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Pantiya P, Thonusin C, Sumneang N, Ongnok B, Chunchai T, Kerdphoo S, Jaiwongkam T, Arunsak B, Siri-Angkul N, Sriwichaiin S, Chattipakorn N, Chattipakorn SC. High Cardiorespiratory Fitness Protects against Molecular Impairments of Metabolism, Heart, and Brain with Higher Efficacy in Obesity-Induced Premature Aging. Endocrinol Metab (Seoul) 2022; 37:630-640. [PMID: 35927067 PMCID: PMC9449107 DOI: 10.3803/enm.2022.1430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 06/08/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGRUOUND High cardiorespiratory fitness (CRF) protects against age-related diseases. However, the mechanisms mediating the protective effect of high intrinsic CRF against metabolic, cardiac, and brain impairments in non-obese versus obese conditions remain incompletely understood. We aimed to identify the mechanisms through which high intrinsic CRF protects against metabolic, cardiac, and brain impairments in non-obese versus obese untrained rats. METHODS Seven-week-old male Wistar rats were divided into two groups (n=8 per group) to receive either a normal diet or a highfat diet (HFD). At weeks 12 and 28, CRF, carbohydrate and fatty acid oxidation, cardiac function, and metabolic parameters were evaluated. At week 28, behavior tests were performed. At the end of week 28, rats were euthanized to collect heart and brain samples for molecular studies. RESULTS The obese rats exhibited higher values for aging-related parameters than the non-obese rats, indicating that they experienced obesity-induced premature aging. High baseline CRF levels were positively correlated with several favorable metabolic, cardiac, and brain parameters at follow-up. Specifically, the protective effects of high CRF against metabolic, cardiac, and brain impairments were mediated by the modulation of body weight and composition, the lipid profile, substrate oxidation, mitochondrial function, insulin signaling, autophagy, apoptosis, inflammation, oxidative stress, cardiac function, neurogenesis, blood-brain barrier, synaptic function, accumulation of Alzheimer's disease-related proteins, and cognition. Interestingly, this effect was more obvious in HFD-fed rats. CONCLUSION The protective effect of high CRF is mediated by the modulation of several mechanisms. These effects exhibit greater efficacy under conditions of obesity-induced premature aging.
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Affiliation(s)
- Patcharapong Pantiya
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Chanisa Thonusin
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Natticha Sumneang
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Benjamin Ongnok
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Titikorn Chunchai
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Sasiwan Kerdphoo
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Thidarat Jaiwongkam
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Busarin Arunsak
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Natthaphat Siri-Angkul
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Sirawit Sriwichaiin
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Nipon Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Siriporn C. Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Cardiac Electrophysiology Unit, Department of Physiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
- Corresponding author: Siriporn C. Chattipakorn. Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Si Phum, Muang, Chiang Mai, 50200, Thailand Tel: +66-53-935329, Fax: +66-53-935368, E-mail:
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Amir M, Kabo P, Mappangara I, Djafar Z, Zainuddin AA, Warliani M, Mustafa A. Peak oxygen uptake and metabolic equivalents explained by six-minute walk test: A prospective observational study in predicting heart failure patient readmission. Ann Med Surg (Lond) 2022; 77:103652. [PMID: 35638025 PMCID: PMC9142551 DOI: 10.1016/j.amsu.2022.103652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/16/2022] [Accepted: 04/17/2022] [Indexed: 11/26/2022] Open
Abstract
Background Methods Results Conclusions Functional capacity contributes to reducing cardiovascular events and re-hospitalization of patients with heart failure. Conducting a 6-min walk test before patient discharge can help identify a patients' risk for readmission. VO2max and METs can be utilized to create a comprehensive treatment flow for heart failure patients to prevent readmission.
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Kim J, Kim MG, Kang S, Kim BR, Baek MY, Park YM, Shin MS. Obesity and Hypertension in Association with Diastolic Dysfunction Could Reduce Exercise Capacity. Korean Circ J 2016; 46:394-401. [PMID: 27275176 PMCID: PMC4891604 DOI: 10.4070/kcj.2016.46.3.394] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 09/30/2015] [Accepted: 11/24/2015] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Empirical evidence is lacking on the cumulative disease burden of obesity and hypertension and its impact on cardiac function and exercise capacity. The purpose of this study was to determine whether the presence of obesity and hypertension together was associated with cardiac dysfunction and exercise capacity. SUBJECTS AND METHODS Using a retrospective study design, medical records were reviewed for echocardiographic and treadmill exercise stress test data. Subjects were grouped according to four categories: normal control, obese, hypertensive, or obese and hypertensive. RESULTS Obese, hypertensive persons showed significantly lower Ea and E/A ratio and greater E/Ea ratio, deceleration time, left ventricular (LV) mass, and LV mass index compared to their counter parts (normal control, obese and/or hypertensive) (all p<0.05), after controlling for age and sex. After controlling for age and sex, significant differences in exercise capacity indices were found, with the obese group having shorter exercise time, lower metabolic equivalents, and lower maximal oxygen uptake than the normal control, hypertensive, or both groups (all p<0.05). The hypertensive or obese and hypertensive group had greater maximal blood pressure compared with the normal control group (all p<0.001). Obese and hypertensive persons were approximately three times more likely to have diastolic dysfunction (odd ratio=2.96, p=0.001), when compared to the reference group (normotensive, non-obese, or hypertensive only persons). CONCLUSION Diastolic dysfunction was associated with obesity and/or hypertension. The cumulative risk of obesity and hypertension and their impact on diastolic dysfunction which could be modifiable could reduce exercise capacity.
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Affiliation(s)
- JinShil Kim
- Gachon University College of Nursing, Incheon, Korea
| | - Myeong Gun Kim
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - SeWon Kang
- Dongseoi University College of Nursing, Pusan, Korea
| | - Bong Roung Kim
- Department of Internal Medicine, Seoul Medical Center, Seoul, Korea
| | - Min Young Baek
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Yae Min Park
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.; Gachon University College of Medicine, Incheon, Korea
| | - Mi-Seung Shin
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.; Gachon University College of Medicine, Incheon, Korea
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Lakoski SG, Savage PD, Berkman AM, Penalosa L, Crocker A, Ades PA, Kahn SR, Cushman M. The safety and efficacy of early-initiation exercise training after acute venous thromboembolism: a randomized clinical trial. J Thromb Haemost 2015; 13:1238-44. [PMID: 25912176 DOI: 10.1111/jth.12989] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 04/16/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND Exercise training after myocardial infarction is the standard of care within a cardiac rehabilitation setting. However, there is scant evidence regarding the safety and efficacy of early exercise training following a venous thromboembolism (VTE). METHODS Eligible consenting participants were randomly allocated, on an individual basis, to either a 3-month exercise and behavioral weight loss intervention group or a control group. The primary clinical outcomes were change in health behavior (body weight and physical activity) and objectively measured fitness (Vo2peak ). RESULTS From 2013 to 2014, 239 patients presented to a community-based specialty clinic after an acute VTE; 43 (18%) of these met the eligibility criteria for inclusion in the study. Of these, 19 (44%) consented to participate (nine in the intervention group; 10 in the control group). There were no adverse events in either group over a 3-month period. The mean difference in body weight between the intervention and control groups was - 4.6 kg (95% confidence interval [CI] - 11.4 to 2.2) in favor of the intervention. The mean difference in duration of physical activity from baseline to 3 months between the intervention and control groups was 133 min (95% CI 7-248) in favor of the intervention. There was a significant change in fitness over a 3-month period for the intervention group (baseline Vo2peak , 26.1 ± 5.4 mL O2 kg(-1) min(-1) ; postintervention Vo2peak , 29.8 ± 5.4 mL O2 kg(-1) min(-1) ). CONCLUSION Early initiation of exercise training resulted in improvements in physical activity and fitness, and did not result in adverse events while individuals were receiving therapeutic anticoagulation. These are the first data on initiation of an exercise training and behavioral weight loss program in the early post-VTE setting.
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Affiliation(s)
- S G Lakoski
- Department of Medicine, University of Vermont, Burlington, VT, USA
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA
- Division of Cardiology, Cardiac Rehabilitation and Prevention, University of Vermont Medical Center, Burlington, VT, USA
| | - P D Savage
- Division of Cardiology, Cardiac Rehabilitation and Prevention, University of Vermont Medical Center, Burlington, VT, USA
| | - A M Berkman
- Department of Medicine, University of Vermont, Burlington, VT, USA
| | - L Penalosa
- Department of Medicine, University of Vermont, Burlington, VT, USA
| | - A Crocker
- Department of Mathematics and Statistics, University of Vermont, Burlington, VT, USA
| | - P A Ades
- Department of Medicine, University of Vermont, Burlington, VT, USA
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA
- Division of Cardiology, Cardiac Rehabilitation and Prevention, University of Vermont Medical Center, Burlington, VT, USA
| | - S R Kahn
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - M Cushman
- Department of Medicine and Pathology, Cardiovascular Research Institute, University of Vermont, Burlington, VT, USA
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Fenk S, Fischer M, Strack C, Schmitz G, Loew T, Lahmann C, Baessler A. Successful weight reduction improves left ventricular diastolic function and physical performance in severe obesity. Int Heart J 2015; 56:196-202. [PMID: 25740581 DOI: 10.1536/ihj.14-261] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Obesity and the metabolic syndrome (MetS) are risk factors for left ventricular diastolic dysfunction (LVDD). However, little is known about the impact of successful weight reduction (WR) on diastolic function and physical performance.Obese subjects (øBMI 40.2 ± 8.6 kg/m(2)) underwent a 1-year WR program comprising diet and lifestyle components. Echocardiography and exercise capacity (6-minute walk) were performed at baseline and after 1 year. The distribution of weight reduction was split at the sample median and subjects were dichotomized in "successful WR" (% WR ≥ median, corresponding to a weight loss of 8%) and "failed-WR" (% WR < median).From a total of 188 obese subjects, 71 had LVDD at baseline. Obese patients with successful WR improved their MetS alterations, including fasting glucose, insulin, lipids, adipokines, blood pressure levels, and epicardial fat thickness. The same was not true for obesity with failed WR. Subjects with successful WR demonstrated significant improvement in echocardiographic LVDD parameters (median [interquartile range]): Δe' (2,5 [-1.0, 4.7], P < 0.01), Δe'/a' (0.34 [0.07, 079], P < 0.01), ΔE/e' (-1.14 [-2.72, -0.54], P < 0.05), ΔE/A (0.08 [-0.04, 0.26], P < 0.05), ΔArd-Ad (-28 [-54, -4], P < 0.01), and 6-minute walk distance (65 [19, 135], P < 0.01). Improvement of ≥ 2 LVDD criteria was accomplished in 30% of subjects with WR versus 10% without (P = 0.009). Using multivariable regression analysis, reduction of epicardial fat thickness was particularly predictive for the improvement of diastolic function.In summary, in severe obesity, successful long-term WR was associated with improved LV diastolic function and exercise capacity.
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Affiliation(s)
- Sabine Fenk
- Klinik und Poliklinik für Innere Medizin II, Universitätsklinikum Regensburg
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Kim DY, Seo BD, Kim DJ. Effect of Walking Exercise on Changes in Cardiorespiratory Fitness, Metabolic Syndrome Markers, and High-molecular-weight Adiponectin in Obese Middle-aged Women. J Phys Ther Sci 2014; 26:1723-7. [PMID: 25435686 PMCID: PMC4242941 DOI: 10.1589/jpts.26.1723] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Accepted: 05/11/2014] [Indexed: 12/23/2022] Open
Abstract
[Purpose] The purpose of this study was to assess the effect of a 24-week exercise
intervention on cardiorespiratory fitness, metabolic syndrome markers, and
high-molecular-weight (HMW) adiponectin among obese middle-aged women. [Subjects] The
subjects were 14 obese middle-aged women. [Methods] The exercise program involved walking
at 50–60% of the maximum oxygen consumption, 3 times a week, for 24 weeks. Body
composition analysis, blood pressure measurements, and blood analysis were performed
before the exercise program and at weeks 6, 12, 18, and 24. [Results] The results showed
that after 24 weeks in the exercise program, the obesity indices and metabolic risk
factors, namely, weight, body fat, body mass index, waist circumference, systolic blood
pressure, diastolic blood pressure, and triglycerides decreased significantly, whereas
HDLC, a metabolic improvement factor, increased significantly. Additionally,
VO2max increased significantly, together with the level of total and HMW
adiponectins. Correlation analysis of the changes in measured variables (∆ score) during
resulting from the 24-week exercise program showed that body fat had a significant
negative correlation and VO2max had a significant positive correlation with HMW
adiponectin. [Conclusion] Among obese middle-aged women, regular exercise increases
cardiorespiratory fitness and HMW adiponectin expression and therefore can be effective in
the prevention and treatment of obesity and metabolic syndrome.
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Affiliation(s)
- Dae-Young Kim
- Research Institute of Sports Medicine, Department of Protection Science, Kyungwoon University, Republic of Korea
| | - Byoung-Do Seo
- Department of Physical Therapy, College of Health, Kyungwoon University, Republic of Korea
| | - Dong-Je Kim
- Research Institute of Sports Medicine, Department of Protection Science, Kyungwoon University, Republic of Korea
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Gray LR, Tompkins SC, Taylor EB. Regulation of pyruvate metabolism and human disease. Cell Mol Life Sci 2013; 71:2577-604. [PMID: 24363178 PMCID: PMC4059968 DOI: 10.1007/s00018-013-1539-2] [Citation(s) in RCA: 535] [Impact Index Per Article: 48.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 11/24/2013] [Accepted: 12/02/2013] [Indexed: 12/31/2022]
Abstract
Pyruvate is a keystone molecule critical for numerous aspects of eukaryotic and human metabolism. Pyruvate is the end-product of glycolysis, is derived from additional sources in the cellular cytoplasm, and is ultimately destined for transport into mitochondria as a master fuel input undergirding citric acid cycle carbon flux. In mitochondria, pyruvate drives ATP production by oxidative phosphorylation and multiple biosynthetic pathways intersecting the citric acid cycle. Mitochondrial pyruvate metabolism is regulated by many enzymes, including the recently discovered mitochondria pyruvate carrier, pyruvate dehydrogenase, and pyruvate carboxylase, to modulate overall pyruvate carbon flux. Mutations in any of the genes encoding for proteins regulating pyruvate metabolism may lead to disease. Numerous cases have been described. Aberrant pyruvate metabolism plays an especially prominent role in cancer, heart failure, and neurodegeneration. Because most major diseases involve aberrant metabolism, understanding and exploiting pyruvate carbon flux may yield novel treatments that enhance human health.
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Affiliation(s)
- Lawrence R Gray
- Department of Biochemistry, Fraternal Order of the Eagles Diabetes Research Center, and François M. Abboud Cardiovascular Research Center, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, 51 Newton Rd, 4-403 BSB, Iowa City, IA, 52242, USA
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Lalande S, Petrella RJ, Shoemaker JK. Effect of exercise training on diastolic function in metabolic syndrome. Appl Physiol Nutr Metab 2013; 38:545-50. [DOI: 10.1139/apnm-2012-0383] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
It has been reported that metabolic syndrome (MetS) impairs left ventricular (LV) diastolic function. The objective of this study was to determine whether exercise training can improve LV diastolic function in individuals with MetS. Twenty-eight individuals with MetS (9 males, aged 60 ± 5 years) underwent a 1-year combined endurance and resistance exercise training program; maximal aerobic capacity (V̇O2max), blood pressure, blood markers, and LV diastolic function were measured at weeks 0, 12, 24, and 52 throughout the training. Pulsed wave Doppler echocardiography across the mitral valve was used to assess peak early flow velocity (E) and peak atrial flow velocity (A) to determine the E/A ratio. Individuals with MetS had a reversed E/A ratio, suggesting impaired LV relaxation, the first stage of LV diastolic dysfunction. Exercise training reduced systolic blood pressure (SBP) (129 ± 14 to 120 ± 12 mm Hg; p < 0.01) and increased V̇O2max (29.2 ± 6.3 to 33.4 ± 6.5 mL·kg−1·min−1; p < 0.01) and high-density lipoprotein cholesterol (1.04 ± 0.21 to 1.12 ± 0.25 mmol·L−1; p = 0.02), but did not improve LV diastolic function. Individuals with an E/A ratio <1 at the start of training had a tendency toward an increased E/A ratio (p = 0.12) accompanied by significant decreases in SBP and increases in V̇O2max with exercise training. Combined resistance and aerobic exercise training improved cardiometabolic health but did not improve the impaired LV diastolic function of individuals with MetS.
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Affiliation(s)
- Sophie Lalande
- Department of Kinesiology, Western University, London, ON N6A 5B9, Canada
| | - Robert J. Petrella
- Department of Kinesiology, Western University, London, ON N6A 5B9, Canada
- Schulich School of Medicine, Family Medicine, London, ON N6A 3K6, Canada
| | - J. Kevin Shoemaker
- Department of Kinesiology, Western University, London, ON N6A 5B9, Canada
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Cardiovascular Effects of Weight Loss. CURRENT CARDIOVASCULAR RISK REPORTS 2011. [DOI: 10.1007/s12170-011-0211-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Athyros VG, Elisaf MS, Alexandrides T, Achimastos A, Ganotakis E, Bilianou E, Karagiannis A, Liberopoulos EN, Tziomalos K, Mikhailidis DP. Long-term impact of multifactorial treatment on new-onset diabetes and related cardiovascular events in metabolic syndrome: a post hoc ATTEMPT analysis. Angiology 2011; 63:358-66. [PMID: 22007026 DOI: 10.1177/0003319711421341] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
This post hoc analysis of the Assessing The Treatment Effect in Metabolic Syndrome Without Perceptible diabeTes (ATTEMPT) study assesses the 3½ year incidence of new-onset diabetes (NOD) and related cardiovascular disease (CVD) events in patients with metabolic syndrome (MetS), after multifactorial (lifestyle and drug, including atorvastatin) intervention. Patients were randomized to group A (low-density lipoprotein cholesterol [LDL-C] target < 100 mg/dL) and group B (< 130 mg/dL). The incidence of NOD during the 42-month follow-up was very low, 0.83 to 1.00/100 patient-years in patients with MetS and MetS with impaired fasting glucose, respectively. Older age, increased waist circumference, and persistent MetS were determinants of NOD. One CVD nonfatal event occurred in the 28 patients with NOD. Our findings suggest that treating the characteristics of MetS is achievable and beneficial. New-onset diabetes incidence and CVD events were negligible and not different from what is expected in the general population.
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Affiliation(s)
- Vassilios G Athyros
- Department of Internal Medicine, Second Propedeutic Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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