Effect of Gaseous Ozone and Storage Time on Polyphenolic Profile and Sugar Content in Fruits of Selected Vaccinium corymbosum L. Genotypes

One of the best sources of antioxidant and health-promoting bioactive substances is the fruit of V. corymbosum. A potent oxidizing agent, ozone (O3), can effectively eliminate bacteria. The application of ozone gas to V. corymbosum fruit during storage had a favorable impact on the fruit's phenolic component and sugar content in the current investigation. After 7 days of storage, phenolic content in all highbush blueberry cultivars and clones tested increased on average by 28.60%, including anthocyanins by 34%. After 14 days of storage, an average increase of 16.50% in phenolic compounds was observed, including a 20.53% increase in anthocyanins. Among all the tested varieties, clone BOR-21 treated with a dose of 0.01 mL·L-1 ozone for 30 min after 14 days had the highest TPC-143.73 mg·100 g-1 f.w. The sugar content of berries treated with a dose of 0.01 mL·L-1 ozone for 30 min, on day 7 and day 14 of storage increased by 9.2% and 6.3%, respectively. On day 7, the highest amount of total sugar (22.74 g·100 g-1) was observed in Duke cultivar after being exposed to 0.01 mL·L-1 ozone for 15 min. The ozonation treatments enhanced the fruit's saturation with nutrients, which raises the fruit's value as food.

Predictors of long-term prognosis based on measurements achieved after 9-week hybrid telerehabilitation in heart failure patients – a subanalyis of the TELEREH-HF RCT

Background

Predicting prognosis in heart failure (HF) is of major importance.

The purpose of the study was to define predictors influencing long-term cardiovascular mortality or HF hospitalization (“composite outcome”) based on clinical status and measurements obtained after the 9-week hybrid comprehensive telerehabilitation (HCTR) programme.

Methods

This analysis is based on TELEREH-HF multicenter, randomized trial that enrolled 850 HF patients (NYHA I-III; left ventricular ejection fraction [LVEF]≤40%). Patients were randomized 1:1 to 9-week HCTR plus usual care (development sample) or usual care only (validation sample) and followed for 12–24 months for development of the composite.

Results

The predictors of our composite were: non-ischaemic etiology of HF, diabetes, higher serum level of: N-terminal prohormone of brain natriuretic peptide, creatinine, and high-sensitivity C-Reactive Protein; low carbon dioxide output at peak exercise, high minute ventilation and breathing frequency at maximum effort in cardiopulmonary test; increase of delta of average heart rate in 24h-ECG Holter monitoring, lower LVEF and patients' non-adherence to HCTR. The model discrimination C-index=0.795 and decreased to 0.755 on validation (Table 1). The 2-year risk of the composite was 48% in the top tertile versus 5% in the bottom tertile (Figure 1).

Conclusion

Risk factors collected at the end of the 9-week telerehabilitaion period did an excellent job in stratifying patients based on their 2-year risk of the composite outcome. Patients in the top tertile had an almost ten-fold higher risk compared to patients in the bottom tertile. Adherence to treatment but not peakVO2 or quality of life were significantly associated with the outcome.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Centre for Research and Development, Warsaw, Poland

The Effect of the Addition of Ozonated and Non-Ozonated Fruits of the Saskatoon Berry (Amelanchier alnifolia Nutt.) on the Quality and Pro-Healthy Profile of Craft Wheat Beers

Research into the suitability of domestic raw materials, including, for example, new wheat cultivars and fruit additives for the production of flavoured beers, is increasingly being undertaken by minibreweries and craft breweries. The fruits of the Saskatoon berry are an important source of bioactive compounds, mainly polyphenols, but also macro- and microelements. The fruits of two Canadian cultivars of this species, 'Honeywood' and 'Thiessen', were used in this study. Physicochemical analysis showed that wheat beers with the addition of non-ozonated fruit were characterised by a higher ethanol content by 7.73% on average. On the other hand, enrichment of the beer product with fruit pulp obtained from the cv. 'Thiessen' had a positive effect on the degree of real attenuation and the polyphenol profile. Sensory evaluation of the beer product showed that wheat beers with the addition of 'Honeywood' fruit were characterised by the most balanced taste and aroma. On the basis of the conducted research, it can be concluded that fruits of both cvs. 'Honeywood' and 'Thiessen' can be used in the production of wheat beers, but the fermentation process has to be modified in order to obtain a higher yield of the fruit beer product.

Relationships between physical capacity and depression in heart failure patients undergoing hybrid comprehensive telerehabilitation vs usual care results of the TELEREH-HF randomized clinical trial

Introduction

The novel hybrid comprehensive telerehabilitation (HCTR) consisting of telecare (with psychological telesupport), telerehabilitation and remote monitoring of cardiovascular implantable electronic devices might be an option to improve both physical capacity and depressive symptoms.

Purpose

The aim of the study was to investigate the influence of HCTR on depressive symptoms and physical capacity in heart failure (HF) patients in comparison with usual care (UC) alone.

Methods

The present analysis formed part of a multicenter, randomized trial that enrolled 850 HF patients (New York Heart Association class I–III, left ventricular ejection fraction ≤40%). Patients were randomized 1:1 to HCTR plus UC or UC only. Patients underwent either an HCTR program (1 week in hospital and 8 weeks at home; exercise training 5 times weekly) or UC with observation. The psychological intervention in the HCTR group included supportive psychological counseling via mobile phone. The Beck Depression Inventory II (BDI II) score (cut point for depression ≥14) was used to assess depression and the physical capacity was measured by peak oxygen consumption (peak VO2). Measurements were made before and after a 9-week intervention (HCTR group)/ observation (UC group).

Results

Both groups were comparable in terms of demographic, clinical characteristics and medical therapy. In HCTR group at entry 23% of the sample (n=88/382) obtaining BDI-II scores ≥14 vs 27.5% (n=107/389) in UC group. The BDI II score at study entry was 9.8±6.6 and after intervention was 9.2±6.6, p=0.016 (HCTR group) vs at entry 10.6±8.2 and after observation 10.0±8.3, p=0.022 (UC group). There were no significant differences between groups regarding ΔBDI II score p=0.992. There was a significant improvement in physical capacity assessed by peak VO2 only in the HCTR group, both in patients with (p=0.033) and without (p<0.001) depression (Table 1). These beneficial effects have not been observed in UC group.

Conclusions

In heart failure patients, HCTR provided similar reduction of depressive symptoms as UC. Hybrid comprehensive telerehabilitation resulted in a significant improvement in physical capacity both in patients with and without depression.

Funding Acknowledgement

Type of funding sources: Other. Main funding source(s): The National Centre for Research and Development, Warsaw, Poland.

Assessment of ECG during hybrid comprehensive telerehabilitation in heart failure patients – subanalysis of the TELEREHabilitation in heart failure patients – TELEREH-HF randomized clinical trial

Background

Exercise training in heart failure (HF) patients (pts) should be monitored to ensure patients safety. That is why we use ECG telemonitoring during hybrid comprehensive telerehabilitation (HCTR).

Purpose

Assessment of frequency of cardiac arrhythmias during telerehabilitation in HF patients.

Methods

The present analysis formed part of TELEREH-HF multicenter, randomized (1:1), controlled trial that enrolled 850 HF pts with New York Heart Association class I, II, or III and left ventricular ejection fraction (LVEF) of 40% or less. Patients were randomized 1:1 to 9 week HCTR plus usual care or usual care only. This subanalysis focuses on 386 pts (aged 62±11 years, LVEF 31±7%) randomized to HCTR based on Nordic walking training 5 times/week. HCTR was tele-monitored with an EHO mini device adjusted to record 16-second fragments of ECG (from three precordial leads) and to transmit the data via mobile phone network to the monitoring center. The timing of automatic ECG recording were pre-set and coordinated with exercise training.

Results

In all, 16622 HCTR sessions were registered and 66488 ECGs transmitted fragments were evaluated (four 16-second recording per patient per one session were recorded). A sinus rhythm was present in 320 (83%) pts, permanent atrial fibrillation in 66 (17%) pts. Assessment of ECG during HCTR procedure is presented in Table 1.

Conclusions

Telerehabilitation in heart failure patients is safe without evidence for symptomatic cardiac arrhythmias requiring discontinuation of training.

Non-sustained ventricular tachycardia and paroxysmal atrial fibrillation episodes were rare but have required adjustment of the telerehabilitation regimen.

The most common arrhythmias were ventricular and supraventricular premature beats.

These arrhythmias did not result in any changes in rehabilitation and therapy regimens.

Funding Acknowledgement

Type of funding sources: Other. Main funding source(s): The National Centre for Research and Development, Warsaw, Poland.

Antiarrhythmic effect of 9-week hybrid cardiac telerehabilitation - subanalysis of the TELEREHabilitation in Heart Failure patients - TELEREH-HF randomized clinical trial

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The National Centre for Research and Development, Warsaw, Poland.

Background. Cardiac rehabilitation is a component of heart failure (HF) management but its effect on ventricular arrhythmias is not well recognized.

Purpose. We analyzed the antiarrhythmic effect of a 9-week hybrid cardiac telerehabilitation (HCTR) and its influence on long term cardiovascular mortality in HF patients taken from the TELEREH-HF trial.

Methods. We evaluated the presence of non-sustained ventricular tachycardia (nsVT) and frequent premature ventricular complexes ≥10 beats/hour (PVCs ≥10) with 24-hour ECG monitoring at the baseline and after 9-week HCTR or usual care (UC) of 773 HF patients (NYHA I-III, LVEF ≤ 40%).

Results. Among 143 patients with nsVT, arrhythmia subsided in 30.8% after HCTR, similarly among 165 patients randomized to UC who had nsVT 34.5% did not show them after 9 weeks (p = 0.481). There was no significant difference in the decrease in PVC ≥10 over 9 weeks between randomization arms (14.9% vs. 17.8%, respectively p = 0.410). Functional response for HCTR (Δ peak oxygen consumption [pVO2] in cardiopulmonary exercise test >2.0 ml/kg/min) did not affect occurrence of arrhythmias. The multivariable analysis of the entire population did not identify HCTR as an independent factor determining improvement in terms of nsVT or PVCs >10.  However, only in the HCTR group, the achievement of the antiarrhythmic effect significantly reduced the cardiovascular mortality in 2 years follow-up (Logrank p = 0.0009) (Figure).

Conclusions. Significant improvement in physical capacity after 9 weeks of HCTR did not correlate with the antiarrhythmic effect in terms of  incidence of nsVT or PVCs ≥10. An antiarrhythmic effect after the 9-week HCTR affected long term cardiovascular mortality in HF patients. Abstract Figure

Heart failure patients' adherence to hybrid comprehensive telerehabilitation and its impact on prognosis based on data from TELEREH-HF randomized clinical trial

Background

Adherence to treatment guidelines in heart failure (HF) patients (pts) is of major prognostic importance, but thorough implementation of guidelines in routine care remains insufficient. Introducing hybrid comprehensive telerehabilitation (HCTR) consisting of telecare, telerehabilitation and remote monitoring of implantable devices might be an option to improve adherence to recommendation and can affect the prognosis. Purpose to investigate the association of adherence to HCTR with mortality and hospitalization. Methods The present analysis formed part of TELEREH-HF multicenter, randomized trial that enrolled 850 HF pts (NYHA I-III,LVEF≤40%). Patients were randomized 1:1 to HCTR plus usual care or usual care only and followed up for 14 to 26 months. During the first 9 weeks, pts underwent either an HCTR (1 week in hospital and 8 weeks at home) or usual care. This analysis focuses on pts randomized to HCTR. Adherent pts were those who adhered both to the number of training sessions prescribed and to the duration of the prescribed cycle by at least80%; non-adherent pts, were those who adhered<20% to the prescribed number of training sessions and their duration. The remaining pts were classified as partially adherent.

Results

There were 350 (88.4%) adherent pts, 39 (9.8%) partially adherent pts and 7 (1.8%) non-adherent pts. There were 54 deaths during follow-up in the HCTR arm. Non-adherence or partial adherence was associated with statistically significantly higher risk of cardiovascular (CV) mortality (hazard ratio (HR) = 2.62, p=0.021); all-cause mortality or HF hospitalization (HR=1.71, p=0.038); CV mortality or HF hospitalization (HR=1.89, p=0.014).

Conclusion

The adherence to HCTR was very high. Adherence to HCTR was associated with improved prognosis for CV mortality.

Kaplan-Meier Probability of CV Mortality

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Centre for Research and Development, Warsaw, Poland

Quality of life in heart failure patients undergoing hybrid comprehensive telerehabilitation versus usual care results of TELEREH-HF randomized clinical trial

Background

Heart failure (HF) is a clinical syndrome associated with physical capacity impairment and poor quality of life (QoL). The hybrid comprehensive telerehabilitation (HCTR) consisting of telecare, telerehabilitation and homemonitoring of implantable devices might be an option to improve QoL. Purpose to investigate the influence of HCTR on various facets of QoL in HF pts in comparison to usual care (UC).

Methods

The present analysis formed part of TELEREH-HF multicenter, randomized trial that enrolled 850 HF pts (NYHA I-III, LVEF≤40%). Patients were randomized 1:1 to HCTR plus UC or UC. Patients underwent either an HCTR (1 week in hospital and 8 weeks at home) or UC with observation. The psychology telecare had a form of supportive psychotherapy via phone. The Short Form 36 Questionnaire was used to assess QoL. Measurements were made before and after intervention/observation.

Results

HCTR group showed significant improvement in overall QoL, physical domain, and 4 areas of QoL (physical functioning [PF], role functioning related to physical state, general health, vitality). A significant positive change in QoL in UC group was observed in vitality and social functioning. There were significant differences in QoL after intervention/observation between groups. Results showed higher improvement in HCTR for overall QoL, physical domain and 3 areas of QoL (PF, role functioning related to physical state and bodily pain [BP]), Table 1.

Conclusion

In comparison to UC, HCTR resulted in significant improvement in overall QoL, physical domain and 3 specific areas of QoL: PF, role functioning related to physical state and BP.

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Centre for Research and Development, Warsaw, Poland

10-year outcomes of triple-site versus standard cardiac resynchronization therapy randomized trial (TRUST CRT)

Background

Triple-Site versus Standard Cardiac Resynchronization Therapy Randomized Trial (TRUST CRT) was initiated in 2009 to verify the hypothesis whether triple-site (single right, double left) cardiac resynchronization therapy (CRT) may be superior to conventional, biventricular resynchronization in patients with advanced heart failure.

Objectives

To report 6-month outcomes and 10-year survival in TRUST CRT.

Methods

100 consecutive patients with moderate to severe heart failure, ejection fraction of 35% or less, electrical and mechanical dyssynchrony, were randomly assigned in a 1:1 fashion to triple-site CRT defibrillator (TRIV) or to conventional CRT-D. The primary objective evaluated response-rate, defined as the 6-month's combined end point of alive status, freedom from hospitalization for heart failure or heart transplantation, relative≥10% increase in ejection fraction, ≥10% in peak oxygen consumption, and ≥10% in 6-minute walking distance. The secondary objective was to assess the occurrence of major adverse cardiovascular events (hospitalization for exacerbated heart failure requiring modification of pharmacotherapy, heart transplant or death) at month 6 and during remote observation.

Results

At month 6, the response-rate was higher in triple-site than conventional CRT-D group (51.1 vs. 26.5%, P=0.014). There were 2 deaths or heart failure events in the triple-site group (4%) as compared with 8 in the group assigned to conventional CRT-D (16%). A triple-site resynchronization resulted in 12% absolute risk reduction for secondary end point (hazard ratio 0.25; 95 percent confidence interval, 0.05 to 1.17, P=0.056, in comparison with the conventional CRT-D group). After 10 years of observation (median follow up of 7.1 years; range: 1.2–10.4) 57 patients (58.2%) died: 24 (53.3%) in the triple-site group, 31 (60.8%) in the conventional group (P=0.46) and 2 patients with and ICD (failed CRT implantation) [Figure].

Conclusions

In patients with advanced heart failure, triple-site resynchronization combined with an ICD did not result in better survival than conventional resynchronization therapy in a median observation of 7.1 years.

Figure 1

Funding Acknowledgement

Type of funding source: None

Anti-Microbiological, Anti-Hyperglycemic and Anti-Obesity Potency of Natural Antioxidants in Fruit Fractions of Saskatoon Berry

The aim of the present work was to evaluate for content of phytochemicals (monophosphate nucleotides, free amino acids, polyphenols), and for anti-microbiological, anti-diabetic (ability to inhibit pancreatic lipase, α-glucosidase, and α-amylase), and antioxidant activities in seven selected fruit and fruit fractions of Amelanchier alnifolia. Most of the fruit and fruit fractions analyzed in this study have not been examined in this respect until now. The content of monophosphate nucleotides and free amino acids were tested by ultra-performance liquid chromatography coupled with photodiode array detector and electrospray ionization-mass spectrometry (UPLC-PDA-ESI-MS). The distribution of the examined compounds and biological activity differed significantly depending on the tested fruit and parts of the fruit. Cultivars “Smoky” and “Thiessen” had a high content of essential free amino acids, monophosphate nucleotides, and the highest antioxidant activity. They were also accountable for the high ability to inhibit Enterococcus hirae (anti-bacterial activity), of activity toward α-amylase, α-glucosidase, and pancreatic lipase. Moreover, the fruit peel was abundant in polyphenolic compounds and showed the highest antioxidative activity, which were strongly correlated with each other. In addition, the peel was characterized by a high concentration of monophosphate nucleotides, free amino acids, and were responsible above all for the strong ability to inhibit pancreatic lipase enzymes contributing to the development of obesity. The seeds were rich in uridine 5’-monophosphate, and total essential and non-essential free amino acids, whose contents correlated with the inhibitory activity toward α-amylase and α-glucosidase. The fruit flesh showed a high content of total free amino acids (hydroxy-L-proline, O-phosphoethanolamine, L-citruline). There was a positive correlation between antioxidant capacity and the content of polyphenolic compounds, nucleotide, and ability to inhibit pancreatic lipase, and between anti-hyperglycemic and free amino acids in fruits and fruit fractions. Therefore, the tested fruit of A. alnifolia and their fractions could be essential ingredients of new functional products and/or probiotic food.

Distribution of phytochemicals and antioxidative potency in fruit peel, flesh, and seeds of Saskatoon berry

The distributions of total soluble solids, pectins, the sum of polyphenolic and terpenoid compounds as well as the antioxidative potency of fruit and their parts, such as peel, flesh, and seeds of Saskatoon berry genotypes are presented in this work. The contents of individual bioactive compounds of in this fruit fraction of Saskatoon berry cultivars and cultivation clones significantly depended on berry genotype and compounds distribution within particular parts of the fruit. The fruit peel contained mainly anthocyanins, polymerized compounds, hydroxycinnamic acids, triterpenoids, and tetraterpenids, as well as exhibited antioxidant activity. The major compounds identified in the fruit flesh included soluble solids, ash, flavonols. In turn, polymeric procyanidins was determined in the seeds of fruit. Individual parts of Saskatoon berry fruit contained many health-promoting constituents and could be deemed attractive materials for the production of functional foods or dietary supplements.

Phytochemical Composition and Antioxidant Capacity of Seven Saskatoon Berry (Amelanchier alnifolia Nutt.) Genotypes Grown in Poland

The basic chemical composition, bioactive compounds, and antioxidant capacity of fruits of three new Polish breeding clones (No. 5/6, type S, and type N) and four Canadian cultivars (cvs.) (“Martin”, “Smoky”, “Pembina”, and “Honeywood”) grown in Poland in 2016 were investigated. Fruits were analyzed for their contents of triterpenoids, carotenoids, chlorophylls, and polyphenolics with the ultra-performance liquid chromatography photodiode detector-quadrupole/time-of-flight mass spectrometry (UPLC-PDA-Q/TOF-MS) method, sugar with the high-performance liquid chromatography–evaporative light scattering detector (HPLC-ELSD) method, and antioxidant capacity with the ability to reduce free radical (ABTS) and ferric reducing ability of plasma (FRAP) method. Thirty-eight bioactive compounds, including twenty-eight polyphenolic compounds (four anthocyanins, nine phenolic acids, nine flavonols, and seven flavan-3-ols), four carotenoids, two chlorophylls, and three triterpenoids were identified in the fruits. The fruits of the tested Saskatoon berry genotypes were found to be rich in phenolic compounds (3773.94–6390.36 mg/100 g·dm), triterpenoids (66.55–91.31 mg/kg·dm), and carotenoids (478.62–561.57 mg/kg·dm), with high ABTS and FRAP capacity (10.38–34.49 and 9.66–25.34 mmol·Trolox/100 g·dm, respectively). Additionally, the berries of these genotypes seemed to be a good source of sugar (9.02–19.69 g/100 g), pectins (0.67%–1.33%), and ash (0.59%–0.67%). Some genotypes of Saskatoon berry, especially the clones type S, type N, and cvs. “Honeywood” and “Smoky”, may be selected for their potential applications in commercial cultivation to produce fruits with valuable health-promoting nutritional effects on human health. Additionally, three new genotypes that may offer new functional materials can be recommended for fruit growers.

Genetic and environmental correlation and path coefficient analysis of fruit yield per bush and other traits in black currants (Ribes nigrum L.)

Twenty-five F1 hybrid families of black currants (Ribes nigrum L.) originating from diallel crosses of five cultivars were assessed. Phenotypic correlation coefficient between full-sib family means (rFS), genetic correlation coefficient between full-sib family expected values (rG) and the environmental correlation were estimated on the basis of two years of observations for 12 quantitative characteristics studied. Evident repeatability of correlations in both years was proved. A considerable consistency between the values of genetic and phenotypic correlation coefficients was also observed. Coefficients of phenotypic and environmental correlation were significant for many pairs of traits. Most of the significant environmental correlation coefficients were found for the same pairs of characteristics for which phenotypic correlation coefficients were significant. This shows that genetic and environmental factors affected similar traits. Fruit yield expressed the largest number of significant correlations with other traits. Path coefficient analysis indicated that plant and berry size were the main factors influencing directly fruit yield in both years. It was proved that the number and length of one-year-old shoots via bush size had very large indirect effects on fruit yield per plant.