Effectiveness of an intervention to reduce sedentary behaviour as a personalised secondary prevention strategy for patients with coronary artery disease: main outcomes of the SIT LESS randomised clinical trial

BACKGROUND

A high sedentary time is associated with increased mortality risk. Previous studies indicate that replacement of sedentary time with light- and moderate-to-vigorous physical activity attenuates the risk for adverse outcomes and improves cardiovascular risk factors. Patients with cardiovascular disease are more sedentary compared to the general population, while daily time spent sedentary remains high following contemporary cardiac rehabilitation programmes. This clinical trial investigated the effectiveness of a sedentary behaviour intervention as a personalised secondary prevention strategy (SIT LESS) on changes in sedentary time among patients with coronary artery disease participating in cardiac rehabilitation.

METHODS

Patients were randomised to usual care (n = 104) or SIT LESS (n = 108). Both groups received a comprehensive 12-week centre-based cardiac rehabilitation programme with face-to-face consultations and supervised exercise sessions, whereas SIT LESS participants additionally received a 12-week, nurse-delivered, hybrid behaviour change intervention in combination with a pocket-worn activity tracker connected to a smartphone application to continuously monitor sedentary time. Primary outcome was the change in device-based sedentary time between pre- to post-rehabilitation. Changes in sedentary time characteristics (prevalence of prolonged sedentary bouts and proportion of patients with sedentary time ≥ 9.5 h/day); time spent in light-intensity and moderate-to-vigorous physical activity; step count; quality of life; competencies for self-management; and cardiovascular risk score were assessed as secondary outcomes.

RESULTS

Patients (77% male) were 63 ± 10 years and primarily diagnosed with myocardial infarction (78%). Sedentary time decreased in SIT LESS (- 1.6 [- 2.1 to - 1.1] hours/day) and controls (- 1.2 [ ─1.7 to - 0.8]), but between group differences did not reach statistical significance (─0.4 [─1.0 to 0.3]) hours/day). The post-rehabilitation proportion of patients with a sedentary time above the upper limit of normal (≥ 9.5 h/day) was significantly lower in SIT LESS versus controls (48% versus 72%, baseline-adjusted odds-ratio 0.4 (0.2-0.8)). No differences were observed in the other predefined secondary outcomes.

CONCLUSIONS

Among patients with coronary artery disease participating in cardiac rehabilitation, SIT LESS did not induce significantly greater reductions in sedentary time compared to controls, but delivery was feasible and a reduced odds of a sedentary time ≥ 9.5 h/day was observed.

TRIAL REGISTRATION

Netherlands Trial Register: NL9263. Outcomes of the SIT LESS trial: changes in device-based sedentary time from pre-to post-cardiac rehabilitation (control group) and cardiac rehabilitation + SIT LESS (intervention group). SIT LESS reduced the odds of patients having a sedentary time >9.5 hours/day (upper limit of normal), although the absolute decrease in sedentary time did not significantly differ from controls. SIT LESS appears to be feasible, acceptable and potentially beneficial, but a larger cluster randomised trial is warranted to provide a more accurate estimate of its effects on sedentary time and clinical outcomes. CR: cardiac rehabilitation.

Resistance Exercise Program in Cognitively Normal Older Adults: CERT-Based Exercise Protocol of the AGUEDA Randomized Controlled Trial

OBJECTIVES

To provide a comprehensive CERT (Consensus on Exercise Reporting Template)-based description of the resistance exercise program implemented in the AGUEDA (Active Gains in brain Using Exercise During Aging) study, a randomized controlled trial investigating the effects of a 24-week supervised resistance exercise program on executive function and related brain structure and function in cognitively normal older adults.

DESIGN AND PARTICIPANTS

90 cognitively normal older adults aged 65 to 80 were randomized (1:1) to a: 1) resistance exercise group; or a 2) wait-list control group. Participants in the exercise group (n = 46) performed 180 min/week of resistance exercise (3 supervised sessions per week, 60 min/session) for 24 weeks.

INTERVENTION

The exercise program consisted of a combination of upper and lower limb exercises using elastic bands and the participant's own body weight as the main resistance. The load and intensity were based on the resistance of the elastic bands (7 resistances), number of repetitions (individualized), motor complexity of exercises (3 levels), sets and rest (3 sets/60 sec rest), execution time (40-60 sec) and velocity (as fast as possible).

SETTINGS

The maximum prescribed-target intensity was 70-80% of the participants' maximum rate of perceived exertion (7-8 RPE). Heart rate, sleep quality and feeling scale were recorded during all exercise sessions. Those in the wait-list control group (n = 44) were asked to maintain their usual lifestyle. The feasibility of AGUEDA project was evaluated by retention, adherence, adverse events and cost estimation on the exercise program.

RESULTS AND CONCLUSIONS

This study details the exercise program of the AGUEDA trial, including well-described multi-language manuals and videos, which can be used by public health professionals, or general public who wish to implement a feasible and low-cost resistance exercise program. The AGUEDA exercise program seems to be feasible by the high retention (95.6%) and attendance rate (85.7%), very low serious adverse event (1%) and low economic cost (144.23 € /participant/24 weeks). We predict that a 24-week resistance exercise program will have positive effects on brain health in cognitively normal older adults.

Prognostic value of left ventricular global longitudinal strain in patients with severe aortic stenosis for transcatheter aortic valve implantation-related morbidity and mortality: a meta-analysis

Aims

Current methods, including left ventricular ejection fraction (LVEF), demonstrate limited prognostic value for post-Transcatheter Aortic Valve Implantation (TAVI) outcomes. Studies elaborating on LV global longitudinal strain (GLS) showed promising results, but are often underpowered.

Purpose

This meta-analysis aims to evaluate the prognostic value of preprocedural global longitudinal strain (GLS) for post-TAVI mortality and morbidity.

Methods

A systematic search was conducted in PubMed, Embase and Web of Science from 2001 to 2021. All studies that comprised patients with severe aortic stenosis who underwent TAVI and investigated the association between preprocedural speckle-tracking-derived GLS and clinical outcomes, were included. An inversely-weighted random effects meta-analysis was adopted to investigate the association between preprocedural GLS vs primary (i.e. all-cause mortality) and secondary (i.e. major cardiovascular events [MACE]) post-TAVI outcomes.

Results

Of the 1,057 identified records, 12 were eligible, all of which had a low-to-moderate risk of bias (Newcastle-Ottawa scale). On average, the 2,068 unique patients demonstrated preserved ejection fraction but impaired longitudinal function (mean LVEF 52.2±4.4%, GLS −13.5±1.6%). Patients with a lower GLS had a higher all-cause mortality (pooled hazard ratio (HR) 1.99 [95% confidence interval (CI): 1.59, 2.50]) and MACE (1.26 [95% CI: 1.08, 1.46]) risk compared to patients with higher GLS. In addition, each 1% decrease of GLS was associated with an increased postprocedural mortality (HR 1.06 [95% CI: 1.03, 1.08]) and MACE risk (pooled HR 1.08 [95% CI: 1.01, 1.15]).

Conclusion

Preprocedural GLS was significantly associated with post-TAVI mortality and morbidity. This suggests a potential clinically important role of pre-TAVI evaluation of GLS for risk stratification of patients with severe aortic stenosis.

Funding Acknowledgement

Type of funding sources: Public hospital(s).

Long-term cardiovascular health and physical functioning of non-hospitalised ex-COVID-19 patients: a case-control study

Funding Acknowledgements

Type of funding sources: Foundation. Main funding source(s): Dutch Heart Foundation (Nederlandse Hartstichting)

Background/Introduction

SARS-CoV-2 and the associated coronavirus disease 2019 (COVID-19) has substantial acute effects on cardiovascular health and physical functioning, but the long-term effects are less clear, especially in individuals that recover from COVID-19 at home, representing ~95% of all cases.

Purpose

We compared cardiovascular health and physical functioning of non-hospitalised ex-COVID-19 patients versus age- and sex-matched healthy peers.

Methods

We recruited non-hospitalised adults with PCR-proven COVID-19 and age- and sex-matched controls for this case-control study. Duration of COVID-19 illness and presence of residual complaints were inquired. Cardiovascular health status and physical functioning were assessed through a series of measurements: blood pressure, blood biomarkers (NT-proBNP, high-sensitive cardiac troponin I, C-reactive protein), carotid-femoral pulse wave velocity (ARTSENS), handgrip strength, 4-metre gait speed, habitual physical activity (days per week with at least 30 minutes of moderate physical activity) and quality of life based on the 12-item short form.

Results

We included 101 ex-COVID-19 patients (median age 59.0 [54.5-65.5], 59 (58.4%) male) at a median of 5.0 [4.0-7.0] months post-infection and 101 age- and sex-matched controls (median age 58.0 [54.0-64.5], 58 (57.4%) male). Median duration of COVID-19 illness was 8.0 days [6.0-14.0] and 32.3% of the cases reported residual complaints at the time of inclusion. We found no differences between ex-COVID-19 patients and controls in blood pressure (134-81 vs. 133-81 mmHg, p=0.40 and p=0.30 for systolic and diastolic pressures respectively), concentrations of NT-proBNP (8.50 vs. 7.00 pmol/L, p=0.22), high-sensitive cardiac troponin I (4.11 vs. 3.38 ng/L, p=0.06), C-reactive protein (4.00 vs. 4.00 mg/L, p=0.93) and carotid-femoral pulse wave velocity (6.63 vs. 7.01 m/s, p=0.30). Ex-COVID-19 patients showed higher handgrip strength compared to controls (43 kg vs. 38 kg, p=0.004), but 4-metre gait speed (2.62 vs. 2.56 s, p=0.33), habitual physical activity levels (6.0 vs. 6.0 days, p=0.16) and reported quality of life (86.4% vs. 88.6%, p=0.10) were not different between groups.

Conclusion(s)

Cardiovascular health and physical functioning parameters were not different between non-hospitalised ex-COVID-19 patients and age- and sex-matched controls at five months post-infection. This suggests that individuals who recovered from COVID-19 at home do not have an increased cardiovascular risk or impaired physical functioning in the long-term.

COVID-19 survivors are physically inactive with high levels of sedentary time, regardless of patient characteristics, disease severity or cardiac dysfunction

Funding Acknowledgements

Type of funding sources: Foundation. Main funding source(s): Dutch Heart Foundation

Background

More than 250 million cases of the coronavirus disease-2019 (COVID-19) infection were confirmed across the globe since 2020, leading to a substantial number of COVID-19 related hospital admissions. Many COVID-19 survivors experience long-term health consequences, but data on physical activity patterns and the impact on recovery post-infection are scarce.

Purpose

This study aimed to objectively assess physical (in)activity patterns among COVID-19 survivors and to explore the association with patient characteristics, disease severity and cardiac dysfunction. We hypothesized that COVID-19 survivors will demonstrate low volumes of physical activity and a high sedentary time, especially those with a more severe disease course (e.g. longer hospital duration; admission to intensive care), cardiac dysfunction, and persistent symptoms at 3-6 months post-discharge.

Methods

In this cross-sectional cohort study, we objectively assessed physical activity, sedentary behaviour and sleep duration for 24 hrs/day during 8 subsequent days in COVID-19 survivors at 3-6 months post-hospitalisation. Activity patterns were compared across pre-defined subgroups based on patient- and disease characteristics, cardiac biomarker release during hospitalisation, abnormal transthoracic echocardiogram regarding left- and right ventricular function and volumes at 3-6 months of follow-up, and persistence of symptoms post-discharge.

Results

Physical activity patterns were assessed in 37 patients (60±10 years old; 78% male) at 125 [116; 132] days after discharge. Patients spent 4.2 [3.2; 5.3] hrs/day in light-intensity physical activity and 1.0 [0.8; 1.4] hrs/day in moderate-to-vigorous intensity physical activity. Median sleep duration was 8.6 [8.2; 9.1] hrs/day. Time spent sitting was 9.8 [8.7; 11.2] hrs/day, which was accumulated in 6.0 [4.7; 6.9] prolonged sitting bouts (≥30 min) and 41.4 [31.5; 48.1] short sitting bouts (<30 min, Central Figure). No differences in activity patterns were found across subgroups, but sleep duration was slightly higher in women versus men (9.2 vs 8.5 hrs/day, p=0.03) and patients with versus without persistent symptoms (9.1 vs 8.3 hrs/day, p=0.02).

Conclusions

COVID-19 survivors are physically inactive for most of their time at 3-6 months post-hospitalisation. Physical (in)activity patterns are not impacted by patient- nor disease characteristics, underlining the need for a uniform approach for re-activation of COVID-19 survivors.

Central Figure.

A: objectively measured light-intensity physical activity (LIPA), moderate-to-vigorous intensity physical activity (MVPA), sleep duration and sedentary time in COVID-19 patients at 3-6 months post-hospitalisation (median and interquartile range).

B: sitting bout frequency (mean + standard deviation).

Acute and long-term mortality rates among participants of mass-participation sport events versus the general population

Funding Acknowledgements

Type of funding sources: Foundation. Main funding source(s): The work of T.M.H.E is supported by the Netherlands Heart Foundation.

Background

Exercise training improves cardiovascular health and lowers the risk for morbidity and mortality. However, an acute bout of exercise transiently increases the risk for sudden death. It is unknown how participation in a mass-participation exercise event impacts mortality risk compared to non-participation.

Purpose

To assess the acute and long-term mortality risk among participants of mass-participation exercise events and to place these risks into perspective.

Methods

Data was collected among participants of Dutch running, cycling and long-distance walking events between 1995 and 2017. We retrieved age, sex, exercise type from the database of event organizers. The survival status and date of death were extracted from the Dutch Population Register (DPR). A time-stratified case-crossover design with an 8-day risk and reference period was used to examine if deceased athletes more frequently participated in mass-participation exercise events at 0 to 8 days before their death compared to the reference period (i.e., 14 to 21 weeks before death). Mixed-effects logistic regression was used to calculate the odds ratio (OR) with 95% confidence intervals (95% CI). We also retrieved controls (i.e., individuals not partaking in mass-participation exercise events) from the DPR (n=211,592) and compared long-term mortality risks between athletes and controls using stratified Kaplan-Meier curves and Cox regression models.

Results

547,014 athletes (age 41 years [Q25 31; Q75 50], 56% male, 72% runners, 11% cyclists) and 211,592 controls (age 41 years [Q25 31; Q75 50], 67% male) were included in this study. Participation in mass-participation exercise events was higher at 0 to 8 days before death (i.e., risk period, n=23 deceased athletes) compared to 14 to 21 days before death (i.e., reference period, n=12 deceased athletes), but the mortality risk was not significantly elevated after participation in an exercise event (OR 1.92; 95%CI 0.95-3.85). During a median follow-up of 3.3 years [Q25 1.1; Q75 4.8], 4,625 (0.8%) athletes and 2,494 (1.2%) controls died. Amateur athletes had a 30% lower risk of death (hazard ratio 0.70; 95% CI 0.67-0.74, Figure 1) compared to controls, after adjustment for age and sex.

Conclusion

Participants of a mass-participation exercise event had a non-significant increased odds of death within 8-days after the event. In contrast, mortality risk was significantly lower for amateur athletes compared to controls from the general population during long-term follow-up, emphasizing that the health benefits of exercise and participation in a mass-participation exercise event outweigh the risks.

Figure 1. Stratified Kaplan-Meier curves with hazard ratio (HR) adjusted for age and sex for amateur athletes compared to controls.

Impact of cardiovascular health status on the association between changes in physical activity and major cardiovascular events and mortality among 88,320 adults: outcomes of the Lifelines Cohort Study

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Lifelines Biobank initiative received funding from the Dutch Ministry of Health, Welfare and Sport, the Dutch Ministry of Economic Affairs, the University Medical Center Groningen [UMCG], University Groningen and the Northern Provinces of the Netherlands. The work of T.M.H.E is supported by the Netherlands Heart Foundation [Senior E-Dekker grant #2017T051].

Background. Regular physical activity (PA) improves health. Many observational studies investigated the association between PA and health at a single time-point, but PA might change over time.

Purpose. To examine the association between change in PA and major adverse cardiovascular events (MACE) and all-cause mortality, and to investigate the impact of cardiovascular health status at baseline on these outcomes.

Methods. This study used data from the Lifelines Cohort Study (N = 88,320). Self-reported PA volumes were presented as Metabolic Equivalent of Task (MET) min/week. Change in PA was calculated by subtracting MET-min/week at the first assessment from the second assessment (median interval: 4 yrs), and 5 groups were created; large reduction (&lt; -1500), moderate reduction (-1500 to -250), no change (-250 to 250), moderate improvement (-250 to 250) and large improvement (&gt;1500). The outcome was a combination of MACE and all-cause mortality.

Results. During a median follow-up of 7 years, 667 events occurred among healthy individuals (43 ± 12 yrs, 1% of 69,818) and 599 in individuals with CVRF (55 ± 11 yrs, 3% of 18,502). Adjusted for confounders and baseline PA, healthy individuals with a large reduction in PA had a greater risk of incident MACE and mortality (Table). In CVRF, moderate to large improvements in PA were associated with reductions in adverse outcomes. Risk estimates became stronger in individuals with lower baseline PA (&lt;2000 MET-min/week), Table).

Conclusions. Maintaining PA in healthy individuals and increasing PA in individuals with CVRF over time is important to prevent MACE and mortality. The impact of changes in PA was stronger for individuals with lower baseline PA.

Table. Change of PA, MACE and mortality. Changes in PA Healthy CVRF Large reduction 1.40 [1.02;1.93] 1.27 [0.95;1.70] Moderate reduction 1.22 [0.89;1.68] 0.97 [0.72;1.30] No changes Ref Ref Moderate improvement 1.04 [0.74;1.44] 0.65 [0.47;0.91] Large improvement 0.96 [0.71;1.31] 0.69 [0.51; 0.94] Individuals with lower baseline PA Large reduction 2.24 [0.96;5.21] 2.85 [1.44;5.63] Moderate reduction 1.77 [1.10;2.84] 1.33 [0.89;1.98] No changes Ref Ref Moderate improvement 1.16 [0.73;1.83] 0.49 [0.31;0.76] Large improvement 0.77 [0.48;1.23] 0.58 [0.39;0.86]

Physical activity and sedentary behaviour in cardiovascular disease patients during the COVID-19 lockdown in the Netherlands; a longitudinal cohort study

Funding Acknowledgements

Type of funding sources: Foundation. Main funding source(s): Dutch Heart Foundation - senior E-Dekker grant

Physical activity and sedentary behaviour in cardiovascular disease patients during the COVID-19 lockdown in the Netherlands; a longitudinal cohort study

Background

Previous studies showed that the COVID-19 lockdown caused a more inactive lifestyle, but it is unknown whether these acute effects persist over time. We prospectively evaluated changes in physical activity and sedentary behaviour among chronic cardiovascular disease (CVD) patients during the first-wave COVID-19 lockdown and aimed to identify factors associated with physical inactivity.

Methods

1,565 CVD patients were included and baseline physical activity and sedentary behaviour were assessed using validated questionnaires at 5 weeks after the initiation of the Dutch lockdown (March 2020). Follow-up measures were collected every subsequent 4 weeks until July 2020. Multivariate mixed model analyses were performed to identify whether age, gender, CVD subtype, lockdown adherence and mental health factors impacted changes in physical (in)activity.

Results

Patients were 67 (interquartile range [60, 73]) years, mostly male (73%) and primarily diagnosed with myocardial infarction (48%) or angina pectoris (18%). Daily time spent in moderate-to-vigorous physical activity was 143 minutes (95% confidence interval (CI) 137; 148) at baseline, with almost no changes during follow-up on a group level (Δ+8.0 (95%CI -1.1; 17.0); Δ+11.2 (95%CI 1.9; 20.5) and Δ+8.0 (95%CI -1.5; 17.5) min/day after 4, 8 and 12 weeks, respectively).Female gender (Δ-40.7 (95%CI -48.5; -33.0) min/day); heart failure (Δ-23.0 (95%CI -36.5; -9.5) min/day); fear of a COVID-19 infection (Δ-6.6 (95%CI -9.4; -3.8) min/day) and limited possibilities for physical activity (Δ-7.4 (95%CI -10.1; -4.7) min/day) were independently associated with a decrease in physical activity.

Sedentary time was 567 (95%CI 555; 578) min/day at baseline which did not change after 4 weeks (Δ+12.1 (95%CI -6.0; 30.2) min/day) and after 8 weeks (Δ+15.2 (95%CI -3.3; 33.8) min/day), but significantly increased after 12 weeks of follow-up (Δ+19.0 (95%CI 0.1; 37.8) min/day). Lack of social contact (Δ+8.4 (95%CI 2.3; 14.5); limited possibilities for physical activity (Δ+14.7 (95%CI 8.8; 20.5) and younger age (Δ+2.1 (95%CI 1.3; 2.8) min/day were independently associated with an increase in sedentary time.

Conclusions

A time-dependent increase in daily sedentary time was observed among chronic CVD patients during the COVID-19 lockdown, whereas physical activity levels did not substantially change. Our findings highlight the need to develop and implement novel solutions to increase physical activity and reduce sedentary time during (and beyond) the COVID-19 pandemic, especially in CVD patients who are female, younger, diagnosed with heart failure, have a lack of social contact, fear of COVID-19 infection and experience limited physical activity possibilities during the lockdown.

Impact of COVID-19 lockdown on physical activity and sedentary behaviour in Dutch cardiovascular disease patients

BACKGROUND

Coronavirus disease 2019 (COVID-19) lockdown restrictions may impact lifestyle and therefore also physical (in)activity patterns in patients with cardiovascular disease (CVD). This study aimed to evaluate the effect of lockdown on physical activity and sedentary behaviour.

METHODS

A total of 1565 Dutch CVD patients participated in this prospective cohort study, in which we compared physical activity and sedentary behaviour before and during the COVID-19 lockdown period. Baseline measures were assessed in 2018 and data on follow-up measures were collected between 17 and 24 April 2020 (5 weeks after the introduction of COVID-19 lockdown restrictions). Validated questionnaires were used to assess physical activity and sedentary behaviour.

RESULTS

Moderate-to-vigorous physical activities increased from 1.6 (0.9, 2.8) to 2.0 (1.0, 3.5) h/day [median (interquartile range)] (p < 0.001) during the COVID-19 lockdown, mainly due to an increase in time spent walking and doing odd jobs. In contrast, time spent exercising significantly declined [1.0 (0.0, 2.3) to 0.0 (0.0, 0.6) h/week], whereas sedentary time increased from 7.8 (6.1, 10.4) to 8.9 (6.8, 11.4) h/day (p < 0.001). The absolute increase in physical activity was 13 (-36, 81) min/day, whereas sedentary behaviour increased by 55 (-72, 186) min/day.

CONCLUSION

Despite a small increase in physical activities, the larger increase in sedentary time induced a net reduction in habitual physical activity levels in Dutch CVD patients during the first-wave COVID-19 lockdown. Since a more inactive lifestyle is strongly associated with disease progression and mortality, we encourage CVD patients and their caregivers to explore novel solutions to increase physical activity levels and reduce sedentary time during (and beyond) the COVID-19 pandemic.

P1513Exercise-induced cardiac troponin I release and incident cardiovascular morbidity and mortality

Background

Blood concentrations of cardiac troponin I (cTnI) above the 99th percentile (upper reference limit, URL) are a key criterion for the diagnosis of acute myocardial injury and infarction. cTnI concentrations, even below the URL, also predict adverse outcomes in general and patient populations. cTnI increases after exercise, but the clinical significance of this exercise-induced cTnI increase is unknown. We examined the association between exercise-induced cTnI elevations and clinical outcomes in long-distance walkers.

Methods

cTnI was measured in 726 participants (median 61 [54–69] yrs) before and immediately after 30–55 km of walking. The primary endpoint was a composite of all-cause mortality and major adverse cardiovascular events (MACE, i.e. myocardial infarction, stroke, heart failure, revascularization or sudden cardiac arrest).

Results

Participants walked 498 [440–555] min at 68±10% of their maximum heart rate. Baseline cTnI concentrations were 2 [0–8] ng/L, with 9 participants (1%) demonstrating a baseline cTnI value above the URL (>40 ng/L). cTnI increased after walking (8 [1–18] ng/L, p<0.001) and 63 participants (9%) had a post-exercise cTnI value >URL. During 43 [23–77] months of follow-up, 62 participants (9%) experienced a primary endpoint; 29 died and 33 had MACE. 27% of participants with post-exercise cTnI >URL experienced a primary endpoint compared to only 7% with cTnI below the URL (log-rank p<0.001). The hazard ratio was 2.35 (95% CI: 1.21–4.53) after adjusting for age, sex, cardiovascular risk factors (hypertension, hypercholesterolemia or diabetes mellitus), cardiovascular diseases (myocardial infarction, stroke or heart failure) and baseline cTnI.

Kaplan-Meier of Mortality and MACE

Conclusion

Post-exercise cTnI concentrations >URL were associated with higher all-cause mortality and MACE, independent of age, sex, presence of cardiovascular risk factors or cardiovascular diseases and baseline cTnI concentrations in a large cohort of older long-distance walkers. Exercise-induced increases in cTnI may not be a benign physiological response to exercise in all, but an early marker of future mortality and cardiovascular events.

Acknowledgement/Funding

V.L.A was supported by a grant from the Radboud Institute for Health Sciences, T.M.H.E by a Horizon 2020 grant from the European Commission

On-line NIR analysis of fat, water and protein in industrial scale ground meat batches

Fat, water and protein contents in industrial scale meat batches were determined on-line by near infrared (NIR) reflectance spectroscopy. The NIR instrument was mounted at the outlet of a large meat grinder, and the measurements were performed in an industrial environment. Beef and pork samples, with chemical compositions of 7-26% fat, 58-75% water and 15-21% protein, were processed with hole diameters of 13mm in the grinder plate. Calibrations were made both for a combined set of beef and pork samples, and for separate sets of beef and pork samples. Validations were either done by full cross validation of the calibration set, or by bias corrected prediction of a test set. Prediction errors for the two sample sets, expressed as root mean square errors of cross validation or standard error of prediction, were in the ranges 0.82-1.49% fat, 0.94-1.33% water and 0.35-0.70% protein, depending of sample set and species of animal. The presented application is an improvement to the existing manual meat standardisation procedure, and has been implemented for regular use in a Norwegian meat manufacturing plant.

Differential effects of various stimuli on AVP levels in blood and cerebrospinal fluid

Water deprivation, drinking water containing 2% NaCl, or systemic injection with histamine or nicotine markedly increased plasma levels of vasopressin in rats. In contrast, none of the applied stimuli changed vasopressin levels in the CSF collected simultaneously from the same animal. These data suggest that the blood levels of vasopressin are controlled quite differently from CSF levels of this hormone.