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Cerkauskaite S, Kubilius R, Dedele A, Vencloviene J. Association between greenery and health indicators in urban patients with symptomatic heart failure: a retrospective cohort study in Lithuania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:2801-2812. [PMID: 37883741 DOI: 10.1080/09603123.2023.2274381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023]
Abstract
Urban green spaces benefit physical, mental health, and reduses the risk of cardiovascular disease. A study in Kaunas, Lithuania collected health data from 100 patients with symptomatic heart failure (HF) during 2006-2009. Residential greenness was measured by the normalized difference vegetation index (NDVI). We assessed the impact of greenness on health indicators and on changes in health markers after 6 months. Higher greenness levels based on the NDVI 1-km radius were related to higher mean values of heart rate (HR) and ejection fraction and lower left ventricular (LV) end-diastolic diameter index (LV EDDI), LV end-systolic volume (ESV), left atrium size (LAS), and right atrium size (RAS) at baseline. After 6 months, a decrease in DBP and HR and an improvement in spiroergometric parameters were associated with exposure to high levels of greenness. The long-term rehabilitation group experienced significant changes in spiroergometric indicators. The results confirm that the greenness of the residential environment can improve health indicators in patients with HF.
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Affiliation(s)
- Sonata Cerkauskaite
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Raimondas Kubilius
- Department of Rehabilitation, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Audrius Dedele
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Jone Vencloviene
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Left atrial structure and function in heart failure with reduced (HFrEF) versus preserved ejection fraction (HFpEF): systematic review and meta-analysis. Heart Fail Rev 2022; 27:1933-1955. [PMID: 35079942 PMCID: PMC9388424 DOI: 10.1007/s10741-021-10204-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 01/10/2023]
Abstract
Left atrial (LA) structure and function in heart failure with reduced (HFrEF) versus preserved ejection fraction (HFpEF) is only established in small studies. Therefore, we conducted a systematic review of LA structure and function in order to find differences between patients with HFrEF and HFpEF. English literature on LA structure and function using echocardiography was reviewed to calculate pooled prevalence and weighted mean differences (WMD). A total of 61 studies, comprising 8806 patients with HFrEF and 9928 patients with HFpEF, were included. The pooled prevalence of atrial fibrillation (AF) was 34.4% versus 42.8% in the acute inpatient setting, and 20.1% versus 33.1% in the chronic outpatient setting when comparing between HFrEF and HFpEF. LA volume index (LAVi), LA reservoir global longitudinal strain (LAGLSR), and E/e’ was 59.7 versus 52.7 ml/m2, 9.0% versus 18.9%, and 18.5 versus 14.0 in the acute inpatient setting, and 48.3 versus 38.2 ml/m2, 12.8% versus 23.4%, and 16.9 versus 13.5 in the chronic outpatient setting when comparing HFrEF versus HFpEF, respectively. The relationship between LAVi and LAGLSR was significant in HFpEF, but not in HFrEF. Also, in those studies that directly compared patients with HFrEF versus HFpEF, those with HFrEF had worse LAGLSR [WMD = 16.3% (22.05,8.61); p < 0.001], and higher E/e’ [WMD = −0.40 (−0.56, −0.24); p < 0.05], while LAVi was comparable. When focusing on acute hospitalized patients, E/e’ was comparable between patients with HFrEF and HFpEF. Despite the higher burden of AF in HFpEF, patients with HFrEF had worse LA global function. Left atrial myopathy is not specifically related to HFpEF.
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Bourscheid G, Just KR, Costa RR, Petry T, Danzmann LC, Pereira AH, Pereira AA, Franzoni LT, Garcia EL. Effect of different physical training modalities on peak oxygen consumptions in post-acute myocardial infarction patients: systematic review and meta-analysis. J Vasc Bras 2021; 20:e20210056. [PMID: 34404997 PMCID: PMC8354336 DOI: 10.1590/1677-5449.210056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 05/08/2021] [Indexed: 11/22/2022] Open
Abstract
Physical training can increase peak oxygen uptake (VO2peak) in people who have suffered acute myocardial infarction (AMI). However, there is still a gap in the literature in relation to the effectiveness of different types of interventions. Therefore, the aim of the present study was to evaluate the effects of different physical training modalities on VO2peak in post-AMI patients. The following databases were used: PubMed (MEDLINE), Cochrane Library, Scopus, and Pedro. Studies that evaluated aerobic exercise, strength exercise, or combined exercise were included. Six studies met eligibility criteria. Aerobic exercise increased VO2peak by 6.07 ml.kg-1.min-1 when compared to the control group (CG) (p = 0.013). The comparison between combined exercise and control group detected a difference of 1.84 ml.kg-1.min-1, but this was not significant (p = 0.312). We therefore conclude that aerobic exercise is the only modality that is effective for increasing VO2peak compared to a control group.
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Affiliation(s)
| | | | - Rochelle Rocha Costa
- Universidade Federal do Rio Grande do Sul – UFRGS, Porto Alegre, RS, Brasil.
- Faculdade SOGIPA, Porto Alegre, RS, Brasil.
| | - Thalia Petry
- Universidade Federal de Santa Maria – UFSM, Santa Maria, RS, Brasil.
| | | | - Adamastor Humberto Pereira
- Universidade Federal do Rio Grande do Sul – UFRGS, Porto Alegre, RS, Brasil.
- Hospital de Clínicas de Porto Alegre – HCPA/UFRGS, Porto Alegre, RS, Brasil.
| | - Alexandre Araújo Pereira
- Universidade Federal do Rio Grande do Sul – UFRGS, Porto Alegre, RS, Brasil.
- Hospital de Clínicas de Porto Alegre – HCPA/UFRGS, Porto Alegre, RS, Brasil.
| | - Leandro Tolfo Franzoni
- Universidade Federal do Rio Grande do Sul – UFRGS, Porto Alegre, RS, Brasil.
- Hospital de Clínicas de Porto Alegre – HCPA/UFRGS, Porto Alegre, RS, Brasil.
| | - Eduardo Lima Garcia
- Hospital de Clínicas de Porto Alegre – HCPA/UFRGS, Porto Alegre, RS, Brasil.
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Mahmod M, Pal N, Rayner J, Holloway C, Raman B, Dass S, Levelt E, Ariga R, Ferreira V, Banerjee R, Schneider JE, Rodgers C, Francis JM, Karamitsos TD, Frenneaux M, Ashrafian H, Neubauer S, Rider O. The interplay between metabolic alterations, diastolic strain rate and exercise capacity in mild heart failure with preserved ejection fraction: a cardiovascular magnetic resonance study. J Cardiovasc Magn Reson 2018; 20:88. [PMID: 30580760 PMCID: PMC6304764 DOI: 10.1186/s12968-018-0511-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 11/27/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Heart failure (HF) is characterized by altered myocardial substrate metabolism which can lead to myocardial triglyceride accumulation (steatosis) and lipotoxicity. However its role in mild HF with preserved ejection fraction (HFpEF) is uncertain. We measured myocardial triglyceride content (MTG) in HFpEF and assessed its relationships with diastolic function and exercise capacity. METHODS Twenty seven HFpEF (clinical features of HF, left ventricular EF >50%, evidence of mild diastolic dysfunction and evidence of exercise limitation as assessed by cardiopulmonary exercise test) and 14 controls underwent 1H-cardiovascular magnetic resonance spectroscopy (1H-CMRS) to measure MTG (lipid/water, %), 31P-CMRS to measure myocardial energetics (phosphocreatine-to-adenosine triphosphate - PCr/ATP) and feature-tracking cardiovascular magnetic resonance (CMR) imaging for diastolic strain rate. RESULTS When compared to controls, HFpEF had 2.3 fold higher in MTG (1.45 ± 0.25% vs. 0.64 ± 0.16%, p = 0.009) and reduced PCr/ATP (1.60 ± 0.09 vs. 2.00 ± 0.10, p = 0.005). HFpEF had significantly reduced diastolic strain rate and maximal oxygen consumption (VO2 max), which both correlated significantly with elevated MTG and reduced PCr/ATP. On multivariate analyses, MTG was independently associated with diastolic strain rate while diastolic strain rate was independently associated with VO2 max. CONCLUSIONS Myocardial steatosis is pronounced in mild HFpEF, and is independently associated with impaired diastolic strain rate which is itself related to exercise capacity. Steatosis may adversely affect exercise capacity by indirect effect occurring via impairment in diastolic function. As such, myocardial triglyceride may become a potential therapeutic target to treat the increasing number of patients with HFpEF.
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Affiliation(s)
- Masliza Mahmod
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU UK
- National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Nikhil Pal
- Divisions of Experimental Therapeutics and Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, UK
| | - Jennifer Rayner
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU UK
| | - Cameron Holloway
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU UK
| | - Betty Raman
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU UK
| | - Sairia Dass
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU UK
| | - Eylem Levelt
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU UK
| | - Rina Ariga
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU UK
| | - Vanessa Ferreira
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU UK
| | - Rajarshi Banerjee
- 1st Department of Cardiology, Aristotle University, Thessaloniki, Greece
| | - Jurgen E. Schneider
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU UK
| | - Christopher Rodgers
- Department of Medicine, John Radcliffe Hospital, Oxford, UK
- Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Jane M. Francis
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU UK
| | - Theodoros D. Karamitsos
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU UK
- 1st Department of Cardiology, Aristotle University, Thessaloniki, Greece
| | - Michael Frenneaux
- Norwich Medical School, Bob Champion Research and Education Building, James Watson Road, University of East Anglia Norwich Research Park, Norwich, NR4 7UQ UK
| | - Houman Ashrafian
- Divisions of Experimental Therapeutics and Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, UK
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU UK
| | - Oliver Rider
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU UK
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