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Aengevaeren VL, Claessen G, Eijsvogels TM. Coronary atherosclerosis in athletes: recent insights and clinical considerations. Br J Sports Med 2024; 58:574-576. [PMID: 38503469 DOI: 10.1136/bjsports-2023-107938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 03/21/2024]
Affiliation(s)
- Vincent L Aengevaeren
- Departments of Medical Biosciences and Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Guido Claessen
- Department of Cardiology, Hartcentrum Jessa Ziekenhuis, Hasselt, Belgium
- Department of Cardiovascular Diseases, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Thijs Mh Eijsvogels
- Department of Medical Biosciences, Radboud University Medical Center, Nijmegen, The Netherlands
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2
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Zhang X, Tang S, Wang R, Qian M, Ying X, Maciejewski ML. Hospital response to a new case-based payment system in China: the patient selection effect. Health Policy Plan 2024; 39:519-527. [PMID: 38581671 PMCID: PMC11095269 DOI: 10.1093/heapol/czae022] [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: 09/14/2023] [Revised: 03/06/2024] [Accepted: 03/27/2024] [Indexed: 04/08/2024] Open
Abstract
Providers have intended and unintended responses to payment reforms, such as China's new case-based payment system, i.e. Diagnosis-Intervention Packet (DIP) under global budget, that classified patients based on the combination of principal diagnosis and procedures. Our study explores the impact of DIP payment reform on hospital selection of patients undergoing total hip/knee arthroplasty (THA/TKA) or with arteriosclerotic heart disease (AHD) from July 2017 to June 2021 in a large city. We used a difference-in-differences approach to compare the changes in patient age, severity reflected by the Charlson Comorbidity Index (CCI), and a measure of treatment intensity [relative weight (RW)] in hospitals that were and were not subject to DIP incentives before and after the DIP payment reform in July 2019. Compared with non-DIP pilot hospitals, trends in patient age after the DIP reform were similar for DIP and non-DIP hospitals for both conditions, while differences in patient severity grew because severity in DIP hospitals increased more for THA/TKA (P = 0.036) or dropped in non-DIP hospitals for AHD (P = 0.011) following DIP reform. Treatment intensity (measured via RWs) for AHD patients in DIP hospitals increased 5.5% (P = 0.015) more than in non-DIP hospitals after payment reform, but treatment intensity trends were similar for THA/TKA patients in DIP and non-DIP hospitals. When the DIP payment reform in China was introduced just prior to the pandemic, hospitals subject to this reform responded by admitting sicker patients and providing more treatment intensity to their AHD patients. Policymakers need to balance between cost containment and the unintended consequences of prospective payment systems, and the DIP payment could also be a new alternative payment system for other countries.
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Affiliation(s)
- Xinyu Zhang
- School of Public Health, Fudan University, 130 Dong’an Road, Shanghai 200030, China
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC 27710, United States
| | - Shenglan Tang
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC 27710, United States
- Global Health Research Center, Duke Kunshan University, No. 8 Duke Avenue, Kunshan, Jiangsu 215316, China
- SingHealth Duke-NUS Global Health Institute, Duke-NUS, 8 College Road, Singapore 169857, Singapore
| | - Ruixin Wang
- School of Public Health, Fudan University, 130 Dong’an Road, Shanghai 200030, China
| | - Mengcen Qian
- School of Public Health, Fudan University, 130 Dong’an Road, Shanghai 200030, China
- Key Laboratory of Health Technology Assessment, National Health Commission (Fudan University), 130 Dong’an Road, Shanghai 200030, China
| | - Xiaohua Ying
- School of Public Health, Fudan University, 130 Dong’an Road, Shanghai 200030, China
- Key Laboratory of Health Technology Assessment, National Health Commission (Fudan University), 130 Dong’an Road, Shanghai 200030, China
| | - Matthew L Maciejewski
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System, 508 Fulton Street, Durham, NC 27705, United States
- Department of Population Health Sciences, Duke University, 215 Morris Street, Durham, NC 27701, United States
- Division of General Internal Medicine, Department of Medicine, Duke University, 40 Duke Medicine Circle, Durham, NC 27710, United States
- Duke-Margolis Health Policy Center, Duke University, 230 Science Drive, Durham, NC 27708, United States
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Xiao Z, Huang G, Li G, Wang H, Zheng X, Li Y, Gong F, Lv Y, Li J. No causal association between the volume of strenuous exercise and coronary atherosclerosis: a two-sample Mendelian randomization study. Front Cardiovasc Med 2024; 11:1344764. [PMID: 38725834 PMCID: PMC11079240 DOI: 10.3389/fcvm.2024.1344764] [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: 11/26/2023] [Accepted: 04/11/2024] [Indexed: 05/12/2024] Open
Abstract
Objective Several observational studies have shown that high-volume and high-intensity exercise training increases the prevalence and severity of coronary atherosclerosis, but the causal effect still remains uncertain. This study aims to explore the causal relationship between the volume of strenuous exercise (SE) and coronary atherosclerosis (CA) using the Mendelian randomization (MR) method. Method The exposure factors were two basic parameters of the volume of strenuous exercise (duration and frequency of strenuous exercise), the outcome factor was coronary atherosclerosis, and the relevant genetic loci were extracted from the summary data of the genome-wide association study (GWAS) as the instrumental variables, and MR analyses were performed using the inverse variance weighting (IVW) method, the weighted median method, and the MR-egger method. Sensitivity analyses were performed using heterogeneity analysis, pleiotropy analysis, and the "leave-one-out" method. The original results were tested using other coronary atherosclerosis data sets. Result IVW results showed no causal association between duration of strenuous exercise (DOSE) [OR = 0.9937, 95% CI (0.9847, 1.0028), P = 0.1757] and frequency of strenuous exercise (FOSE) in the last 4 weeks [OR = 0.9930, 95% CI (0.9808, 1.0054), P = 0.2660] and coronary atherosclerosis. All of the above results were validated with other coronary atherosclerosis data sets. Conclusion The present study supports that the causal association of duration and frequency of SE with CA was not found, and provides valuable insights into the choice of scientific and correct volume of SE to cardiac rehabilitation (CR).
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Affiliation(s)
- Zijie Xiao
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Guolin Huang
- The Second School of Clinic Medicine, Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Guanhong Li
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Huihui Wang
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiaoyu Zheng
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Yongchun Li
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- The Second School of Clinic Medicine, Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Fengying Gong
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Ying Lv
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jingjun Li
- Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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Li Y, Du L, Meng L, Lv C, Tian X. High expression of CASP1 induces atherosclerosis. Medicine (Baltimore) 2024; 103:e37616. [PMID: 38640260 PMCID: PMC11030018 DOI: 10.1097/md.0000000000037616] [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: 01/26/2024] [Revised: 02/17/2024] [Accepted: 02/23/2024] [Indexed: 04/21/2024] Open
Abstract
Atherosclerosis is a chronic, progressive vascular disease. The relationship between CASP1 gene expression and atherosclerosis remains unclear. The atherosclerosis dataset GSE132651 and GSE202625 profiles were downloaded from gene expression omnibus. Differentially expressed genes (DEGs) were screened. The construction and analysis of protein-protein interaction network, functional enrichment analysis, gene set enrichment analysis, and Comparative Toxicogenomics Database analysis were performed. Gene expression heatmap was drawn. TargetScan was used to screen miRNAs that regulate central DEG. 47 DEGs were identified. According to gene ontology analysis, they were mainly enriched in the regulation of stimulus response, response to organic matter, extracellular region, extracellular region, and the same protein binding. Kyoto Encyclopedia of Gene and Genome analysis results showed that the target cells were mainly enriched in the PI3K-Akt signaling pathway, Ras signaling pathway, and PPAR signaling pathway. In the enrichment project of Metascape, vascular development, regulation of body fluid levels, and positive regulation of cell motility can be seen in the gene ontology enrichment project. Eleven core genes (CASP1, NLRP3, MRC1, IRS1, PPARG, APOE, IL13, FGF2, CCR2, ICAM1, HIF1A) were obtained. IRS1, PPARG, APOE, FGF2, CCR2, and HIF1A genes are identified as core genes. Gene expression heatmap showed that CASP1 was highly expressed in atherosclerosis samples and low expressed in normal samples. NLRP3, MRC1, IRS1, PPARG, APOE, IL13, FGF2, CCR2, ICAM1, HIF1A were low expressed in atherosclerosis samples. CTD analysis showed that 5 genes (CASP1, NLRP3, CCR2, ICAM1, HIF1A) were found to be associated with pneumonia, inflammation, cardiac enlargement, and tumor invasiveness. CASP1 gene is highly expressed in atherosclerosis. The higher the CASP1 gene, the worse the prognosis.
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Affiliation(s)
- Yongchao Li
- Department of Cardiac Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Lihong Du
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
| | - Lingbing Meng
- Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Chao Lv
- Department of neurology, Pizhou Hospital Affiliated to Xuzhou Medical University, Pizhou People's Hospital, Pizhou, Jiangsu Province, China
| | - Xinping Tian
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China
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5
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Bu F, Qin X, Wang T, Li N, Zheng M, Wu Z, Ma K. Unlocking potential biomarkers bridging coronary atherosclerosis and pyrimidine metabolism-associated genes through an integrated bioinformatics and machine learning approach. BMC Cardiovasc Disord 2024; 24:148. [PMID: 38454353 PMCID: PMC10921789 DOI: 10.1186/s12872-024-03819-w] [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: 11/10/2023] [Accepted: 02/27/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND This study delves into the intricate landscape of atherosclerosis (AS), a chronic inflammatory disorder with significant implications for cardiovascular health. AS poses a considerable burden on global healthcare systems, elevating both mortality and morbidity rates. The pathological underpinnings of AS involve a marked metabolic disequilibrium, particularly within pyrimidine metabolism (PyM), a crucial enzymatic network central to nucleotide synthesis and degradation. While the therapeutic relevance of pyrimidine metabolism in diverse diseases is acknowledged, the explicit role of pyrimidine metabolism genes (PyMGs) in the context of AS remains elusive. Utilizing bioinformatics methodologies, this investigation aims to reveal and substantiate PyMGs intricately linked with AS. METHODS A set of 41 candidate PyMGs was scrutinized through differential expression analysis. GSEA and GSVA were employed to illuminate potential biological pathways and functions associated with the identified PyMGs. Simultaneously, Lasso regression and SVM-RFE were utilized to distill core genes and assess the diagnostic potential of four quintessential PyMGs (CMPK1, CMPK2, NT5C2, RRM1) in discriminating AS. The relationship between key PyMGs and clinical presentations was also explored. Validation of the expression levels of the four PyMGs was performed using the GSE43292 and GSE9820 datasets. RESULTS This investigation identified four PyMGs, with NT5C2 and RRM1 emerging as key players, intricately linked to AS pathogenesis. Functional analysis underscored their critical involvement in metabolic processes, including pyrimidine-containing compound metabolism and nucleotide biosynthesis. Diagnostic evaluation of these PyMGs in distinguishing AS showcased promising results. CONCLUSION In conclusion, this exploration has illuminated a constellation of four PyMGs with a potential nexus to AS pathogenesis. These findings unveil emerging biomarkers, paving the way for novel approaches to disease monitoring and progression, and providing new avenues for therapeutic intervention in the realm of atherosclerosis.
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Affiliation(s)
- Fanli Bu
- Dongying People's Hospital (Dongying Hospital of Shandong Provincial Hospital Group), Dongying, Shandong, 257091, People's Republic of China
| | - Xiao Qin
- Dongying People's Hospital (Dongying Hospital of Shandong Provincial Hospital Group), Dongying, Shandong, 257091, People's Republic of China
| | - Tiantian Wang
- Dongying People's Hospital (Dongying Hospital of Shandong Provincial Hospital Group), Dongying, Shandong, 257091, People's Republic of China
| | - Na Li
- Dongying People's Hospital (Dongying Hospital of Shandong Provincial Hospital Group), Dongying, Shandong, 257091, People's Republic of China
| | - Man Zheng
- Dongying People's Hospital (Dongying Hospital of Shandong Provincial Hospital Group), Dongying, Shandong, 257091, People's Republic of China
| | - Zixuan Wu
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Kai Ma
- Dongying People's Hospital (Dongying Hospital of Shandong Provincial Hospital Group), Dongying, Shandong, 257091, People's Republic of China.
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Chhatwal K, Deighton A, Dhir A, Kumar VV, Titus-Glover S, Shah D, Holt L. Digital tools in cardiac reperfusion pathways: A systematic review. Future Healthc J 2024; 11:100128. [PMID: 38689702 PMCID: PMC11059274 DOI: 10.7861/fhj.2023-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
With health and surgery increasingly aided by digital technologies, there exists a growing impetus to understand how such tools must integrate into existing clinical pathways to ensure a positive impact on patient and organisational outcomes. Consequently, this study sought to collate evidence on the use of digital technology in cardiac reperfusion surgeries. We systematically searched three scientific databases for relevant articles. In total, 1,092 articles were retrieved, with 126 screened using inclusion/exclusion criteria, and 21 selected for analysis. Articles reported on the use of virtual reality, mHealth and telehealth in cardiovascular reperfusion procedures, ranging from surgical training regimens to postoperative rehabilitation. Here, despite clinical advantages, limitations were highlighted, including cost, ineffective interfaces and extensive training needed to operate novel digital tools. Nevertheless with further development and input from patient stakeholders, many limitations look set to dematerialise and provide tangible improvements to the benefit of patients and hard-pressed health institutions.
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Affiliation(s)
| | - Alexander Deighton
- Foundation year 1 doctor, Homerton Healthcare NHS Foundation Trust, London, UK
| | - Abhay Dhir
- Foundation year 1 doctor, North Devon Healthcare NHS Foundation Trust, Exeter, UK
| | - Varun Vijay Kumar
- Medical student, Barts and the London School of Medicine and Dentistry, London, UK
| | - Sean Titus-Glover
- Medical student, Barts and the London School of Medicine and Dentistry, London, UK
| | - Darsh Shah
- Medical student, Barts and the London School of Medicine and Dentistry, London, UK
| | - Luke Holt
- Medical student, Barts and the London School of Medicine and Dentistry, London, UK
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7
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Cavallero S, Roustaei M, Satta S, Cho JM, Phan H, Baek KI, Blázquez-Medela AM, Gonzalez-Ramos S, Vu K, Park SK, Yokota T, Sumner J, Mack JJ, Sigmund CD, Reddy ST, Li R, Hsiai TK. Exercise mitigates flow recirculation and activates metabolic transducer SCD1 to catalyze vascular protective metabolites. SCIENCE ADVANCES 2024; 10:eadj7481. [PMID: 38354249 PMCID: PMC10866565 DOI: 10.1126/sciadv.adj7481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 01/11/2024] [Indexed: 02/16/2024]
Abstract
Exercise promotes pulsatile shear stress in the arterial circulation and ameliorates cardiometabolic diseases. However, exercise-mediated metabolic transducers for vascular protection remain under-investigated. Untargeted metabolomic analysis demonstrated that wild-type mice undergoing voluntary wheel running exercise expressed increased endothelial stearoyl-CoA desaturase 1 (SCD1) that catalyzes anti-inflammatory lipid metabolites, namely, oleic (OA) and palmitoleic acids (PA), to mitigate NF-κB-mediated inflammatory responses. In silico analysis revealed that exercise augmented time-averaged wall shear stress but mitigated flow recirculation and oscillatory shear index in the lesser curvature of the mouse aortic arch. Following exercise, endothelial Scd1-deleted mice (Ldlr-/- Scd1EC-/-) on high-fat diet developed persistent VCAM1-positive endothelium in the lesser curvature and the descending aorta, whereas SCD1 overexpression via adenovirus transfection mitigated endoplasmic reticulum stress and inflammatory biomarkers. Single-cell transcriptomics of the aorta identified Scd1-positive and Vcam1-negative endothelial subclusters interacting with other candidate genes. Thus, exercise mitigates flow recirculation and activates endothelial SCD1 to catalyze OA and PA for vascular endothelial protection.
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Affiliation(s)
- Susana Cavallero
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- Department of Medicine, VA Greater Los Angeles Health Care System, Los Angeles, CA, USA
| | - Mehrdad Roustaei
- Department of Bioengineering, School of Engineering and Applied Science, University of California, Los Angeles, CA, USA
| | - Sandro Satta
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- Department of Medicine, VA Greater Los Angeles Health Care System, Los Angeles, CA, USA
| | - Jae Min Cho
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- Department of Medicine, VA Greater Los Angeles Health Care System, Los Angeles, CA, USA
| | - Henry Phan
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
| | - Kyung In Baek
- Department of Bioengineering, School of Engineering and Applied Science, University of California, Los Angeles, CA, USA
| | - Ana M. Blázquez-Medela
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- Department of Medicine, VA Greater Los Angeles Health Care System, Los Angeles, CA, USA
| | - Sheila Gonzalez-Ramos
- Department of Bioengineering, School of Engineering and Applied Science, University of California, Los Angeles, CA, USA
| | - Khoa Vu
- Department of Bioengineering, School of Engineering and Applied Science, University of California, Los Angeles, CA, USA
| | - Seul-Ki Park
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
| | - Tomohiro Yokota
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- Department of Medicine, VA Greater Los Angeles Health Care System, Los Angeles, CA, USA
| | - Jennifer Sumner
- Department of Psychology, College of Life Sciences, University of California, Los Angeles, CA, USA
| | - Julia J. Mack
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
| | - Curt D. Sigmund
- Department of Physiology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Srinivasa T. Reddy
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- Department of Molecular and Medical Pharmacology, University of California, Los Angeles, CA, USA
| | - Rongsong Li
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- Department of Medicine, VA Greater Los Angeles Health Care System, Los Angeles, CA, USA
| | - Tzung K. Hsiai
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
- Department of Medicine, VA Greater Los Angeles Health Care System, Los Angeles, CA, USA
- Department of Bioengineering, School of Engineering and Applied Science, University of California, Los Angeles, CA, USA
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8
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Herraiz-Adillo Á, Ahlqvist VH, Higueras-Fresnillo S, Hedman K, Hagström E, Fortuin-de Smidt M, Daka B, Lenander C, Berglind D, Östgren CJ, Rådholm K, Ortega FB, Henriksson P. Physical fitness in male adolescents and atherosclerosis in middle age: a population-based cohort study. Br J Sports Med 2024; 58:bjsports-2023-107663. [PMID: 38355280 DOI: 10.1136/bjsports-2023-107663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVES To examine the associations between physical fitness in male adolescents and coronary and carotid atherosclerosis in middle age. METHODS This population-based cohort study linked physical fitness data from the Swedish Military Conscription Register during adolescence to atherosclerosis data from the Swedish CArdioPulmonary bioImage Study in middle age. Cardiorespiratory fitness was assessed using a maximal cycle-ergometer test, and knee extension muscular strength was evaluated through an isometric dynamometer. Coronary atherosclerosis was evaluated via Coronary Computed Tomography Angiography (CCTA) stenosis and Coronary Artery Calcium (CAC) scores, while carotid plaques were evaluated by ultrasound. The associations were analysed using multinomial logistic regression, adjusted (marginal) prevalences and restricted cubic splines. RESULTS The analysis included 8986 male adolescents (mean age 18.3 years) with a mean follow-up of 38.2 years. Physical fitness showed a reversed J-shaped association with CCTA stenosis and CAC, but no consistent association was observed for carotid plaques. After adjustments, compared with adolescents in the lowest tertile of cardiorespiratory fitness and muscular strength, those in the highest tertile had 22% (OR 0.78; 95% CI 0.61 to 0.99) and 26% (OR 0.74; 95% CI 0.58 to 0.93) lower ORs for severe (≥50%) coronary stenosis, respectively. The highest physical fitness group (high cardiorespiratory fitness and muscular strength) had 33% (OR 0.67; 95% CI 0.52 to 0.87) lower OR for severe coronary stenosis compared with those with the lowest physical fitness. CONCLUSION This study supports that a combination of high cardiorespiratory fitness and high muscular strength in adolescence is associated with lower coronary atherosclerosis, particularly severe coronary stenosis, almost 40 years later.
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Affiliation(s)
- Ángel Herraiz-Adillo
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Viktor H Ahlqvist
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Sara Higueras-Fresnillo
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Physical Education, Sport and Human Motricity, Universidad Autónoma de Madrid, Madrid, Spain
| | - Kristofer Hedman
- Department of Clinical Physiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Emil Hagström
- Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden
| | | | - Bledar Daka
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg Sahlgrenska Academy, Goteborg, Sweden
| | - Cecilia Lenander
- Department of Clinical Sciences in Malmö, Centre for Primary Health Care Research, Lund University, Lund, Sweden
| | - Daniel Berglind
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
| | - Carl Johan Östgren
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Centre of Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Karin Rådholm
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Francisco B Ortega
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS) and CIBEROBN Physiopathology of Obesity and Nutrition, University of Granada, Granada, Spain
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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9
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Chen K, Liu Y, Xu B, Ye T, Chen L, Wu G, Zong G. Relationship between the lymphocyte to C‑reactive protein ratio and coronary artery disease severity. Exp Ther Med 2024; 27:60. [PMID: 38234629 PMCID: PMC10790159 DOI: 10.3892/etm.2023.12348] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/23/2023] [Indexed: 01/19/2024] Open
Abstract
Coronary atherosclerosis is a chronic systemic inflammatory disease. Laboratory parameters such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune inflammation index (SII) have been used to assess inflammation degree and coronary artery disease (CAD) severity. The lymphocyte-to-C-reactive protein ratio (LCR) is a new SII. However, its relationship with CAD development and severity is unclear. A total of 1,107 patients (479 in control group, 628 in CAD group) underwent coronary angiography. The routine and biochemical indices of the venous blood of patients were assessed before coronary angiography. LCR, SII, NLR and PLR were calculated and statistical analyses were performed. Propensity score matching (PSM) and a logistic regression model were used to analyze the relationship between LCR and CAD. After the PSM, 384 pairs of patients with or without CAD were successfully matched. After the median binary classification of all indicators, uni- and multivariate logistic regression analyses showed that platelet count was an independent risk factor and LCR was an independent protective factor. Using the same method, in the coronary heart disease severity group, 212 pairs were successfully matched and NLR and PLR were independent risk factors, while LCR was an independent protective factor. In conclusion, LCR is an independent protective factor against CAD development and severity.
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Affiliation(s)
- Ke Chen
- Department of Cardiology, Wuxi Clinical College of Anhui Medical University, Wuxi, Jiangsu 214044, P.R. China
- Department of Cardiology, The 904th Hospital of Joint Logistic Support Force of People's Liberation Army, Wuxi, Jiangsu 214044, P.R. China
| | - Yehong Liu
- Department of Cardiology, Wuxi Clinical College of Anhui Medical University, Wuxi, Jiangsu 214044, P.R. China
- Department of Cardiology, The 904th Hospital of Joint Logistic Support Force of People's Liberation Army, Wuxi, Jiangsu 214044, P.R. China
| | - Baida Xu
- Department of Cardiology, Wuxi Clinical College of Anhui Medical University, Wuxi, Jiangsu 214044, P.R. China
- Department of Cardiology, The 904th Hospital of Joint Logistic Support Force of People's Liberation Army, Wuxi, Jiangsu 214044, P.R. China
| | - Ting Ye
- Department of Cardiology, Wuxi Clinical College of Anhui Medical University, Wuxi, Jiangsu 214044, P.R. China
- Department of Cardiology, The 904th Hospital of Joint Logistic Support Force of People's Liberation Army, Wuxi, Jiangsu 214044, P.R. China
| | - Liang Chen
- Department of Cardiology, Wuxi Clinical College of Anhui Medical University, Wuxi, Jiangsu 214044, P.R. China
- Department of Cardiology, The 904th Hospital of Joint Logistic Support Force of People's Liberation Army, Wuxi, Jiangsu 214044, P.R. China
| | - Gangyong Wu
- Department of Cardiology, Wuxi Clinical College of Anhui Medical University, Wuxi, Jiangsu 214044, P.R. China
- Department of Cardiology, The 904th Hospital of Joint Logistic Support Force of People's Liberation Army, Wuxi, Jiangsu 214044, P.R. China
| | - Gangjun Zong
- Department of Cardiology, Wuxi Clinical College of Anhui Medical University, Wuxi, Jiangsu 214044, P.R. China
- Department of Cardiology, The 904th Hospital of Joint Logistic Support Force of People's Liberation Army, Wuxi, Jiangsu 214044, P.R. China
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10
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Kunutsor SK, Laukkanen JA. Physical activity, exercise and adverse cardiovascular outcomes in individuals with pre-existing cardiovascular disease: a narrative review. Expert Rev Cardiovasc Ther 2024; 22:91-101. [PMID: 38488568 PMCID: PMC11057847 DOI: 10.1080/14779072.2024.2328644] [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: 10/14/2023] [Accepted: 03/06/2024] [Indexed: 03/28/2024]
Abstract
INTRODUCTION The evidence supporting the cardiovascular health benefits of physical activity and/or exercise training is well-established. While the role of physical activity in primary prevention is unequivocal, its significance in secondary prevention (among those with preexisting cardiovascular disease) is less definitive. Though guidelines universally recommend physical activity as part of the secondary preventive strategy, the empirical evidence underpinning these recommendations is not as robust as that for primary prevention. AREAS COVERED This review distills the body of available observational and interventional evidence on the relationship between physical activity, exercise, and adverse cardiovascular outcomes among those with preexisting cardiovascular disease. The postulated biologic mechanisms underlying the relationships, areas of prevailing uncertainty, and potential public health implications are also discussed. EXPERT OPINION A physical activity level of 500 MET-min/week (equivalent to 150 min of moderate-intensity physical activity or 75 min of vigorous-intensity physical activity or an equivalent combination) may be a minimum requirement for patients with preexisting CVD. However, to reap the maximum benefits of physical activity and also minimize adverse effects, physical activity and/or exercise regimens should be tailored to unique factors such as individual's baseline physical activity habits, cardiovascular health status and the specific nature of their cardiovascular disease.
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Affiliation(s)
- Setor K. Kunutsor
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Jari A. Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland
- Wellbeing Services County of Central Finland, Department of Medicine, Jyväskylä, Finland
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11
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Agbaje AO. Longitudinal Mediating Effect of Fat Mass and Lipids on Sedentary Time, Light PA, and MVPA with Inflammation in Youth. J Clin Endocrinol Metab 2023; 108:3250-3259. [PMID: 37310686 PMCID: PMC10655530 DOI: 10.1210/clinem/dgad354] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/19/2023] [Accepted: 06/09/2023] [Indexed: 06/14/2023]
Abstract
CONTEXT Inflammation has been associated with atherosclerosis and metabolic disorders in youth. Preventing inflammation through exposure to different accelerometer-based movement behaviors has not been longitudinally examined. OBJECTIVE This work aimed to examine the mediating role of fat mass, lipids, and insulin resistance on the associations of cumulative sedentary time (ST), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) with inflammation. METHODS From the Avon Longitudinal Study of Parents and Children, United Kingdom, 792 children with data on at least 2 time-point measures of accelerometer-based ST, LPA, and MVPA during age 11, 15, and 24 years follow-up clinic visits with complete high-sensitivity C-reactive protein (hsCRP) measures at age 15, 17, and 24 years were studied. Mediating associations were examined using structural equation models. When the magnitude of the association between the exposure and outcome is increased after including a third variable, suppression occurred but mediation if decreased. RESULTS Among 792 (58% female; mean [SD] age at baseline, 11.7 [0.2] years), ST increased, LPA decreased, and MVPA had a U-shaped increase while hsCRP increased during 13-year follow-up. Insulin resistance partly suppressed (23.5% suppression) the positive associations of ST with hsCRP among participants who were overweight/obese. Fat mass partly mediated (30% mediation) the negative associations of LPA with hsCRP. Fat mass had a 77% mediation effect on the negative associations of MVPA with hsCRP. CONCLUSION ST worsens inflammation, but increased LPA had a 2-fold inflammatory-lowering effect and was more resistant to the attenuating effect of fat mass compared with MVPA, and hence should be targeted in future interventions.
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Affiliation(s)
- Andrew O Agbaje
- Institute of Public Health and Clinical Nutrition, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, 70211 Kuopio, Finland
- Children’s Health and Exercise Research Centre, Department of Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter EX1 2LU, UK
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12
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Shi SY, Jia F, Wang MF, Zhou YF, Li JJ. Impacts of Non-alcoholic Fatty Liver Disease on Acute Coronary Syndrome: Evidence and Controversies. Curr Atheroscler Rep 2023; 25:751-768. [PMID: 37768409 PMCID: PMC10564833 DOI: 10.1007/s11883-023-01146-7] [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] [Accepted: 08/23/2023] [Indexed: 09/29/2023]
Abstract
PURPOSE OF REVIEW Acute coronary syndrome (ACS) and non-alcoholic fatty liver disease (NAFLD) are two clinically common disease entities that share numerous risk factors. This review aimed to discuss the impacts of NAFLD on ACS. RECENT FINDINGS In an era of improved control of traditional risk factors, the substantial burden of cardiometabolic abnormalities has caused widespread concern. NAFLD is considered the hepatic component of metabolic syndrome, which can exert an impact on human health beyond the liver. Accumulating studies have demonstrated that NAFLD is closely related to cardiovascular disease, especially coronary artery disease. Interestingly, although recent data have suggested an association between NAFLD and the incidence and outcomes of ACS, the results are not consistent. In this review, we comprehensively summarized evidence and controversies regarding whether NAFLD is a contributor to either the development of ACS or worse outcomes in patients with ACS. The potential pathophysiological and molecular mechanisms involved in the impacts of NAFLD on ACS were also elucidated.
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Affiliation(s)
- Shun-Yi Shi
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Fang Jia
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Meng-Fei Wang
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Ya-Feng Zhou
- Department of Cardiology, Suzhou Dushu Lake Hospital, Dushu Lake Hospital Affiliated to Soochow University, Medical Center of Soochow University, Suzhou, China
| | - Jian-Jun Li
- Cardio-Metabolism Center, Fu Wai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 10037, China.
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13
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Ahmadi MN, Hamer M, Gill JMR, Murphy M, Sanders JP, Doherty A, Stamatakis E. Brief bouts of device-measured intermittent lifestyle physical activity and its association with major adverse cardiovascular events and mortality in people who do not exercise: a prospective cohort study. Lancet Public Health 2023; 8:e800-e810. [PMID: 37777289 DOI: 10.1016/s2468-2667(23)00183-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND Guidelines emphasise the health benefits of bouts of physical activity of any duration. However, the associations of intermittent lifestyle physical activity accumulated through non-exercise with mortality and major adverse cardiovascular events (MACE) remain unclear. We aimed to examine the associations of bouts of moderate-to-vigorous intermittent lifestyle physical activity (MV-ILPA) and the proportion of vigorous activity contributing within these bouts with mortality and MACE. METHODS In this prospective cohort study, we used data from the UK Biobank on adults who do not exercise (ie, those who did not report leisure-time exercise) who had wrist-worn accelerometry data available. Participants were followed up until Nov 30, 2022, with the outcome of interest of all-cause mortality obtained through linkage with NHS Digital of England and Wales, and the NHS Central Register and National Records of Scotland, and MACE obtained from inpatient hospitalisation data provided by the Hospital Episode Statistics for England, the Patient Episode Database for Wales, and the Scottish Morbidity Record for Scotland. MV-ILPA bouts were derived using a two-level Random Forest classifier and grouped as short (<1 min), medium (1 to <3 min; 3 to <5 min), and long (5 to <10 min). We further examined the dose-response relationship of the proportion of vigorous physical activity contributing to the MV-ILPA bout. FINDINGS Between June 1, 2013, and Dec 23, 2015, 103 684 Biobank participants wore an accelerometer on their wrist. 25 241 adults (mean age 61·8 years [SD 7·6]), of whom 14 178 (56·2%) were women, were included in our analysis of all-cause mortality. During a mean follow-up duration of 7·9 years (SD 0·9), 824 MACE and 1111 deaths occurred. Compared with bouts of less than 1 min, mortality risk was lower for bouts of 1 min to less than 3 min (hazard ratio [HR] 0·66 [0·53-0·81]), 3 min to less than 5 min (HR 0·56 [0·46-0·69]), and 5 to less than 10 min (HR 0·48 [0·39-0·59]). Similarly, compared with bouts of less than 1 min, risk of MACE was lower for bouts of 1 min to less than 3 min (HR 0·71 [0·54-0·93]), 3 min to less than 5 min (0·62 [0·48-0·81]), and 5 min to less than 10 min (0·59 [0·46-0·76]). Short bouts (<1 min) were associated with lower MACE risk only when bouts were comprised of at least 15% vigorous activity. INTERPRETATION Intermittent non-exercise physical activity was associated with lower mortality and MACE. Our results support the promotion of short intermittent bouts of non-exercise physical activity of moderate-to-vigorous intensity to improve longevity and cardiovascular health among adults who do not habitually exercise in their leisure time. FUNDING Australian National Health, Medical Research Council, and Wellcome Trust.
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Affiliation(s)
- Matthew N Ahmadi
- Mackenzie Wearables Research Hub, Charles Perkins Centre and School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
| | - Mark Hamer
- Institute of Sport, Exercise and Health, Division of Surgery and Interventional Science, University College London, London, UK
| | - Jason M R Gill
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Marie Murphy
- Centre for Exercise Medicine, Physical Activity and Health, Sports and Exercise Sciences Research Institute, Ulster University, Newtownabbey, UK
| | - James P Sanders
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, UK
| | - Aiden Doherty
- Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Emmanuel Stamatakis
- Mackenzie Wearables Research Hub, Charles Perkins Centre and School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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14
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Jia F, Chen Y, Xin G, Li L, Liu Z, Xu S, Gao J, Meng H, Shi Y, Ma Y, Li L, Fu J. Shuangshen Ningxin capsule alleviates myocardial ischemia-reperfusion injury in miniature pigs by modulating mitophagy: network pharmacology and experiments in vivo. Chin Med 2023; 18:120. [PMID: 37730607 PMCID: PMC10510173 DOI: 10.1186/s13020-023-00810-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/20/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Myocardial ischemia/reperfusion injury (MI/RI) is involved in a variety of pathological states for which there is no effective treatment exists. Shuangshen Ningxin (SSNX) capsule which is developed by Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine has been demonstrated to alleviate MI/RI, but its mechanism remains to be further elucidated. METHODS The MI/RI miniature pigs model was constructed to assess the pharmacodynamics of SSNX by blocking the proximal blood flow of the left anterior descending branch of the cardiac coronary artery through an interventional balloon. The principal chemical compounds and potential targets of SSNX were screened by HPLC-MS and SwissTargetPrediction. The targets of MI/RI were identified based on Online Mendelian Inheritance in Man (OMIM) and GeneCards. Cytoscape 3.9.0 was applied to construct a protein-protein interaction (PPI) network, and Gene Ontology (GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed using metascape. To further validate the mechanism of SSNX, Molecular docking, Transmission electron microscopy, and Western blot analysis were used to test the effectiveness of targets in related pathways. RESULTS Our results indicated that SSNX significantly improved cardiac function, attenuated myocardial I/R injury. Through network analysis, a total of 15 active components and 201 targets were obtained from SSNX, 75 of which are potential targets for the treatment of MI/RI. KEGG and MCODE analysis showed that SSNX is involved in the mitophagy signaling pathway, and ginsenoside Rg1, ginsenoside Rb1 and ginsenoside Rb2 are key components associated with the mitophagy. Further experimental results proved that SSNX protected mitochondrial structure and function, and significantly reduced the expression of mitophagy-related proteins PTEN-induced putative kinase 1 (PINK1), Parkin, FUN14 domain containing 1 (FUNDC1) and Bcl-2/E1B-19 kDa interacting protein 3 (BNIP3) in MI/RI miniature pigs. CONCLUSION In our study, the integration of network pharmacology and experiments in vivo demonstrated that SSNX interfered with MI/RI by inhibiting mitophagy.
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Affiliation(s)
- Feifan Jia
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Yuanyuan Chen
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Gaojie Xin
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Lingmei Li
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Zixin Liu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Sujuan Xu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Jiaming Gao
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Hongxu Meng
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Yue Shi
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Yanlei Ma
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China
| | - Lei Li
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China.
| | - Jianhua Fu
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, Chinese Academy of Chinese Medical Sciences, Beijing, China.
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15
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BERGE KRISTIAN, AENGEVAEREN VINCENTL, MOSTERD AREND, VELTHUIS BIRGITTAK, LYNGBAKKEN MAGNUSN, OMLAND TORBJØRN, SCHALKWIJK CASPERG, EIJSVOGELS THIJSMH. Plasma Advanced Glycation End Products and Dicarbonyl Compounds Are Not Associated with Coronary Atherosclerosis in Athletes. Med Sci Sports Exerc 2023; 55:1143-1150. [PMID: 36849122 PMCID: PMC10241437 DOI: 10.1249/mss.0000000000003152] [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] [Indexed: 03/01/2023]
Abstract
PURPOSE Coronary atherosclerosis is the leading cause of sudden death among athletes >35 yr old, but current cardiovascular risk prediction algorithms have not been validated for athletes. Advanced glycation end products (AGE) and dicarbonyl compounds have been associated with atherosclerosis and rupture-prone plaques in patients and ex vivo studies. The detection of AGE and dicarbonyl compounds might be a novel screening tool for high-risk coronary atherosclerosis in older athletes. METHODS Concentrations of three different AGE and the dicarbonyl compounds methylglyoxal, glyoxal, and 3-deoxyglucosone were measured in plasma with ultraperformance liquid chromatography tandem mass spectrometry in athletes from the Measuring Athletes' Risk of Cardiovascular Events 2 study cohort. Coronary plaques, plaque characteristics (calcified, noncalcified or mixed), and coronary artery calcium (CAC) scores were assessed with coronary computed tomography, and potential associations with AGE and dicarbonyl compounds were analyzed using linear and logistic regression. RESULTS A total of 289 men were included (60 [quartiles 1-3 = 56-66] yr old, body mass index = 24.5 [22.9-26.6] kg·m -2 ), with a weekly exercise volume of 41 (25-57) MET-hours. Coronary plaques were detected in 241 participants (83%), with a dominant plaque type of calcified plaques in 42%, noncalcified plaques in 12% and mixed plaques in 21%. No AGE or dicarbonyl compounds were associated with total number of plaques or any of the plaque characteristics in adjusted analyses. Similarly, AGE and dicarbonyl compounds were not associated with CAC score. CONCLUSIONS Concentrations of plasma AGE and dicarbonyl compounds do not predict the presence of coronary plaques, plaque characteristics or CAC scores, in middle-age and older athletes.
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Affiliation(s)
- KRISTIAN BERGE
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, THE NETHERLANDS
- Division of Medicine, Department of Cardiology, Akershus University Hospital, Lørenskog, NORWAY
- K.G. Jebsen Center for Cardiac Biomarkers, Institute of Clinical Medicine, University of Oslo, Oslo, NORWAY
| | - VINCENT L. AENGEVAEREN
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, THE NETHERLANDS
| | - AREND MOSTERD
- Department of Cardiology, Meander Medical Center, Amersfoort, THE NETHERLANDS
| | | | - MAGNUS N. LYNGBAKKEN
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, THE NETHERLANDS
- Division of Medicine, Department of Cardiology, Akershus University Hospital, Lørenskog, NORWAY
| | - TORBJØRN OMLAND
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, THE NETHERLANDS
- Division of Medicine, Department of Cardiology, Akershus University Hospital, Lørenskog, NORWAY
| | - CASPER G. SCHALKWIJK
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, University Hospital Maastricht, Maastricht, THE NETHERLANDS
| | - THIJS M. H. EIJSVOGELS
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, THE NETHERLANDS
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16
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Schake MA, McCue IS, Curtis ET, Ripperda TJ, Harvey S, Hackfort BT, Fitzwater A, Chatzizisis YS, Kievit FM, Pedrigi RM. Restoration of normal blood flow in atherosclerotic arteries promotes plaque stabilization. iScience 2023; 26:106760. [PMID: 37235059 PMCID: PMC10206490 DOI: 10.1016/j.isci.2023.106760] [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: 01/23/2023] [Revised: 03/23/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
Blood flow is a key regulator of atherosclerosis. Disturbed blood flow promotes atherosclerotic plaque development, whereas normal blood flow protects against plaque development. We hypothesized that normal blood flow is also therapeutic, if it were able to be restored within atherosclerotic arteries. Apolipoprotein E-deficient (ApoE-/-) mice were initially instrumented with a blood flow-modifying cuff to induce plaque development and then five weeks later the cuff was removed to allow restoration of normal blood flow. Plaques in decuffed mice exhibited compositional changes that indicated increased stability compared to plaques in mice with the cuff maintained. The therapeutic benefit of decuffing was comparable to atorvastatin and the combination had an additive effect. In addition, decuffing allowed restoration of lumen area, blood velocity, and wall shear stress to near baseline values, indicating restoration of normal blood flow. Our findings demonstrate that the mechanical effects of normal blood flow on atherosclerotic plaques promote stabilization.
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Affiliation(s)
- Morgan A. Schake
- Department of Mechanical and Materials Engineering, University of Nebraska-Lincoln, Lincoln, NE 68588, USA
| | - Ian S. McCue
- Department of Mechanical and Materials Engineering, University of Nebraska-Lincoln, Lincoln, NE 68588, USA
| | - Evan T. Curtis
- Department of Biological Systems Engineering, University of Nebraska-Lincoln, Lincoln, NE 68583, USA
| | - Thomas J. Ripperda
- Department of Mechanical and Materials Engineering, University of Nebraska-Lincoln, Lincoln, NE 68588, USA
| | - Samuel Harvey
- Department of Mechanical and Materials Engineering, University of Nebraska-Lincoln, Lincoln, NE 68588, USA
| | - Bryan T. Hackfort
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Anna Fitzwater
- Institutional Animal Care Program, University of Nebraska-Lincoln, Lincoln, NE 68583, USA
| | - Yiannis S. Chatzizisis
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE 68198, USA
- Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Forrest M. Kievit
- Department of Biological Systems Engineering, University of Nebraska-Lincoln, Lincoln, NE 68583, USA
| | - Ryan M. Pedrigi
- Department of Mechanical and Materials Engineering, University of Nebraska-Lincoln, Lincoln, NE 68588, USA
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE 68198, USA
- Nebraska Center for Integrated Biomolecular Communication, University of Nebraska-Lincoln, Lincoln, NE 68588, USA
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17
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Perry AS, Dooley EE, Master H, Spartano NL, Brittain EL, Gabriel KP. Physical Activity Over the Lifecourse and Cardiovascular Disease. Circ Res 2023; 132:1725-1740. [PMID: 37289900 PMCID: PMC10254078 DOI: 10.1161/circresaha.123.322121] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Despite improvements in cardiovascular care in recent decades, cardiovascular disease (CVD) remains a leading cause of death worldwide. At its core, CVD is a largely preventable disease with diligent risk factor management and early detection. As highlighted in the American Heart Association's Life's Essential 8, physical activity plays a central role in CVD prevention at an individual and population level. Despite pervasive knowledge of the numerous cardiovascular and noncardiovascular health benefits of physical activity, physical activity has steadily decreased over time and unfavorable changes in physical activity occur throughout people's lives. Here, we use a lifecourse framework to examine the evidence reporting on the association of physical activity with CVD. From in utero to older adults, we review and discuss the evidence detailing how physical activity may prevent incident CVD and mitigate CVD-related morbidity and death across all life stages.
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Affiliation(s)
- Andrew S. Perry
- Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Erin E. Dooley
- Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Hiral Master
- Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Nicole L. Spartano
- Section of Endocrinology, Diabetes, Nutrition, and Weight Management, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Evan L. Brittain
- Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Kelley Pettee Gabriel
- Department of Epidemiology, The University of Alabama at Birmingham, Birmingham, AL, USA
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18
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Robbins JM, Gerszten RE. Exercise, exerkines, and cardiometabolic health: from individual players to a team sport. J Clin Invest 2023; 133:168121. [PMID: 37259917 DOI: 10.1172/jci168121] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Exercise confers numerous salutary effects that extend beyond individual organ systems to provide systemic health benefits. Here, we discuss the role of exercise in cardiovascular health. We summarize major findings from human exercise studies in cardiometabolic disease. We next describe our current understanding of cardiac-specific substrate metabolism that occurs with acute exercise and in response to exercise training. We subsequently focus on exercise-stimulated circulating biochemicals ("exerkines") as a paradigm for understanding the global health circuitry of exercise, and discuss important concepts in this emerging field before highlighting exerkines relevant in cardiovascular health and disease. Finally, this Review identifies gaps that remain in the field of exercise science and opportunities that exist to translate biologic insights into human health improvement.
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Affiliation(s)
- Jeremy M Robbins
- Division of Cardiovascular Medicine and
- CardioVascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Robert E Gerszten
- Division of Cardiovascular Medicine and
- CardioVascular Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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19
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Zhang Z, Zheng M, Lei H, Jiang Z, Chen Y, He H, Zhao G, Huang H. A clinical study of the correlation between metabolic-associated fatty liver disease and coronary plaque pattern. Sci Rep 2023; 13:7224. [PMID: 37142746 PMCID: PMC10160090 DOI: 10.1038/s41598-023-34462-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/30/2023] [Indexed: 05/06/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome (MetS) and has been correlated with coronary atherosclerosis (CAS). Since NAFLD was renamed metabolic-associated fatty liver disease(MAFLD) in 2020, no studies have evaluated the correlation between MAFLD and CAS. The aim of this study was to evaluate the relationship between MAFLD and CAS. A total of 1330 patients underwent continuous coronary computed tomography angiography (CCTA) and abdominal ultrasound as part of a routine physical examination. Ultrasonography was used to assess fatty liver, and CCTA was used to assess coronary artery plaques, degree of stenosis, and diseased blood vessels. Univariate and multivariate logistic regression analyses were performed with plaque type and degree of stenosis as dependent variables and MAFLD and traditional cardiovascular risk factors as independent variables to analyze the correlation between MAFLD and CAS. Among the 1164 patients, 680 (58.4%) were diagnosed with MAFLD through a combination of ultrasound and auxiliary examinations. Compared with the non-MAFLD group, the MAFLD group had more cardiovascular risk factors,and the MAFLD group had more likely to have coronary atherosclerosis, coronary stenosis and multiple coronary artery stenosis.In the univariate logistic regression, MAFLD was significantly correlated with overall plaque, calcified plaques, noncalcified plaques, mixed plaques,and significant stenosis in the coronary arteries.(p < 0.05). After adjusting for cardiovascular risk factors , MAFLD was correlated with noncalcified plaques (1.67; 95% confidence interval (CI) 1.15-2.43; p = 0.007) and mixed plaques (1.54; 95% CI 1.10-2.16; p = 0.011). In this study, MAFLD group had more cardiovascular risk factors, MAFLD was correlated with coronary atherosclerosis,and significant stenosis.Further study found independent associations between MAFLD and noncalcified plaques and mixed plaques, which suggest a clinically relevant link between MAFLD and coronary atherosclerosis.
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Affiliation(s)
- Zhijiao Zhang
- Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Avenue, Wuhua District, Kunming City, 650000, China
| | - Mengyao Zheng
- Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Avenue, Wuhua District, Kunming City, 650000, China
| | - Hongtao Lei
- Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Avenue, Wuhua District, Kunming City, 650000, China
| | - Zimeng Jiang
- Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Avenue, Wuhua District, Kunming City, 650000, China
| | - Yuhang Chen
- Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Avenue, Wuhua District, Kunming City, 650000, China
| | - Haiyu He
- Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Avenue, Wuhua District, Kunming City, 650000, China
| | - Gongfang Zhao
- Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Avenue, Wuhua District, Kunming City, 650000, China.
| | - Hua Huang
- Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University, No. 374, Dianmian Avenue, Wuhua District, Kunming City, 650000, China
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20
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Cavallero S, Roustaei M, Satta S, Cho JM, Phan H, Baek KI, Blázquez-Medela AM, Gonzalez-Ramos S, Vu K, Park SK, Yokota T, Sumner JA, Mack JJ, Sigmund CD, Reddy ST, Li R, Hsiai TK. Exercise Mitigates Flow Recirculation and Activates Mechanosensitive Transcriptome to Uncover Endothelial SCD1-Catalyzed Anti-Inflammatory Metabolites. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.02.539172. [PMID: 37205360 PMCID: PMC10187200 DOI: 10.1101/2023.05.02.539172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Exercise modulates vascular plasticity in multiple organ systems; however, the metabolomic transducers underlying exercise and vascular protection in the disturbed flow-prone vasculature remain under-investigated. We simulated exercise-augmented pulsatile shear stress (PSS) to mitigate flow recirculation in the lesser curvature of the aortic arch. When human aortic endothelial cells (HAECs) were subjected to PSS ( τ ave = 50 dyne·cm -2 , ∂τ/∂t = 71 dyne·cm -2 ·s -1 , 1 Hz), untargeted metabolomic analysis revealed that Stearoyl-CoA Desaturase (SCD1) in the endoplasmic reticulum (ER) catalyzed the fatty acid metabolite, oleic acid (OA), to mitigate inflammatory mediators. Following 24 hours of exercise, wild-type C57BL/6J mice developed elevated SCD1-catalyzed lipid metabolites in the plasma, including OA and palmitoleic acid (PA). Exercise over a 2-week period increased endothelial SCD1 in the ER. Exercise further modulated the time-averaged wall shear stress (TAWSS or τ ave) and oscillatory shear index (OSI ave ), upregulated Scd1 and attenuated VCAM1 expression in the disturbed flow-prone aortic arch in Ldlr -/- mice on high-fat diet but not in Ldlr -/- Scd1 EC-/- mice. Scd1 overexpression via recombinant adenovirus also mitigated ER stress. Single cell transcriptomic analysis of the mouse aorta revealed interconnection of Scd1 with mechanosensitive genes, namely Irs2 , Acox1 and Adipor2 that modulate lipid metabolism pathways. Taken together, exercise modulates PSS ( τ ave and OSI ave ) to activate SCD1 as a metabolomic transducer to ameliorate inflammation in the disturbed flow-prone vasculature.
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21
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Zhong X, He R, You S, Liu B, Wang X, Mao J. The Roles of Aerobic Exercise and Folate Supplementation in Hyperhomocysteinemia-Accelerated Atherosclerosis. ACTA CARDIOLOGICA SINICA 2023; 39:309-318. [PMID: 36911543 PMCID: PMC9999187 DOI: 10.6515/acs.202303_39(2).20221027a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 10/27/2022] [Indexed: 03/14/2023]
Abstract
Background Hyperhomocysteinemia (HHcy) is an independent risk factor for atherosclerosis. Effective interventions to reduce HHcy-accelerated atherosclerosis are required. Objectives This study aimed to investigate the effects of aerobic exercise (AE) and folate (FA) supplementation on plasma homocysteine (Hcy) level and atherosclerosis development in a mouse model. Methods Six-week-old female apoE-/- mice were grouped into five groups (N = 6-8): HHcy (1.8 g/L DL-homocysteine (DL-Hcy) in drinking water), HHcy + AE (1.8 g/L DL-Hcy and aerobic exercise training on a treadmill), HHcy + FA (1.8 g/L DL-Hcy and 0.006% folate in diet), HHcy + AE + FA (1.8 g/L DL-Hcy, 0.006% folate, and aerobic exercise training on a treadmill), and a control group (regular water and diet). All treatment was sustained for 8 weeks. Triglyceride, cholesterol, lipoprotein, and Hcy levels were determined enzymatically. Plaque and monocyte chemoattractant protein-1 (MCP-1) expression levels in mouse aortic roots were evaluated by immunohistochemistry. Results Compared to the HHcy group (18.88 ± 6.13 μmol/L), plasma Hcy concentration was significantly reduced in the HHcy + AE (14.79 ± 3.05 μmol/L, p = 0.04), HHcy + FA (9.4 ± 3.85 μmol/L, p < 0.001), and HHcy + AE + FA (9.33 ± 2.21 μmol/L, p < 0.001) groups. Significantly decreased aortic root plaque area and plaque burden were found in the HHcy + AE and HHcy + AE + FA groups compared to those in the HHcy group (both p < 0.05). Plasma MCP-1 level and MCP-1 expression in atherosclerotic lesions were significantly decreased in the HHcy + AE and HHcy + AE + FA groups compared to the HHcy group (all p < 0.05). Conclusions AE reduced atherosclerosis development in HHcy apoE-/- mice independently of reducing Hcy levels. FA supplementation decreased plasma Hcy levels without attenuating HHcy-accelerated atherosclerosis. AE and FA supplementation have distinct mechanisms in benefiting atherosclerosis.
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Affiliation(s)
- Xingming Zhong
- School of Kinesiology and Health, Capital University of Physical Education and Sports
| | - Rong He
- Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University
| | - Shaohua You
- School of Kinesiology and Health, Capital University of Physical Education and Sports
| | - Bo Liu
- Department of Physiology, Peking University Health Center
| | - Xiujie Wang
- School of Kinesiology and Health, Capital University of Physical Education and Sports
| | - Jieming Mao
- Department of Cardiology, Peking University Third Hospital, Beijing, China
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22
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Opdebeeck B, Neven E, Maudsley S, Leysen H, Walter D, Geryl H, D’Haese PC, Verhulst A. A Proteomic Screen to Unravel the Molecular Pathways Associated with Warfarin-Induced or TNAP-Inhibited Arterial Calcification in Rats. Int J Mol Sci 2023; 24:ijms24043657. [PMID: 36835062 PMCID: PMC9963640 DOI: 10.3390/ijms24043657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/27/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023] Open
Abstract
Arterial media calcification refers to the pathological deposition of calcium phosphate crystals in the arterial wall. This pathology is a common and life-threatening complication in chronic kidney disease, diabetes and osteoporosis patients. Recently, we reported that the use of a TNAP inhibitor, SBI-425, attenuated arterial media calcification in a warfarin rat model. Employing a high-dimensionality unbiased proteomic approach, we also investigated the molecular signaling events associated with blocking arterial calcification through SBI-425 dosing. The remedial actions of SBI-425 were strongly associated with (i) a significant downregulation of inflammatory (acute phase response signaling) and steroid/glucose nuclear receptor signaling (LXR/RXR signaling) pathways and (ii) an upregulation of mitochondrial metabolic pathways (TCA cycle II and Fatty Acid β-oxidation I). Interestingly, we previously demonstrated that uremic toxin-induced arterial calcification contributes to the activation of the acute phase response signaling pathway. Therefore, both studies suggest a strong link between acute phase response signaling and arterial calcification across different conditions. The identification of therapeutic targets in these molecular signaling pathways may pave the way to novel therapies against the development of arterial media calcification.
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Affiliation(s)
- Britt Opdebeeck
- Laboratory of Pathophysiology, Department of Biomedical Sciences, University of Antwerp, 2000 Antwerpen, Belgium
| | - Ellen Neven
- Laboratory of Pathophysiology, Department of Biomedical Sciences, University of Antwerp, 2000 Antwerpen, Belgium
| | - Stuart Maudsley
- Receptor Biology Lab, Department of Biomedical Sciences, University of Antwerp, 2000 Antwerpen, Belgium
| | - Hanne Leysen
- Receptor Biology Lab, Department of Biomedical Sciences, University of Antwerp, 2000 Antwerpen, Belgium
| | - Deborah Walter
- Receptor Biology Lab, Department of Biomedical Sciences, University of Antwerp, 2000 Antwerpen, Belgium
| | - Hilde Geryl
- Laboratory of Pathophysiology, Department of Biomedical Sciences, University of Antwerp, 2000 Antwerpen, Belgium
| | - Patrick C. D’Haese
- Laboratory of Pathophysiology, Department of Biomedical Sciences, University of Antwerp, 2000 Antwerpen, Belgium
| | - Anja Verhulst
- Laboratory of Pathophysiology, Department of Biomedical Sciences, University of Antwerp, 2000 Antwerpen, Belgium
- Correspondence: ; Tel.: +32-3-2659085
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23
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Effects of shear stress on vascular endothelial functions in atherosclerosis and potential therapeutic approaches. Biomed Pharmacother 2023; 158:114198. [PMID: 36916427 DOI: 10.1016/j.biopha.2022.114198] [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: 10/14/2022] [Revised: 12/09/2022] [Accepted: 12/29/2022] [Indexed: 01/07/2023] Open
Abstract
Different blood flow patterns in the arteries can alter the adaptive phenotype of vascular endothelial cells (ECs), thereby affecting the functions of ECs and are directly associated with the occurrence of lesions in the early stages of atherosclerosis (AS). Atherosclerotic plaques are commonly found at curved or bifurcated arteries, where the blood flow pattern is dominated by oscillating shear stress (OSS). OSS can induce ECs to transform into pro-inflammatory phenotypes, increase cellular inflammation, oxidative stress response, mitochondrial dysfunction, metabolic abnormalities and endothelial permeability, thereby promoting the progression of AS. On the other hand, the straight artery has a stable laminar shear stress (LSS), which promotes the transformation of ECs into an anti-inflammatory phenotype, improves endothelial cell function, thereby inhibits atherosclerotic progression. ECs have the ability to actively sense, integrate, and convert mechanical stimuli by shear stress into biochemical signals that further induces intracellular changes (such as the opening and closing of ion channels, activation and transcription of signaling pathways). Here we not only outline the relationship between functions of vascular ECs and different forms of fluid shear stress in AS, but also aim to provide new solutions for potential atherosclerotic therapies targeting intracellular mechanical transductions.
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24
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Zambrano A, Tintut Y, Demer LL, Hsu JJ. Potential mechanisms linking high-volume exercise with coronary artery calcification. HEART (BRITISH CARDIAC SOCIETY) 2023:heartjnl-2022-321986. [PMID: 36702539 DOI: 10.1136/heartjnl-2022-321986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/12/2023] [Indexed: 01/27/2023]
Abstract
Recent studies have found an association between high volumes of physical activity and increased levels of coronary artery calcification (CAC) among older male endurance athletes, yet the underlying mechanisms have remained largely elusive. Potential mechanisms include greater exposure to inflammatory cytokines, reactive oxygen species and oxidised low-density lipoproteins, as acute strenuous physical activity has been found to enhance their systemic release. Other possibilities include post-exercise elevations in circulating parathyroid hormone, which can modify the amount and morphology of calcific plaque, and long-term exposure to non-laminar blood flow within the coronary arteries during vigorous physical activity, particularly in individuals with pre-existing atherosclerosis. Further, although the association has only been identified in men, the role of testosterone in this process remains unclear. This brief review discusses the association between high-volume endurance exercise and CAC in older men, elaborates on the potential mechanisms underlying the increased calcification, and provides clinical implications and recommendations for those at risk.
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Affiliation(s)
- Angelica Zambrano
- Paul L Foster School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Yin Tintut
- Medicine/Cardiology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA.,Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Linda L Demer
- Medicine/Cardiology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA.,Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Jeffrey J Hsu
- Medicine/Cardiology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA .,Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
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25
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Ni X, Liu L, Yao Y, Zhang C, Su H, Lv Y, Li R, Sun L, Zhou Q, Zhu X, Yang Z, Chen Z, He W, Zhu H, Zhang S, Hu C, Yuan H. The genetic correlation and causal association between key factors that influence vascular calcification and cardiovascular disease incidence. Front Cardiovasc Med 2023; 10:1096662. [PMID: 36776247 PMCID: PMC9908996 DOI: 10.3389/fcvm.2023.1096662] [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: 11/12/2022] [Accepted: 01/13/2023] [Indexed: 01/27/2023] Open
Abstract
Background Serum calcium (Ca), vitamin D (VD), and vitamin K (VK) levels are key determinants of vascular calcification, which itself impacts cardiovascular disease (CVD) risk. The specific relationships between the levels of these different compounds and particular forms of CVD, however, remain to be fully defined. Objective This study was designed to explore the associations between these serum levels and CVDs with the goal of identifying natural interventions capable of controlling vascular calcification and thereby protecting against CVD pathogenesis, extending the healthy lifespan of at-risk individuals. Methods Linkage disequilibrium score (LDSC) regression and a two-sample Mendelian randomization (MR) framework were leveraged to systematically examine the causal interplay between these serum levels and nine forms of CVD, as well as longevity through the use of large publically accessible Genome-Wide Association Studies (GWAS) datasets. The optimal concentrations of serum Ca and VD to lower CVD risk were examined through a restrictive cubic spline (RCS) approach. Results After Bonferroni correction, the positive genetic correlations were observed between serum Ca levels and myocardial infarction (MI) (p = 1.356E-04), as well as coronary artery disease (CAD) (p = 3.601E-04). Negative genetic correlations were detected between levels of VD and CAD (p = 0.035), while elevated VK1 concentrations were causally associated with heart failure (HF) [odds ratios (OR) per 1-standard deviation (SD) increase: 1.044], large artery stroke (LAS) (OR per 1-SD increase: 1.172), and all stroke (AS) (OR per 1-SD increase: 1.041). Higher serum Ca concentrations (OR per 1-SD increase: 0.865) and VD levels (OR per 1-SD increase: 0.777) were causally associated with reduced odds of longevity. These findings remained consistent in sensitivity analyses, and serum Ca and VD concentrations of 2.376 mmol/L and 46.8 nmol/L, respectively, were associated with a lower CVD risk (p < 0.001). Conclusion Our findings support a genetic correlation between serum Ca and VD and CVD risk, and a causal relationship between VK1 levels and CVD risk. The optimal serum Ca (2.376 mmol/L) and VD levels (46.8 nmol/L) can reduce cardiovascular risk.
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Affiliation(s)
- Xiaolin Ni
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China,State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing, China,Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing, China
| | - Lei Liu
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Chi Zhang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | | | - Yuan Lv
- Jiangbin Hospital, Zhenjiang, China
| | | | - Liang Sun
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - Qi Zhou
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - Xiaoquan Zhu
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - Ze Yang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China
| | - Zuoguan Chen
- Department of Vascular Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences Peking Union Medical College, Beijing, China
| | - Wei He
- Department of Cardiology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Huolan Zhu
- Department of Geriatrics, Shaanxi Provincial Clinical Research Center for Geriatric Medicine, Shaanxi Provincial People’s Hospital, Xi’an, China
| | - Shenqi Zhang
- Department of Joint and Sports Medicine, Zaozhuang Municipal Hospital Affiliated to Jining Medical University, Zaozhuang, Shandong, China
| | - Caiyou Hu
- Jiangbin Hospital, Zhenjiang, China,Caiyou Hu,
| | - Huiping Yuan
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital, National Center of Gerontology of National Health Commission, Beijing, China,*Correspondence: Huiping Yuan,
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26
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Knauer K, Chaudry O, Uder M, Kohl M, Kemmler W, Bickelhaupt S, Engelke K. Effects of High-Intensity Resistance Training on Visceral Adipose Tissue and Abdominal Aortic Calcifications in Older Men with Osteosarcopenia - Results from the FrOST Study. Clin Interv Aging 2023; 18:71-80. [PMID: 36700164 PMCID: PMC9869795 DOI: 10.2147/cia.s388026] [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: 09/10/2022] [Accepted: 12/06/2022] [Indexed: 01/20/2023] Open
Abstract
Purpose To evaluate the effect of a high-intensity resistance training (HIT-RT) on visceral adipose tissue (VAT) and abdominal aortic calcifications (AAC). Patients and Methods We conducted a post hoc analysis of the Franconian Osteopenia and Sarcopenia Trial (FrOST). 43 community-dwelling men with osteosarcopenia aged 72 years and older were randomly allocated to a supervised high-intensity resistance training (HIT-RT) twice weekly for 18 months (EG; n=21) and a non-training control group (CG; n=22). Non-contrast enhanced 2-point Dixon MRI scans covering mid L2 to mid L3 were acquired to measure VAT volume inside the abdominal cavity. Volume of AAC and hard plaques in renal arteries, truncus celiacus and superior mesenteric artery was measured by computed tomography (CT) scans covering mid T12 to mid L3. Intention-to-treat analysis with imputation for missing data was used to determine longitudinal changes in VAT and AAC volume. Correlations were used to determine associations between VAT and AAC. Results Significant reduction of VAT volume in the EG (-7.7%; p<0.001) combined with no change in the CG (-1.3%; p=0.46) resulted in a significant 6.4% between group effect (p=0.022). We observed a significant increase of AAC volume in EG (+10.3%; p<0.001) and CG (12.0%; p<0.001). AAC differences between groups were not significant (p=0.57). In vascular outlets increases in volume of the hard plaques were observed in both groups, however, not all of them were significant. There was no significant correlation between changes in VAT and AAC volumes. Conclusion The study confirmed a positive impact of HIT-RT on the metabolic and cardiovascular risk profile with respect to reduction of VAT volume. No positive exercise effect on AAC was observed. However, there was a further progression of AAC volume independent of group affiliation. Whether different exercise regimen may show a positive effect on AAC remains subject to further studies.
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Affiliation(s)
- Kira Knauer
- Institute of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, 91054, Germany,Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, 91052, Germany,Correspondence: Kira Knauer, Institute of Radiology, Friedrich-Alexander University of Erlangen-Nürnberg, University Hospital Erlangen, Maximiliansplatz 3, Erlangen, 91054, Germany, Tel +49 9131/85-36065, Email
| | - Oliver Chaudry
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, 91052, Germany,Department of Medicine III, Friedrich-Alexander University of Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, 91054, Germany
| | - Michael Uder
- Institute of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, 91054, Germany
| | - Matthias Kohl
- Faculty Medical and Life Sciences, University of Furtwangen, Villingen-Schwenningen, 78054, Germany
| | - Wolfgang Kemmler
- Institute of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, 91054, Germany,Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, 91052, Germany
| | - Sebastian Bickelhaupt
- Institute of Radiology, Friedrich-Alexander-Universität Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, 91054, Germany
| | - Klaus Engelke
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, 91052, Germany,Department of Medicine III, Friedrich-Alexander University of Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, 91054, Germany
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27
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Thompson PD, Eijsvogels TMH, Kim JH. Can the Heart Get an Overuse Sports Injury? NEJM EVIDENCE 2023; 2:EVIDra2200175. [PMID: 38320102 DOI: 10.1056/evidra2200175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Can the Heart Get an Overuse Sports Injury?Recent studies suggest that vigorous endurance exercise increases markers of cardiomyocyte injury and that lifelong endurance exercise may increase myocardial scarring, coronary artery atherosclerosis, AF, and aortic dilatation. This review summarizes the evidence linking these conditions with physical exertion and an approach to their management.
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Affiliation(s)
- Paul D Thompson
- Hartford Hospital, Hartford, CT
- University of Connecticut, Farmington, CT
- Massachusetts General Hospital, Boston
| | - Thijs M H Eijsvogels
- Radboud Institute for Health Sciences, Department of Physiology, Nijmegen, the Netherlands
- Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jonathan H Kim
- Emory University School of Medicine, Atlanta
- Emory Clinical Cardiovascular Research Institute, Atlanta
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28
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100 Long-Distance Triathlons in 100 Days: A Case Study on Ultraendurance, Biomarkers, and Physiological Outcomes. Int J Sports Physiol Perform 2023; 18:444-453. [PMID: 36898387 DOI: 10.1123/ijspp.2022-0327] [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: 08/24/2022] [Revised: 12/03/2022] [Accepted: 12/23/2022] [Indexed: 03/12/2023]
Abstract
The physical demands of a single long-distance triathlon (LDT) are sufficient to cause robust physiological perturbations. In this unique case study, an ultraendurance athlete completed 100 LDTs in 100 days (100LDT). PURPOSE This study aims to describe and analyze this single athlete's performance, physiological biomarkers, and sleep parameters throughout the 100LDT. METHODS An ultraendurance athlete completed an LDT (2.4-mile swim, 112-mile bike ride, and 26.2-mile marathon) each day for 100 consecutive days. Physical work, physiological biomarkers, and sleep parameters were recorded each night using a wrist-worn photoplethysmographic sensor. Clinical exercise tests were performed before and after the 100LDT. Time-series analysis assessed changes in biomarkers and sleep parameters across the 100LDT, and cross-correlations considered the associations between exercise performance and physiological metrics at varying time lags. RESULTS The swim and cycling performances varied across the 100LDT, while the run was relatively stable. Resting heart rate, heart-rate variability, oxygen saturation, sleep score, light sleep, sleep efficiency, and sleep duration were all best characterized by cubic models. Additional post hoc subanalyses suggest that the first half of the 100LDT most influenced these dynamics. CONCLUSIONS The 100LDT resulted in nonlinear alterations to physiological metrics. This world record was a unique event but allows valuable insights into the limits of human endurance performance.
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29
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Vesterbekkmo EK, Aamot Aksetøy IL, Follestad T, Nilsen HO, Hegbom K, Wisløff U, Wiseth R, Madssen E. High intensity interval training induces beneficial effects on coronary atheromatous plaques - a randomized trial. Eur J Prev Cardiol 2022; 30:384-392. [PMID: 36562212 DOI: 10.1093/eurjpc/zwac309] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Coronary atheroma volume is associated with risk of coronary events in coronary artery disease (CAD). Exercise training is a cornerstone in primary and secondary prevention of CAD, but the effect of exercise on coronary atheromatous plaques is largely unknown. PURPOSE We assessed the effect of six months supervised high intensity interval training (HIIT) on coronary plaque geometry using intravascular ultrasound in patients with stable CAD following percutaneous coronary intervention (PCI). METHODS Sixty patients were randomized to two sessions of weekly supervised HIIT at 85-95% of peak heart rate (n = 30) or to follow contemporary preventive guidelines (control group, n = 30). The study endpoints were change in percent atheroma volume (PAV) and total atheroma volume (TAV) normalized for segment length (TAVnorm) at six-month follow-up. RESULTS The change in average PAV for matched coronary segments from baseline to follow-up showed a significant between-group difference (-1.4, 95% CI: -2.7 to -0.1, p = 0.036). There was a significant reduction in the HIIT group (-1.2, 95% CI: -2.1 to -0.2, p = 0.017) while not in the control group (0.2, 95% CI: -0.7 to 1.1, p = 0.616). TAVnorm was reduced (-9 mm3, 95% CI: -14.7 to -3.4, p = 0.002) after HIIT, with a significant between-group difference (-12.0 mm3, 95% CI: -19.9 to -4.2, p = 0.003). CONCLUSION In patients with established CAD, a regression of atheroma volume was observed in those undergoing six months of supervised HIIT compared with patients following contemporary preventive guidelines. Our study indicates that high intensity interval training counteracts atherosclerotic coronary disease progression and reduces atheroma volume in residual coronary atheromatous plaques following PCI.
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Affiliation(s)
- Elisabeth Kleivhaug Vesterbekkmo
- Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway.,Department of Circulation and Medical Imaging at Norwegian University of Science and Technology, Trondheim, Norway.,National Advisory Unit on Exercise Training as Medicine for Cardiopulmonary Conditions, Trondheim, Norway
| | - Inger-Lise Aamot Aksetøy
- Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway.,Department of Circulation and Medical Imaging at Norwegian University of Science and Technology, Trondheim, Norway.,National Advisory Unit on Exercise Training as Medicine for Cardiopulmonary Conditions, Trondheim, Norway
| | - Turid Follestad
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Queensland, Australia
| | - Hans Olav Nilsen
- Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway.,Department of Circulation and Medical Imaging at Norwegian University of Science and Technology, Trondheim, Norway
| | - Knut Hegbom
- Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging at Norwegian University of Science and Technology, Trondheim, Norway.,School of Human Movement and Nutrition Science, University of Queensland, Queensland, Australia
| | - Rune Wiseth
- Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway.,Department of Circulation and Medical Imaging at Norwegian University of Science and Technology, Trondheim, Norway
| | - Erik Madssen
- Clinic of Cardiology, St. Olavs University Hospital, Trondheim, Norway.,Department of Circulation and Medical Imaging at Norwegian University of Science and Technology, Trondheim, Norway
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There is urgent need to treat atherosclerotic cardiovascular disease risk earlier, more intensively, and with greater precision: A review of current practice and recommendations for improved effectiveness. Am J Prev Cardiol 2022; 12:100371. [PMID: 36124049 PMCID: PMC9482082 DOI: 10.1016/j.ajpc.2022.100371] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/10/2022] [Accepted: 08/05/2022] [Indexed: 12/12/2022] Open
Abstract
Atherosclerotic cardiovascular disease (ASCVD) is epidemic throughout the world and is etiologic for such acute cardiovascular events as myocardial infarction, ischemic stroke, unstable angina, and death. ASCVD also impacts risk for dementia, chronic kidney disease peripheral arterial disease and mobility, impaired sexual response, and a host of other visceral impairments that adversely impact the quality and rate of progression of aging. The relationship between low-density lipoprotein cholesterol (LDL-C) and risk for ASCVD is one of the most highly established and investigated issues in the entirety of modern medicine. Elevated LDL-C is a necessary condition for atherogenesis induction. Basic scientific investigation, prospective longitudinal cohorts, and randomized clinical trials have all validated this association. Yet despite the enormous number of clinical trials which support the need for reducing the burden of atherogenic lipoprotein in blood, the percentage of high and very high-risk patients who achieve risk stratified LDL-C target reductions is low and has remained low for the last thirty years. Atherosclerosis is a preventable disease. As clinicians, the time has come for us to take primordial and primary prevention more serously. Despite a plethora of therapeutic approaches, the large majority of patients at risk for ASCVD are poorly or inadequately treated, leaving them vulnerable to disease progression, acute cardiovascular events, and poor aging due to loss of function in multiple visceral organs. Herein we discuss the need to greatly intensify efforts to reduce risk, decrease disease burden, and provide more comprehensive and earlier risk assessment to optimally prevent ASCVD and its complications. Evidence is presented to support that treatment should aim for far lower goals in cholesterol management, should take into account many more factors than commonly employed today and should begin significantly earlier in life.
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Franklin BA, Eijsvogels TM, Pandey A, Quindry J, Toth PP. Physical activity, cardiorespiratory fitness, and cardiovascular health: A clinical practice statement of the ASPC Part I: Bioenergetics, contemporary physical activity recommendations, benefits, risks, extreme exercise regimens, potential maladaptations. Am J Prev Cardiol 2022; 12:100424. [PMID: 36281324 PMCID: PMC9586848 DOI: 10.1016/j.ajpc.2022.100424] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 09/05/2022] [Accepted: 10/06/2022] [Indexed: 11/07/2022] Open
Abstract
Regular moderate-to-vigorous physical activity (PA) and increased levels of cardiorespiratory fitness (CRF) or aerobic capacity are widely promoted as cardioprotective measures in the primary and secondary prevention of atherosclerotic cardiovascular (CV) disease (CVD). Nevertheless, physical inactivity and sedentary behaviors remain a worldwide concern. The continuing coronavirus (COVID-19) pandemic has been especially devastating to patients with known or occult CVD since sitting time and recreational PA have been reported to increase and decrease by 28% and 33%, respectively. Herein, in this first of a 2-part series, we discuss foundational factors in exercise programming, with specific reference to energy metabolism, contemporary PA recommendations, the dose-response relationship of exercise as medicine, the benefits of regular exercise training, including the exercise preconditioning cardioprotective phenotype, as well as the CV risks of PA. Finally, we discuss the 'extreme exercise hypothesis,' specifically the potential maladaptations resulting from high-volume, high-intensity training programs, including accelerated coronary artery calcification and incident atrial fibrillation. The latter is commonly depicted by a reverse J-shaped or U-shaped curve. On the other hand, longevity data argue against this relationship, as elite endurance athletes live 3-6 years longer than the general population.
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Affiliation(s)
- Barry A. Franklin
- Preventive Cardiology and Cardiac Rehabilitation, Beaumont Health, Royal Oak, Michigan, USA
- Professor, Internal Medicine, Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA
| | - Thijs M.H. Eijsvogels
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ambarish Pandey
- Department of Internal Medicine at UT Southwestern Medical Center, Dallas, TX, Michigan, USA
| | - John Quindry
- Integrative Physiology and Athletic Training, University of Montana, Missoula, Montana and International Heart Institute – St. Patrick's Hospital, Providence Medical Center, Missoula, Montana, USA
| | - Peter P. Toth
- CGH Medical Center, Sterling, IL, USA
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Tiller NB, Kinninger A, Abbasi A, Casaburi R, Rossiter HB, Budoff MJ, Adami A. Physical Activity, Muscle Oxidative Capacity, and Coronary Artery Calcium in Smokers with and without COPD. Int J Chron Obstruct Pulmon Dis 2022; 17:2811-2820. [PMID: 36353139 PMCID: PMC9639376 DOI: 10.2147/copd.s385000] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/25/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction Severe chronic obstructive pulmonary disease (COPD) is partly characterized by diminished skeletal muscle oxidative capacity and concurrent dyslipidemia. It is unknown whether such metabolic derangements increase the risk of cardiovascular disease. This study explored associations among physical activity (PA), muscle oxidative capacity, and coronary artery calcium (CAC) in COPDGene participants. Methods Data from current and former smokers with COPD (n = 75) and normal spirometry (n = 70) were retrospectively analyzed. Physical activity was measured for seven days using triaxial accelerometry (steps/day and vector magnitude units [VMU]) along with the aggregate of self-reported PA amount and PA difficulty using the PROactive D-PPAC instrument. Muscle oxidative capacity (k) was assessed via near-infrared spectroscopy, and CAC was assessed via chest computerized tomography. Results Relative to controls, COPD patients exhibited higher CAC (median [IQR], 31 [0–431] vs 264 [40–799] HU; p = 0.003), lower k (mean ± SD = 1.66 ± 0.48 vs 1.25 ± 0.37 min−1; p < 0.001), and lower D-PPAC total score (65.2 ± 9.9 vs 58.8 ± 13.2; p = 0.003). Multivariate analysis—adjusting for age, sex, race, diabetes, disease severity, hyperlipidemia, smoking status, and hypertension—revealed a significant negative association between CAC and D-PPAC total score (β, −0.05; p = 0.013), driven primarily by D-PPAC difficulty score (β, −0.03; p = 0.026). A 1 unit increase in D-PPAC total score was associated with a 5% lower CAC (p = 0.013). There was no association between CAC and either k, steps/day, VMU, or D-PPAC amount. Conclusion Patients with COPD and concomitantly elevated CAC exhibit greater perceptions of difficulty when performing daily activities. This may have implications for exercise adherence and risk of overall physical decline.
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Affiliation(s)
- Nicholas B Tiller
- Institute of Respiratory Medicine and Exercise Physiology, Division of Respiratory and Critical Care Physiology and Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - April Kinninger
- Division of Cardiology, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Asghar Abbasi
- Institute of Respiratory Medicine and Exercise Physiology, Division of Respiratory and Critical Care Physiology and Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Richard Casaburi
- Institute of Respiratory Medicine and Exercise Physiology, Division of Respiratory and Critical Care Physiology and Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Harry B Rossiter
- Institute of Respiratory Medicine and Exercise Physiology, Division of Respiratory and Critical Care Physiology and Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
- Correspondence: Harry B Rossiter, Institute of Respiratory Medicine and Exercise Physiology, Division of Respiratory and Critical Care Physiology and Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, CDCRC Building, Torrance, CA, 90502, USA, Tel +1 310-222-8200, Email
| | - Matthew J Budoff
- Division of Cardiology, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Alessandra Adami
- Department of Kinesiology, University of Rhode Island, Kingston, RI, USA
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Masson W, Barbagelata L, Falconi M, Arenaza DPD. Association between physical activity and coronary artery calcification estimated by computed tomography: A systematic review. CLÍNICA E INVESTIGACIÓN EN ARTERIOSCLEROSIS 2022:S0214-9168(22)00130-9. [DOI: 10.1016/j.arteri.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/03/2022] [Accepted: 10/05/2022] [Indexed: 11/11/2022]
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Abstract
PURPOSE OF REVIEW Lipids and lipoproteins have long been known to contribute to atherosclerosis and cardiovascular calcification. One theme of recent work is the study of lipoprotein (a) [Lp(a)], a lipoprotein particle similar to LDL-cholesterol that carries a long apoprotein tail and most of the circulating oxidized phospholipids. RECENT FINDINGS In-vitro studies show that Lp(a) stimulates osteoblastic differentiation and mineralization of vascular smooth muscle cells, while the association of Lp(a) with coronary artery calcification continues to have varying results, possibly because of the widely varying threshold levels of Lp(a) chosen for association analyses. Another emerging area in the field of cardiovascular calcification is pathological endothelial-to-mesenchymal transition (EndMT), the process whereby endothelial cell transition into multipotent mesenchymal cells, some of which differentiate into osteochondrogenic cells and mineralize. The effects of lipids and lipoproteins on EndMT suggest that they modulate cardiovascular calcification through multiple mechanisms. There are also emerging trends in imaging of calcific vasculopathy, including: intravascular optical coherence tomography for quantifying plaque characteristics, PET with a radiolabeled NaF tracer, with either CT or MRI to detect coronary plaque vulnerability. SUMMARY Recent work in this field includes studies of Lp(a), EndMT, and new imaging techniques.
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Affiliation(s)
- Jeffrey J Hsu
- Department of Medicine
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Yin Tintut
- Department of Medicine
- Department of Physiology
- Department of Orthopaedic Surgery
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Linda L Demer
- Department of Medicine
- Department of Physiology
- Department of Bioengineering, University of California
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
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Association of Obstructive Sleep Apnea Syndrome (OSA/OSAHS) with Coronary Atherosclerosis Risk: Systematic Review and Meta-Analysis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:8905736. [PMID: 36035275 PMCID: PMC9402316 DOI: 10.1155/2022/8905736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 11/17/2022]
Abstract
Objective Obstructive sleep apnea syndrome (OSA) is the most common type of sleep disorders. This study aimed to systematically review the correlation between OSA and the risk of coronary atherosclerosis. Methods Literature on case-control studies on the relationship between coronary heart disease (CHD) and sleep apnea syndrome was collected and collated, and the incidence of SAS in CHD and non-CHD patients was observed and compared. RevMan 5.2 analysis software and Stata12SE analysis software were used for heterogeneity test and combination analysis of the included studies. The results were expressed with odds ratio (OR), 95% confidence intervals (CI) were calculated, and publication bias and sensitivity tests were evaluated. Results There was a statistical difference in OSA associated with the risk of coronary atherosclerosis between the experimental group and the control group [OR = 1.38, 95% CI (1.18, 1.62), P < 0.0001, I 2 = 0%, Z = 3.93]. OSA associated with vascular endothelial injury [OR = 3.59, 95% CI (3.00, 4.29), P < 0.00001, I 2 = 90%, Z = 14.09]. OSA is associated with vascular oxidation emergency [OR = 2.19, 95% CI (2.05, 2.33), P < 0.00001, I 2 = 94%, Z = 23.40]; OSA is associated with chronic vascular inflammation [OR = 1.70, 95% CI (1.39, 2.07), P < 0.00001, I 2 = 16%, Z = 5.18]. Conclusion The incidence of obstructive sleep apnea in patients with CHD was higher than that in non-CHD patients, and obstructive sleep apnea was a risk factor for CHD.
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Annual Dynamics of Blood Lipid Parameters in Highly Qualified Physical Training. Appl Biochem Biotechnol 2022; 194:3582-3593. [PMID: 35451795 DOI: 10.1007/s12010-022-03918-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2022] [Indexed: 11/02/2022]
Abstract
The purpose of the paper is to study and analyse the annual dynamics of blood lipid parameters in highly qualified physical training. An experiment is a leading method for studying this problem that allows considering the problem comprehensively and in practice, as well as a comparison method, which makes it possible to analyse common features and differences as well as consider the dynamics of blood lipid parameters. Athletes who developed endurance or strength to a greater extent had no significant differences in many blood parameters. However, the groups of athletes who developed only strength had a more pronounced anisocytosis. In addition, it was possible to identify a correlation between the parameters of red blood cells and trained sports results. It was concluded that the highest indicators of the number of red blood cells, haemoglobin and average haemoglobin concentration in red blood cells were observed in strength training, and the lowest-in athletes training speed indicators. The article is of practical value for future research in the field of medicine and regenerative physiotherapy.
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Guanxinning Tablet Attenuates Coronary Atherosclerosis via Regulating the Gut Microbiota and Their Metabolites in Tibetan Minipigs Induced by a High-Fat Diet. J Immunol Res 2022; 2022:7128230. [PMID: 35935588 PMCID: PMC9352486 DOI: 10.1155/2022/7128230] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 06/02/2022] [Indexed: 11/17/2022] Open
Abstract
Coronary atherosclerosis (CA) is a chronic and evolving inflammatory disease characterized by the build-up of atherosclerotic plaque in the wall of coronary arteries. Guanxinning tablet (GXNT) is a novel Chinese medicine formula, which has been clinically used to treat coronary heart disease for many years. However, the potential mechanism for treating CA remains unclear. Thus, the study was aimed at investigating the therapeutic effect of GXNT on CA and further explore the underlying mechanisms from the perspective of gut microbiota. Following the establishment of a CA model in Tibetan minipigs, GXNT was orally administrated. We simultaneously detected blood lipid levels, observed ventricular function using ultrasound examination, measured platelet aggregation, and checked changes in inflammatory factors, oxidative stress factors, and vascular endothelial injury-related indexes applying ELISA assays. Histopathological changes of coronary artery tissue were subsequently evaluated using Sudan IV staining, HE staining, Oil red “O” staining, and immunohistochemistry assays. Finally, alterations of the gut microbiota and microbial metabolites were detected using metagenomic sequencing and targeted metabolomics, respectively. The results have suggested that GXNT could regulate dyslipidemia, improve heart function, and inhibit the levels of ox-LDL, CRP, TNF-α, IL-1β, SOD, MDA, vWF, and ET-1, as well as platelet aggregation. Additionally, histopathological findings revealed that GXNT could reduce lipid deposition, alleviate AS lesions, and restrain the expressions of NF-κB, TNF-α, and MMP-9. Furthermore, the composition of the gut microbiota was altered. Specifically, GXNT could upregulate the relative abundance of Prevotellaceae and Prevotella and downregulate the abundance of Proteobacteria, Enterobacteriaceae, and Escherichia. As for microbial metabolites, GXNT could increase fecal propionic acid, butyric acid, and LCA-3S and decrease fecal TMA-related metabolites, CDCA, and serum TMAO. In sum, the results showed that GXNT had a satisfactory anti-CA effect, and the mechanism was closely associated with modulating gut microbiota and related metabolites.
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Bavishi A, Zielinski A, Stone NJ. Risk and Treatment Decisions for Primary Prevention in the Athlete: Worth Going the Extra Mile. Am J Cardiol 2022; 179:129-131. [PMID: 35879155 DOI: 10.1016/j.amjcard.2022.06.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 11/01/2022]
Affiliation(s)
- Aakash Bavishi
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Allison Zielinski
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Neil J Stone
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Cai WB, Wang Y, Wang J, Guo WG, Duan YY, Zhang L. Preliminary study of carotid variables under ultrasound analysis as predictors for the risk of coronary arterial atherosclerosis. Echocardiography 2022; 39:1054-1063. [PMID: 35781700 PMCID: PMC9544001 DOI: 10.1111/echo.15404] [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: 02/12/2022] [Revised: 05/13/2022] [Accepted: 05/30/2022] [Indexed: 12/01/2022] Open
Abstract
Background Carotid atherosclerosis by ultrasound scanning can be considered as an ideal window to reflect systemic artery atherosclerosis, which has aroused wide concern for predicting the severity of coronary artery atherosclerosis clinically. Ultrasound radio frequency (RF) data technology has enabled us to evaluate the carotid structure and elastic function precisely, for predicting the severity of coronary artery atherosclerosis. Methods Patients with suspected coronary artery disease (CAD) underwent coronary angiography and were assigned to four groups according to whether atherosclerotic plaque was found or not and it caused stenosis. Carotid artery intima‐media thickness (IMT) and arterial stiffness were investigated by quality intima‐media thickness (QIMT) and quality arterial stiffness (QAS) techniques during ultrasound scanning. Univariable and multivariable modeling were used to investigate correlations of carotid parameters to coronary artery atherosclerosis. Receive operating characteristic (ROC) curves were used to evaluate diagnostic performance of these ultrasound variables. Results Carotid IMT and stiffness variables pulse wave velocity (PWV), α, β and compliance coefficient (CC) were statistically different between every two‐group's comparisons. IMT correlated with stiffness variables significantly with r = 0.70, 0.77, 0.63, and −0.39, respectively. All variables correlated with the severity of coronary atherosclerosis with the odd ratio (OR) of 1.73, 1.67, 1.19, 1.23, and 0.56 accordingly as IMT, PWV, α, β and CC were concerned. The AUC of IMT, PWV, α, β and CC were 0.9257, 0.8910, 0.8016, 0.9383, 0.8581 with correctly classified rate of 88.16%, 83.77%, 78.07%, 86.84%, and 81.58%, respectively. Conclusions Carotid artery IMT and stiffness variable PWV, α, β and CC presented favorable predicting and differentiating values for patients with coronary atherosclerosis of different severity.
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Affiliation(s)
- Wen-Bin Cai
- Department of Ultrasound Diagnostics, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.,Department of Ultrasound Diagnostics, General Hospital of Tibet Military Region, Lhasa, China
| | - Yi Wang
- Department of Ultrasound Diagnostics, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China.,Disease Surveillance Division, Jiangsu International Travel Healthcare Center, Nanjing, China
| | - Jia Wang
- Department of Ultrasound Diagnostics, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Wan-Gang Guo
- Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University, Xi'an, China
| | - Yun-You Duan
- Department of Ultrasound Diagnostics, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
| | - Li Zhang
- Department of Ultrasound Diagnostics, Tangdu Hospital, The Fourth Military Medical University, Xi'an, China
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40
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Li H, Su W, Dang H, Han K, Lu H, Yue S, Zhang H. Exercise Training for Mild Cognitive Impairment Adults Older Than 60: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2022; 88:1263-1278. [PMID: 35811527 PMCID: PMC9484098 DOI: 10.3233/jad-220243] [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] [Indexed: 11/26/2022]
Abstract
Background: The prevalence of mild cognitive impairment (MCI) continues to increase due to population aging. Exercise has been a supporting health strategy that may elicit beneficial effects on cognitive function and prevent dementia. Objective: This study aimed to examine the effects of aerobic, resistance, and multimodal exercise training on cognition in adults aged > 60 years with MCI. Methods: We searched the Cochrane Library, PubMed, and Embase databases and ClinicalTrials.gov (https://clinicaltrials.gov) up to November 2021, with no language restrictions. We included all published randomized controlled trials (RCTs) comparing the effect of exercise programs on cognitive function with any other active intervention or no intervention in participants with MCI aged > 60 years. Results: Twelve RCTs were included in this review. Meta-analysis results revealed significant improvements in resistance training on measures of executive function (p < 0.05) and attention (p < 0.05); no significant differences were observed between aerobic exercise and controls on any of the cognitive comparisons. Conclusion: Exercise training had a small beneficial effect on executive function and attention in older adults with MCI. Larger studies are required to examine the effects of exercise and the possible moderators.
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Affiliation(s)
- Hui Li
- Rehabilitation Center, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,China Rehabilitation Research Center, Beijing, China.,University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
| | - Wenlong Su
- China Rehabilitation Research Center, Beijing, China
| | - Hui Dang
- Rehabilitation Center, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,China Rehabilitation Research Center, Beijing, China.,University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
| | - Kaiyue Han
- China Rehabilitation Research Center, Beijing, China
| | - Haitao Lu
- China Rehabilitation Research Center, Beijing, China
| | - Shouwei Yue
- Rehabilitation Center, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
| | - Hao Zhang
- Rehabilitation Center, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.,China Rehabilitation Research Center, Beijing, China.,University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
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Rao P, Belanger MJ, Robbins JM. Exercise, Physical Activity, and Cardiometabolic Health: Insights into the Prevention and Treatment of Cardiometabolic Diseases. Cardiol Rev 2022; 30:167-178. [PMID: 34560712 PMCID: PMC8920940 DOI: 10.1097/crd.0000000000000416] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Physical activity (PA) and exercise are widely recognized as essential components of primary and secondary cardiovascular disease (CVD) prevention efforts and are emphasized in the health promotion guidelines of numerous professional societies and committees. The protean benefits of PA and exercise extend across the spectrum of CVD, and include the improvement and reduction of risk factors and events for atherosclerotic CVD (ASCVD), cardiometabolic disease, heart failure, and atrial fibrillation (AF), respectively. Here, we highlight recent insights into the salutary effects of PA and exercise on the primary and secondary prevention of ASCVD, including their beneficial effects on both traditional and nontraditional risk mediators; exercise "prescriptions" for ASCVD; the role of PA regular exercise in the prevention and treatment of heart failure; and the relationships between, PA, exercise, and AF. While our understanding of the relationship between exercise and CVD has evolved considerably, several key questions remain including the association between extreme volumes of exercise and subclinical ASCVD and its risk; high-intensity exercise and resistance (strength) training as complementary modalities to continuous aerobic exercise; and dose- and intensity-dependent associations between exercise and AF. Recent advances in molecular profiling technologies (ie, genomics, transcriptomics, proteomics, and metabolomics) have begun to shed light on interindividual variation in cardiometabolic responses to PA and exercise and may provide new opportunities for clinical prediction in addition to mechanistic insights.
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Affiliation(s)
- Prashant Rao
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA
- Cardiovascular Research Center, Beth Israel Deaconess Medical Center, Boston, MA
| | | | - Jeremy M. Robbins
- Cardiovascular Research Center, Beth Israel Deaconess Medical Center, Boston, MA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
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Rubies C, Batlle M, Sanz-de la Garza M, Dantas AP, Jorba I, Fernandez G, Sangüesa G, Abuli M, Brugada J, Sitges M, Navajas D, Mont L, Guasch E. Long-Term Strenuous Exercise Promotes Vascular Injury by Selectively Damaging the Tunica Media. JACC Basic Transl Sci 2022; 7:681-693. [PMID: 35958697 PMCID: PMC9357576 DOI: 10.1016/j.jacbts.2022.02.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/24/2022] [Accepted: 02/24/2022] [Indexed: 12/12/2022]
Abstract
Long-term strenuous endurance training promotes a deleterious vascular remodeling, in contrast to the beneficial effects of moderate exercise. Tunica media fibrosis, possibly mediated by miR-212, miR-132, and miR-146b down-regulation, and intrinsic vascular smooth muscle cell stiffening may contribute to aortic stiffening. Endothelial function improves in a similar intensity after moderate and strenuous training. However, in the INT group, a larger NO-mediated vasorelaxation is compensated by more intense vasoconstriction, leading to a potentially unstable balance. Strenuous exercise-induced vascular stiffening and changes in endothelial function remain after ceasing physical activity.
Moderate exercise has well-founded benefits in cardiovascular health. However, increasing, yet controversial, evidence suggests that extremely trained athletes may not be protected from cardiovascular events as much as moderately trained individuals. In our rodent model, intensive but not moderate training promoted aorta and carotid stiffening and elastic lamina ruptures, tunica media thickening of intramyocardial arteries, and an imbalance between vasoconstrictor and relaxation agents. An up-regulation of angiotensin-converter enzyme, miR-212, miR-132, and miR-146b might account for this deleterious remodeling. Most changes remained after a 4-week detraining. In conclusion, our results suggest that intensive training blunts the benefits of moderate exercise.
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Affiliation(s)
- Cira Rubies
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Montserrat Batlle
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red - Cardiovascular (CIBERCV), Madrid, Spain
| | - Maria Sanz-de la Garza
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Catalonia, Spain
| | - Ana-Paula Dantas
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
| | - Ignasi Jorba
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology, Barcelona, Spain
- School of Medicine and Health Sciences, University of Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red–Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Guerau Fernandez
- Bioinformatics Unit, Genetics and Molecular Medicine Service, Hospital Sant Joan de Déu, Esplugues Del Llobregat, Spain
| | - Gemma Sangüesa
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red - Cardiovascular (CIBERCV), Madrid, Spain
| | - Marc Abuli
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Catalonia, Spain
| | - Josep Brugada
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red - Cardiovascular (CIBERCV), Madrid, Spain
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Catalonia, Spain
| | - Marta Sitges
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red - Cardiovascular (CIBERCV), Madrid, Spain
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Catalonia, Spain
| | - Daniel Navajas
- School of Medicine and Health Sciences, University of Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red–Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Lluís Mont
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red - Cardiovascular (CIBERCV), Madrid, Spain
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Catalonia, Spain
- Dr Lluís Mont, Cardiovascular Institute–Hospital Clinic, IDIBAPS, C/ Villarroel, 170, 08036 Barcelona, Spain.
| | - Eduard Guasch
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red - Cardiovascular (CIBERCV), Madrid, Spain
- Institut Clínic Cardiovascular, Hospital Clínic, Universitat de Barcelona, Catalonia, Spain
- Address for correspondence: Dr Eduard Guasch, Cardiovascular Institute–Hospital Clinic, IDIBAPS, C/ Villarroel, 170, 08036 Barcelona, Spain. @EduGuasch
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Exercise at the Extremes. JACC Basic Transl Sci 2022; 7:694-696. [PMID: 35958684 PMCID: PMC9357574 DOI: 10.1016/j.jacbts.2022.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Patel NR, Setya K, Pradhan S, Lu M, Demer LL, Tintut Y. Microarchitectural Changes of Cardiovascular Calcification in Response to In Vivo Interventions Using Deep-Learning Segmentation and Computed Tomography Radiomics. Arterioscler Thromb Vasc Biol 2022; 42:e228-e241. [PMID: 35708025 PMCID: PMC9339530 DOI: 10.1161/atvbaha.122.317761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Coronary calcification associates closely with cardiovascular risk, but its progress is accelerated in response to some interventions widely used to reduce risk. This paradox suggests that qualitative, not just quantitative, changes in calcification may affect plaque stability. To determine if the microarchitecture of calcification varies with aging, Western diet, statin therapy, and high intensity, progressive exercise, we assessed changes in a priori selected computed tomography radiomic features (intensity, size, shape, and texture). METHODS Longitudinal computed tomography scans of mice (Apoe-/-) exposed to each of these conditions were autosegmented by deep learning segmentation, and radiomic features of the largest deposits were analyzed. RESULTS Over 20 weeks of aging, intensity and most size parameters increased, but surface-area-to-volume ratio (a measure of porosity) decreased, suggesting stabilization. However, texture features (coarseness, cluster tendency, and nonuniformity) increased, suggesting heterogeneity and likely destabilization. Shape parameters showed no significant changes, except sphericity, which showed a decrease. The Western diet had significant effects on radiomic features related to size and texture, but not intensity or shape. In mice undergoing either pravastatin treatment or exercise, the selected radiomic features of their computed tomography scans were not significantly different from those of their respective controls. Interestingly, the total number of calcific deposits increased significantly less in the 2 intervention groups compared with the respective controls, suggesting more coalescence and/or fewer de novo deposits. CONCLUSIONS Thus, aging and standard interventions alter the microarchitectural features of vascular calcium deposits in ways that may alter plaque biomechanical stability.
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Affiliation(s)
- Nikhil Rajesh Patel
- Department of Medicine, University of California, Los Angeles. (N.R.P., K.S., S.P., M.L., L.L.D., Y.T.)
| | - Kulveer Setya
- Department of Medicine, University of California, Los Angeles. (N.R.P., K.S., S.P., M.L., L.L.D., Y.T.)
| | - Stuti Pradhan
- Department of Medicine, University of California, Los Angeles. (N.R.P., K.S., S.P., M.L., L.L.D., Y.T.)
| | - Mimi Lu
- Department of Medicine, University of California, Los Angeles. (N.R.P., K.S., S.P., M.L., L.L.D., Y.T.)
| | - Linda L Demer
- Department of Medicine, University of California, Los Angeles. (N.R.P., K.S., S.P., M.L., L.L.D., Y.T.).,Department of Bioengineering, University of California, Los Angeles. (L.L.D.).,Department of Physiology, University of California, Los Angeles. (L.L.D., Y.T.).,VA Greater Los Angeles Healthcare System, CA (L.L.D., Y.T.)
| | - Yin Tintut
- Department of Medicine, University of California, Los Angeles. (N.R.P., K.S., S.P., M.L., L.L.D., Y.T.).,Department of Physiology, University of California, Los Angeles. (L.L.D., Y.T.).,Department of Orthopaedic Surgery, University of California, Los Angeles. (Y.T.).,VA Greater Los Angeles Healthcare System, CA (L.L.D., Y.T.)
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Peng JF, Salami OM, Lei C, Ni D, Habimana O, Yi GH. Targeted mitochondrial drugs for treatment of Myocardial ischemia-reperfusion injury. J Drug Target 2022; 30:833-844. [PMID: 35652502 DOI: 10.1080/1061186x.2022.2085728] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Myocardial ischemia-reperfusion injury (MI/RI) refers to the further damage done to ischemic cardiomyocytes when restoring blood flow. A large body of evidence shows that MI/RI is closely associated with excessive production of mitochondrial reactive oxygen species, mitochondrial calcium overload, disordered mitochondrial energy metabolism, mitophagy, mitochondrial fission, and mitochondrial fusion. According to the way it affects mitochondria, it can be divided into mitochondrial quality abnormalities and mitochondrial quantity abnormalities. Abnormal mitochondrial quality refers to the dysfunction caused by the severe destruction of mitochondria, which then affects the balance of mitochondrial density and number, causing an abnormal mitochondrial quantity. In the past, most of the reports were limited to the study of the mechanism of myocardial ischemia-reperfusion injury, some of which involved mitochondria, but no specific countermeasures were proposed. In this review, we outline the mechanisms for treating myocardial ischemia-reperfusion injury from the direction of mitochondria and focus on targeted interventions and drugs to restore mitochondrial health during abnormal mitochondrial quality control and abnormal mitochondrial quantity control. This is an update in the field of myocardial ischemia-reperfusion injury.
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Affiliation(s)
- Jin-Fu Peng
- Institute of Pharmacy and Pharmacology, Hunan province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, Hunan, 421001, China.,Institute of Cardiovascular Disease, Key Laboratory for Arteriosclerology of Hunan Province, Hunan International Scientific and Technological Cooperation Base of Arteriosclerotic Disease, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | | | - Cai Lei
- Institute of Cardiovascular Disease, Key Laboratory for Arteriosclerology of Hunan Province, Hunan International Scientific and Technological Cooperation Base of Arteriosclerotic Disease, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Dan Ni
- Institute of Cardiovascular Disease, Key Laboratory for Arteriosclerology of Hunan Province, Hunan International Scientific and Technological Cooperation Base of Arteriosclerotic Disease, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
| | - Olive Habimana
- International College, University of South China, 28 W Changsheng Road, Hengyang, Hunan 421001, China
| | - Guang-Hui Yi
- Institute of Pharmacy and Pharmacology, Hunan province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, Hunan, 421001, China.,Institute of Cardiovascular Disease, Key Laboratory for Arteriosclerology of Hunan Province, Hunan International Scientific and Technological Cooperation Base of Arteriosclerotic Disease, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China
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Harnett J, Climstein M, Walsh J, Gifford J. The Use of Medications and Dietary Supplements by Masters Athletes - a Review. Curr Nutr Rep 2022; 11:253-262. [PMID: 35635719 PMCID: PMC9174319 DOI: 10.1007/s13668-022-00398-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE OF REVIEW Masters athletes (MA) are generally considered healthier than their sedentary peers. However, the prevalence of chronic conditions in any population increases with age. Treatments involve pharmacological and non-pharmacological interventions. A substantial proportion of the general population also use dietary supplements (DS). This raises questions about the potential for drug-nutrient interactions which may lead to adverse effects. We sought to determine the potential for drug-nutrient interactions MA may be exposed to by examining the prevalence of chronic conditions treated with medications and their DS use. RECENT FINDINGS Common conditions in MA include hypertension, hyperlipidemia, asthma, osteoarthritis, depression and anxiety. Treatments may involve prescribed medications. Few recent studies were identified on DS use; however, indications are for around 60% prevalence of supplement usage. The higher prevalence of DS use by MA may result in drug-nutrient interactions that impact the effectiveness and safety of prescribed medications for chronic conditions.
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Affiliation(s)
- Joanna Harnett
- Nutritional Pharmacology, Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2005 Australia
| | - Mike Climstein
- Clinical Exercise Physiology, Faculty of Health, Southern Cross University, Bilinga, QLD 4225 Australia
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, The University of Sydney, Camperdown, Australia
| | - Joe Walsh
- Sport Science Institute, Sydney, NSW Australia
| | - Janelle Gifford
- Discipline of Exercise and Sport Science, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2005 Australia
- Sport and Physical Activity Research and Teaching Network, The University of Sydney, Sydney, Australia
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Hyperparathyroidism Possibly Causing Increased Coronary Artery Calcification. Am J Cardiol 2022; 172:164-165. [PMID: 35361476 DOI: 10.1016/j.amjcard.2022.02.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 02/28/2022] [Accepted: 02/28/2022] [Indexed: 11/21/2022]
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Vesterbekkmo EK, Madssen E, Aamot Aksetøy I, Follestad T, Nilsen HO, Hegbom K, Wisløff U, Wiseth R. CENIT (Impact of Cardiac Exercise Training on Lipid Content in Coronary Atheromatous Plaques Evaluated by Near‐Infrared Spectroscopy): A Randomized Trial. J Am Heart Assoc 2022; 11:e024705. [PMID: 35574968 PMCID: PMC9238565 DOI: 10.1161/jaha.121.024705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background The effect of physical exercise on lipid content of coronary artery plaques is unknown. With near infrared spectroscopy we measured the effect of high intensity interval training (HIIT) on lipid content in coronary plaques in patients with stable coronary artery disease following percutaneous coronary intervention. Methods and Results In CENIT (Impact of Cardiac Exercise Training on Lipid Content in Coronary Atheromatous Plaques Evaluated by Near‐Infrared Spectroscopy) 60 patients were randomized to 6 months supervised HIIT or to a control group. The primary end point was change in lipid content measured as maximum lipid core burden index at 4 mm (maxLCBI4mm). A predefined cutoff of maxLCBI4mm >100 was required for inclusion in the analysis. Forty‐nine patients (HIIT=20, usual care=29) had maxLCBI4mm >100 at baseline. Change in maxLCBI4mm did not differ between groups (−1.2, 95% CI, −65.8 to 63.4, P=0.97). The estimated reduction in maxLCBI4mm was −47.7 (95% CI, −100.3 to 5.0, P=0.075) and −46.5 (95% CI, −87.5 to −5.4, P=0.027) after HIIT and in controls, respectively. A negative correlation was observed between change in peak oxygen uptake (VO2peak) and change in lipid content (Spearman’s correlation −0.44, P=0.009). With an increase in VO2peak above 1 metabolic equivalent task, maxLCBI4mm was on average reduced by 142 (−8 to −262), whereas the change was −3.2 (154 to −255) with increased VO2peak below 1 metabolic equivalent task. Conclusions Six months of HIIT following percutaneous coronary intervention did not reduce lipid content in coronary plaques compared with usual care. A moderate negative correlation between increase in VO2peak and change in lipid content generates the hypothesis that exercise with a subsequent increase in fitness may reduce lipid content in coronary atheromatous plaques. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT02494947.
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Affiliation(s)
- Elisabeth Kleivhaug Vesterbekkmo
- Clinic of Cardiology St. Olavs University Hospital Trondheim Norway
- Department of Circulation and Medical Imaging Norwegian University of Science and Technology Trondheim Norway
- National Advisory Unit on Exercise Training as Medicine for Cardiopulmonary Conditions Trondheim Norway
| | - Erik Madssen
- Clinic of Cardiology St. Olavs University Hospital Trondheim Norway
- Department of Circulation and Medical Imaging Norwegian University of Science and Technology Trondheim Norway
| | - Inger‐Lise Aamot Aksetøy
- Clinic of Cardiology St. Olavs University Hospital Trondheim Norway
- Department of Circulation and Medical Imaging Norwegian University of Science and Technology Trondheim Norway
- National Advisory Unit on Exercise Training as Medicine for Cardiopulmonary Conditions Trondheim Norway
| | - Turid Follestad
- Department of Clinical and Molecular Medicine Norwegian University of Science and Technology Trondheim Norway
| | - Hans Olav Nilsen
- Clinic of Cardiology St. Olavs University Hospital Trondheim Norway
- Department of Circulation and Medical Imaging Norwegian University of Science and Technology Trondheim Norway
| | - Knut Hegbom
- Clinic of Cardiology St. Olavs University Hospital Trondheim Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging Norwegian University of Science and Technology Trondheim Norway
- School of Human Movement and Nutrition Science University of Queensland Australia
| | - Rune Wiseth
- Clinic of Cardiology St. Olavs University Hospital Trondheim Norway
- Department of Circulation and Medical Imaging Norwegian University of Science and Technology Trondheim Norway
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Jae SY, Kim HJ, Lee KH, Kunutsor SK, Heffernan KS, Choi YH, Kang M. Joint Associations of Obesity and Cardiorespiratory Fitness With Coronary Artery Calcium Composition: IS THERE EVIDENCE FOR FAT-BUT-FIT? J Cardiopulm Rehabil Prev 2022; 42:202-207. [PMID: 35135962 DOI: 10.1097/hcr.0000000000000631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The purpose of this study was to examine the individual and joint associations of obesity and cardiorespiratory fitness (CRF) with indices of coronary artery calcification (CAC) in 2090 middle-aged men. METHODS Obesity was defined as a body mass index (BMI) ≥25 kg/m2 and a waist circumference (WC) ≥90 cm. Cardiorespiratory fitness was operationally defined as peak oxygen uptake (V˙o2peak) directly measured using gas analysis. Participants were then divided into unfit and fit categories based on age-specific V˙o2peak percentiles. Agatston scores >100 and volume and density scores >75th percentile were defined as indices of CAC, signifying advanced subclinical atherosclerosis. RESULTS Obese men had increased CAC Agatston, volume, and density scores, while higher CRF was associated with lower Agatston and volume scores after adjusting for potential confounders. In the joint analysis, unfit-obese men had higher CAC Agatston and CAC volume. The fit-obesity category was not associated with CAC Agatston (OR = 0.91: 95% CI, 0.66-1.25, for BMI and OR = 1.21: 95% CI, 0.86-1.70, for WC) and CAC volume (OR = 1.14: 95% CI, 0.85-1.53, for BMI and OR = 1.23: 95% CI, 0.90-1.69, for WC), which were similar to estimates for the fit-normal weight category. CONCLUSIONS These findings demonstrate that while obesity is positively associated with the prevalence of moderate to severe CAC scores, CRF is inversely associated with the prevalence of moderate to severe CAC scores. Additionally, the combination of being fit and obese was not associated with CAC scores, which could potentially reinforce the fat-but-fit paradigm.
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Affiliation(s)
- Sae Young Jae
- Department of Sport Science, University of Seoul, Seoul, South Korea (Drs Jae and Kim); Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea (Mr Lee and Drs Choi and Kang); National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK (Dr Kunutsor); Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, UK (Dr Kunutsor); Department of Exercise Science, Syracuse University, Syracuse, New York (Dr Heffernan); and Division of Urban Social Health, Graduate School of Urban Public Health, University of Seoul, Seoul, South Korea (Dr Jae)
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Stanton KM, Liu H, Kienzle V, Bursill C, Bao S, Celermajer DS. The Effects of Exercise on Plaque Volume and Composition in a Mouse Model of Early and Late Life Atherosclerosis. Front Cardiovasc Med 2022; 9:837371. [PMID: 35419434 PMCID: PMC8995971 DOI: 10.3389/fcvm.2022.837371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/17/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundExercise is associated with a less atherogenic lipid profile; however, there is limited research on the effect of exercise on atherosclerotic plaque composition and markers of plaque stability.MethodsA total of 110 apolipoprotein (apo)E−/− mice were placed on a chow diet and randomly assigned to control or exercise for a period of 10 weeks, commencing either at 12 weeks of age (the early-stage atherosclerosis, EA group) or at 40 weeks of age (the late-stage atherosclerosis, LA group). At the end of the exercise period, blood was assayed for lipids. Histologic analysis of the aortic sinus was undertaken to assess plaque size and composition that includes macrophage content, monocyte chemoattractant protein (MCP)-1, matrix metalloproteinase-2 (MMP-2), and tissue inhibitors of metalloproteinase 1 and 2 (TIMP-1 and 2).ResultsA total of 103 mice (38 EA, 65 LA) completed the protocol. In the EA group, exercise reduced plasma total cholesterol (TC) (−16%), free cholesterol (−13%), triglyceride (TG) (−35%), and phospholipid (−27%) levels, when compared to sedentary control mice (p < 0.01). In the EA group, exercise also significantly reduced plaque stenosis (−25%, p < 0.01), and there were higher levels of elastin (3-fold increase, p < 0.0001) and collagen (11-fold increase, p < 0.0001) in plaques, compared to control mice. There was an increase in plaque MMP-2 content in the exercise group (13% increase, p < 0.05) but no significant difference in macrophage or MCP-1 content. In the LA group, exercise reduced plaque stenosis (−18%, p < 0.05), but there was no significant difference in plaque composition. There was no difference in macrophage, MCP-1, or MMP-2 content in the LA groups. TIMP-1 was lower with exercise in both the EA and LA groups (−59%, p < 0.01 and −51%, p < 0.01 respectively); however, there was no difference in TIMP-2 levels.ConclusionA 10-week exercise period reduces atherosclerotic plaque stenosis when commenced at both early- and late-stage atherosclerosis. Intervening earlier with exercise had a greater beneficial effect on lipids and plaque composition than when starting exercise at a later disease stage.
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Affiliation(s)
- Kelly M. Stanton
- Clinical Research Group, Heart Research Institute, Sydney, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- *Correspondence: Kelly M. Stanton
| | - Hongjuan Liu
- Discipline of Pathology and School of Medical Science, University of Sydney, Sydney, NSW, Australia
| | - Vivian Kienzle
- Clinical Research Group, Heart Research Institute, Sydney, NSW, Australia
| | - Christina Bursill
- Clinical Research Group, Heart Research Institute, Sydney, NSW, Australia
- Vascular Research Centre, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
- Faculty of Health and Medical Science, University of Adelaide, Adelaide, SA, Australia
| | - Shisan Bao
- Discipline of Pathology and School of Medical Science, University of Sydney, Sydney, NSW, Australia
| | - David S. Celermajer
- Clinical Research Group, Heart Research Institute, Sydney, NSW, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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