen stenosis. They stabilize the plaque, increasing its content in elastin and collagen, by influencing the MMP/TIMP equilibrium, which is mainly associated with the macrophage amount. While the increased MMP-2,-3,-8 -9, as well as TIMP-1 and TIMP-2 circulating levels are markers of atherosclerosis, they are not correlated with their corresponding concentrations within the lesions after the therapeutic interventions, and cannot serve as markers for the disease development/amelioration.
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Affiliation(s)
- Petros Moustardas
- Center for Experimental Surgery, Biomedical Research Foundation, Academy of Athens, Athens, Greece
- * E-mail:
| | - Nikolaos P. E. Kadoglou
- Center for Experimental Surgery, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Michalis Katsimpoulas
- Center for Experimental Surgery, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Alkistis Kapelouzou
- Center for Experimental Surgery, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | | | | | - Alkiviadis Kostakis
- Center for Experimental Surgery, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Christos D. Liapis
- Department of Vascular Surgery, «Attikon» Hospital, Medical School, University of Athens, Athens, Greece
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Gomez-Marcos MA, Recio-Rodríguez JI, Patino-Alonso MC, Agudo-Conde C, Lasaosa-Medina L, Rodriguez-Sanchez E, Maderuelo-Fernandez JA, García-Ortiz L. Relationship between objectively measured physical activity and vascular structure and function in adults. Atherosclerosis 2014; 234:366-72. [DOI: 10.1016/j.atherosclerosis.2014.02.028] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 02/27/2014] [Accepted: 02/28/2014] [Indexed: 10/25/2022]
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Feairheller DL, Diaz KM, Kashem MA, Thakkar SR, Veerabhadrappa P, Sturgeon KM, Ling C, Williamson ST, Kretzschmar J, Lee H, Grimm H, Babbitt DM, Vin C, Fan X, Crabbe DL, Brown MD. Effects of moderate aerobic exercise training on vascular health and blood pressure in African Americans. J Clin Hypertens (Greenwich) 2014; 16:504-10. [PMID: 24779748 DOI: 10.1111/jch.12328] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 03/17/2014] [Accepted: 03/20/2014] [Indexed: 01/22/2023]
Abstract
As healthcare progresses toward individualized medicine, understanding how different racial groups respond to lifestyle interventions is valuable. It is established that African Americans have disproportionate levels of cardiovascular disease and impaired vascular health, and clinical practice guidelines suggest lifestyle interventions as the first line of treatment. Recently, the authors reported that 6 months of aerobic exercise improved inflammatory markers, flow-mediated dilation (FMD), and levels of circulating endothelial microparticles (EMPs) in African American adults. This study is a subgroup analysis of the aerobic exercise-induced changes in vascular health and blood pressure (BP) measures, including carotid artery intima-media thickness (IMT), nitroglycerin-mediated dilation (NMD), ambulatory BP, and office BP. Sedentary African American adults (53.4±6.2 years; 21 women and 5 men) showed improved vascular health but no change in BP. Carotid artery IMT decreased 6.4%, plasma nitric oxide levels increased 76.6%, plasma EMP levels decreased, percentage of FMD increased 59.6%, and FMD/NMD ratio increased 36.2% (P<.05 for all). Six months of aerobic exercise training is sufficient to elicit improvements in vascular structure and function in African Americans, even without improvements in BP measures or NMD (ie, smooth muscle function). To our knowledge, this is the first study to report such findings in African Americans.
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Affiliation(s)
- Deborah L Feairheller
- Hypertension and Endothelial Function with Aerobic and Resistance Training (HEART) Laboratory, Health & Exercise Physiology Department, Ursinus College, Collegeville, PA; Hypertension, Molecular and Applied Physiology Laboratory, Department of Kinesiology, Temple University, Philadelphia, PA
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Pälve KS, Pahkala K, Magnussen CG, Koivistoinen T, Juonala M, Kähönen M, Lehtimäki T, Rönnemaa T, Viikari JSA, Raitakari OT. Association of physical activity in childhood and early adulthood with carotid artery elasticity 21 years later: the cardiovascular risk in Young Finns Study. J Am Heart Assoc 2014; 3:e000594. [PMID: 24755150 PMCID: PMC4187482 DOI: 10.1161/jaha.113.000594] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Decreased arterial elasticity is a risk factor for several cardiovascular outcomes. Longitudinal data on the effect of physical activity in youth on adult arterial elasticity are limited. The aim of this study was to determine the long-term effects of physical activity in children and young adults on carotid artery elasticity after 21 years of follow-up. METHODS AND RESULTS Participants were 1417 children (aged 9 to 15 years) and 999 young adults (aged 18 to 24 years) from the prospective Cardiovascular Risk in Young Finns Study. Participants had questionnaire measures of leisure-time physical activity available from 1986 and ultrasound-derived indices of carotid artery elasticity measured in 2007. Carotid artery elasticity indices were distensibility (%/10 mm Hg), Young's elastic modulus (kPa), and stiffness index (unitless). Physical activity at age 18 to 24 years was directly associated with distensibility (β=0.068, P=0.014) and inversely with Young's elastic modulus (β=-0.057, P=0.0037) and indirectly with stiffness index (β=-0.050, P=0.0028) 21 years later in males and females. The associations remained after adjustment for age, sex, body mass index, smoking, systolic blood pressure, serum lipids and insulin, and 21-year change in physical activity. At age 9 to 15 years, the favorable association, remaining after adjustment, was found in males (distensibility [β=0.097, P=0.010], Young's elastic modulus [β=-0.060, P=0.028], and stiffness index [β=-0.062, P=0.007]) but not in females (P=0.70, P=0.85, and P=0.91, respectively). CONCLUSIONS Leisure-time physical activity in boys and young adults is associated with carotid artery elasticity later in life, suggesting that higher levels of physical activity in youth may benefit future cardiovascular health.
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Affiliation(s)
- Kristiina S Pälve
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
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Taylor BA, Zaleski AL, Capizzi JA, Ballard KD, Troyanos C, Baggish AL, D'Hemecourt PA, Dada MR, Thompson PD. Influence of chronic exercise on carotid atherosclerosis in marathon runners. BMJ Open 2014; 4:e004498. [PMID: 24531453 PMCID: PMC3927935 DOI: 10.1136/bmjopen-2013-004498] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES The effect of habitual, high-intensity exercise training on the progression of atherosclerosis is unclear. We assessed indices of vascular health (central systolic blood pressure (SBP) and arterial stiffness as well as carotid intima-medial thickness (cIMT)) in addition to cardiovascular risk factors of trained runners versus their untrained spouses or partners to evaluate the impact of exercise on the development of carotid atherosclerosis. SETTING field study at Boston Marathon. PARTICIPANTS 42 qualifiers (mean age±SD: 46±13 years, 21 women) for the 2012 Boston Marathon and their sedentary domestic controls (46±12 years, n=21 women). OUTCOMES We measured medical and running history, vital signs, anthropometrics, blood lipids, C reactive protein (CRP), 10 years Framingham risk, central arterial stiffness and SBP and cIMT. RESULTS Multiple cardiovascular risk factors, including CRP, non-high-density lipoprotein cholesterol, triglycerides, heart rate, body weight and body mass index (all p<0.05), were reduced in the runners. The left and right cIMT, as well as central SBP, were not different between the two groups (all p>0.31) and were associated with age (all r≥0.41; p<0.01) and Framingham risk score (all r≥0.44; p<0.01) independent of exercise group (all p>0.08 for interactions). The amplification of the central pressure waveform (augmentation pressure at heart rate 75 bpm) was also not different between the two groups (p=0.07) but was related to age (p<0.01) and group (p=0.02) in a multiple linear regression model. CONCLUSIONS Habitual endurance exercise improves the cardiovascular risk profile, but does not reduce the magnitude of carotid atherosclerosis associated with age and cardiovascular risk factors.
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Affiliation(s)
- Beth A Taylor
- Department of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, Connecticut, USA
- Department of Health Sciences, University of Hartford, Bloomfield, Connecticut, USA
| | - Amanda L Zaleski
- Department of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, Connecticut, USA
| | - Jeffrey A Capizzi
- Department of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, Connecticut, USA
| | - Kevin D Ballard
- Department of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, Connecticut, USA
| | | | - Aaron L Baggish
- Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Marcin R Dada
- Department of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, Connecticut, USA
| | - Paul D Thompson
- Department of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford, Connecticut, USA
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Takashima A, Ise T, Yagi S, Iwase T, Kimura S, Ueda Y, Nishikawa K, Ishii A, Niki T, Yamaguchi K, Taketani Y, Yamada H, Soeki T, Wakatsuki T, Katoh S, Akaike M, Sata M. Cardiac Rehabilitation Reduces Serum Levels of Oxidized Low-Density Lipoprotein. Circ J 2014; 78:2682-7. [DOI: 10.1253/circj.cj-14-0532] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Akira Takashima
- Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
| | - Takayuki Ise
- Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
| | - Shusuke Yagi
- Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
| | - Takashi Iwase
- Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
| | - Sahika Kimura
- Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
| | - Yuka Ueda
- Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
| | - Koji Nishikawa
- Department of Rehabilitation, Tokushima University Hospital
| | - Ayumi Ishii
- Department of Rehabilitation, Tokushima University Hospital
| | - Toshiyuki Niki
- Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
| | - Koji Yamaguchi
- Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
| | - Yoshio Taketani
- Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
| | - Hirotsugu Yamada
- Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
| | - Takeshi Soeki
- Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
| | - Tetsuzo Wakatsuki
- Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
| | - Shinsuke Katoh
- Department of Rehabilitation, Tokushima University Hospital
| | - Masashi Akaike
- Department of Medical Education, Institute of Health Biosciences, The University of Tokushima Graduate School
| | - Masataka Sata
- Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School
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Arsenault BJ, Larose E. Appreciating the local and systemic effects of exercise training on vascular health. Atherosclerosis 2013; 231:15-7. [PMID: 24125403 DOI: 10.1016/j.atherosclerosis.2013.08.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 08/21/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Benoit J Arsenault
- Centre de recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Canada; Department of Medicine, Faculty of Medicine, Université Laval, Québec, Canada.
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Kadoglou NPE, Moustardas P, Kapelouzou A, Katsimpoulas M, Giagini A, Dede E, Kostomitsopoulos N, Karayannacos PE, Kostakis A, Liapis CD. The anti-inflammatory effects of exercise training promote atherosclerotic plaque stabilization in apolipoprotein E knockout mice with diabetic atherosclerosis. Eur J Histochem 2013; 57:e3. [PMID: 23549462 PMCID: PMC3683610 DOI: 10.4081/ejh.2013.e3] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2012] [Revised: 10/12/2012] [Accepted: 07/27/2012] [Indexed: 01/30/2023] Open
Abstract
Physical exercise is the cornerstone of cardiovascular disease treatment. The present study investigated whether exercise training affects atherosclerotic plaque composition through the modification of inflammatoryrelated pathways in apolipoprotein E knockout (apoE−/−) mice with diabetic atherosclerosis. Forty-five male apoE−/− mice were randomized into three equivalent (n=15) groups: control (CO), sedentary (SED), and exercise (EX). Diabetes was induced by streptozotocin administration. High-fat diet was administered to all groups for 12 weeks. Afterwards, CO mice were euthanatized, while the sedentary and exercise groups continued high-fat diet for 6 additional weeks. Exercising mice followed an exercise program on motorizedtreadmill (5 times/week, 60 min/session). Then, blood samples and atherosclerotic plaques in the aortic root were examined. A considerable (P<0.001) regression of the atherosclerotic lesions was observed in the exercise group (180.339±75.613×103µm2) compared to the control (325.485±72.302×103 µm2) and sedentary (340.188±159.108×103µm2) groups. We found decreased macrophages, matrix metalloproteinase-2 (MMP-2), MMP-3, MMP-8 and interleukin-6 (IL-6) concentrations (P<0.05) in the atherosclerotic plaques of the exercise group. Compared to both control and sedentary groups, exercise training significantly increased collagen (P<0.05), elastin (P<0.001), and tissue inhibitor of matrix metalloproteinase-2 (TIMP-2) (P<0.001) content in the atherosclerotic plaques. Those effects paralleled with increased fibrous cap thickness and less internal elastic lamina ruptures after exercise training (P<0.05), while body-weight and lipid parameters did not significantly change. Plasma MMP-2 and MMP-3 concentrations in atherosclerotic tissues followed a similar trend. From our study we can conclude that exercise training reduces and stabilizes atherosclerotic lesions in apoE−/− mice with diabetic atherosclerosis. A favorable modification of the inflammatory regulators seems to explain those beneficial effects.
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Affiliation(s)
- N P E Kadoglou
- Biomedical Research Foundation, Academy of Athens, Athens, Greece.
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Kadoglou NPE, Fotiadis G, Kapelouzou A, Kostakis A, Liapis CD, Vrabas IS. The differential anti-inflammatory effects of exercise modalities and their association with early carotid atherosclerosis progression in patients with type 2 diabetes. Diabet Med 2013; 30:e41-50. [PMID: 23078531 DOI: 10.1111/dme.12055] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Revised: 09/18/2012] [Accepted: 10/15/2012] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Adipokines, visfatin, apelin, vaspin and ghrelin have emerged as novel cardiovascular risk factors. We aimed to evaluate the effects of different exercise modalities on the aforementioned novel adipokines and carotid intima-media thickness in patients with Type 2 diabetes mellitus. METHODS One hundred patients with Type 2 diabetes were equivalently (n = 25) randomized into four groups: (1) a control group with patients encouraged to perform self-controlled exercise; (2) a supervised aerobic exercise group (exercise four times/week, 60 min/session, 60-75% of maximum heart rate); (3) a resistance training group (60-80% baseline maximum load achieved in one repetition); and (4) a combined aerobic exercise plus resistance training group, as in groups 2 and 3. All participants had HbA(1c) levels ≥ 48 mmol/mol (≥ 6.5%), without overt diabetic vascular complications. Blood samples, clinical characteristics, peak oxygen uptake and carotid intima-media thickness measurements were obtained at baseline and at the end of the study, after 6 months. RESULTS At baseline, there were non-significant differences between groups. All active groups significantly ameliorated glycaemic profile, insulin sensitivity and triglycerides levels compared with the control group (P < 0.05). Aerobic training further improved lipids, systolic blood pressure and exercise capacity compared with the resistance training and the control groups (P < 0.05). Moreover, high-sensitivity C-reactive protein and visfatin decreased, while vaspin and apelin circulating levels increased within the aerobic exercise group and the aerobic exercise plus resistance training group, and compared with the other groups (P < 0.05). Within- and between-group comparisons showed negligible alterations in ghrelin serum levels and body weight after all exercise modalities. Finally, aerobic training attenuated the carotid intima-media thickness progression (0.017 ± 0.006 mm) compared with the control subjects (0.129 ± 0.042 mm, P < 0.001). That effect was independently associated with visfatin and amelioration of peak oxygen uptake. CONCLUSIONS In subjects with Type 2 diabetes, all exercise training modalities improved metabolic profile. Importantly, aerobic training predominantly ameliorated adipokines concentrations and carotid intima-media thickness progression.
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Affiliation(s)
- N P E Kadoglou
- Department of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki.
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43
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Katano H, Ohno M, Yamada K. Protection by Physical Activity Against Deleterious Effect of Smoking on Carotid Intima-media Thickness in Young Japanese. J Stroke Cerebrovasc Dis 2013; 22:176-83. [DOI: 10.1016/j.jstrokecerebrovasdis.2011.07.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2011] [Accepted: 07/14/2011] [Indexed: 10/15/2022] Open
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Nikolopoulou A, Kadoglou NPE. Obesity and metabolic syndrome as related to cardiovascular disease. Expert Rev Cardiovasc Ther 2013; 10:933-9. [PMID: 22908926 DOI: 10.1586/erc.12.74] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The metabolic syndrome (MetS) constitutes a multifaceted disorder, including obesity, dyslipidemia, hyperglycemia and hypertension, associated with an increased propensity towards cardiovascular disease (CVD). Besides this, accumulating data suggest the involvement of nontraditional, novel, cardiovascular risk factors in MetS. Among them, insulin resistance seems to possess a predominant role in MetS-related CVD in obese patients. Furthermore, adipose tissue fatty acid metabolism, increased incidence of oxidative stress and endothelial dysfunction, and excessive production of adipocyte derivatives, known as adipokines, have all been proposed to contribute to the pathogenesis of CVD in obese patients with MetS. Lifestyle interventions, such as weight loss and increased physical activity, have long been the cornerstone for the treatment of obesity-related disorders. With the exception of obesity, pharmaceutical interventions targeting each disorder of MetS have yielded considerable improvement in cardiovascular morbidity and mortality. The long-term management of obesity and its complications seems promising but requires further investigation.
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Matsumoto A, Manthey HD, Marsh SA, Fassett RG, de Haan JB, Rolfe BE, Coombes JS. Effects of exercise training and RhoA/ROCK inhibition on plaque in ApoE-/- mice. Int J Cardiol 2012; 167:1282-8. [PMID: 22525349 DOI: 10.1016/j.ijcard.2012.03.172] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2011] [Revised: 03/22/2012] [Accepted: 03/30/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND The molecular mechanisms of exercise-induced cardioprotection are poorly understood. We recently reported that exercise training down-regulated gene expression of the Ras homolog gene family member A (RhoA). RhoA and its first effectors, the Rho-kinases (ROCK), have already been implicated in the pathogenesis of cardiovascular disease. The aim of this study was to compare the effects of a RhoA/ROCK inhibitor (fasudil) and exercise in the Apolipoprotein E knockout (ApoE(-/-)) mouse model of atherosclerosis. METHODS Four groups of 14 week old ApoE(-/-) mice were randomised as follows (n=12/group): i) sedentary controls (Cont); ii) fasudil (Fas) treatment (100mg/kg bodyweight/day) for 8 weeks; iii) exercise intervention (Ex:free access to running wheel for 8 weeks) and iv) exercise intervention and fasudil treatment (ExFas) for 8 weeks. RESULTS Phosphorylation of myosin light chain was significantly reduced in the brachiocephalic artery of all treatment groups compared with sedentary controls, implying an inhibitory effect of exercise and fasudil on the RhoA/ROCK pathway. Furthermore, atherosclerotic lesions were significantly smaller in all treatment and intervention groups compared with the control group (Fas: 34.7%, Ex: 48.3%, ExFas: 40.9% less than Control). The intima:media ratio was reduced by both exercise intervention and fasudil treatment alone or in combination (Fas: 23.6%, Ex: 35.5%, ExFas: 43.9% less than Control). Exercise alone and fasudil treatment alone also showed similar effects on plaque composition, increasing both smooth muscle cell and macrophage density. CONCLUSION These results suggest that the protective effects of exercise on atherogenesis are similar to the inhibitory effects on the RhoA/ROCK signalling pathway.
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Affiliation(s)
- Aya Matsumoto
- School of Human Movement Studies, The University of Queensland, Brisbane, Queensland, Australia.
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46
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Ferré R, Plana N, Merino J, Aragonès G, Girona J, Heras M, Coll B, Cos R, Masana L. Effects of therapeutic lifestyle changes on peripheral artery tonometry in patients with abdominal obesity. Nutr Metab Cardiovasc Dis 2012; 22:95-102. [PMID: 20708393 DOI: 10.1016/j.numecd.2010.04.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Revised: 04/18/2010] [Accepted: 04/19/2010] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS Abdominal obesity (AO) is associated with endothelial function (EF) alteration and increased global cardiovascular (CV) risk. Therapeutic lifestyle changes (TLSC) reduce CV risk, but the impact on EF assessed by peripheral artery tonometry (PAT) is unknown. In this study, we aimed to prospectively assess the effects of TLSC on EF measured by PAT in increased CV risk patients with AO. METHODS AND RESULTS 150 patients with AO and moderate CV risk were randomized to groups receiving a one-year intervention of either conventional medical care (control group, CG) or an intensive TLSC program (intervention group, IG). Vascular studies (EF by PAT, intima-media thickness (IMT)) and lifestyle (LS) assessment were performed before and after intervention. The PAT ratio improved in the IG and worsened in the CG. The global CV risk was reduced (P = 0.017) in the IG due to a significant decrease in systolic blood pressure (P < 0.001), increase in HDL cholesterol and ApolipoproteinA1 (P = 0.013). More individuals in the IG than in the CG quit smoking (P = 0.001) and increased their physical activity (P = 0.014). The improvement in at least two LS components was associated with a PAT ratio increase (2.44 IC: 95% 0.99-6.00, P = 0.051). The PAT ratio increase determined less IMT progression (-1.1 IC: 95% 0.91-1.00, P = 0.053). CONCLUSIONS Good adherence to a TLSC program reduces global CV risk and determines PAT ratio improvement. The PAT ratio increase is the main determinant of lower IMT progression.
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Affiliation(s)
- R Ferré
- Vascular Medicine and Metabolism Unit, Sant Joan University Hospital, IISPV, Universitat Rovira i Virgili, C.Sant Llorenç 21, 43201 Reus, Spain
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Pellegrin M, Miguet-Alfonsi C, Berthelot A, Mazzolai L, Laurant P. Long-term swimming exercise does not modulate the Akt-dependent endothelial nitric oxide synthase phosphorylation in healthy mice. Can J Physiol Pharmacol 2011; 89:72-6. [PMID: 21186380 DOI: 10.1139/y10-107] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Molecular mechanisms by which exercise exerts cardiovascular benefits are poorly understood. Exercise-induced increase of endothelial NO synthase (eNOS) phosphorylation through the protein kinase Akt has been shown to be a key mechanism underlying the beneficial effect of exercise in coronary artery disease patients. We examined whether this protective pathway might also be activated in long-term-exercised healthy mice. C57BL/6 wild-type mice swam for 24 weeks. A group of sedentary animals were used as controls. Aortic levels of total protein kinase Akt (protein kinase B), phosphorylated Akt at ser473 (p-Akt), total eNOS, phosphorylated eNOS at Ser1177 (p-eNOS), and PECAM-1 (platelet endothelial cell adhesion molecule-1) were assessed by Western blotting. Protein expressions of Akt, p-Akt, eNOS, p-eNOS, and PECAM-1 were not modulated by 24 weeks of exercise. The Akt-dependent eNOS phosphorylation did not seem to be a primary molecular adaptation in response to long-term exercise in healthy mice.
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Affiliation(s)
- Maxime Pellegrin
- Lausanne University Hospital, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
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The forgotten face of regular physical exercise: a 'natural' anti-atherogenic activity. Clin Sci (Lond) 2011; 121:91-106. [PMID: 21729002 DOI: 10.1042/cs20100520] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Humans are not programmed to be inactive. The combination of both accelerated sedentary lifestyle and constant food availability disturbs ancient metabolic processes leading to excessive storage of energy in tissue, dyslipidaemia and insulin resistance. As a consequence, the prevalence of Type 2 diabetes, obesity and the metabolic syndrome has increased significantly over the last 30 years. A low level of physical activity and decreased daily energy expenditure contribute to the increased risk of cardiovascular morbidity and mortality following atherosclerotic vascular damage. Physical inactivity leads to the accumulation of visceral fat and consequently the activation of the oxidative stress/inflammation cascade, which promotes the development of atherosclerosis. Considering physical activity as a 'natural' programmed state, it is assumed that it possesses atheroprotective properties. Exercise prevents plaque development and induces the regression of coronary stenosis. Furthermore, experimental studies have revealed that exercise prevents the conversion of plaques into a vulnerable phenotype, thus preventing the appearance of fatal lesions. Exercise promotes atheroprotection possibly by reducing or preventing oxidative stress and inflammation through at least two distinct pathways. Exercise, through laminar shear stress activation, down-regulates endothelial AT1R (angiotensin II type 1 receptor) expression, leading to decreases in NADPH oxidase activity and superoxide anion production, which in turn decreases ROS (reactive oxygen species) generation, and preserves endothelial NO bioavailability and its protective anti-atherogenic effects. Contracting skeletal muscle now emerges as a new organ that releases anti-inflammatory cytokines, such as IL-6 (interleukin-6). IL-6 inhibits TNF-α (tumour necrosis factor-α) production in adipose tissue and macrophages. The down-regulation of TNF-α induced by skeletal-muscle-derived IL-6 may also participate in mediating the atheroprotective effect of physical activity.
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Padilla J, Simmons GH, Bender SB, Arce-Esquivel AA, Whyte JJ, Laughlin MH. Vascular effects of exercise: endothelial adaptations beyond active muscle beds. Physiology (Bethesda) 2011; 26:132-45. [PMID: 21670160 PMCID: PMC3286126 DOI: 10.1152/physiol.00052.2010] [Citation(s) in RCA: 144] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Endothelial adaptations to exercise training are not exclusively conferred within the active muscle beds. Herein, we summarize key studies that have evaluated the impact of chronic exercise on the endothelium of vasculatures perfusing nonworking skeletal muscle, brain, viscera, and skin, concluding with discussion of potential mechanisms driving these endothelial adaptations.
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Affiliation(s)
- Jaume Padilla
- Biomedical Sciences, University of Missouri, Columbia, Missouri, USA.
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50
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Newcomer SC, Padilla J. Racket sports as a model of studying vascular adaptations: a comeback after a quarter of a century. J Appl Physiol (1985) 2011; 110:1156-7. [DOI: 10.1152/japplphysiol.00245.2011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Sean C. Newcomer
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana; and
| | - Jaume Padilla
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri
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