1
|
Winther JB, Holst JJ. Glucagon agonism in the treatment of metabolic diseases including type 2 diabetes mellitus and obesity. Diabetes Obes Metab 2024. [PMID: 38853300 DOI: 10.1111/dom.15693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/18/2024] [Accepted: 05/18/2024] [Indexed: 06/11/2024]
Abstract
Type 2 diabetes mellitus (T2DM) is associated with obesity and, therefore, it is important to target both overweight and hyperglycaemia. Glucagon plays important roles in glucose, amino acid and fat metabolism and may also regulate appetite and energy expenditure. These physiological properties are currently being exploited therapeutically in several compounds, most often in combination with glucagon-like peptide-1 (GLP-1) agonism in the form of dual agonists. With this combination, increases in hepatic glucose production and hyperglycaemia, which would be counterproductive, are largely avoided. In multiple randomized trials, the co-agonists have been demonstrated to lead to significant weight loss and, in participants with T2DM, even improved glycated haemoglobin (HbA1c) levels. In addition, significant reductions in hepatic fat content have been observed. Here, we review and discuss the studies so far available. Twenty-six randomized trials of seven different GLP-1 receptor (GLP-1R)/glucagon receptor (GCGR) co-agonists were identified and reviewed. GLP-1R/GCGR co-agonists generally provided significant weight loss, reductions in hepatic fat content, improved lipid profiles, insulin secretion and sensitivity, and in some cases, improved HbA1c levels. A higher incidence of adverse effects was present with GLP-1R/GCGR co-agonist treatment than with GLP-1 agonist monotherapy or placebo. Possible additional risks associated with glucagon agonism are also discussed. A delicate balance between GLP-1 and glucagon agonism seems to be of particular importance. Further studies exploring the optimal ratio of GLP-1 and glucagon receptor activation and dosage and titration regimens are needed to ensure a sufficient safety profile while providing clinical benefits.
Collapse
Affiliation(s)
- Jonathan Brix Winther
- Department of Biomedical Sciences and the NovoNordisk Foundation Centre for Basic Metabolic Research, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens Juul Holst
- Department of Biomedical Sciences and the NovoNordisk Foundation Centre for Basic Metabolic Research, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
2
|
Rozenman M, Gonzalez A, Vreeland A, Thamrin H, Perez J, Peris TS. Resting State Psychophysiology in Youth with OCD and Their Caregivers: Preliminary Evidence for Trend Synchrony and Links to Family Functioning. Child Psychiatry Hum Dev 2024; 55:635-643. [PMID: 36107282 DOI: 10.1007/s10578-022-01426-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 07/27/2022] [Accepted: 08/26/2022] [Indexed: 11/27/2022]
Abstract
The burden of OCD in children and adolescents extends to their caregivers. Prior work in other disorders and unaffected youth has found synchrony in psychophysiological arousal for youth-caregiver dyads. This preliminary study explored whether psychophysiological trend synchrony in youth-caregiver dyads (N = 48) occurred and was moderated by youth OCD diagnosis. We also explored whether psychophysiological indices (i.e., electrodermal activity, heart rate, respiratory sinus arrhythmia) were correlated with reported family functioning in the OCD subsample (n = 25). Youth with OCD had higher resting heart rate than unaffected peers; this was not replicated in caregivers. Trend synchrony was found across the full sample of dyads for electrodermal activity and heart rate, with no moderation by diagnostic group. In the OCD group, youth heart rate was correlated with family conflict and caregiver heart rate with expressiveness. Findings provide preliminary support for further examination of heart rate and family factors in OCD-affected youth and their caregivers.
Collapse
Affiliation(s)
- Michelle Rozenman
- Department of Psychology, University of Denver, 2155 S. Race St, 80209, Denver, CO, USA.
| | - Araceli Gonzalez
- Department of Psychology, California State University Long Beach, Long Beach, CA, USA
| | - Allison Vreeland
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Hardian Thamrin
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Jocelyn Perez
- Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Tara S Peris
- UCLA Semel Institute Division of Child & Adolescent Psychiatry, Los Angeles, CA, USA
| |
Collapse
|
3
|
Plaza-Florido A, Ruiz JR, Alcantara JMA. Resting heart rate but not heart rate variability is associated with the normal-weight obesity phenotype. Am J Hum Biol 2024; 36:e24043. [PMID: 38275139 DOI: 10.1002/ajhb.24043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/12/2024] [Accepted: 01/13/2024] [Indexed: 01/27/2024] Open
Abstract
OBJECTIVE To determine differences in resting heart rate variability (HRV) and heart rate (HR) between young adults with normal-weight obesity (NWO) and normal-weight lean (NWL). METHODS A total of 65 normal-weight individuals (18-25 years old, 50 women, body mass index 18.5 to 24.9 kg/m2) were included in this cross-sectional study. Body fat percentage was determined using a whole-body dual energy x-ray absorptiometry scanner. Resting HRV and HR were assessed with the Polar RS800CX. Forty-one participants were classified as NWO and 24 NWL using cutoff points for body fat percentage (33.3% for women and 23.1% for men). RESULTS There were no differences in HRV between NWO and NWL groups (all p > .05). HR was higher in NWO (mean 70 beats per minute [bpm], standard deviation [SD] 8) than in NWL adults (mean 65 bpm, SD 10), the adjusted mean difference 5 bpm (95% CI, 0 to 10 bpm). CONCLUSION HR is a noninvasive biomarker and relatively cheap, fast, and easy to measure that could detect "apparently healthy" young individuals with an adverse cardiovascular disease risk profile despite presenting a normal body weight.
Collapse
Affiliation(s)
- Abel Plaza-Florido
- Pediatric Exercise and Genomics Research Center, Department of Pediatrics, School of Medicine, University of California Irvine, Irvine, USA
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Jonatan R Ruiz
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Biosanitaria, ibs.Granada, Granada, Spain
| | - Juan M A Alcantara
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Health Sciences, Institute for Innovation & Sustainable Food Chain Development, Public University of Navarre, Pamplona, Spain
- Navarra Institute for Health Research, IdiSNA, Pamplona, Spain
| |
Collapse
|
4
|
Persson AP, Måneheim A, Economou Lundeberg J, Fedorowski A, Healey JS, Sundström J, Engström G, Johnson LSB. Reference ranges for ambulatory heart rate measurements in a middle-aged population. Heart 2024; 110:831-837. [PMID: 38580434 PMCID: PMC11137473 DOI: 10.1136/heartjnl-2023-323681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/10/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Elevated heart rate (HR) predicts cardiovascular disease and mortality, but there are no established normal limits for ambulatory HR. We used data from the Swedish CArdioPulmonary Imaging Study to determine reference ranges for ambulatory HR in a middle-aged population. We also studied clinical correlates of ambulatory HR. METHODS A 24-hour ECG was registered in 5809 atrial fibrillation-free individuals, aged 50-65 years. A healthy subset (n=3942) was used to establish reference values (excluding persons with beta-blockers, cardiovascular disease, hypertension, heart failure, anaemia, diabetes, sleep apnoea or chronic obstructive pulmonary disease).Minimum HR was defined as the lowest 1-minute HR. Reference ranges are reported as means±SDs and 2.5th-97.5th percentiles. Clinical correlates of ambulatory HR were analysed with multivariable linear regression. RESULTS The average mean and minimum HRs were 73±9 and 48±7 beats per minute (bpm) in men and 76±8 and 51±7 bpm in women; the reference range for mean ambulatory HR was 57-90 bpm in men and 61-92 bpm in women. Average daytime and night-time HRs are also reported. Clinical correlates, including age, sex, height, body mass index, physical activity, smoking, alcohol intake, diabetes, hypertension, haemoglobin level, use of beta-blockers, estimated glomerular filtration rate, per cent of predicted forced expiratory volume in 1 s and coronary artery calcium score, explained <15% of the interindividual differences in HR. CONCLUSION Ambulatory HR varies widely in healthy middle-aged individuals, a finding with relevance for the management of patients with a perception of tachycardia. Differences in ambulatory HR between individuals are largely independent of common clinical correlates.
Collapse
Affiliation(s)
- Anders Paul Persson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Clinical Physiology, Skånes universitetssjukhus Malmö, Malmö, Sweden
| | - Alexandra Måneheim
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Clinical Physiology, Skånes universitetssjukhus Malmö, Malmö, Sweden
| | - Johan Economou Lundeberg
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Department of Clinical Physiology, Skånes universitetssjukhus Lund, Lund, Sweden
| | - Artur Fedorowski
- Department of Clinical Sciences, Lund University Faculty of Medicine, Malmö, Sweden
- Department of Medicine, Karolinska Institute, Solna, Sweden
| | - Jeff S Healey
- Population Health Research Institute, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Johan Sundström
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Gunnar Engström
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Linda S B Johnson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
- Population Health Research Institute, Hamilton, Ontario, Canada
| |
Collapse
|
5
|
Silişteanu SC, Antonescu E, Duică L, Totan M, Cucu AI, Costea AI. Lumbar Paravertebral Muscle Pain Management Using Kinesitherapy and Electrotherapeutic Modalities. Healthcare (Basel) 2024; 12:853. [PMID: 38667615 PMCID: PMC11050304 DOI: 10.3390/healthcare12080853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/05/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Low back pain is considered a public health problem internationally. Low back pain is a cause of disability that occurs in adolescents and causes negative effects in adults as well. The work environment and physical and psychosocial factors can influence the occurrence and evolution of low back pain. METHODS The purpose of this paper is to highlight the physiological and functional changes in young adults with painful conditions of the lumbar spine, after using exercise therapy. The study was of the longitudinal type and was carried out over a period 6 months in an outpatient setting. The rehabilitation treatment included electrotherapeutic modalities and kinesitherapy. RESULTS The results obtained when evaluating each parameter, for all moments, show statistically significant values in both groups. The results obtained regarding the relationship between the therapeutic modalities specific to rehabilitation medicine and low back pain are consistent with those reported in studies. CONCLUSIONS Depending on the clinical-functional status of each patient, kinesitherapy can accelerate the heart rate and increase the blood pressure and oxygen saturation of the arterial blood, values that can later return to their initial levels, especially through training.
Collapse
Affiliation(s)
- Sînziana Călina Silişteanu
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania; (S.C.S.); (A.I.C.); (A.I.C.)
| | - Elisabeta Antonescu
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
| | - Lavinia Duică
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
| | - Maria Totan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania;
| | - Andrei Ionuţ Cucu
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania; (S.C.S.); (A.I.C.); (A.I.C.)
| | - Andrei Ioan Costea
- Faculty of Medicine and Biological Sciences, Stefan cel Mare University of Suceava, 720229 Suceava, Romania; (S.C.S.); (A.I.C.); (A.I.C.)
| |
Collapse
|
6
|
Lv L, Chen Q, Lu J, Zhao Q, Wang H, Li J, Yuan K, Dong Z. Potential regulatory role of epigenetic modifications in aging-related heart failure. Int J Cardiol 2024; 401:131858. [PMID: 38360101 DOI: 10.1016/j.ijcard.2024.131858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/27/2023] [Accepted: 02/10/2024] [Indexed: 02/17/2024]
Abstract
Heart failure (HF) is a serious clinical syndrome and a serious development or advanced stage of various heart diseases. Aging is an independent factor that causes pathological damage in cardiomyopathy and participates in the occurrence of HF at the molecular level by affecting mechanisms such as telomere shortening and mitochondrial dysfunction. Epigenetic changes have a significant impact on the aging process, and there is increasing evidence that genetic and epigenetic changes are key features of aging and aging-related diseases. Epigenetic modifications can affect genetic information by changing the chromatin state without changing the DNA sequence. Most of the genetic loci that are highly associated with cardiovascular diseases (CVD) are located in non-coding regions of the genome; therefore, the epigenetic mechanism of CVD has attracted much attention. In this review, we focus on the molecular mechanisms of HF during aging and epigenetic modifications mediating aging-related HF, emphasizing that epigenetic mechanisms play an important role in the pathogenesis of aging-related CVD and can be used as potential diagnostic and prognostic biomarkers, as well as therapeutic targets.
Collapse
Affiliation(s)
- Lin Lv
- Department of Pharmacy, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - QiuYu Chen
- The Key Laboratory of Cardiovascular Disease Acousto-Optic Electromagnetic Diagnosis and Treatment in Heilongjiang Province, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jing Lu
- Department of Pharmacy, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Qi Zhao
- Department of Pharmacy, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - HongYan Wang
- Department of Pharmacy, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - JiaHao Li
- Department of Pharmacy, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - KeYing Yuan
- Department of Pharmacy, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - ZengXiang Dong
- The Key Laboratory of Cardiovascular Disease Acousto-Optic Electromagnetic Diagnosis and Treatment in Heilongjiang Province, First Affiliated Hospital of Harbin Medical University, Harbin, China; NHC Key Laboratory of Cell Transplantation, First Affiliated Hospital of Harbin Medical University, Harbin, China.
| |
Collapse
|
7
|
Wang C, Lei W, Jiang C, Du L, Huang X, Cui X, Gao D, Wang H. Exposure to tris (1,3-dichloro-2-propyl) phosphate affects the embryonic cardiac development of Oryzias melastigma. Heliyon 2024; 10:e25554. [PMID: 38327441 PMCID: PMC10847999 DOI: 10.1016/j.heliyon.2024.e25554] [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: 11/01/2022] [Revised: 01/19/2024] [Accepted: 01/29/2024] [Indexed: 02/09/2024] Open
Abstract
Tris (1,3-dichloro-2-propyl) phosphate (TDCPP) is a growing concern and may be a potential risk to marine environmental health due to its widespread usage and distribution. However, the toxic effects of TDCPP on cardiac development in marine fish have not been reported. In this study, Oryzias melastigma embryos were exposed to TDCPP at doses of 0, 0.04, 0.4, 4 and 40 μg/L from early embryogenesis to 10 days postfertilization (dpf). Then, the heart rate and sinus venosus-bulbus arteriosus (SV-BA) distance of the exposed embryos were measured at 5, 6, 8 and 10 dpf. Furthermore, alterations in the mRNA levels of the genes encoding cyclooxygenase-2 (COX-2), bone morphogenetic protein 4 (BMP4), fibroblast growth factor 8 (FGF8), and GATA-binding protein 4 (GATA4) were evaluated at 5, 6, 8 and 10 dpf. We found that the heart rate significantly increased in all TDCPP exposure groups at 10 dpf. The SV-BA distance significantly decreased in all TDCPP exposure groups at all developmental stages (except for the 0.4 μg/L group at 5 dpf and the 4 μg/L group at 10 dpf). The mRNA expression of COX-2 was downregulated at 5 dpf, BMP4 was downregulated at 5 and 6 dpf, FGF8 was downregulated at 5, 6 and 8 dpf, GATA4 was downregulated at 8 dpf, and GATA4 was upregulated at 10 dpf. These results indicate that the changes in heart rate and SV-BA distance might be accompanied by disturbances in the four genes involved in cardiac development. Our findings will help to illustrate the possible cardiac toxic effects of marine fish exposed to TDCPP.
Collapse
Affiliation(s)
- Chenshi Wang
- Key Laboratory of Mariculture & Stock Enhancement in North China's Sea, Ministry of Agriculture and Rural Affairs, Dalian Ocean University, Dalian, China
| | - Wei Lei
- State Environmental Protection Key Laboratory of Marine Ecosystem Restoration, National Marine Environmental Monitoring Center, Dalian, China
- Fujian Provincial Key Laboratory of Marine Ecological Conservation and Restoration, Xiamen, China
| | - Chengchen Jiang
- Key Laboratory of Mariculture & Stock Enhancement in North China's Sea, Ministry of Agriculture and Rural Affairs, Dalian Ocean University, Dalian, China
| | - Lichao Du
- Key Laboratory of Mariculture & Stock Enhancement in North China's Sea, Ministry of Agriculture and Rural Affairs, Dalian Ocean University, Dalian, China
| | - Xindi Huang
- Key Laboratory of Mariculture & Stock Enhancement in North China's Sea, Ministry of Agriculture and Rural Affairs, Dalian Ocean University, Dalian, China
| | - Xiaoyu Cui
- Key Laboratory of Mariculture & Stock Enhancement in North China's Sea, Ministry of Agriculture and Rural Affairs, Dalian Ocean University, Dalian, China
| | - Dongxu Gao
- Key Laboratory of Mariculture & Stock Enhancement in North China's Sea, Ministry of Agriculture and Rural Affairs, Dalian Ocean University, Dalian, China
| | - Hua Wang
- Key Laboratory of Mariculture & Stock Enhancement in North China's Sea, Ministry of Agriculture and Rural Affairs, Dalian Ocean University, Dalian, China
| |
Collapse
|
8
|
Leszto K, Frąk W, Kurciński S, Sinkowska J, Skwira S, Młynarska E, Rysz J, Franczyk B. Associations of Dietary and Lifestyle Components with Atrial Fibrillation. Nutrients 2024; 16:456. [PMID: 38337740 PMCID: PMC10856828 DOI: 10.3390/nu16030456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/27/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
Atrial fibrillation (AF) is a prevalent cardiac arrhythmia that still remains a significant health concern, especially due to its consequences, including stroke and heart failure. This review explores the intricate interplay between AF, lifestyle choices, and dietary habits. It is particularly focused on findings from diverse studies about non-pharmacological methods of managing AF. Moreover, its purpose is to elucidate the implementation of lifestyle changes such as physical activity or proper diet choices in the integrated treatment strategy of patients with AF.
Collapse
Affiliation(s)
- Klaudia Leszto
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland; (K.L.); (J.S.); (S.S.)
| | - Weronika Frąk
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland; (K.L.); (J.S.); (S.S.)
| | - Szymon Kurciński
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland; (K.L.); (J.S.); (S.S.)
| | - Julia Sinkowska
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland; (K.L.); (J.S.); (S.S.)
| | - Sylwia Skwira
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland; (K.L.); (J.S.); (S.S.)
| | - Ewelina Młynarska
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland; (K.L.); (J.S.); (S.S.)
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Beata Franczyk
- Department of Nephrocardiology, Medical University of Lodz, Ul. Zeromskiego 113, 90-549 Lodz, Poland; (K.L.); (J.S.); (S.S.)
| |
Collapse
|
9
|
Brennan D, Lal S, Hugo F, Waters F, Shymko G. Clozapine-related tachycardia: A conundrum to identify and treat. Australas Psychiatry 2024; 32:84-88. [PMID: 38165132 DOI: 10.1177/10398562231224156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
OBJECTIVE This study examined the rates and persistence of clozapine-induced tachycardia and heart-rate differences in patients treated with β-blockers in the largest sample of patients with a psychotic disorder to date. METHOD An audit of medical files for 101 patients who attended a clozapine community clinic and analysis of monthly measurements of resting heart rates. RESULTS 51% met the clinical criteria for tachycardia. Heart rates were stable over time. β-blockers were associated with small but significant reductions in heart rates. CONCLUSION The cardiovascular risks of clozapine are often overlooked. β-blockers are useful in lowering heart rates but they may be insufficient to reduce cardiac risk.
Collapse
Affiliation(s)
- Dermot Brennan
- Armadale Health Service, East Metropolitan Health Service, Armadale, WA, Australia
| | - Sweta Lal
- Armadale Health Service, East Metropolitan Health Service, Armadale, WA, Australia
- Peel and Rockingham Kwinana (PaRK) Mental Health Service, South Metropolitan Health Service, Rockingham, WA, Australia
| | - Frans Hugo
- Armadale Health Service, East Metropolitan Health Service, Armadale, WA, Australia
| | - Flavie Waters
- School of Psychological Sciences, The University of Western Australia, Perth, WA, Australia
- Black Swan Health, Headspace Youth Early Psychosis Program, Perth, WA, Australia
- North Metropolitan Health Service, Clinical Research Centre, Mount Claremont, WA, Australia
| | - Gordon Shymko
- Peel and Rockingham Kwinana (PaRK) Mental Health Service, South Metropolitan Health Service, Rockingham, WA, Australia
- Black Swan Health, Headspace Youth Early Psychosis Program, Perth, WA, Australia
| |
Collapse
|
10
|
Zhong Y, Li J, Hong Y, Yang S, Pei L, Chen X, Wu H, Wang T. Resting heart rate causally affects the brain cortical structure: Mendelian randomization study. Cereb Cortex 2024; 34:bhad536. [PMID: 38212288 PMCID: PMC10839837 DOI: 10.1093/cercor/bhad536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/13/2024] Open
Abstract
Resting heart rate (RHR) has been linked to impaired cortical structure in observational studies. However, the extent to which this association is potentially causal has not been determined. Using genetic data, this study aimed to reveal the causal effect of RHR on brain cortical structure. A Two-Sample Mendelian randomization (MR) analysis was conducted. Sensitivity analyses, weighted median, MR Pleiotropy residual sum and outlier, and MR-Egger regression were conducted to evaluate heterogeneity and pleiotropy. A causal relationship between RHR and cortical structures was identified by MR analysis. On the global scale, elevated RHR was found to decrease global surface area (SA; P < 0.0125). On a regional scale, the elevated RHR significantly decreased the SA of pars triangularis without global weighted (P = 1.58 × 10-4) and the thickness (TH) of the paracentral with global weighted (P = 3.56 × 10-5), whereas it increased the TH of banks of the superior temporal sulcus in the presence of global weighted (P = 1.04 × 10-4). MR study provided evidence that RHR might be causally linked to brain cortical structure, which offers a different way to understand the heart-brain axis theory.
Collapse
Affiliation(s)
- Yinsheng Zhong
- Department of Emergency, the Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518003, P. R. China
| | - Jun Li
- Department of Emergency, the Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518003, P. R. China
| | - Yinghui Hong
- Department of Emergency, the Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518003, P. R. China
| | - Shujun Yang
- Department of Emergency, the Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518003, P. R. China
| | - Liying Pei
- Department of Emergency, the Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518003, P. R. China
| | - Xuxiang Chen
- Department of Emergency, the Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518003, P. R. China
| | - Haidong Wu
- Department of Emergency, the Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518003, P. R. China
| | - Tong Wang
- Department of Emergency, the Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518003, P. R. China
| |
Collapse
|
11
|
Zhou X, Yuan Q, Yuan J, Du Z, Zhuang X, Liao X. The impact of visit-to-visit heart rate variability on all-cause mortality in atrial fibrillation. Ann Noninvasive Electrocardiol 2024; 29:e13094. [PMID: 38288511 PMCID: PMC10790108 DOI: 10.1111/anec.13094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/21/2023] [Accepted: 10/25/2023] [Indexed: 02/01/2024] Open
Abstract
OBJECTIVE We aimed to investigate the association between visit-to-visit heart rate variability (VVHRV) and all-cause mortality in patients diagnosed with atrial fibrillation (AF). Previous studies have shown a positive correlation between VVHRV and several adverse outcomes. However, the relationship between VVHRV and the prognosis of AF remains uncertain. METHODS In our study, we aimed to examine the relationship between VVHRV and mortality rates among 3983 participants with AF, who were part of the AFFIRM study (Atrial Fibrillation Follow-Up Investigation of Rhythm Management). We used the standard deviation of heart rate (HRSD) to measure VVHRV and divided the patients into four groups based on quartiles of HRSD (1st, <5.69; 2nd, 5.69-8.00; 3rd, 8.01-11.01; and 4th, ≥11.02). Our primary endpoint was all-cause death, and we estimated the hazard ratios for mortality using the Cox proportional hazard regressions. RESULTS Our analysis included 3983 participants from the AFFIRM study and followed for an average of 3.5 years. During this period, 621 participants died from all causes. In multiple-adjustment models, we found that the lowest and highest quartiles of HRSD independently predicted an increased risk of all-cause mortality compared to the other two quartiles, presenting a U-shaped relationship (1st vs 2nd, hazard ratio = 2.28, 95% CI = 1.63-3.20, p < .01; 1st vs. 3rd, hazard ratio = 2.23, 95% CI = 1.60-3.11, p < .01; 4th vs. 2nd, hazard ratio = 1.82, 95% CI = 1.26-2.61, p < .01; and 4th vs. 3rd, hazard ratio = 1.78, 95% CI = 1.25-2.52, p < .01). CONCLUSION In patients with AF, we found that both lower VVHRV and higher VVHRV increased the risk of all-cause mortality, indicating a U-shaped curve relationship.
Collapse
Affiliation(s)
- Xiaoyan Zhou
- Department of CardiologyThe Seventh Affiliated Hospital of SunYat‐sen UniversityShenzhenChina
| | - Qinghua Yuan
- Department of CardiologyThe Seventh Affiliated Hospital of SunYat‐sen UniversityShenzhenChina
| | - Jie Yuan
- Hanyi Data Technology (Shenzhen) Co., LtdShenzhenChina
| | - Zhi‐Min Du
- Department of CardiologyThe Seventh Affiliated Hospital of SunYat‐sen UniversityShenzhenChina
| | - Xiaodong Zhuang
- Department of Cardiology, The First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Xinxue Liao
- Department of Cardiology, The First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
| |
Collapse
|
12
|
Lhoste VPF, Zhou B, Mishra A, Bennett JE, Filippi S, Asaria P, Gregg EW, Danaei G, Ezzati M. Cardiometabolic and renal phenotypes and transitions in the United States population. NATURE CARDIOVASCULAR RESEARCH 2023; 3:46-59. [PMID: 38314318 PMCID: PMC7615595 DOI: 10.1038/s44161-023-00391-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 11/13/2023] [Indexed: 02/06/2024]
Abstract
Cardiovascular and renal conditions have both shared and distinct determinants. In this study, we applied unsupervised clustering to multiple rounds of the National Health and Nutrition Examination Survey from 1988 to 2018, and identified 10 cardiometabolic and renal phenotypes. These included a 'low risk' phenotype; two groups with average risk factor levels but different heights; one group with low body-mass index and high levels of high-density lipoprotein cholesterol; five phenotypes with high levels of one or two related risk factors ('high heart rate', 'high cholesterol', 'high blood pressure', 'severe obesity' and 'severe hyperglycemia'); and one phenotype with low diastolic blood pressure (DBP) and low estimated glomerular filtration rate (eGFR). Prevalence of the 'high blood pressure' and 'high cholesterol' phenotypes decreased over time, contrasted by a rise in the 'severe obesity' and 'low DBP, low eGFR' phenotypes. The cardiometabolic and renal traits of the US population have shifted from phenotypes with high blood pressure and cholesterol toward poor kidney function, hyperglycemia and severe obesity.
Collapse
Affiliation(s)
- Victor P. F. Lhoste
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Bin Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, London, UK
| | - Anu Mishra
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - James E. Bennett
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Sarah Filippi
- Department of Mathematics, Imperial College London, London, UK
| | - Perviz Asaria
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Edward W. Gregg
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, London, UK
- School of Population Health, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Goodarz Danaei
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Majid Ezzati
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, London, UK
- Regional Institute for Population Studies, University of Ghana, Accra, Ghana
| |
Collapse
|
13
|
Carrick-Ranson G, Howden EJ, Brazile TL, Levine BD, Reading SA. Effects of aging and endurance exercise training on cardiorespiratory fitness and cardiac structure and function in healthy midlife and older women. J Appl Physiol (1985) 2023; 135:1215-1235. [PMID: 37855034 DOI: 10.1152/japplphysiol.00798.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 10/05/2023] [Accepted: 10/07/2023] [Indexed: 10/20/2023] Open
Abstract
Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in women in developed societies. Unfavorable structural and functional adaptations within the heart and central blood vessels with sedentary aging in women can act as the substrate for the development of debilitating CVD conditions such as heart failure with preserved ejection fraction (HFpEF). The large decline in cardiorespiratory fitness, as indicated by maximal or peak oxygen uptake (V̇o2max and V̇o2peak, respectively), that occurs in women as they age significantly affects their health and chronic disease status, as well as the risk of cardiovascular and all-cause mortality. Midlife and older women who have performed structured endurance exercise training for several years or decades of their adult lives exhibit a V̇o2max and cardiac and vascular structure and function that are on par or even superior to much younger sedentary women. Therefore, regular endurance exercise training appears to be an effective preventative strategy for mitigating the adverse physiological cardiovascular adaptations associated with sedentary aging in women. Herein, we narratively describe the aging and short- and long-term endurance exercise training adaptations in V̇o2max, cardiac structure, and left ventricular systolic and diastolic function at rest and exercise in midlife and older women. The role of circulating estrogens on cardiac structure and function is described for consideration in the timing of exercise interventions to maximize beneficial adaptations. Current research gaps and potential areas for future investigation to advance our understanding in this critical knowledge area are highlighted.
Collapse
Affiliation(s)
- Graeme Carrick-Ranson
- Department of Surgery, the University of Auckland, Auckland, New Zealand
- Department of Exercise Sciences, the University of Auckland, Auckland, New Zealand
| | - Erin J Howden
- Human Integrative Physiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Tiffany L Brazile
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, Texas, United States
- University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, Texas, United States
- University of Texas Southwestern Medical Center, Dallas, Texas, United States
| | - Stacey A Reading
- Department of Exercise Sciences, the University of Auckland, Auckland, New Zealand
| |
Collapse
|
14
|
Ghram A, Latiri I, Methnani J, Souissi A, Benzarti W, Toulgui E, Ben Saad H. Effects of cardiorespiratory rehabilitation program on submaximal exercise in patients with long-COVID-19 conditions: a systematic review of randomized controlled trials and recommendations for future studies. Expert Rev Respir Med 2023; 17:1095-1124. [PMID: 38063359 DOI: 10.1080/17476348.2023.2293226] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/06/2023] [Indexed: 02/21/2024]
Abstract
INTRODUCTION Long-COVID-19 patients (LC19Ps) often experience cardiovascular and respiratory complications. Cardiorespiratory rehabilitation programs (CRRPs) have emerged as promising interventions to enhance exercise capacity in this population. This systematic review aimed to assess the impact of CRRPs on submaximal exercise performance, specifically the 6-minute walk test (6MWT) outcomes, in LC19Ps through an analysis of available randomized controlled trials (RCTs). METHODS A systematic search was conducted in PubMed/Medline and Scopus to identify relevant RCTs. Six RCTs meeting inclusion criteria were included in this review, investigating the effects of CRRPs on 6MWT outcomes in LC19Ps. RESULTS The findings from the included RCTs provide compelling evidence supporting the effectiveness of CRRPs in improving submaximal exercise performance in LC19Ps. These results underscore the potential of CRRPs to enhance submaximal exercise capacity and overall functional well-being in this population. However, future research is imperative to determine optimal CRRPs, including duration, intensity, and specific intervention components. Additionally, the long-term sustainability and durability of CRRP-induced improvements warrant further exploration. Future studies should prioritize patient-centric outcomes and address potential implementation barriers. CONCLUSION CRRPs show promise in ameliorating submaximal exercise performance among LC19Ps. Further research is needed to refine these programs and ensure their lasting impact on this patient group. SYSTEMATIC REVIEW REGISTRATION https://doi.org/10.17605/OSF.IO/HMN38. [Figure: see text].
Collapse
Affiliation(s)
- Amine Ghram
- Department of Cardiac Rehabilitation, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Imed Latiri
- Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED Hospital, Sousse, Tunisia
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
| | - Jabeur Methnani
- LR19ES09, Laboratoire de Physiologie de l'Exercice et Physiopathologie: de l'Intégré au Moléculaire 10 « Biologie, Médecine et Santé », Faculty of Medicine of Sousse, Sousse, Tunisia
| | - Amine Souissi
- Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED Hospital, Sousse, Tunisia
| | - Wafa Benzarti
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Emna Toulgui
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Helmi Ben Saad
- Heart Failure (LR12SP09) Research Laboratory, Farhat HACHED Hospital, Sousse, Tunisia
- Laboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
- Department of Physiology and Functional Exploration, Farhat HACHED Hospital, Sousse, Tunisia
| |
Collapse
|
15
|
Chen Y, Deng X, Lin D, Yang P, Wu S, Wang X, Zhou H, Chen X, Wang X, Wu W, Ke K, Huang W, Tan X. Predicting 1-, 3-, 5-, and 8-year all-cause mortality in a community-dwelling older adult cohort: relevance for predictive, preventive, and personalized medicine. EPMA J 2023; 14:713-726. [PMID: 38094581 PMCID: PMC10713970 DOI: 10.1007/s13167-023-00342-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 10/14/2023] [Indexed: 02/29/2024]
Abstract
BACKGROUND Population aging is a global public health issue involving increased prevalence of age-related diseases, and concomitant burden on medical resources and the economy. Ninety-two diseases have been identified as age-related, accounting for 51.3% of the global adult disease burden. The economic cost per capita for older people over 60 years is 10 times that of the younger population. From the aspects of predictive, preventive, and personalized medicine (PPPM), developing a risk-prediction model can help identify individuals at high risk for all-cause mortality and provide an opportunity for targeted prevention through personalized intervention at an early stage. However, there is still a lack of predictive models to help community-dwelling older adults do well in healthcare. OBJECTIVES This study aims to develop an accurate 1-, 3-, 5-, and 8-year all-cause mortality risk-prediction model by using clinical multidimensional variables, and investigate risk factors for 1-, 3-, 5-, and 8-year all-cause mortality in community-dwelling older adults to guide primary prevention. METHODS This is a two-center cohort study. Inclusion criteria: (1) community-dwelling adult, (2) resided in the districts of Chaonan or Haojiang for more than 6 months in the past 12 months, and (3) completed a health examination. Exclusion criteria: (1) age less than 60 years, (2) more than 30 incomplete variables, (3) no signed informed consent. The primary outcome of the study was all-cause mortality obtained from face-to-face interviews, telephone interviews, and the medical death database from 2012 to 2021. Finally, we enrolled 5085 community-dwelling adults, 60 years and older, who underwent routine health screening in the Chaonan and Haojiang districts, southern China, from 2012 to 2021. Of them, 3091 participants from Chaonan were recruited as the primary training and internal validation study cohort, while 1994 participants from Haojiang were recruited as the external validation cohort. A total of 95 clinical multidimensional variables, including demographics, lifestyle behaviors, symptoms, medical history, family history, physical examination, laboratory tests, and electrocardiogram (ECG) data were collected to identify candidate risk factors and characteristics. Risk factors were identified using least absolute shrinkage and selection operator (LASSO) models and multivariable Cox proportional hazards regression analysis. A nomogram predictive model for 1-, 3-, 5- and 8-year all-cause mortality was constructed. The accuracy and calibration of the nomogram prediction model were assessed using the concordance index (C-index), integrated Brier score (IBS), receiver operating characteristic (ROC), and calibration curves. The clinical validity of the model was assessed using decision curve analysis (DCA). RESULTS Nine independent risk factors for 1-, 3-, 5-, and 8-year all-cause mortality were identified, including increased age, male, alcohol status, higher daily liquor consumption, history of cancer, elevated fasting glucose, lower hemoglobin, higher heart rate, and the occurrence of heart block. The acquisition of risk factor criteria is low cost, easily obtained, convenient for clinical application, and provides new insights and targets for the development of personalized prevention and interventions for high-risk individuals. The areas under the curve (AUC) of the nomogram model were 0.767, 0.776, and 0.806, and the C-indexes were 0.765, 0.775, and 0.797, in the training, internal validation, and external validation sets, respectively. The IBS was less than 0.25, which indicates good calibration. Calibration and decision curves showed that the predicted probabilities were in good agreement with the actual probabilities and had good clinical predictive value for PPPM. CONCLUSION The personalized risk prediction model can identify individuals at high risk of all-cause mortality, help offer primary care to prevent all-cause mortality, and provide personalized medical treatment for these high-risk individuals from the PPPM perspective. Strict control of daily liquor consumption, lowering fasting glucose, raising hemoglobin, controlling heart rate, and treatment of heart block could be beneficial for improving survival in elderly populations. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s13167-023-00342-4.
Collapse
Affiliation(s)
- Yequn Chen
- Department of Community Monitoring, First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Xiulian Deng
- Department of Community Monitoring, First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Dong Lin
- Department of Community Monitoring, First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
- Centre for Precision Health, Edith Cowan University, Perth, WA 6027 Australia
| | - Peixuan Yang
- Department of Health Management Centre, First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Shiwan Wu
- Department of Community Monitoring, First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Xidong Wang
- Department of Community Monitoring, First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Hui Zhou
- Department of Community Monitoring, First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Ximin Chen
- Department of Community Monitoring, First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Xiaochun Wang
- Department of Community Monitoring, First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Weichai Wu
- Department of Community Monitoring, First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Kaibing Ke
- Department of Community Monitoring, First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Wenjia Huang
- Department of Community Monitoring, First Affiliated Hospital of Shantou University Medical College, Shantou, 515041 Guangdong China
| | - Xuerui Tan
- Clinical Research Centre, First Affiliated Hospital of Shantou University Medical College, No. 22 Xinling Road, Jinping District, Shantou, 515041 Guangdong China
| |
Collapse
|
16
|
Mishra S, Bentley-Hewitt K, McGhie T, Fraser K, Hedderley D, Martell S, Dinnan H, Monro J. Effects of Daily Ingestion of Two SunGold Kiwifruit for 6 Weeks on Metabolic and Inflammatory Biomarkers: A Randomized, Cross-Over, Exploratory Intervention Study. Foods 2023; 12:4236. [PMID: 38231672 DOI: 10.3390/foods12234236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 01/19/2024] Open
Abstract
Kiwifruit contain many components, some considered beneficial, such as vitamins, phytochemicals and dietary fibre, and others potentially harmful, such as fructose and glucose in fruit sugars. In a 6-week, randomised, crossover study aimed at exploring the net effects of daily consumption of kiwifruit, 23 healthy participants consumed two Actinidia chinensis var. chinensis 'Zesy002' (marketed as Zespri™ SunGold™ Kiwifruit) per day as part of their customary diet (intervention) or without kiwifruit (control) as their customary diet for 6 weeks in a cross-over study. Anthropometric data, venous blood, and urine samples were collected at the start and end of the 6-week intervention and control periods for the measurement of physical changes, plasma glucose, insulin, glycated haemoglobin, short-chain fatty acids, blood lipids, uric acid, inflammatory biomarkers, and urinary ascorbic acid. Variables were measured between the start and finish of interventions, and between intervention and control periods. Food diaries were completed on the 3 days before blood sampling to estimate dietary ascorbic acid and dietary fibre intakes. Despite urinary vitamin C and food diaries indicating compliance, and good precision in measurements, there were no appreciable changes in biomarkers during the study, either within or between intervention and control periods, that would indicate a change in health status. Thus, the sizes of any effects of kiwifruit ingestion were too small to become significant under the test conditions used, indicating a high probability that daily ingestion of two SunGold kiwifruit is safe with respect to metabolic health.
Collapse
Affiliation(s)
- Suman Mishra
- The New Zealand Institute for Plant and Food Research Limited, Palmerston North 4442, New Zealand
| | - Kerry Bentley-Hewitt
- The New Zealand Institute for Plant and Food Research Limited, Palmerston North 4442, New Zealand
| | - Tony McGhie
- The New Zealand Institute for Plant and Food Research Limited, Palmerston North 4442, New Zealand
| | - Karl Fraser
- AgResearch Limited, Palmerston North 4410, New Zealand
- Riddet Institute, University Avenue, Fitzherbert, Palmerston North 4474, New Zealand
| | - Duncan Hedderley
- The New Zealand Institute for Plant and Food Research Limited, Palmerston North 4442, New Zealand
| | - Sheridan Martell
- The New Zealand Institute for Plant and Food Research Limited, Palmerston North 4442, New Zealand
| | - Hannah Dinnan
- The New Zealand Institute for Plant and Food Research Limited, Palmerston North 4442, New Zealand
| | - John Monro
- The New Zealand Institute for Plant and Food Research Limited, Palmerston North 4442, New Zealand
- Riddet Institute, University Avenue, Fitzherbert, Palmerston North 4474, New Zealand
| |
Collapse
|
17
|
Baheti B, Chen G, Ding Z, Wu R, Zhang C, Zhou L, Liu X, Song X, Wang C. Residential greenness alleviated the adverse associations of long-term exposure to ambient PM 1 with cardiac conduction abnormalities in rural adults. ENVIRONMENTAL RESEARCH 2023; 237:116862. [PMID: 37574100 DOI: 10.1016/j.envres.2023.116862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/27/2023] [Accepted: 08/08/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Ambient air pollution was linked to elevated risks of adverse cardiovascular events, and alterations in electrophysiological properties of the heart might be potential pathways. However, there is still lacking research exploring the associations between PM1 exposure and cardiac conduction parameters. Additionally, the interactive effects of PM1 and residential greenness on cardiac conduction parameters in resource-limited areas remain unknown. METHODS A total of 27483 individuals were enrolled from the Henan Rural Cohort study. Cardiac conduction parameters were tested by 12-lead electrocardiograms. Concentrations of PM1 were evaluated by satellite-based spatiotemporal models. Levels of residential greenness were assessed using Enhanced Vegetation Index (EVI) and Normalized difference vegetation index (NDVI). Logistic regression models and restricted cubic splines were fitted to explore the associations of PM1 and residential greenness exposure with cardiac conduction abnormalities risk, and the interaction plot method was performed to visualize their interaction effects. RESULTS The 3-year median concentration of PM1 was 56.47 (2.55) μg/m3, the adjusted odds rate (ORs) and 95% confidence intervals (CIs) for abnormal HR, PR, QRS, and QTc interval risk in response to 1 μg/m3 increase in PM1 were 1.064 (1.044, 1.085), 1.037 (1.002, 1.074), 1.061 (1.044, 1.077) and 1.046 (1.028, 1.065), respectively. Participants exposure to higher levels of PM1 had increased risks of abnormal HR (OR = 1.221, 95%CI: 1.144, 1.303), PR (OR = 1.061, 95%CI: 0.940, 1.196), QRS (OR = 1.225, 95%CI: 1.161, 1.294) and QTc interval (OR = 1.193, 95%CI: 1.121, 1.271) compared with lower levels of PM1. Negative interactive effects of exposure to PM1 and residential greenness on abnormal HR, QRS, and QTc intervals were observed (Pfor interaction < 0.05). CONCLUSION Long-term PM1 exposure was associated with elevated cardiac conduction abnormalities risks, and this adverse association might be mitigated by residential greenness to some extent. These findings emphasize that controlling PM1 pollution and increasing greenness levels might be effective strategies to reduce cardiovascular disease burdens in resource-limited areas.
Collapse
Affiliation(s)
- Bota Baheti
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Gongbo Chen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Zhongao Ding
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ruiyu Wu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Caiyun Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Lue Zhou
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaoqin Song
- Physical Examination Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, PR China.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China; NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, Henan, PR China.
| |
Collapse
|
18
|
Olshansky B, Ricci F, Fedorowski A. Importance of resting heart rate. Trends Cardiovasc Med 2023; 33:502-515. [PMID: 35623552 DOI: 10.1016/j.tcm.2022.05.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/20/2022] [Accepted: 05/20/2022] [Indexed: 11/30/2022]
Abstract
Resting heart rate is a determinant of cardiac output and physiological homeostasis. Although a simple, but critical, parameter, this vital sign predicts adverse outcomes, including mortality, and development of diseases in otherwise normal and healthy individuals. Temporal changes in heart rate can have valuable predictive capabilities. Heart rate can reflect disease severity in patients with various medical conditions. While heart rate represents a compilation of physiological inputs, including sympathetic and parasympathetic tone, aside from the underlying intrinsic sinus rate, how resting heart rate affects outcomes is uncertain. Mechanisms relating resting heart rate to outcomes may be disease-dependent but why resting heart rate in otherwise healthy, normal individuals affects outcomes remains obscure. For specific conditions, physiologically appropriate heart rate reductions may improve outcomes. However, to date, in the normal population, evidence that interventions aimed at reducing heart rate improves outcomes remains undefined. Emerging data suggest that reduction in heart rate via vagal activation and/or sympathetic inhibition is propitious.
Collapse
Affiliation(s)
- Brian Olshansky
- Division of Cardiology, Department of Internal Medicine, University of Iowa, Iowa City, IA 52242, USA.
| | - Fabrizio Ricci
- Department of Neuroscience, Imaging and Clinical Sciences, "G.d'Annunzio" University of Chieti-Pescara, Via dei Vestini, 33, Chieti 66100, Italy; Department of Clinical Sciences, Lund University, 214 28 Malmö, Sweden
| | - Artur Fedorowski
- Department of Clinical Sciences, Lund University, 214 28 Malmö, Sweden; Department of Cardiology, Karolinska University Hospital, and Department of Medicine, Karolinska Institute, 171 76 Stockholm, Sweden
| |
Collapse
|
19
|
Klevjer M, Rasheed H, Romundstad PR, Madssen E, Brumpton BM, Bye A. Insight into the relationship between resting heart rate and atrial fibrillation: a Mendelian randomization study. Europace 2023; 25:euad292. [PMID: 37738632 PMCID: PMC10551233 DOI: 10.1093/europace/euad292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/19/2023] [Indexed: 09/24/2023] Open
Abstract
AIMS A low resting heart rate (RHR) implies a more efficient heart function and a lower risk of cardiovascular disease. However, observational studies have reported a U-shaped association between RHR and atrial fibrillation (AF). In contrast, Mendelian randomization (MR) studies have found an inverse causal association between RHR and AF. Hence, the causal nature of the relationship is not clear. The aim is to investigate the causal association and its shape between RHR on AF using linear and non-linear MR (NLMR). METHODS AND RESULTS Linear and non-linear MR were performed on individual-level data in the Trøndelag Health Study (HUNT) and UK Biobank (UKB). HUNT consists of 69 155 individuals with 7,062 AF cases, while UKB provides data on 431 852 individuals with 20 452 AF cases. The linear MR found an inverse relationship between RHR and AF with an OR = 0.95 [95% confidence interval (CI): 0.93-0.98] and OR = 0.96 (95% CI: 0.95-0.97) per unit decrease in RHR in HUNT and UKB, respectively. The NLMR was supportive of an inverse linear relationship in both HUNT and UKB for RHR values <90 beats per minute (bpm). Several sensitivity analyses were also consistent. CONCLUSION In contrast with the current observational knowledge of RHR and AF, an inverse causal association between RHR and AF was demonstrated in both linear and non-linear MR for RHR values up to 90 bpm. Further exploring the underlying mechanisms of the genetic instrument for RHR may shed light on whether pleiotropy is biasing this association.
Collapse
Affiliation(s)
- Marie Klevjer
- Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Prinsesse Kristinas Gate 3, Trondheim 7030, Norway
- Department of Cardiology, St.Olavs Hospital, Trondheim University Hospital, Prinsesse Kristinas Gate 3, Trondheim 7030, Norway
| | - Humaira Rasheed
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, UK
- Division of Medicine and Laboratory Sciences, University of Oslo, Oslo, Norway
| | - Pål R Romundstad
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Erik Madssen
- Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Prinsesse Kristinas Gate 3, Trondheim 7030, Norway
- Department of Cardiology, St.Olavs Hospital, Trondheim University Hospital, Prinsesse Kristinas Gate 3, Trondheim 7030, Norway
| | - Ben M Brumpton
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Anja Bye
- Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Prinsesse Kristinas Gate 3, Trondheim 7030, Norway
- Department of Cardiology, St.Olavs Hospital, Trondheim University Hospital, Prinsesse Kristinas Gate 3, Trondheim 7030, Norway
| |
Collapse
|
20
|
Chubb SAP, Davis WA, Davis TME. Serum bicarbonate concentration and the risk of death in type 2 diabetes: the Fremantle Diabetes Study Phase II. Acta Diabetol 2023; 60:1333-1342. [PMID: 37330446 PMCID: PMC10442265 DOI: 10.1007/s00592-023-02130-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/03/2023] [Indexed: 06/19/2023]
Abstract
AIMS To examine whether all-cause mortality is independently associated with serum bicarbonate concentration below the laboratory reference interval in a representative, well-characterised community-based cohort of people with type 2 diabetes. METHODS 1478 FDS2 participants with type 2 diabetes (mean age 65.8 years, 51.6% males, median diabetes duration 9.0 years) from the longitudinal, observational Fremantle Diabetes Study Phase II (FDS2) were followed from study entry to death or end-2016. Independent associates of a low baseline serum bicarbonate (< 22 mmol/L) were determined using multiple logistic regression. The role of important covariates in influencing the association between bicarbonate and mortality was assessed by a stepwise Cox regression approach. RESULTS A low serum bicarbonate was associated with increased all-cause mortality in unadjusted analysis (hazard ratio (HR) 1.90 (95% confidence limits (CL) 1.39, 2.60 per mmol/L). Mortality remained significantly associated with low serum bicarbonate (HR 1.40 (95% CL 1.01, 1.94) per mmol/L) in a Cox regression model with adjustment for factors associated with mortality but not low serum bicarbonate, but inclusion of estimated glomerular filtration rate categories rendered the association non-significant (HR 1.16 (95% CL 0.83, 1.63) per mmol/L). CONCLUSIONS A low serum bicarbonate is not an independent prognostic marker in people with type 2 diabetes but it may be a manifestation of the pathway between the development of impaired renal function and death.
Collapse
Affiliation(s)
- S A Paul Chubb
- PathWest Laboratory Medicine WA, Fiona Stanley Hospital, Murdoch, WA, Australia
- Medical School, University of Western Australia, Fremantle Hospital, P. O. Box 480, Fremantle, WA, 6959, Australia
| | - Wendy A Davis
- Medical School, University of Western Australia, Fremantle Hospital, P. O. Box 480, Fremantle, WA, 6959, Australia
| | - Timothy M E Davis
- Medical School, University of Western Australia, Fremantle Hospital, P. O. Box 480, Fremantle, WA, 6959, Australia.
| |
Collapse
|
21
|
Lu JK, Sijm M, Janssens GE, Goh J, Maier AB. Remote monitoring technologies for measuring cardiovascular functions in community-dwelling adults: a systematic review. GeroScience 2023; 45:2939-2950. [PMID: 37204639 PMCID: PMC10196312 DOI: 10.1007/s11357-023-00815-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 04/28/2023] [Indexed: 05/20/2023] Open
Abstract
Remote monitoring technologies (RMTs) allow continuous, unobtrusive, and real-time monitoring of the cardiovascular system. An overview of existing RMTs measuring cardiovascular physiological variables is lacking. This systematic review aimed to describe RMTs measuring cardiovascular functions in community-dwelling adults. An electronic search was conducted via PubMed, EMBASE, and Cochrane Library from January 1, 2020, to April 7, 2022. Articles reporting on non-invasive RMTs used unsupervised in community-dwelling adults were included. Reviews and studies in institutionalized populations were excluded. Two reviewers independently assessed the studies and extracted the technologies used, cardiovascular variables measured, and wearing locations of RMTs. Validation of the RMTs was examined based on the COSMIN tool, and accuracy and precision were presented. This systematic review was registered with PROSPERO (CRD42022320082). A total of 272 articles were included representing 322,886 individuals with a mean or median age from 19.0 to 88.9 years (48.7% female). Of all 335 reported RMTs containing 216 distinct devices, photoplethysmography was used in 50.3% of RMTs. Heart rate was measured in 47.0% of measurements, and the RMT was worn on the wrist in 41.8% of devices. Nine devices were reported in more than three articles, of which all were sufficiently accurate, six were sufficiently precise, and four were commercially available in December 2022. The top four most reported technologies were AliveCor KardiaMobile®, Fitbit Charge 2, and Polar H7 and H10 Heart Rate Sensors. With over 200 distinct RMTs reported, this review provides healthcare professionals and researchers an overview of available RMTs for monitoring the cardiovascular system.
Collapse
Affiliation(s)
- Jessica K Lu
- Centre for Healthy Longevity, National University Health System, Singapore, Singapore
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Georges E Janssens
- Laboratory Genetic Metabolic Diseases, Amsterdam University Medical Centers - location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Jorming Goh
- Centre for Healthy Longevity, National University Health System, Singapore, Singapore
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Andrea B Maier
- Centre for Healthy Longevity, National University Health System, Singapore, Singapore.
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorstsraat 7, 1081 BT, Amsterdam, The Netherlands.
| |
Collapse
|
22
|
Jacinto M, Matos R, Monteiro D, Antunes R, Caseiro A, Gomes B, Campos MJ, Ferreira JP. Effects of a 24-week exercise program on anthropometric, body composition, metabolic status, cardiovascular response, and neuromuscular capacity, in individuals with intellectual and developmental disabilities. Front Physiol 2023; 14:1205463. [PMID: 37288435 PMCID: PMC10242032 DOI: 10.3389/fphys.2023.1205463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 04/28/2023] [Indexed: 06/09/2023] Open
Abstract
Introduction: The prevalence of overweight and obesity has increased in the last decades, including in people with Intellectual and Developmental Disabilities (IDD). This is even more concerning when it is globally accepted that a low physical condition contributes to the deterioration of functionality and increases the risk of developing chronic diseases during life, with effective implications for health and well-being. The aim of the present study is to investigate the effects of two physical exercise intervention programs on institutionalized individuals with IDD. Methods: Twenty-one adults with IDD (43.04 ± 11.18 years) were split by convenience into three groups: i) an indoor training group (IG; N = 7; 24-week machine-based gym intervention), ii) an outdoor training group (OG; N = 7; 24-week outdoor intervention with low-content materials), and iii) a control group (CG; N = 7). Assessed outcomes included indicators of health and neuromuscular capacity. The ShapiroWilk (n < 50) and Levene tests were used to verify data normality and homoscedasticity. A Kruskal-Walli test was performed to understand if there were differences between the groups. For comparison purposes and to assess hypothetical differences between groups, the Wilcoxon signed-rank test and the Friedman test were used. The respective effect size was calculated, and the significance level was defined at 0.05. Results/Discussion: There was a difference in fat mass in OG (initial ≠ intermediate; Bonferroni corrected: t = 2.405; p = 0.048; W = 0.08 and initial ≠ final moments; Bonferroni corrected: t = 2.405; p = 0.048; W = 0.08). Indoor intervention programs seem to be more effective than outdoor intervention programs for reducing heart rate rest (t = -2.912; p = 0.011; W = -0.104) when compared with CG. Conclusion: A low-cost outdoor intervention in contact with nature appears to be more effective for fat mass reduction. The results for heart rate variability are not clear and robust. Finally, an indoor intervention using weight-training machines appears to be a good method to promote neuromuscular capacity.
Collapse
Affiliation(s)
- Miguel Jacinto
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
- ESECS—Polytechnic of Leiria, Leiria, Portugal
- Life Quality Research Centre (CIEQV), Leiria, Portugal
| | - Rui Matos
- ESECS—Polytechnic of Leiria, Leiria, Portugal
- Life Quality Research Centre (CIEQV), Leiria, Portugal
| | - Diogo Monteiro
- ESECS—Polytechnic of Leiria, Leiria, Portugal
- Life Quality Research Centre (CIEQV), Leiria, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal
| | - Raul Antunes
- ESECS—Polytechnic of Leiria, Leiria, Portugal
- Life Quality Research Centre (CIEQV), Leiria, Portugal
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal
| | - André Caseiro
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Beatriz Gomes
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
- Research Center for Sport and Physical Activity (CIDAF), Coimbra, Portugal
| | - Maria João Campos
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
- Research Center for Sport and Physical Activity (CIDAF), Coimbra, Portugal
| | - José Pedro Ferreira
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
- Research Center for Sport and Physical Activity (CIDAF), Coimbra, Portugal
| |
Collapse
|
23
|
Gonzales TI, Jeon JY, Lindsay T, Westgate K, Perez-Pozuelo I, Hollidge S, Wijndaele K, Rennie K, Forouhi N, Griffin S, Wareham N, Brage S. Resting heart rate is a population-level biomarker of cardiorespiratory fitness: The Fenland Study. PLoS One 2023; 18:e0285272. [PMID: 37167327 PMCID: PMC10174582 DOI: 10.1371/journal.pone.0285272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 04/19/2023] [Indexed: 05/13/2023] Open
Abstract
INTRODUCTION Few large studies have evaluated the relationship between resting heart rate (RHR) and cardiorespiratory fitness. Here we examine cross-sectional and longitudinal relationships between RHR and fitness, explore factors that influence these relationships, and demonstrate the utility of RHR for remote population monitoring. METHODS In cross-sectional analyses (The UK Fenland Study: 5,722 women, 5,143 men, aged 29-65y), we measured RHR (beats per min, bpm) while seated, supine, and during sleep. Fitness was estimated as maximal oxygen consumption (ml⋅min-1⋅kg-1) from an exercise test. Associations between RHR and fitness were evaluated while adjusting for age, sex, adiposity, and physical activity. In longitudinal analyses (6,589 participant subsample), we re-assessed RHR and fitness after a median of 6 years and evaluated the association between within-person change in RHR and fitness. During the coronavirus disease-2019 pandemic, we used a smartphone application to remotely and serially measure RHR (1,914 participant subsample, August 2020 to April 2021) and examined differences in RHR dynamics by pre-pandemic fitness level. RESULTS Mean RHR while seated, supine, and during sleep was 67, 64, and 57 bpm. Age-adjusted associations (beta coefficients) between RHR and fitness were -0.26, -0.29, and -0.21 ml⋅kg-1⋅beat-1 in women and -0.27, -0.31, and -0.19 ml⋅kg-1⋅beat-1 in men. Adjustment for adiposity and physical activity attenuated the RHR-to-fitness relationship by 10% and 50%, respectively. Longitudinally, a 1-bpm increase in supine RHR was associated with a 0.23 ml⋅min-1⋅kg-1 decrease in fitness. During the pandemic, RHR increased in those with low pre-pandemic fitness but was stable in others. CONCLUSIONS RHR is a valid population-level biomarker of cardiorespiratory fitness. Physical activity and adiposity attenuate the relationship between RHR and fitness.
Collapse
Affiliation(s)
- Tomas I. Gonzales
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Justin Y. Jeon
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
- Department of Sport Industry Studies, Exercise Medicine Center for Diabetes and Cancer Patients (ICONS), Yonsei University, Seoul, Korea
| | - Timothy Lindsay
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Kate Westgate
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | | | - Stefanie Hollidge
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Katrien Wijndaele
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Kirsten Rennie
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Nita Forouhi
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Simon Griffin
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Nick Wareham
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| |
Collapse
|
24
|
Nelde A, Klammer MG, Nolte CH, Stengl H, Krämer M, von Rennenberg R, Meisel A, Scheibe F, Endres M, Scheitz JF, Meisel C. Data lake-driven analytics identify nocturnal non-dipping of heart rate as predictor of unfavorable stroke outcome at discharge. J Neurol 2023:10.1007/s00415-023-11718-x. [PMID: 37079032 DOI: 10.1007/s00415-023-11718-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/06/2023] [Accepted: 04/07/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Post-stroke heart rate (HR) and heart rate variability (HRV) changes have been proposed as outcome predictors after stroke. We used data lake-enabled continuous electrocardiograms to assess post-stroke HR and HRV, and to determine the utility of HR and HRV to improve machine learning-based predictions of stroke outcome. METHODS In this observational cohort study, we included stroke patients admitted to two stroke units in Berlin, Germany, between October 2020 and December 2021 with final diagnosis of acute ischemic stroke or acute intracranial hemorrhage and collected continuous ECG data through data warehousing. We created circadian profiles of several continuously recorded ECG parameters including HR and HRV parameters. The pre-defined primary outcome was short-term unfavorable functional outcome after stroke indicated through modified Rankin Scale (mRS) score of > 2. RESULTS We included 625 stroke patients, 287 stroke patients remained after matching for age and National Institute of Health Stroke Scale (NIHSS; mean age 74.5 years, 45.6% female, 88.9% ischemic, median NIHSS 5). Both higher HR and nocturnal non-dipping of HR were associated with unfavorable functional outcome (p < 0.01). The examined HRV parameters were not associated with the outcome of interest. Nocturnal non-dipping of HR ranked highly in feature importance of various machine learning models. CONCLUSIONS Our data suggest that a lack of circadian HR modulation, specifically nocturnal non-dipping, is associated with short-term unfavorable functional outcome after stroke, and that including HR into machine learning-based prediction models may lead to improved stroke outcome prediction.
Collapse
Affiliation(s)
- Alexander Nelde
- Department of Neurology with Experimental Neurology, Charité-Universitätsmedizin Berlin, Bonhoefferweg 3, 10117, Berlin, Germany
| | - Markus G Klammer
- Department of Neurology with Experimental Neurology, Charité-Universitätsmedizin Berlin, Bonhoefferweg 3, 10117, Berlin, Germany
- Center for Stroke Research Berlin, Berlin, Germany
| | - Christian H Nolte
- Department of Neurology with Experimental Neurology, Charité-Universitätsmedizin Berlin, Bonhoefferweg 3, 10117, Berlin, Germany
- Center for Stroke Research Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Helena Stengl
- Department of Neurology with Experimental Neurology, Charité-Universitätsmedizin Berlin, Bonhoefferweg 3, 10117, Berlin, Germany
- Center for Stroke Research Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | | | - Regina von Rennenberg
- Department of Neurology with Experimental Neurology, Charité-Universitätsmedizin Berlin, Bonhoefferweg 3, 10117, Berlin, Germany
- Center for Stroke Research Berlin, Berlin, Germany
- German Center for Neurodegenerative Diseases (DZNE), Partner Site Berlin, Berlin, Germany
| | - Andreas Meisel
- Department of Neurology with Experimental Neurology, Charité-Universitätsmedizin Berlin, Bonhoefferweg 3, 10117, Berlin, Germany
- Center for Stroke Research Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Berlin, Germany
| | - Franziska Scheibe
- Department of Neurology with Experimental Neurology, Charité-Universitätsmedizin Berlin, Bonhoefferweg 3, 10117, Berlin, Germany
- NeuroCure Cluster of Excellence, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Matthias Endres
- Department of Neurology with Experimental Neurology, Charité-Universitätsmedizin Berlin, Bonhoefferweg 3, 10117, Berlin, Germany
- Center for Stroke Research Berlin, Berlin, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
- NeuroCure Cluster of Excellence, Charité-Universitätsmedizin Berlin, Berlin, Germany
- German Center for Neurodegenerative Diseases (DZNE), Partner Site Berlin, Berlin, Germany
| | - Jan F Scheitz
- Department of Neurology with Experimental Neurology, Charité-Universitätsmedizin Berlin, Bonhoefferweg 3, 10117, Berlin, Germany
- Center for Stroke Research Berlin, Berlin, Germany
| | - Christian Meisel
- Department of Neurology with Experimental Neurology, Charité-Universitätsmedizin Berlin, Bonhoefferweg 3, 10117, Berlin, Germany.
- Center for Stroke Research Berlin, Berlin, Germany.
- Berlin Institute of Health, Berlin, Germany.
- NeuroCure Cluster of Excellence, Charité-Universitätsmedizin Berlin, Berlin, Germany.
- Bernstein Center for Computational Neuroscience, Berlin, Germany.
| |
Collapse
|
25
|
Häfele MS, Alberton CL, Häfele V, Schaun GZ, Nunes GN, Calonego C, Castro TF, Andrade LS, Pinto SS. Water-Based Training Programs Improve Functional Capacity, Cognitive and Hemodynamic Outcomes? The ACTIVE Randomized Clinical Trial. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2023; 94:24-34. [PMID: 35294330 DOI: 10.1080/02701367.2021.1935433] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 05/20/2021] [Indexed: 06/14/2023]
Abstract
Purpose: To compare the effects of 16 weeks of aerobic training (AT) to 8 weeks of AT followed by 8 weeks of combined training (CT), as well as to a control group (CG), on the functional, cognitive and hemodynamic responses of older women exercising in the aquatic environment. Materials and Methods: The study is a three-armed parallel randomized controlled clinical trial. For this, 52 older women were first randomized in an aerobic training (AT; n = 35) or control group (CG; n = 17). After 8 weeks of intervention, participants from AT group were again randomized into another 8-week period of either AT (n = 17) or combined training (CT; n = 18). AT was performed at the percentage of the heart rate corresponding to the anaerobic threshold, resistance training was performed with sets at maximal effort and the control group performed low-intensity therapeutic exercises in water. All outcomes were assessed before (week 0) and after the intervention (week 17). In addition, some outcomes were also investigated in the middle timepoint (week 9). Generalized Estimating Equations (GEE) and Bonferroni post-hoc tests (α = 0.05) were used to compare timepoints and groups. Results: All groups similarly improved functional capacity (3-11%) and blood pressure (-4 to -10%), whereas cognitive function was not modified for any group. Conclusion: Water-based training programs and therapeutic exercises (i.e., CG) improve functional capacity and blood pressure responses in older women. Clinical Trials NCT03892278.
Collapse
|
26
|
Mahfooz K, Vasavada AM, Joshi A, Pichuthirumalai S, Andani R, Rajotia A, Hans A, Mandalia B, Dayama N, Younas Z, Hafeez N, Bheemisetty N, Patel Y, Tumkur Ranganathan H, Sodala A. Waterpipe Use and Its Cardiovascular Effects: A Systematic Review and Meta-Analysis of Case-Control, Cross-Sectional, and Non-Randomized Studies. Cureus 2023; 15:e34802. [PMID: 36915837 PMCID: PMC10008028 DOI: 10.7759/cureus.34802] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/09/2023] [Indexed: 02/11/2023] Open
Abstract
Approximately 100 million people globally smoke cigarettes, making it a significant and quickly spreading global tobacco epidemic. Substance use disorders are frequently evaluated by non-randomized studies. Tobacco use and its impacts on the cardiovascular system were the subjects of a comprehensive search across five electronic databases: Cochrane, MEDLINE, Scopus, Embase, and PubMed. The findings demonstrated that waterpipe smokers in comparison to non-smokers have immediate elevations in heart rate and blood pressure, lower levels of high-density lipoprotein, higher levels of low-density lipoprotein, higher levels of triglycerides, higher levels of fasting blood glucose, and a higher heart rate. Users of waterpipes and cigarettes had similar average heart rates, blood pressure, and lipid levels, with the exception that waterpipe smokers had greater total cholesterol. Smoking a waterpipe has significant negative effects on the cardiovascular system comparable to cigarette smoking, and non-randomized studies proved to yield substantial evidence related to its cardiovascular effects. Such study designs can be used to evaluate substance use and its cardiovascular impact.
Collapse
Affiliation(s)
- Kamran Mahfooz
- Internal Medicine, Lincoln Medical Center, New York, USA
| | - Advait M Vasavada
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.,Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND
| | - Arpit Joshi
- Medicine, B. J. (Byramjee Jeejeebhoy) Medical, Ahmedabad, IND
| | | | - Rupesh Andani
- Internal Medicine, Jeevandhara Hospital, Jamnagar, IND
| | | | - Aakash Hans
- Internal Medicine, Henry Ford Health System, Detroit, USA
| | - Bilvesh Mandalia
- House Officer, Lokmanya Tilak Municipal General Hospital and Medical College, Sion Mumbai, Mumbai, IND
| | - Neeraj Dayama
- Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, USA
| | - Zara Younas
- Medicine, King Edward Medical University, Lahore, PAK
| | | | - Niharika Bheemisetty
- Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Yash Patel
- Medicine, Gujarat Cancer Society Medical College, Ahmedabad, IND
| | | | - Ashok Sodala
- Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND
| |
Collapse
|
27
|
Mohan JC, Sathyamurthy I, Panja M, Agarwala R, Ponde CK, Kumar AS, Mahala BK, Kolapkar V, Kumar RVL, Patel K. Expert Consensus on Ivabradine-based Therapy for Heart Rate Management in Chronic Coronary Syndrome and Heart Failure with Reduced Ejection Fraction in India. Curr Cardiol Rev 2023; 19:97-106. [PMID: 36941812 PMCID: PMC10518888 DOI: 10.2174/1573403x19666230320105623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 03/23/2023] Open
Abstract
Heart rate is an important indicator of health and disease and the modulation of heart rate can help to improve cardiovascular outcomes. Besides β-blockers, Ivabradine is a wellestablished heart rate modulating drug that reduces heart rate without any hemodynamic effects. This consensus document was developed with the help of expert opinions from cardiologists across India on effective heart rate management in routine clinical practice and choosing an appropriate Ivabradine-based therapy considering the available scientific data and guideline recommendations. Based on the discussion during the meetings, increased heart rate was recognized as a significant predictor of adverse cardiovascular outcomes among patients with chronic coronary syndromes and heart failure with reduced ejection fraction making heart rate modulation important in these subsets. Ivabradine is indicated in the management of chronic coronary syndromes and heart failure with reduced ejection fraction for patients in whom heart rate targets cannot be achieved despite guideline-directed β-blocker dosing or having contraindication/intolerance to β-blockers. A prolonged release once-daily dosage of Ivabradine can be considered in patients already stabilized on Ivabradine twice-daily. Ivabradine/β-blocker fixed-dose combination can also be considered to reduce pill burden. Two consensus algorithms have been developed for further guidance on the appropriate usage of Ivabradine-based therapies. Ivabradine and β-blockers can provide more pronounced clinical improvement in most chronic coronary syndromes and heart failure with reduced ejection fraction patients with a fixed-dose combination providing an opportunity to improve adherence.
Collapse
Affiliation(s)
- J C Mohan
- Head of Department & Senior Consultant Cardiology, Jaipur Golden Hospital, Delhi, India
| | - I Sathyamurthy
- Senior Interventional Cardiologist, Apollo Hospitals, Chennai, India
| | - Monotosh Panja
- Senior Interventional Cardiologist, AMRI Hospitals, Kolkata, India
| | - Rajeev Agarwala
- Head of Department and Consultant Cardiologist, Jaswant Rai Speciality Hospital, Meerut, India
| | - C K Ponde
- Head of Department and Consultant Cardiologist, P. D. Hinduja National Hospital & Medical Research Centre, Mumbai, India
| | - A Sreenivas Kumar
- Director Cardiology & Clinical Research, Apollo Health City, Hyderabad, India; Apollo Hospitals, Hyderabad, India
| | - Bijay Kumar Mahala
- Senior Consultant Cardiology, Narayana Institute of Cardiac Sciences, Bangalore, India
| | | | | | | |
Collapse
|
28
|
Associations between Intra-Assessment Resting Metabolic Rate Variability and Health-Related Factors. Metabolites 2022; 12:metabo12121218. [PMID: 36557256 PMCID: PMC9781460 DOI: 10.3390/metabo12121218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 11/28/2022] [Accepted: 12/01/2022] [Indexed: 12/11/2022] Open
Abstract
In humans, the variation in resting metabolic rate (RMR) might be associated with health-related factors, as suggested by previous studies. This study explored whether the intra-assessment RMR variability (expressed as a coefficient of variation (CV; %)) is similar in men and women and if it is similarly associated with diverse health-related factors. The RMR of 107 young, and relatively healthy adults, was assessed using indirect calorimetry. Then, the CV for volumes of oxygen consumption (VO2) and carbon dioxide production (VCO2), respiratory exchange ratio (RER), and resting energy expenditure (REE) were computed as indicators of intra-assessment RMR variability. Body composition, cardiorespiratory fitness (peak VO2 uptake), circulating cardiometabolic risk factors, and heart rate and its variability (HR and HRV) were assessed. Men presented higher CVs for VO2, VCO2, and REE (all p ≤ 0.001) compared to women. Furthermore, in men, the intra-assessment RER variability was associated with vagal-related HRV parameters and with mean HR (standardized β = −0.36, −0.38, and 0.41, respectively; all p < 0.04). In contrast, no associations were observed in women. In conclusion, men exhibited higher variability (CVs for VO2, VCO2, and REE) compared to women. The CV for RER could be a potential marker of cardiometabolic risk in young men.
Collapse
|
29
|
Webb AJ, Wartolowska KA, Li L, Rothwell PM. Low Heart Rate Is Associated with Cerebral Pulsatility after TIA or Minor Stroke. Ann Neurol 2022; 92:909-920. [PMID: 36054225 PMCID: PMC9804869 DOI: 10.1002/ana.26480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/12/2022] [Accepted: 08/12/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Beta-blockers are beneficial in coronary artery disease but less so in stroke prevention and dementia, potentially due to reduced heart rate (HR). Cerebral pulsatility is strongly associated with cerebral small vessel disease (SVD) and may be increased by lower diastolic pressures resulting from longer cardiac cycles. METHODS Patients 4-6 weeks after TIA or non-disabling stroke (Oxford Vascular Study) underwent 5 minutes continuous monitoring of blood pressure (BP), electrocardiogram (ECG), and middle cerebral artery flow velocity (transcranial ultrasound). Beat-to-beat relationships between HR, blood pressure and Gosling's pulsatility index (MCA-PI) are reported as beta-coefficients from general linear models for each individual. RESULTS Across 759 patients, average MCA-PI during monitoring was associated with lower HR and diastolic BP (DBP) and greater systolic BP (SBP) (∆MCA-PI per 10 bpm/mmHg: -0.02, -0.04, 0.03, all p < 0.001), with HR particularly associated with low end-diastolic cerebral velocity (0.86, p = 0.014). Beat-to-beat HR was strongly associated with concurrent low DBP and high SBP, potentially mediating the association with greater beat-to-beat cerebral pulsatility (average ∆MCA-PI vs HR/DBP/SBP unadjusted: -0.062, -0.052, 0.0092; adjusted for concurrent BP: -0.039, -0.11, 0.041). The beat-to-beat association between HR and MCA-PI increased with age, beta-blockers, arterial stiffness, low HR (age > 70 + HR < 65 vs age < 70 + HR > 65: -0.081 vs -0.024, interaction p < 0.001), and severe SVD on MRI (age > 70 + severe vs age < 70 + none: -0.087 vs -0.047, interaction p = 0.03), with interactions between age, severe SVD, and low HR synergistically increasing MCA-PI. INTERPRETATION Low HR is associated with greater cerebral pulsatility in patients with SVD, potentially mediated by lower diastolic blood flow and representing a novel potential treatment target. ANN NEUROL 2022;92:909-920.
Collapse
Affiliation(s)
- Alastair J.S. Webb
- Wolfson Centre for Prevention of Stroke and DementiaUniversity of OxfordOxfordUK
| | | | - Linxin Li
- Wolfson Centre for Prevention of Stroke and DementiaUniversity of OxfordOxfordUK
| | - Peter M. Rothwell
- Wolfson Centre for Prevention of Stroke and DementiaUniversity of OxfordOxfordUK
| |
Collapse
|
30
|
Truong C, Recto C, Lafont C, Canoui-Poitrine F, Belmin JB, Lafuente-Lafuente C. Effect of Cholinesterase Inhibitors on Mortality in Patients With Dementia: A Systematic Review of Randomized and Nonrandomized Trials. Neurology 2022; 99:e2313-e2325. [PMID: 36096687 DOI: 10.1212/wnl.0000000000201161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 07/11/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Cholinesterase inhibitors (ChEIs) have cardiovascular effects in addition to their neurologic activity and might alter mortality. We wanted to know whether treatment with ChEIs modifies mortality in patients with dementia. METHODS We searched PubMed, Embase, Cochrane CENTRAL, ClinicalTrials.gov, and ICRTP, from their inception to November 2021, and screened bibliographies of reviews, guidelines, and included studies. We included randomized controlled trials (RCTs) and nonrandomized controlled studies at lower risk of bias comparing ChEI treatment with placebo or usual treatment, for 6 months or longer, in patients with dementia of any type. Two investigators independently assessed studies for inclusion, assessed their risk of bias, and extracted data using predefined forms. Any discordance between investigators was solved by discussion and consensus. Data on all-cause and cardiovascular mortality, measured as either crude death rates or multivariate adjusted hazard ratios (HRs), were pooled using a random-effect model. Information size achieved was assessed using trial sequential analysis (TSA). We followed Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. RESULTS Twenty-four studies (12 RCTs, 12 cohorts, mean follow-up 6-120 months), cumulating 79,153 patients with Alzheimer (13 studies), Parkinson (1), vascular (1), or any type (9) dementia, fulfilled inclusion criteria. Pooled all-cause mortality in control patients was 15.1 per 100 person-years. Treatment with ChEIs was associated with lower all-cause mortality (unadjusted risk ratio [RR] 0.74, 95% CI 0.66-0.84; adjusted HR 0.77, 95% CI 0.70-0.84, moderate-quality to high-quality evidence). This result was consistent between randomized and nonrandomized studies and in several sensitivity analyses. No difference appeared between subgroups by type of dementia, age, individual drug, or dementia severity. Less data were available for cardiovascular mortality (3 RCTs, 2 cohorts, 9,182 patients, low-quality to moderate-quality evidence), which was also lower in patients treated with ChEIs (unadjusted RR 0.61, 95% CI 0.40-0.93, adjusted HR 0.47, 95% CI 0.32-0.68). In TSA analysis, the results for all-cause mortality were conclusive but not those for cardiovascular mortality. DISCUSSION There is moderate-quality to high-quality evidence of a consistent association between long-term treatment with ChEIs and a reduction in all-cause mortality in patients with dementia. These findings may influence decisions to prescribe ChEIs in those patients. TRIAL REGISTRATION INFORMATION This systematic review was registered in the PROSPERO international prospective register of systematic reviews with the number CRD42021254458 (June 11, 2021).
Collapse
Affiliation(s)
- Céline Truong
- From the AP-HP (C.T., C.R., J.B.B., C.L.-L.), Sorbonne Université, Hôpitaux universitaires Pitie-Salpêtrière-Charles Foix, Service de Gériatrie à orientation Cardiologique et Neurologique, Ivry-sur-Seine; Université Paris Est Créteil (UPEC) (C.L., F.C.-P., C.L.-L.), INSERM, IMRB, Clinical Epidemiology and Ageing (CEpiA) Team; and APHP (C.L., F.C.-P.), Hôpital Henri Mondor, Service de Santé Publique, Créteil, France
| | - Caryn Recto
- From the AP-HP (C.T., C.R., J.B.B., C.L.-L.), Sorbonne Université, Hôpitaux universitaires Pitie-Salpêtrière-Charles Foix, Service de Gériatrie à orientation Cardiologique et Neurologique, Ivry-sur-Seine; Université Paris Est Créteil (UPEC) (C.L., F.C.-P., C.L.-L.), INSERM, IMRB, Clinical Epidemiology and Ageing (CEpiA) Team; and APHP (C.L., F.C.-P.), Hôpital Henri Mondor, Service de Santé Publique, Créteil, France
| | - Charlotte Lafont
- From the AP-HP (C.T., C.R., J.B.B., C.L.-L.), Sorbonne Université, Hôpitaux universitaires Pitie-Salpêtrière-Charles Foix, Service de Gériatrie à orientation Cardiologique et Neurologique, Ivry-sur-Seine; Université Paris Est Créteil (UPEC) (C.L., F.C.-P., C.L.-L.), INSERM, IMRB, Clinical Epidemiology and Ageing (CEpiA) Team; and APHP (C.L., F.C.-P.), Hôpital Henri Mondor, Service de Santé Publique, Créteil, France
| | - Florence Canoui-Poitrine
- From the AP-HP (C.T., C.R., J.B.B., C.L.-L.), Sorbonne Université, Hôpitaux universitaires Pitie-Salpêtrière-Charles Foix, Service de Gériatrie à orientation Cardiologique et Neurologique, Ivry-sur-Seine; Université Paris Est Créteil (UPEC) (C.L., F.C.-P., C.L.-L.), INSERM, IMRB, Clinical Epidemiology and Ageing (CEpiA) Team; and APHP (C.L., F.C.-P.), Hôpital Henri Mondor, Service de Santé Publique, Créteil, France
| | - Joel Belmin Belmin
- From the AP-HP (C.T., C.R., J.B.B., C.L.-L.), Sorbonne Université, Hôpitaux universitaires Pitie-Salpêtrière-Charles Foix, Service de Gériatrie à orientation Cardiologique et Neurologique, Ivry-sur-Seine; Université Paris Est Créteil (UPEC) (C.L., F.C.-P., C.L.-L.), INSERM, IMRB, Clinical Epidemiology and Ageing (CEpiA) Team; and APHP (C.L., F.C.-P.), Hôpital Henri Mondor, Service de Santé Publique, Créteil, France
| | - Carmelo Lafuente-Lafuente
- From the AP-HP (C.T., C.R., J.B.B., C.L.-L.), Sorbonne Université, Hôpitaux universitaires Pitie-Salpêtrière-Charles Foix, Service de Gériatrie à orientation Cardiologique et Neurologique, Ivry-sur-Seine; Université Paris Est Créteil (UPEC) (C.L., F.C.-P., C.L.-L.), INSERM, IMRB, Clinical Epidemiology and Ageing (CEpiA) Team; and APHP (C.L., F.C.-P.), Hôpital Henri Mondor, Service de Santé Publique, Créteil, France.
| |
Collapse
|
31
|
Naz H, Haider R, Rashid H, Ul Haq Z, Malik J, Zaidi SMJ, Ishaq U, Trevisan R. Islamic fasting: cardiovascular disease perspective. Expert Rev Cardiovasc Ther 2022; 20:795-805. [PMID: 36260858 DOI: 10.1080/14779072.2022.2138344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
INTRODUCTION Ramadan is a month of obligatory fasting observed by the majority of 2 billion Muslims living around the globe. The guidelines for 'risk-free' fasting exist for chronic diseases, including diabetes mellitus, but recommendations for cardiovascular disease (CVD) patients are deficient due to the paucity of literature. AREAS COVERED Databases were screened to find relevant studies for an evidence-based consensus regarding the risk stratification and management of CVD. Using practical guidelines of the European Society of Cardiology (ESC), we categorized patients into low-, moderate-, and high-risk categories and proposed a pre-Ramadan checklist for the assessment of cardiac patients before fasting. Regular moderate-intensity exercise is recommended for most cardiac patients, which has been demonstrated to provide an anti-inflammatory and antioxidant effect that improves immune function. EXPERT OPINION In Ramadan, many physiological changes occur during fasting, which brings about a balanced metabolic homeostasis of the body. In addition, Ramadan fasting is a nonpharmacologic means of decreasing CV risk factors. As Islam exempts Muslims from fasting if they are unwell; therefore, patients with the acute coronary syndrome (ACS), advanced heart failure (HF), recent percutaneous coronary intervention (PCI), or cardiac surgery should avoid fasting.
Collapse
Affiliation(s)
- Hifza Naz
- Medical Student, School of Medicine and Surgery, University of Milan Bicocca, Bergamo, Italy
| | - Rakhshan Haider
- Department of Medicine, Shifa International Hospital, Islamabad, Pakistan
| | - Haroon Rashid
- Department of Intensive care, Wythenshawe Hospital, Manchester, UK
| | | | - Jahanzeb Malik
- Department of Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi, Pakistan
| | | | - Uzma Ishaq
- Department of Hematology, Healthways Laboratories, Rawalpindi, Pakistan
| | - Roberto Trevisan
- Department of Endocrinology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| |
Collapse
|
32
|
Dysautonomia in Children with Post-Acute Sequelae of Coronavirus 2019 Disease and/or Vaccination. Vaccines (Basel) 2022; 10:vaccines10101686. [PMID: 36298551 PMCID: PMC9607162 DOI: 10.3390/vaccines10101686] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/05/2022] [Accepted: 10/07/2022] [Indexed: 11/05/2022] Open
Abstract
Long-term health problems such as fatigue, palpitations, syncope, and dizziness are well-known in patients after COVID-19 (post-acute sequelae of coronavirus (PASC)). More recently, comparable problems have been noticed after the SARS-CoV-2 vaccination (post-VAC). The pathophysiology of these problems is not well-understood. Methods: In 38 children and young adults, we tested if these health problems were related to dysautonomia in an active standing test (Group 1: 19 patients after COVID-19; Group 2: 12 patients with a breakthrough infection despite a vaccination; and Group 3: 7 patients after a vaccination without COVID-19). The data were compared with a control group of 47 healthy age-matched patients, as recently published. Results: All patients had a normal left ventricular function as measured by echocardiography. Significantly elevated diastolic blood pressure in all patient groups indicated a regulatory cardiovascular problem. Compared with the healthy control group, the patient groups showed significantly elevated heart rates whilst lying and standing, with significantly higher heart rate increases. The stress index was significantly enhanced in all patient groups whilst lying and standing. Significantly decreased pNN20 values, mostly whilst standing, indicated a lower vagus activity in all patient groups. The respiratory rates were significantly elevated in Groups 1 and 2. Conclusion: The uniform increase in the heart rates and stress indices, together with low pNN20 values, indicated dysautonomia in children with health problems after COVID-19 disease and/or vaccination. A total of 8 patients fulfilled the criteria of postural orthostatic tachycardia syndrome and 9 patients of an inappropriate sinus tachycardia, who were successfully treated with omega-3 fatty acid supplementation and pharmacotherapy.
Collapse
|
33
|
Imahori Y, Vetrano DL, Xia X, Grande G, Ljungman P, Fratiglioni L, Qiu C. Association of resting heart rate with cognitive decline and dementia in older adults: A population-based cohort study. Alzheimers Dement 2022; 18:1779-1787. [PMID: 34859936 DOI: 10.1002/alz.12495] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/09/2021] [Accepted: 09/15/2021] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Resting heart rate (RHR) predicts future risk for cardiovascular disease (CVD). However, longitudinal studies investigating the relationship of RHR with cognitive decline are scarce. METHODS This population-based cohort study included 2147 participants (age≥60) in SNAC-K who were free of dementia and regularly followed from 2001-2004 to 2013-2016. RHR was assessed with electrocardiogram. Dementia was diagnosed following the Diagnostic and Statistical Manual of Mental Disorders 4th Revision criteria. Global cognitive function was assessed using Mini-Mental State Examination (MMSE). Data were analyzed using Cox and linear mixed-effects models. RESULTS RHR≥80 (vs. 60-69) bpm was associated with a multi-adjusted hazard ratio of 1.55 (95% confidence interval 1.06-2.27) for dementia. The association remained significant after excluding participants with prevalent and incident CVDs. Similarly, RHR≥80 bpm was associated with a multi-adjusted β-coefficient of -0.13 (-0.21 to -0.04) for MMSE score. DISCUSSION Higher RHR is associated with increased risk for dementia and faster cognitive decline independent of CVDs in a general population of elderly people.
Collapse
Affiliation(s)
- Yume Imahori
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Davide L Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Centro Medicina dell'Invecchiamento, Fondazione Policlinico "A- Gemelli" IRCCS and Catholic University of Rome, Rome, Italy
| | - Xin Xia
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Giulia Grande
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.,Department of Cardiology, Danderyd Hospital, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Chengxuan Qiu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| |
Collapse
|
34
|
Cardiac Autonomic Neuropathy in Type 1 and 2 Diabetes: Epidemiology, Pathophysiology, and Management. Clin Ther 2022; 44:1394-1416. [DOI: 10.1016/j.clinthera.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 07/23/2022] [Accepted: 09/06/2022] [Indexed: 11/21/2022]
|
35
|
Toulgui E, Benzarti W, Rahmani C, Aissa S, Ghannouchi I, Knaz A, Sayhi A, Sellami S, Mahmoudi K, Jemni S, Gargouri I, Hayouni A, Ouanes W, Ammar A, Ben saad H. Impact of cardiorespiratory rehabilitation program on submaximal exercise capacity of Tunisian male patients with post-COVID19: A pilot study. Front Physiol 2022; 13:1029766. [PMID: 36246110 PMCID: PMC9555273 DOI: 10.3389/fphys.2022.1029766] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 09/12/2022] [Indexed: 12/12/2022] Open
Abstract
Post-COVID19 patients suffer from persistent respiratory, cardiovascular, neurological, and musculoskeletal health complaints such as dyspnea, chest pain/discomfort, and fatigue. In Tunisia, the potential benefits of a cardiorespiratory rehabilitation program (CRRP) after COVID19 remain unclear. The main aim of this study was to evaluate the impact of a CRRP on submaximal exercise capacity, evaluated through the 6-min walk test (6MWT) data in post-COVID19 Tunisian patients. This was a cross-sectional study including 14 moderate to severe COVID19 patients aged from 50 to 70 years. CRRP was performed after the end of patients’ hospitalization in COVID19 units for extensive or severe extents of COVID19. Dyspnea (modified medical research council), spirometry data, handgrip strength values, 6MWT data, and 6-min walk work (i.e., 6-min walk distance x weight) were evaluated 1-week pre-CRRP, and 1-week post-CRRP. CRRP included 12 sessions [3 sessions (70 min each)/week for 4 weeks]. Exercise-training included aerobic cycle endurance, strength training, and educational sessions. Comparing pre- and post- CRRP results showed significant improvements in the means±standard deviations of dyspnea by 1.79 ± 0.80 points (p < 0.001), forced expiratory volume in one second by 110 ± 180 ml (p = 0.04), 6-min walk distance by 35 ± 42 m (p = 0.01), 6-min walk work by 2,448 ± 3,925 mkg (p = 0.048), resting heart-rate by 7 ± 9 bpm (p = 0.02) and resting diastolic blood pressure by 6 ± 10 mmHg (p = 0.045). In Tunisia, CRRP seems to improve the submaximal exercise capacity of post-COVID19 patients, mainly the 6-min walk distance and work.
Collapse
Affiliation(s)
- Emna Toulgui
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Wafa Benzarti
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Chiraz Rahmani
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Sana Aissa
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Ines Ghannouchi
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse, Tunisia
| | - Asma Knaz
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | - Amani Sayhi
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse, Tunisia
| | - Sana Sellami
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse, Tunisia
| | - Khaoula Mahmoudi
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse, Tunisia
| | - Sonia Jemni
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Imene Gargouri
- Department of Pneumology, Farhat HACHED Hospital, Sousse, Tunisia
| | | | - Walid Ouanes
- Department of Physical Medicine and Rehabilitation, Sahloul Hospital, Sousse, Tunisia
| | - Achraf Ammar
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UPL, Paris Nanterre University, UFR STAPS, Nanterre, France
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- *Correspondence: Achraf Ammar,
| | - Helmi Ben saad
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse, Tunisia
| |
Collapse
|
36
|
Na Nongkhai MP, Huntula S, Kumar R, Narkkul U. Effects of an online yoga program on anthropometric parameters among overweight female students during the COVID-19 pandemic. Heliyon 2022; 8:e10661. [PMID: 36127920 PMCID: PMC9477786 DOI: 10.1016/j.heliyon.2022.e10661] [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: 03/02/2022] [Revised: 06/08/2022] [Accepted: 09/09/2022] [Indexed: 11/06/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) outbreak is a public health concern. However, stay-at-home regulations to prevent disease spread increased sedentary behavior with unintended adverse outcomes. Overweight is a major global health issue, and standard treatments have a poor track record of long-term effectiveness. The purpose of this study was to evaluate how online yoga affected participants who were overweight in terms of anthropometric measurements. The study, which was designed as a experimental study, enrolled sixty overweight adolescents. The participants were divided into two groups: a control group (n = 30) and an intervention group (n = 30) who performed an online yoga home exercise program comprising basic yoga practice with 15 poses and minimal rest periods on Monday Wednesday and Friday, from 5.00 to 5.45 pm for 12 weeks. The intensity of the exercise was 65–75 percent of maximum heart rate (MHR). Anthropometric parameters, including body weight (BW), body mass index (BMI), body circumference measurements (BCM), and resting heart rate (RHR) were assessed. All parameters were measured at weeks 0, 8, and 12. Within group and between group comparisons were performed. The results revealed improved BW, BMI, BCM, and RHR in the intervention group; the median BW and BMI of the intervention group was significantly decreased at week 12, and the BCM of the intervention group showed a significant decrease in the chest, waist, hip, and thigh. This declining trend started from week 8. This 12-week online yoga program decreased BW, BMI, BCM, and RHR, which indicates that practicing yoga at home is effective on anthropometric parameters and may be an alternative therapy for health promotion and controlling body weight during the COVID-19 pandemic. However, an appropriate and continuous exercise program must be followed.
Collapse
Affiliation(s)
- Marisa Poomiphak Na Nongkhai
- Department of Sports Science and Exercise, School of Medicine, Walailak University, Nakhon Si Thammarat 80160, Thailand.,Movement Science and Exercise Research Center, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Soontaraporn Huntula
- Department of Sports Science and Exercise, School of Medicine, Walailak University, Nakhon Si Thammarat 80160, Thailand
| | - Rajesh Kumar
- University College of Physical Education, Osmania University, Hyderabad, India
| | - Udomsak Narkkul
- Department of Medical Science, School of Medicine, Walailak University, Nakhon Si Thammarat 80160, Thailand.,Research Center in Tropical Pathobiology, Walailak University, Nakhon Si Thammarat 80160, Thailand
| |
Collapse
|
37
|
Mayuga KA, Fedorowski A, Ricci F, Gopinathannair R, Dukes JW, Gibbons C, Hanna P, Sorajja D, Chung M, Benditt D, Sheldon R, Ayache MB, AbouAssi H, Shivkumar K, Grubb BP, Hamdan MH, Stavrakis S, Singh T, Goldberger JJ, Muldowney JAS, Belham M, Kem DC, Akin C, Bruce BK, Zahka NE, Fu Q, Van Iterson EH, Raj SR, Fouad-Tarazi F, Goldstein DS, Stewart J, Olshansky B. Sinus Tachycardia: a Multidisciplinary Expert Focused Review. Circ Arrhythm Electrophysiol 2022; 15:e007960. [PMID: 36074973 PMCID: PMC9523592 DOI: 10.1161/circep.121.007960] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sinus tachycardia (ST) is ubiquitous, but its presence outside of normal physiological triggers in otherwise healthy individuals remains a commonly encountered phenomenon in medical practice. In many cases, ST can be readily explained by a current medical condition that precipitates an increase in the sinus rate, but ST at rest without physiological triggers may also represent a spectrum of normal. In other cases, ST may not have an easily explainable cause but may represent serious underlying pathology and can be associated with intolerable symptoms. The classification of ST, consideration of possible etiologies, as well as the decisions of when and how to intervene can be difficult. ST can be classified as secondary to a specific, usually treatable, medical condition (eg, pulmonary embolism, anemia, infection, or hyperthyroidism) or be related to several incompletely defined conditions (eg, inappropriate ST, postural tachycardia syndrome, mast cell disorder, or post-COVID syndrome). While cardiologists and cardiac electrophysiologists often evaluate patients with symptoms associated with persistent or paroxysmal ST, an optimal approach remains uncertain. Due to the many possible conditions associated with ST, and an overlap in medical specialists who see these patients, the inclusion of experts in different fields is essential for a more comprehensive understanding. This article is unique in that it was composed by international experts in Neurology, Psychology, Autonomic Medicine, Allergy and Immunology, Exercise Physiology, Pulmonology and Critical Care Medicine, Endocrinology, Cardiology, and Cardiac Electrophysiology in the hope that it will facilitate a more complete understanding and thereby result in the better care of patients with ST.
Collapse
Affiliation(s)
- Kenneth A. Mayuga
- Section of Cardiac Electrophysiology and Pacing, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH
| | - Artur Fedorowski
- Karolinska Institutet & Karolinska University Hospital, Stockholm, Sweden
| | - Fabrizio Ricci
- Department of Neuroscience, Imaging and Clinical Sciences, “G.d’Annunzio” University of Chieti-Pescara, Chieti Scalo, Italy
| | | | | | | | | | | | - Mina Chung
- Section of Cardiac Electrophysiology and Pacing, Department of Cardiovascular Medicine, Cleveland Clinic, Phoenix, AZ
| | - David Benditt
- University of Minnesota Medical School, Minneapolis, MN
| | | | - Mirna B. Ayache
- MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Hiba AbouAssi
- Division of Endocrinology, Metabolism, and Nutrition, Duke University Medical Center, Durham, NC
| | | | | | | | | | - Tamanna Singh
- Department of Cardiovascular Medicine, Cleveland Clinic, OH
| | | | - James A. S. Muldowney
- Vanderbilt University Medical Center &Tennessee Valley Healthcare System, Nashville Campus, Department of Veterans Affairs, Nashville, TN
| | - Mark Belham
- Cambridge University Hospitals NHS FT, Cambridge, UK
| | - David C. Kem
- University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Cem Akin
- University of Michigan, Ann Arbor, MI
| | | | - Nicole E. Zahka
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Qi Fu
- Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas & University of Texas Southwestern Medical Center, Dallas, TX
| | - Erik H. Van Iterson
- Section of Preventive Cardiology & Rehabilitation, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Miller Family Heart, Vascular & Thoracic Institute, Cleveland Clinic Cleveland, OH
| | - Satish R Raj
- Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | | | | | | |
Collapse
|
38
|
Groves AM, Price AN, Russell-Webster T, Jhaveri S, Yang Y, Battersby EE, Shahid S, Costa Vieira M, Hughes E, Miller F, Briley AL, Singh C, Seed PT, Chowienczyk PJ, Stern KWD, Cohen J, Pasupathy D, Edwards AD, Poston L, Taylor PD. Impact of maternal obesity on neonatal heart rate and cardiac size. Arch Dis Child Fetal Neonatal Ed 2022; 107:481-487. [PMID: 34789488 DOI: 10.1136/archdischild-2021-322860] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/29/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Maternal obesity may increase offspring risk of cardiovascular disease. We assessed the impact of maternal obesity on cardiac structure and function in newborns as a marker of fetal cardiac growth. METHODS Neonates born to mothers of healthy weight (body mass index (BMI) 20-25 kg/m2, n=56) and to mothers who were obese (BMI ≥30 kg/m2, n=31) underwent 25-minute continuous ECG recording and non-sedated, free-breathing cardiac MRI within 72 hours of birth. RESULTS Mean (SD) heart rate during sleep was higher in infants born to mothers who were versus were not obese (123 (12.6) vs 114 (9.8) beats/min, p=0.002). Heart rate variability during sleep was lower in infants born to mothers who were versus were not obese (SD of normal-to-normal R-R interval 34.6 (16.8) vs 43.9 (16.5) ms, p=0.05). Similar heart rate changes were seen during wakefulness. Left ventricular end-diastolic volume (2.35 (0.14) vs 2.54 (0.29) mL/kg, p=0.03) and stroke volume (1.50 (0.09) vs 1.60 (0.14), p=0.04) were decreased in infants born to mothers who were versus were not obese. There were no differences in left ventricular end-systolic volume, ejection fraction, output or myocardial mass between the groups. CONCLUSION Maternal obesity was associated with increased heart rate, decreased heart rate variability and decreased left ventricular volumes in newborns. If persistent, these changes may provide a causal mechanism for the increased cardiovascular risk in adult offspring of mothers with obesity. In turn, modifying antenatal and perinatal maternal health may have the potential to optimise long-term cardiovascular health in offspring.
Collapse
Affiliation(s)
- Alan M Groves
- Department of Pediatrics, The University of Texas at Austin Dell Medical School, Austin, Texas, USA
| | - Anthony N Price
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Tamarind Russell-Webster
- Women's and Children's Health, King's College London, London, UK
- Academic Women's Health, University of Bristol, Bristol, UK
| | - Simone Jhaveri
- Department of Pediatric Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Yang Yang
- Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ellie E Battersby
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Shiffa Shahid
- Women's and Children's Health, King's College London, London, UK
| | | | - Emer Hughes
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Faith Miller
- Women's and Children's Health, King's College London, London, UK
| | - Annette L Briley
- Women's and Children's Health, King's College London, London, UK
| | - Claire Singh
- Women's and Children's Health, King's College London, London, UK
| | - Paul T Seed
- Women's and Children's Health, King's College London, London, UK
| | | | - Kenan W D Stern
- Department of Pediatric Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jennifer Cohen
- Department of Pediatric Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Dharmintra Pasupathy
- Women's and Children's Health, King's College London, London, UK
- Department of Maternal and Fetal Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - A David Edwards
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Lucilla Poston
- Women's and Children's Health, King's College London, London, UK
| | - Paul D Taylor
- Women's and Children's Health, King's College London, London, UK
| |
Collapse
|
39
|
Hou CR, Olshansky B, Cortez D, Duval S, Benditt DG. Inappropriate sinus tachycardia: an examination of existing definitions. Europace 2022; 24:1655-1664. [DOI: 10.1093/europace/euac057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/10/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
Aims
Inappropriate sinus tachycardia (IST) is a syndrome characterized by an elevated sinus rate unassociated with known physiological, pathological, or pharmacological causes. Despite published consensus documents, IST definitions appear to vary in the literature. In this study, we reviewed IST publications to evaluate IST definition variability and ascertain the degree to which consensus definitions are being adopted.
Methods and results
English-language articles in PubMed, Ovid MEDLINE, Ovid Embase, and Google Scholar published from 1 January 1970 to 1 June 2021 with the title terms ‘inappropriate sinus tachycardia,’ ‘non-paroxysmal sinus tachycardia,’ or ‘permanent sinus tachycardia’ were searched. In each, the IST definition used, qualifying characteristics, and publications cited to support each definition were recorded. We identified 138 publications meeting the search criteria. Inappropriate sinus tachycardia definitions were provided in 114 of 138 articles (83%). A majority of definitions (92/114, 81%) used distinct heart rate (HR) thresholds. Among these, the most common threshold was ≥100 beats per minute (BPM) (75/92, 82%), mainly measured at rest (54/92, 59%). Most definitions (47/92, 51%) included a second criterion to qualify for IST; these were most often an HR threshold of 90 BPM measured over 24 h by ambulatory electrocardiogram (37/47, 79%). Diagnosis of exclusion was a common criterion (75/92, 82%) but symptom status was not (41/92, 45%). The 2015 Heart Rhythm Society IST consensus was commonly cited but adopted in only 37% of definitions published after 2015.
Conclusions
Inappropriate sinus tachycardia definitions in current literature are inconsistent, and professional society consensus IST definitions have, to date, had limited impact.
Collapse
Affiliation(s)
- Cody R Hou
- Cardiac Arrhythmia Center, Cardiovascular Division, University of Minnesota , Mail Code 508, 420 Delaware St SE, Minneapolis, MN 55455 , USA
| | - Brian Olshansky
- Department of Medicine, University of Iowa , Iowa City, IA 52242 , USA
| | - Daniel Cortez
- Division of Pediatric Cardiology, Department of Pediatrics, University of California Davis Medical Center , Sacramento, CA 95616 , USA
| | - Sue Duval
- Cardiac Arrhythmia Center, Cardiovascular Division, University of Minnesota , Mail Code 508, 420 Delaware St SE, Minneapolis, MN 55455 , USA
| | - David G Benditt
- Cardiac Arrhythmia Center, Cardiovascular Division, University of Minnesota , Mail Code 508, 420 Delaware St SE, Minneapolis, MN 55455 , USA
| |
Collapse
|
40
|
He K, Chen X, Shi Z, Shi S, Tian Q, Hu X, Song R, Bai K, Shi W, Wang J, Li H, Ding J, Geng S, Sheng X. Relationship of resting heart rate and blood pressure with all-cause and cardiovascular disease mortality. Public Health 2022; 208:80-88. [PMID: 35728416 DOI: 10.1016/j.puhe.2022.03.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/21/2022] [Accepted: 03/30/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES This study aimed to investigate associations of resting heart rate (RHR) and blood pressure (BP) with all-cause and cardiovascular disease (CVD) mortality. STUDY DESIGN A retrospective cohort study. METHODS A total of 67,028 Chinese participants aged ≥60 years were included in the analysis. RHR, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were evaluated according to quartiles ([41-69, 70-74, 75-79, 80-127 beats/min], [80-119, 120-129, 130-139, 140-238 mm Hg], and [40-70, 71-79, 80-84, 85-133 mm Hg]). Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause and CVD mortality with RHR, SBP, and DBP. Restricted cubic splines were used to evaluate the dose-response association. RESULTS During the 361,975 person-year follow-up, 9326 deaths were recorded, of which 5039 deaths were due to CVD. The risk of all-cause mortality was increased by 25% with the quartiles four vs quartile one of RHR (HR [95% CI]:1.25 [1.17-1.33]), and CVD mortality was increased by 32% (HR [95% CI]: 1.32 [1.22-1.44]). Similar results were observed when comparing the quartiles four vs quartile one of SBP with the risk of all-cause and CVD mortality (HRs [95% CIs]: 1.14 [1.07, 1.22] and 1.23 [1.12. 1.34]) and DBP with the risk of all-cause and CVD mortality (HRs [95% CIs]: 1.17 [1.11. 1.24] and 1.36 [1.26. 1.47]). We found linear associations of RHR, SBP, and DBP with all-cause and CVD mortality (Pnon-linearity >0.05), except for the approximately J-shaped association between DBP and all-cause mortality (Pnon-linearity = 0.008). There was a significant interaction of RHR and SBP with all-cause and CVD mortality (Pinteraction <0.05). CONCLUSIONS RHR and BP increased the risk of all-cause and CVD mortality, especially fast RHR combined with high SBP.
Collapse
Affiliation(s)
- K He
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - X Chen
- Department of Social Medicine and Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Z Shi
- Department of Pharmacy, Zhengzhou People's Hospital, Zhengzhou, Henan, People's Republic of China
| | - S Shi
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
| | - Q Tian
- Department of Social Medicine and Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - X Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - R Song
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - K Bai
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - W Shi
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - J Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - H Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - J Ding
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - S Geng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - X Sheng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| |
Collapse
|
41
|
Cardiovascular Signal Entropy Predicts All-Cause Mortality: Evidence from The Irish Longitudinal Study on Ageing (TILDA). ENTROPY 2022; 24:e24050676. [PMID: 35626560 PMCID: PMC9142113 DOI: 10.3390/e24050676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/04/2022] [Accepted: 05/09/2022] [Indexed: 11/17/2022]
Abstract
In this study, the relationship between cardiovascular signal entropy and the risk of seven-year all-cause mortality was explored in a large sample of community-dwelling older adults from The Irish Longitudinal Study on Ageing (TILDA). The hypothesis under investigation was that physiological dysregulation might be quantifiable by the level of sample entropy (SampEn) in continuously noninvasively measured resting-state systolic (sBP) and diastolic (dBP) blood pressure (BP) data, and that this SampEn measure might be independently predictive of mortality. Participants’ date of death up to 2017 was identified from official death registration data and linked to their TILDA baseline survey and health assessment data (2010). BP was continuously monitored during supine rest at baseline, and SampEn values were calculated for one-minute and five-minute sections of this data. In total, 4543 participants were included (mean (SD) age: 61.9 (8.4) years; 54.1% female), of whom 214 died. Cox proportional hazards regression models were used to estimate the hazard ratios (HRs) with 95% confidence intervals (CIs) for the associations between BP SampEn and all-cause mortality. Results revealed that higher SampEn in BP signals was significantly predictive of mortality risk, with an increase of one standard deviation in sBP SampEn and dBP SampEn corresponding to HRs of 1.19 and 1.17, respectively, in models comprehensively controlled for potential confounders. The quantification of SampEn in short length BP signals could provide a novel and clinically useful predictor of mortality risk in older adults.
Collapse
|
42
|
Changes in Heart Rate Variability and Post‐Exercise Blood Pressure from Manipulating Rest Intervals Between Sets of Resistance Training. J Hum Kinet 2022; 82:61-73. [PMID: 36196336 PMCID: PMC9465723 DOI: 10.2478/hukin-2022-0031] [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] [Indexed: 11/20/2022] Open
Abstract
The purpose of this study was to compare blood pressure and heart rate variability responses in physically active men after performing resistance training sessions with rest intervals of 1 min, 2 min and 3 min. Eighteen men (age, 21.6±1.1 years; body mass, 74.1±8.1 kg; body height, 175.3±7.1 cm) who performed 180min of physical activity per week participated in this study. After determining the 15RM loads for the squat, bench press, bent-over row and deadlift, participants performed a resistance training session. Participants performed three resistance training protocols in randomized counterbalanced order. Each experimental protocol comprised different rest intervals between sets of resistance training exercises (1min, 2min or 3min). During each experimental session, participants performed three sets with a 15RM load. Blood pressure and heart rate variability were measured before and for 2h after each session. The results demonstrated a greater blood pressure (p<0.05) reduction with a longer rest interval. There was no statistically significant difference in heart rate variability changes between groups. These results indicate that 2min and 3min rest intervals while using a 15RM load provide the best stimulus for a blood pressure reduction response after a resistance training session. Our findings suggest that strength and conditioning professionals should prescribe 2min or 3min rest intervals when resistance training is performed with a 15RM load if the aim is to obtain an acute reduction in blood pressure after a resistance training session.
Collapse
|
43
|
Prognostic Impact and Predictors of New-Onset Atrial Fibrillation in Heart Failure. Life (Basel) 2022; 12:life12040579. [PMID: 35455070 PMCID: PMC9025044 DOI: 10.3390/life12040579] [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: 03/18/2022] [Revised: 04/08/2022] [Accepted: 04/08/2022] [Indexed: 11/25/2022] Open
Abstract
Background: The prognostic impact and predictors of NOAF in HF patients are not fully elucidated. This study aims to determine whether new-onset atrial fibrillation (NOAF) affects patient outcome and investigate predictors of atrial fibrillation (AF) in acute heart failure (HF) patients using real-world data. Methods: The factors associated with NOAF in 2894 patients with sinus rhythm (SR) enrolled in the Korean Acute Heart Failure (KorAHF) registry were investigated. Survival was analyzed using AF as a time-dependent covariate. Relevant predictors of NOAF were analyzed using multivariate proportional hazards models. Results: Over 27.4 months, 187 patients developed AF. The median overall survival time was over 48 and 9.9 months for the SR and NOAF groups, respectively. Cox regression analysis with NOAF as a time-dependent covariate showed a higher risk of death among patients with NOAF. Multivariate Cox modeling showed that age, worsening HF, valvular heart disease (VHD), loop diuretics, lower heart rate, larger left atrium (LA) diameter, and elevated creatinine levels were independently associated with NOAF. Risk score indicated the number of independent predictors. The incidence of NOAF was 2.9%, 9.4%, and 21.8% in the low-risk, moderate-risk, and high-risk groups, respectively (p < 0.001). Conditional inference tree analysis identified worsening HF, heart rate, age, LA diameter, and VHD as discriminators. Conclusions: NOAF was associated with decreased survival in acute HF patients with SR. Age, worsening HF, VHD, loop diuretics, lower heart rate, larger LA diameter, and elevated creatinine could independently predict NOAF. This may be useful to risk-stratify HF patients at risk for AF.
Collapse
|
44
|
Peng X, Li Y, Wang X, Ruan Y, Liu N. Relationship Between Resting Heart Rate and Microalbuminuria in Adults With Hypertension: National Health and Nutrition Examination Survey 2009–2018. Front Cardiovasc Med 2022; 9:739113. [PMID: 35498047 PMCID: PMC9039360 DOI: 10.3389/fcvm.2022.739113] [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: 07/10/2021] [Accepted: 03/21/2022] [Indexed: 11/29/2022] Open
Abstract
Background The impact of elevated resting heart rate on early-stage renal dysfunction, manifesting as microalbuminuria, in hypertension is unclear. This study aimed to analyze the association between resting heart rate and microalbuminuria in patients with hypertension according to their blood pressure status. In addition, the effect of antihypertensive agents on this relationship was evaluated. Methods and Results We searched the National Health and Nutrition Examination Survey for eligible participants from 2009 to 2018. Data on key parameters such as age, sex, blood pressure, heart rate, albumin creatinine ratio, and medication were collected for analysis. Subsequently, participants were classified according to the heart rate quartile and blood pressure status for subgroups assessment. A total of 5,692 participants were enrolled in this study. After adjusting the confounding factors, there was a linear association between resting heart rate and microalbuminuria in patients with hypertension (OR 1.184 [per 1 SD]; 95% CI: 1.101, 1.274; P < 0.001). However, the association between elevated resting heart rate and microalbuminuria was not significant in patients with uncontrolled hypertension (OR 1.092 [per 1 SD]; 95% CI: 0.935, 1.275; P = 0.269). The OR of the indirect effect of β-blockers on the risk of microalbuminuria incidence through heart rate was 0.926 (95% CI: 0.895, 0.956), while the direct effect was 1.374 (95% CI: 1.138, 1.662, P = 0.010). Similarly, dihydropyridine calcium channel blockers were associated with a higher prevalence of microalbuminuria (OR 1.300, 95% CI: 1.058, 1.597, P = 0.013), but the association between non-dihydropyridine calcium channel blockers and microalbuminuria was not significant (OR 1.207, 95% CI: 0.737, 1.978, P = 0.454). Conclusion Elevated resting heart rate is associated with a high risk of microalbuminuria in untreated patients and patients with controlled hypertension. Although there is a linear association between heart rate and microalbuminuria, the use of β-blockers exhibits a significantly increase in the prevalence of microalbuminuria in hypertension. Likewise, dihydropyridine calcium channel blockers may increase the risk of microalbuminuria in hypertension.
Collapse
Affiliation(s)
- Xiaodong Peng
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, China
| | - Yukun Li
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, China
| | - Xuesi Wang
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, China
| | - Yanfei Ruan
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, China
| | - Nian Liu
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, China
- *Correspondence: Nian Liu
| |
Collapse
|
45
|
Frerich S, Malik R, Georgakis MK, Sinner MF, Kittner SJ, Mitchell BD, Dichgans M. Cardiac Risk Factors for Stroke: A Comprehensive Mendelian Randomization Study. Stroke 2022; 53:e130-e135. [PMID: 34911345 PMCID: PMC10510836 DOI: 10.1161/strokeaha.121.036306] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/05/2021] [Accepted: 11/15/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Observational studies suggest an association of stroke with cardiac traits beyond atrial fibrillation, the leading source of cardioembolism. However, controversy remains regarding a causal role of these traits in stroke pathogenesis. Here, we leveraged genetic data to systematically assess associations between cardiac traits and stroke risk using a Mendelian Randomization framework. METHODS We studied 66 cardiac traits including cardiovascular diseases, magnetic resonance imaging-derived cardiac imaging, echocardiographic imaging, and electrocardiographic measures, as well as blood biomarkers in a 2-sample Mendelian Randomization approach. Genetic predisposition to each trait was explored for associations with risk of stroke and stroke subtypes in data from the MEGASTROKE consortium (40 585 cases/406 111 controls). Using multivariable Mendelian Randomization, we adjusted for potential pleiotropic or mediating effects relating to atrial fibrillation, coronary artery disease, and systolic blood pressure. RESULTS As expected, we observed strong independent associations between genetic predisposition to atrial fibrillation and cardioembolic stroke and between genetic predisposition to coronary artery disease as a proxy for atherosclerosis and large-artery stroke. Our data-driven analyses further indicated associations of genetic predisposition to both heart failure and lower resting heart rate with stroke. However, these associations were explained by atrial fibrillation, coronary artery disease, and systolic blood pressure in multivariable analyses. Genetically predicted P-wave terminal force in V1, an electrocardiographic marker for atrial cardiopathy, was inversely associated with large-artery stroke. CONCLUSIONS Available genetic data do not support substantial effects of cardiac traits on the risk of stroke beyond known clinical risk factors. Our findings highlight the need to carefully control for confounding and other potential biases in studies examining candidate cardiac risk factors for stroke.
Collapse
Affiliation(s)
- Simon Frerich
- Institute for Stroke and Dementia Research (S.F., R.M., M.K.G., M.D.), University Hospital, LMU Munich, Germany
| | - Rainer Malik
- Institute for Stroke and Dementia Research (S.F., R.M., M.K.G., M.D.), University Hospital, LMU Munich, Germany
| | - Marios K. Georgakis
- Institute for Stroke and Dementia Research (S.F., R.M., M.K.G., M.D.), University Hospital, LMU Munich, Germany
| | - Moritz F. Sinner
- Department of Cardiology (M.F.S.), University Hospital, LMU Munich, Germany
- German Centre for Cardiovascular Research (DZHK), partner site: Munich Heart Alliance, Germany (M.F.S.)
| | | | - Braxton D. Mitchell
- Department of Medicine (B.D.M.), University of Maryland School of Medicine and Baltimore VAMC
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (S.F., R.M., M.K.G., M.D.), University Hospital, LMU Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Germany (M.D.)
- German Centre for Neurodegenerative Diseases (DZNE), Munich, Germany (M.D.)
| |
Collapse
|
46
|
Ma R, Gao J, Mao S, Wang Z. Association between heart rate and cardiovascular death in patients with coronary heart disease: A NHANES-based cohort study. Clin Cardiol 2022; 45:574-582. [PMID: 35352385 PMCID: PMC9045079 DOI: 10.1002/clc.23818] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 03/08/2022] [Accepted: 03/11/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Due to the lack of research, this study aimed to assess the association between the specific range of heart rate and cardiovascular (CV) death in coronary heart disease (CHD) patients. HYPOTHESIS Heart rate of 70-79 bpm may be associated with reduced risk of CV death in CHD patients. METHODS This retrospective cohort study collected the data of CHD patients from the eight cycles of the Health and Nutrition Examination Survey (NHANES). The included patients were divided into four groups: <60, 60-69, 70-79, and ≥80 bpm. The start of follow-up date was the mobile examination center date, the last follow-up date was December 31, 2015. The average follow-up time was 81.70 months, and the longest follow-up time was 200 months. Competing risk models were developed to evaluate the association between heart rate and CV death, with hazard ratios (HRs) and 95% confidence intervals (CIs) calculated. RESULTS A total of 1648 patients with CHD were included in this study. CHD patients at heart rate of <60 (HR, 1.35; 95% CI, 1.34-1.36), 60-69 (HR, 1.05; 95% CI, 1.04-1.06) or ≥80 (HR, 1.39; 95% CI, 1.38-1.41) bpm had a higher risk of CV death than those at heart rate of 70-79 bpm. CONCLUSIONS Heart rate of <70 or ≥80 bpm was associated with an elevated risk of CV death among CHD patients. Continuous monitoring of heart rate may help to screen for health risks and offer early interventions to corresponding patients.
Collapse
Affiliation(s)
- Ruicong Ma
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Jianbo Gao
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Shiyuan Mao
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Zhirong Wang
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| |
Collapse
|
47
|
Arrieta H, Rezola-Pardo C, Gil J, Kortajarena M, Zarrazquin I, Echeverria I, Mugica I, Limousin M, Rodriguez-Larrad A, Irazusta J. Effects of an individualized and progressive multicomponent exercise program on blood pressure, cardiorespiratory fitness, and body composition in long-term care residents: Randomized controlled trial. Geriatr Nurs 2022; 45:77-84. [PMID: 35339954 DOI: 10.1016/j.gerinurse.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/10/2022] [Accepted: 03/12/2022] [Indexed: 11/04/2022]
Abstract
This study analyzed the effects of an individualized and progressive multicomponent exercise program on blood pressure, cardiorespiratory fitness, and body composition in long-term care residents. This was a single-blind, multicenter, randomized controlled trial performed in 10 long-term care settings and involved 112 participants. Participants were randomly assigned to a control group or an intervention group. The control group participated in routine activities; the intervention group participated in a six-month individualized and progressive multicomponent exercise program focused on strength, balance, and walking recommendations. The intervention group maintained peak VO2, oxygen saturation, and resting heart rate, while the control group showed a significant decrease in peak VO2 and oxygen saturation and an increase in resting heart rate throughout the six-month period. Individualized and progressive multicomponent exercise programs comprising strength, balance, and walking recommendations appear to be effective in preventing cardiorespiratory fitness decline in older adults living in long-term care settings.
Collapse
Affiliation(s)
- Haritz Arrieta
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Begiristain Doktorea Pasealekua 105, E-20014 Donostia-San Sebastián, Gipuzkoa, Spain..
| | - Chloe Rezola-Pardo
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, E-48940 Leioa, Bizkaia, Spain
| | - Javier Gil
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, E-48940 Leioa, Bizkaia, Spain
| | - Maider Kortajarena
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Begiristain Doktorea Pasealekua 105, E-20014 Donostia-San Sebastián, Gipuzkoa, Spain
| | - Idoia Zarrazquin
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Begiristain Doktorea Pasealekua 105, E-20014 Donostia-San Sebastián, Gipuzkoa, Spain
| | - Iñaki Echeverria
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, E-48940 Leioa, Bizkaia, Spain.; Department of Physical Education and Sport, Faculty of Education and Sport, University of the Basque Country (UPV/EHU), Portal de Lasarte 71, E-01007 Vitoria-Gasteiz (Araba), Spain
| | - Itxaso Mugica
- Department of Nursing II, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Begiristain Doktorea Pasealekua 105, E-20014 Donostia-San Sebastián, Gipuzkoa, Spain
| | - Marta Limousin
- Uzturre Asistentzia Gunea, San Joan Kalea 4, E-20400 Tolosa (Gipuzkoa), Spain
| | - Ana Rodriguez-Larrad
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, E-48940 Leioa, Bizkaia, Spain
| | - Jon Irazusta
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, E-48940 Leioa, Bizkaia, Spain
| |
Collapse
|
48
|
Stress Management Intervention for Leaders Increases Nighttime SDANN: Results from a Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073841. [PMID: 35409525 PMCID: PMC8997599 DOI: 10.3390/ijerph19073841] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 02/01/2023]
Abstract
Stress management interventions aim to reduce the disease risk that is heightened by work stress. Possible pathways of risk reduction include improvements in the autonomous nervous system, which is indexed by the measurement of heart rate variability (HRV). A randomized controlled trial on improving stress management skills at work was conducted to investigate the effects of intervention on HRV. A total of 174 lower management employees were randomized into either the waiting list control group (CG) or the intervention group (IG) receiving a 2-day stress management training program and another half-day booster after four and six months. In the trial, 24 h HRV was measured at baseline and after 12 months. Heart rate (HR), root mean square of successive differences (RMSSD), standard deviation of normal-to-normal intervals (SDNN), and standard deviation of the average of normal-to-normal intervals (SDANN) were calculated for 24 h and nighttime periods. Age-adjusted multilevel mixed effects linear regressions with unstructured covariance, time as a random coefficient, and time × group interaction with the according likelihood-ratio tests were calculated. The linear mixed-effect regression models showed neither group effects between IG and CG at baseline nor time effects between baseline and follow-up for SDANN (24 h), SDNN (24 h and nighttime), RMSSD (24 h and nighttime), and HR (24 h and nighttime). Nighttime SDANN significantly improved in the intervention group (z = 2.04, p = 0.041) compared to the control group. The objective stress axis measures (SDANN) showed successful stress reduction due to the training. Nighttime SDANN was strongly associated with minimum HR. Though the effects were small and only visible at night, it is highly remarkable that 3 days of intervention achieved a measurable effect considering that stress is only one of many factors that can influence HR and HRV.
Collapse
|
49
|
Han S, Li Y, Song R, Gao H, Zhang W. Effect of Probiotics Supplementation on Heart Rate: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Front Nutr 2022; 9:829703. [PMID: 35392286 PMCID: PMC8982511 DOI: 10.3389/fnut.2022.829703] [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: 12/06/2021] [Accepted: 02/16/2022] [Indexed: 11/23/2022] Open
Abstract
Background and Aims Probiotics consumption lowers the risk of cardiovascular disease, but whether it affects heart rate (HR) remains controversial. Therefore, our study aimed to assess the chronotropic effects of probiotics on heartbeat via a meta-analysis of randomized clinical trials. Methods Relevant studies were identified by searching PubMed, Cochrane library, and Clinical Trials databases up to October 2021. Either a fixed-effects or a random-effects model was used to calculate the pooled effect sizes and 95% confidence intervals (CIs). Results This meta-analysis included 13 studies involving 16 interventional trial arms and 931 participants according to inclusion criteria. The overall pooled estimate showed that probiotics supplementation had a slight, but no significant reduction of 0.28 bpm (95% CI: −1.17, 0.60) on HR. Relatively high heterogeneity was observed among included trials (I2 = 80.8%, P heterogeneity < 0.001). Subgroup analysis displayed that probiotics supplementation significantly reduced HR by 2.94 bpm (95% CI: −5.06, −0.82) among participants with baseline HR ≥ 75 bpm, by 1.17 bpm (95% CI: −2.34, −0.00) with probiotics dose ≥1 × 1010 CFU/day, and by 1.43 bpm (95% CI: −2.69, −0.17) with multiple-strain intervention. Meta-regression analysis showed that baseline HR was a major potential effect modifier of probiotics supplementation on lowering HR. Conclusion Hitherto, the overall evidence in the literature was insufficient to support the notion that probiotics supplementation has a class effect on HR reduction. However, in subgroup analysis, probiotics reduced HR significantly in those who had higher baseline HR, received a higher dose or multiple strains of probiotics.
Collapse
Affiliation(s)
- Shufen Han
- School of Public Health, Hangzhou Normal University, Hangzhou, China
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
- *Correspondence: Shufen Han ;
| | - Yuezhen Li
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Ruijuan Song
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Hui Gao
- Prefecture Center for Disease Control and Prevention, Jiaxing, China
| | - Weiguo Zhang
- Independent Researcher, Irving, TX, United States
- Weiguo Zhang
| |
Collapse
|
50
|
Yuan W, Wu B, Lou M, Song B, Han X, Sheng F, Xu W. Identification of Risk Factors for Stroke in China: A Meta-Analysis of Prospective Cohort Studies. Front Neurol 2022; 13:847304. [PMID: 35370884 PMCID: PMC8972128 DOI: 10.3389/fneur.2022.847304] [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: 01/08/2022] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
This study aimed to identify independent risk factors for first occurrence of stroke in Chinese individuals based on prospective cohort studies. Forty prospective cohort studies assessing 1,984,552 individuals were selected for the final meta-analysis. The identified risk factors for stroke in the Chinese population included old age (RR = 1.86, 95%CI: 1.47–2.36), hypertension (RR = 2.76, 95%CI: 2.26–3.37), cardiovascular disease history (RR = 1.98, 95%CI: 1.06–3.69), chronic kidney disease (RR = 1.65, 95%CI: 1.36–2.01), diabetes mellitus (RR = 1.71, 95%CI: 1.34–2.18), metabolic syndrome (RR = 1.59, 95%CI: 1.33–1.90), hyperglycemia (RR = 1.49, 95% CI: 1.31–1.69), obesity (RR = 1.45, 95%CI: 1.29–1.63), smoking (RR = 1.42, 95% CI: 1.27–1.58), prolonged sleep time (> 7.5 h, RR = 1.44, 95%CI: 1.19–1.75), higher levels of triglyceride (RR = 1.19, 95%CI: 1.07-1.32), C-reactive protein (RR = 1.34, 95%CI: 1.07-1.69). High fruit-rich diet (RR = 0.68, 95%CI: 0.58-0.80) was associated with a lower risk of stroke. The spectrum and power of risk factors varied among different cohort inclusion years. These findings provide a comprehensive tool for the primary prevention of stroke in Chinese individuals.
Collapse
Affiliation(s)
- Weizhuang Yuan
- Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Wu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Min Lou
- Department of Neurology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China
| | - Bo Song
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiang Han
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Feng Sheng
- Medical Development, Amgen Biology Technology Consulting (Shanghai) Co., Ltd., Shanghai, China
| | - Weihai Xu
- Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Weihai Xu
| |
Collapse
|