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Sánchez-González JL, Sánchez-Rodríguez JL, Varela-Rodríguez S, González-Sarmiento R, Rivera-Picón C, Juárez-Vela R, Tejada-Garrido CI, Martín-Vallejo J, Navarro-López V. Effects of Physical Exercise on Telomere Length in Healthy Adults: Systematic Review, Meta-Analysis, and Meta-Regression. JMIR Public Health Surveill 2024; 10:e46019. [PMID: 38194261 PMCID: PMC10806448 DOI: 10.2196/46019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 07/03/2023] [Accepted: 10/24/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Physical exercise is one of the main nonpharmacological treatments for most pathologies. In addition, physical exercise is beneficial in the prevention of various diseases. The impact of physical exercise has been widely studied; however, existing meta-analyses have included diverse and heterogeneous samples. Therefore, to our knowledge, this is the first meta-analysis to evaluate the impact of different physical exercise modalities on telomere length in healthy populations. OBJECTIVE In this review, we aimed to determine the effect of physical exercise on telomere length in a healthy population through a meta-analysis of randomized controlled trials. METHODS A systematic review with meta-analysis and meta-regression of the published literature on the impact of physical exercise on telomere length in a healthy population was performed. PubMed, Cochrane Library, SCOPUS, Web of Science, and Embase databases were searched for eligible studies. Methodological quality was evaluated using the Risk Of Bias In Nonrandomized Studies of Interventions and the risk-of-bias tool for randomized trials. Finally, the certainty of our findings (closeness of the estimated effect to the true effect) was evaluated using Grading of Recommendations, Assessment, Development, and Evaluations (GRADE). RESULTS We included 9 trials that met the inclusion criteria with fair methodological quality. Random-effects model analysis was used to quantify the difference in telomere length between the exercise and sham groups. Meta-analysis showed that exercise did not significantly increase telomere length compared with the control intervention (mean difference=0.0058, 95% CI -0.05 to 0.06; P=.83). Subgroup analysis suggested that high-intensity interventional exercise significantly increased telomere length compared with the control intervention in healthy individuals (mean difference=0.15, 95% CI 0.03-0.26; P=.01). Furthermore, 56% of the studies had a high risk of bias. Certainty was graded from low to very low for most of the outcomes. CONCLUSIONS The findings of this systematic review and meta-analysis suggest that high-intensity interval training seems to have a positive effect on telomere length compared with other types of exercise such as resistance training or aerobic exercise in a healthy population. TRIAL REGISTRATION PROSPERO CRD42022364518; http://tinyurl.com/4fwb85ff.
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Affiliation(s)
| | - Juan Luis Sánchez-Rodríguez
- Department of Basic Psychology, Psychobiology and Methodology, Faculty of Psychology, University of Salamanca, Salamanca, Spain
| | | | - Rogelio González-Sarmiento
- Molecular Medicine Unit, Instituto de Investigación Biomédica de Salamanca, University of Salamanca-Sanidad de Castilla y León - Consejo Superior de Investigaciones Científicas, Salamanca, Spain
| | - Cristina Rivera-Picón
- Faculty of Health Sciences, Nursing, Pontifical University of Salamanca, Salamanca, Spain
| | - Raúl Juárez-Vela
- Nursing Department, Faculty of Heatlh Sciences, University of La Rioja, Logroño, Spain
| | | | - Javier Martín-Vallejo
- Departament of Stadístics, Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - Víctor Navarro-López
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
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Bertomeu-Gonzalez V, Cordero A, Ruiz-Nodar JM, Sánchez-Ferrer F, López-Pineda A, Quesada JA. Risk factors for major adverse cardiovascular events in postmenopausal women: UK Biobank prospective cohort study. Atherosclerosis 2023; 386:117372. [PMID: 37976635 DOI: 10.1016/j.atherosclerosis.2023.117372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 10/24/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND AND AIMS Cardiovascular risk increases during menopause, so the medical and scientific community should consider women's specific risk factors to prevent cardiovascular disease. This study aims to assess the risk factors for the incidence of major adverse cardiovascular events (MACE) exclusive to postmenopausal women. METHODS We conducted a prospective cohort study in postmenopausal women aged 40 years and older, who were included in the UK Biobank cohort between 2006 and 2010 and followed to 2021 (12 years). A total of 156,787 women were followed for a median of 12.5 years (nearly 2 million person-years), and MACE risk was assessed using Fine-Gray competing risk models. RESULTS The cumulative incidence of cardiovascular morbidity and mortality was 1.2% (0.97 cases per 1000 women-years). Not having taken birth control pills, not having children, and early menarche (≤12 years) were independently associated with cardiovascular morbidity and mortality. CONCLUSIONS Risk factors for cardiovascular disease that are specific to women include early menarche, not having taken oral contraceptives, and reproductive history, and this relationship is independent of classic cardiovascular risk factors.
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Affiliation(s)
- Vicente Bertomeu-Gonzalez
- Cardiology Department, Benidorm Clinical Hospital, Benidorm, Spain; GRINCAVA Research Group, Clinical Medicine Department, University Miguel Hernández de Elche, Alicante, Spain
| | - Alberto Cordero
- GRINCAVA Research Group, Clinical Medicine Department, University Miguel Hernández de Elche, Alicante, Spain; Cardiology Department, Hospital IMED, Alicante, Spain; Cardiovascular CIBER, Madrid, Spain
| | - Juan Miguel Ruiz-Nodar
- GRINCAVA Research Group, Clinical Medicine Department, University Miguel Hernández de Elche, Alicante, Spain; Cardiology Department, University Hospital Dr. Balmis de Alicante, Alicante, Spain
| | - Francisco Sánchez-Ferrer
- GRINCAVA Research Group, Clinical Medicine Department, University Miguel Hernández de Elche, Alicante, Spain; Pediatrics Department, University Hospital San Juan de Alicante, Alicante, Spain
| | - Adriana López-Pineda
- GRINCAVA Research Group, Clinical Medicine Department, University Miguel Hernández de Elche, Alicante, Spain; Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, Alicante, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Alicante, Spain.
| | - José Antonio Quesada
- GRINCAVA Research Group, Clinical Medicine Department, University Miguel Hernández de Elche, Alicante, Spain; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Alicante, Spain
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Reljic D, Koller A, Herrmann HJ, Ekici AB, Neurath MF, Zopf Y. Differential Effects of Very-Low-Volume Exercise Modalities on Telomere Length, Inflammation, and Cardiometabolic Health in Obese Metabolic Syndrome Patients: A Subanalysis from Two Randomized Controlled Trials. Antioxidants (Basel) 2023; 12:1847. [PMID: 37891926 PMCID: PMC10603979 DOI: 10.3390/antiox12101847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Oxidative stress (OS) and inflammation are features of metabolic syndrome (MetS) that can contribute to the shortening of telomere length (TL), a marker of cellular ageing. Research indicates that exercise can positively influence MetS-associated conditions and TL. However, the effects of low-volume exercise types on TL are still unknown. We investigated the impact of very-low-volume high-intensity interval training (LV-HIIT), one-set resistance training (1-RT), and whole-body electromyostimulation (WB-EMS) on TL, inflammation, and cardiometabolic indices in 167 MetS patients. Data were derived from two randomized controlled trials where patients were allocated to an exercise group (2 sessions/week, for 12 weeks) or a control group. All groups received standard-care nutritional weight loss counselling. TL was determined as the T/S ratio (telomere to single-copy gene amount). All groups significantly reduced body weight (p < 0.05), but the T/S-ratio (p < 0.001) only increased with LV-HIIT. OS-related inflammatory markers (C-reactive protein, interleukin-6, and lipopolysaccharide-binding protein) only decreased (p < 0.05) following LV-HIIT. The MetS severity z-score improved with LV-HIIT (p < 0.001) and 1-RT (p = 0.014) but not with WB-EMS. In conclusion, very-low-volume exercise modalities have differential effects on telomeres, inflammation, and cardiometabolic health. Only LV-HIIT but not strength-based low-volume exercise increased TL in MetS patients, presumably due to superior effects on OS-related inflammatory markers.
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Affiliation(s)
- Dejan Reljic
- Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (H.J.H.); (M.F.N.); (Y.Z.)
- Hector-Center for Nutrition, Exercise and Sports, Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
- German Center Immunotherapy (DZI), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Adriana Koller
- Institute of Genetic Epidemiology, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - Hans J. Herrmann
- Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (H.J.H.); (M.F.N.); (Y.Z.)
- Hector-Center for Nutrition, Exercise and Sports, Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
- German Center Immunotherapy (DZI), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Arif B. Ekici
- Institute of Human Genetics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany;
| | - Markus F. Neurath
- Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (H.J.H.); (M.F.N.); (Y.Z.)
- German Center Immunotherapy (DZI), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Yurdagül Zopf
- Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany; (H.J.H.); (M.F.N.); (Y.Z.)
- Hector-Center for Nutrition, Exercise and Sports, Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
- German Center Immunotherapy (DZI), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
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Marti A, Fernández de la Puente M, Canudas S, Zalba G, Razquin C, Valle-Hita C, Fitó M, Martínez-González MÁ, García-Calzón S, Salas-Salvadó J. Effect of a 3-year lifestyle intervention on telomere length in participants from PREDIMED-Plus: A randomized trial. Clin Nutr 2023; 42:1581-1587. [PMID: 37478811 DOI: 10.1016/j.clnu.2023.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/12/2023] [Accepted: 06/28/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND & AIMS Short telomeres have been observed in chronic disease patients. Identifying environmental and lifestyle factors that could reduce telomere attrition is crucial for disease prevention. The aim of this work was to determine whether weight-loss induced by an energy-reduced Mediterranean diet (erMedDiet) and physical activity (PA) could modify telomere length (TL). METHODS In 317 randomized non-smoker participants (mean age, 65.8 ± 4.98 years) with metabolic syndrome from two "Prevención con Dieta Mediterránea-Plus" (PREDIMED-Plus) trial centers, we evaluated MedDiet adherence, PA, anthropometric variables and TL at baseline and after a 3-year intervention using an intensive lifestyle program (IG) with an erMedDiet and PA or an unrestricted MedDiet without PA promotion (CG). RESULTS Participants in the IG displayed greater 3-year weight reductions (-3.7 ± 4 kg, P < 0.001) compared to those in the CG. No differences in TL changes between groups were observed in the cohort as a whole. However, an interaction was observed between the intervention group and sex for TL changes (pinteraction = 0.039). Women in the IG showed an increase in TL after 3-y (+0.25 ± 0.9, relative units) compared to women in the CG (-0.07 ± 1.0) (pANCOVA = 0.036), whereas no differences between groups were observed in men. Women in the IG had a lower risk of telomere shortening after the intervention (OR = 0.17, 95%CI: 0.05-0.64, p = 0.008) compared to women in the CG. CONCLUSIONS A 3-year lifestyle intervention based on an erMedDiet and PA slowed telomere shortening in women but not in men. TRIAL REGISTRATION ISRCTN, ISRCTN89898870. Registered 24 July 2014- Retrospectively registered, https://www.isrctn.com/ISRCTN89898870.
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Affiliation(s)
- Amelia Marti
- Consorcio CIBER, M.P. Fisiopatología de La Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Nutrition, Food Sciences and Physiology, Center for Nutrition and Research, University of Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), University of Navarra, Pamplona, Spain.
| | - María Fernández de la Puente
- Consorcio CIBER, M.P. Fisiopatología de La Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentació, Nutrició, Desenvolupament i Salut Mental (ANUT-DSM), Unitat de Nutrició Humana, Reus, Spain; Institut D'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari San Joan de Reus, Reus, Spain
| | - Silvia Canudas
- Department of Nutrition, Food Sciences and Gastronomy, School of Pharmacy and Food Sciences, Food Torribera Campus, University of Barcelona, Santa Coloma de Gramenet, Spain; Institute of Nutrition and Food Safety of the University of Barcelona, INSA-UB Maria de Maeztu Unit of Excellence, Santa Coloma de Gramenet, Spain.
| | - Guillermo Zalba
- Navarra Institute for Health Research (IdiSNA), University of Navarra, Pamplona, Spain; Department of Biochemistry and Genetics, University of Navarra, Pamplona, Spain
| | - Cristina Razquin
- Consorcio CIBER, M.P. Fisiopatología de La Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Navarra Institute for Health Research (IdiSNA), University of Navarra, Pamplona, Spain; Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
| | - Cristina Valle-Hita
- Consorcio CIBER, M.P. Fisiopatología de La Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentació, Nutrició, Desenvolupament i Salut Mental (ANUT-DSM), Unitat de Nutrició Humana, Reus, Spain; Institut D'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari San Joan de Reus, Reus, Spain
| | - Montse Fitó
- Consorcio CIBER, M.P. Fisiopatología de La Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Cardiovascular Risk and Nutrition Research Group (CARIN), Hospital Del Mar Research Institute (IMIM), Barcelona, Spain
| | - Miguel Ángel Martínez-González
- Consorcio CIBER, M.P. Fisiopatología de La Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Navarra Institute for Health Research (IdiSNA), University of Navarra, Pamplona, Spain; Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Sonia García-Calzón
- Department of Nutrition, Food Sciences and Physiology, Center for Nutrition and Research, University of Navarra, Pamplona, Spain; Epigenetic and Diabetes Unit, Department of Clinical Sciences, Lund University Diabetes Center, Scania University Hospital, Malmö, Sweden.
| | - Jordi Salas-Salvadó
- Consorcio CIBER, M.P. Fisiopatología de La Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Alimentació, Nutrició, Desenvolupament i Salut Mental (ANUT-DSM), Unitat de Nutrició Humana, Reus, Spain; Institut D'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari San Joan de Reus, Reus, Spain
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Bovolini A, Costa-Brito AR, Martins F, Furtado GE, Mendonça GV, Vila-Chã C. Impact of Exercise on Vascular Function in Middle-Aged and Older Adults: A Scoping Review. Sports (Basel) 2022; 10:sports10120208. [PMID: 36548505 PMCID: PMC9786288 DOI: 10.3390/sports10120208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/02/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
There is a substantial literature gap related to the vascular response to different types of exercise training in middle-aged and older populations. Thus, this scoping review aimed to examine the outcomes of controlled trials testing the long-term effects of exercise interventions on vascular function-related outcomes in middle-aged and older populations. The literature search was conducted following PRISMA guidelines. Data sources: five databases were used (EBSCO, MEDLINE, Web of Science, Science Direct, and Google Scholar). Eligibility criteria: controlled trials, published in the last 10 years, in English, containing well-described exercise interventions, reporting vascular quantitative effects of exercise in middle-aged and older people. A total of 62 publications were included. The studies included distinct types and intensities of exercise and were heterogeneous in volume and frequency. The assessed vascular outcomes also presented considerable variability. Overall, most studies reported positive effects of exercise on vascular function outcomes, regardless of exercise characteristics. Different exercise interventions can be applied to improve vascular function in middle-aged and older adults. Studies on combined and stretching exercises reported encouraging results in improving vascular function. Stretching exercises rise as an effective alternative in promoting vascular function among older adults, while combined exercise delivered promising vascular benefits in both populations.
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Affiliation(s)
- Antonio Bovolini
- Laboratory for the Evaluation of Sports Performance, Physical Exercise, and Health (LABMOV), Polytechnic of Guarda, 6300-559 Guarda, Portugal
- Research Center in Sports Sciences, Health Sciences, and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Correspondence: (A.B.); (C.V.-C.)
| | - Ana Raquel Costa-Brito
- Laboratory for the Evaluation of Sports Performance, Physical Exercise, and Health (LABMOV), Polytechnic of Guarda, 6300-559 Guarda, Portugal
| | - Faber Martins
- Laboratory for the Evaluation of Sports Performance, Physical Exercise, and Health (LABMOV), Polytechnic of Guarda, 6300-559 Guarda, Portugal
| | - Guilherme Eustáquio Furtado
- Laboratory for the Evaluation of Sports Performance, Physical Exercise, and Health (LABMOV), Polytechnic of Guarda, 6300-559 Guarda, Portugal
| | - Gonçalo V. Mendonça
- Neuromuscular Research Laboratory, Faculty of Human Motricity, University of Lisbon, Cruz Quebrada-Dafundo, 1495-751 Lisbon, Portugal
- Interdisciplinary Centre for the Study of Human Performance (CIPER), Faculty of Human Motricity, University of Lisbon, Cruz Quebrada-Dafundo, 1495-751 Lisbon, Portugal
| | - Carolina Vila-Chã
- Laboratory for the Evaluation of Sports Performance, Physical Exercise, and Health (LABMOV), Polytechnic of Guarda, 6300-559 Guarda, Portugal
- Research Center in Sports Sciences, Health Sciences, and Human Development (CIDESD), 5001-801 Vila Real, Portugal
- Correspondence: (A.B.); (C.V.-C.)
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Schellnegger M, Lin AC, Hammer N, Kamolz LP. Physical Activity on Telomere Length as a Biomarker for Aging: A Systematic Review. Sports Med - Open 2022; 8:111. [PMID: 36057868 PMCID: PMC9441412 DOI: 10.1186/s40798-022-00503-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 08/07/2022] [Indexed: 11/25/2022]
Abstract
Background Overall life expectancy continues to rise, approaching 80 years of age in several developed countries. However, healthy life expectancy lags far behind, which has, in turn, contributed to increasing costs in healthcare. One way to improve health and attenuate the socio-economic impact of an aging population is to increase overall fitness through physical activity. Telomere attrition or shortening is a well-known molecular marker in aging. As such, several studies have focused on whether exercise influences health and aging through telomere biology. This systematic review examines the recent literature on the effect of physical activity on telomere length (TL) and/or telomerase activity as molecular markers of aging. Methods A focused search was performed in the databases PubMed and Web of Science for retrieving relevant articles over the past ten years. The search contained the following keywords: exercise, sport, physical activity, fitness, sedentary, physical inactivity, telomere, telomere length, t/s ratio, and telomerase. PRISMA guidelines for systematic reviews were observed. Results A total of 43 articles were identified and categorized into randomized controlled trials (RCT), observational or interventional studies. RCTs (n = 8) showed inconsistent findings of increased TL length with physical activity in, e.g. obese, post-menopausal women. In comparison with a predominantly sedentary lifestyle, observational studies (n = 27) showed significantly longer TL with exercise of moderate to vigorous intensity; however, there was no consensus on the duration and type of physical activity and training modality. Interventional studies (n = 8) also showed similar findings of significantly longer TL prior to exercise intervention; however, these studies had smaller numbers of enrolled participants (mostly of high-performance athletes), and the physical activities covered a range of exercise intensities and duration. Amongst the selected studies, aerobic training of moderate to vigorous intensity is most prevalent. For telomere biology analysis, TL was determined mainly from leukocytes using qPCR. In some cases, especially in RCT and interventional studies, different sample types such as saliva, sperm, and muscle biopsies were analyzed; different leukocyte cell types and potential genetic markers in regulating telomere biology were also investigated. Conclusions Taken together, physical activity with regular aerobic training of moderate to vigorous intensity appears to help preserve TL. However, the optimal intensity, duration of physical activity, as well as type of exercise still need to be further elucidated. Along with TL or telomerase activity, participants’ fitness level, the type of physical activity, and training modality should be assessed at different time points in future studies, with the plan for long-term follow-up. Reducing the amount of sedentary behavior may have a positive effect of preserving and increasing TL. Further molecular characterization of telomere biology in different cell types and tissues is required in order to draw definitive causal conclusions on how physical activity affects TL and aging.
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Buttet M, Bagheri R, Ugbolue UC, Laporte C, Trousselard M, Benson A, Bouillon-Minois JB, Dutheil F. Effect of a lifestyle intervention on telomere length: A systematic review and meta-analysis. Mech Ageing Dev 2022; 206:111694. [PMID: 35760212 DOI: 10.1016/j.mad.2022.111694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 06/22/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND We conducted a systematic review and meta-analysis to assess the effects of lifestyle intervention on telomere length (TL). METHOD Four databases were searched for studies reporting TL in leukocytes, before and after a lifestyle intervention. We computed random-effects meta-analysis on TL within intervention and control group after versus before intervention, and on changes in TL between groups. Sensitivity analyses and Meta-regression were conducted. RESULTS We included 20 studies in the systematic review (2995 participants, mean 50.3 years old, 77% women, 2045 following an intervention and 950 controls) and 19 in the meta-analysis. TL were similar at baseline between intervention and control groups. The physical activity ± diet group had an increase in TL (Effect size 0.17, 95%CI 0.03-0.31, p = 0.020) using changes within the intervention group, whereas TL shortened in the control group (-0.32, -0.61 to -0.02, p = 0.037). TL was longer in the physical activity ± diet intervention group (0.24, 0.08-0.40, p = 0.004) compared to controls after the intervention. Sensitivity analysis gave similar results. Meta-regressions demonstrated that combining strength and endurance exercise increased TL more than endurance alone or strength alone. CONCLUSION A lifestyle intervention with physical activity ± diet can increase telomere length, independently of population characteristics or baseline TL.
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Affiliation(s)
- Marjorie Buttet
- Université Clermont Auvergne, General medicine, F-63000 Clermont-Ferrand, France
| | - Reza Bagheri
- University of Isfahan, Exercise physiology department, Isfahan, Iran
| | - Ukadike C Ugbolue
- University of the West of Scotland, Health and Life Sciences, Institute for Clinical Exercise & Health Science, University of Strathclyde, Glasgow, Scotland, UK
| | - Catherine Laporte
- Université Clermont Auvergne, EA 7280 NPsy-Sydo, General medicine, F-63000 Clermont-Ferrand, France
| | - Marion Trousselard
- French Armed Forces, Biomedical Research Institute, IRBA, Neurophysiology of Stress, Neuroscience and Operational Constraint Department, Brétigny-sur-Orge, France; APEMAC/EPSAM, EA 4360, Ile du Saulcy, 57000 Metz, France
| | - Amanda Benson
- Swinburne University of Technology, Sport Innovation Research Group, Department of Health and Biostatistics, Melbourne, VIC 3122, Australia
| | - Jean-Baptiste Bouillon-Minois
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Emergency medicine, F-63000 Clermont-Ferrand, France.
| | - Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Occupational and Environmental Medicine, WittyFit, F-63000 Clermont-Ferrand, France
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Maas AHEM, Rosano G, Cifkova R, Chieffo A, van Dijken D, Hamoda H, Kunadian V, Laan E, Lambrinoudaki I, Maclaran K, Panay N, Stevenson JC, van Trotsenburg M, Collins P. Cardiovascular health after menopause transition, pregnancy disorders, and other gynaecologic conditions: a consensus document from European cardiologists, gynaecologists, and endocrinologists. Eur Heart J 2021; 42:967-984. [PMID: 33495787 PMCID: PMC7947184 DOI: 10.1093/eurheartj/ehaa1044] [Citation(s) in RCA: 105] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/29/2020] [Accepted: 12/08/2020] [Indexed: 12/13/2022] Open
Abstract
Women undergo important changes in sex hormones throughout their lifetime that can impact cardiovascular disease risk. Whereas the traditional cardiovascular risk factors dominate in older age, there are several female-specific risk factors and inflammatory risk variables that influence a woman’s risk at younger and middle age. Hypertensive pregnancy disorders and gestational diabetes are associated with a higher risk in younger women. Menopause transition has an additional adverse effect to ageing that may demand specific attention to ensure optimal cardiovascular risk profile and quality of life. In this position paper, we provide an update of gynaecological and obstetric conditions that interact with cardiovascular risk in women. Practice points for clinical use are given according to the latest standards from various related disciplines (Figure 1).
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Affiliation(s)
- Angela H E M Maas
- Department of Cardiology, Director Women's Cardiac Health Program, Radboud University Medical Center, Geert Grooteplein-Zuid 10, Route 616, 6525GA Nijmegen, The Netherlands
| | - Giuseppe Rosano
- St George's Hospitals NHS Trust University of London, Cranmer Terrace, London SW17 0RE, UK.,Department of Medical Sciences, Centre for Clinical and Basic Research, IRCCS San Raffaele Pisana, via della Pisana, 235 Rome, Italy
| | - Renata Cifkova
- Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer Hospital, Vídeňská 800, 140 59 Prague 4, Czech Republic.,Department of Internal Cardiovascular Medicine, First Medical Faculty, Charles University in Prague and General University Hospital in Prague, U Nemocnice 2, 128 08 Prague 2, Czech Republic
| | - Alaide Chieffo
- Interventional Cardiology Unit, IRCCS San Raffaele Hospital, Olgettina Street, 60 - 20132 Milan (Milan), Italy
| | - Dorenda van Dijken
- Department of Obstetrics and Gynaecology, OLVG location West, Jan Tooropstraat 164, 1061 AE Amsterdam, The Netherlands
| | - Haitham Hamoda
- Department Gynaecology, King's College Hospital, Denmark Hill, London SE5 9RS, UK
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University and Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne NHS Foundation Trust, M4:146 4th Floor William Leech Building, Newcastle upon Tyne NE2 4HH, UK
| | - Ellen Laan
- Department of Sexology and Psychosomatic Gynaecology, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Irene Lambrinoudaki
- Menopause Clinic, 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Aretaieio Hospital, 30 Panepistimiou Str., 10679 Athens, Greece
| | - Kate Maclaran
- Department Gynaecology, Chelsea and Westminster Hospital, NHS Foundation Trust, 69 Fulham Road London SW10 9NH, UK
| | - Nick Panay
- Department of Gynaecology, Queen Charlotte's & Chelsea and Westminster Hospitals, Imperial College, Du Cane Road, London W12 0HS, UK
| | - John C Stevenson
- Department of Cardiology, National Heart & Lung Institute, Imperial College London, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK
| | - Mick van Trotsenburg
- Bureau Gender PRO Vienna and Department of Obstetrics and Gynaecology, University Hospital St. Poelten-Lilienfeld, Probst Führer Straße 4 · 3100 St. Pölten, Austria
| | - Peter Collins
- Department of Cardiology, National Heart & Lung Institute, Imperial College London, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK
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9
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Affiliation(s)
- Maciej Banach
- Department of Hypertension, Medical University of Lodz (MUL), Rzgowska 281/289, 93-338 Lodz, Poland
- Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland
- Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
| | - Peter E Penson
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK
- Liverpool Centre For Cardiovascular Science, Liverpool, UK
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10
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Torlasco C, D'Silva A, Bhuva AN, Faini A, Augusto JB, Knott KD, Benedetti G, Jones S, Zalen JV, Scully P, Lobascio I, Parati G, Lloyd G, Hughes AD, Manisty CH, Sharma S, Moon JC. Age matters: differences in exercise-induced cardiovascular remodelling in young and middle aged healthy sedentary individuals. Eur J Prev Cardiol 2020; 28:738-746. [PMID: 34247225 DOI: 10.1177/2047487320926305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/23/2020] [Indexed: 12/26/2022]
Abstract
AIMS Remodelling of the cardiovascular system (including heart and vasculature) is a dynamic process influenced by multiple physiological and pathological factors. We sought to understand whether remodelling in response to a stimulus, exercise training, altered with healthy ageing. METHODS A total of 237 untrained healthy male and female subjects volunteering for their first time marathon were recruited. At baseline and after 6 months of unsupervised training, race completers underwent tests including 1.5T cardiac magnetic resonance, brachial and non-invasive central blood pressure assessment. For analysis, runners were divided by age into under or over 35 years (U35, O35). RESULTS Injury and completion rates were similar among the groups; 138 runners (U35: n = 71, women 49%; O35: n = 67, women 51%) completed the race. On average, U35 were faster by 37 minutes (12%). Training induced a small increase in left ventricular mass in both groups (3 g/m2, P < 0.001), but U35 also increased ventricular cavity sizes (left ventricular end-diastolic volume (EDV)i +3%; left ventricular end-systolic volume (ESV)i +8%; right ventricular end-diastolic volume (EDV)i +4%; right ventricular end-systolic volume (ESV)i +5%; P < 0.01 for all). Systemic aortic compliance fell in the whole sample by 7% (P = 0.020) and, especially in O35, also systemic vascular resistance (-4% in the whole sample, P = 0.04) and blood pressure (systolic/diastolic, whole sample: brachial -4/-3 mmHg, central -4/-2 mmHg, all P < 0.001; O35: brachial -6/-3 mmHg, central -6/-4 mmHg, all P < 0.001). CONCLUSION Medium-term, unsupervised physical training in healthy sedentary individuals induces measurable remodelling of both heart and vasculature. This amount is age dependent, with predominant cardiac remodelling when younger and predominantly vascular remodelling when older.
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Affiliation(s)
- Camilla Torlasco
- Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Italy.,Department of Medicine and Surgery, University of Milano-Bicocca, Italy
| | - Andrew D'Silva
- Cardiovascular Sciences Research Centre, St George's University of London, UK
| | - Anish N Bhuva
- Institute of Cardiovascular Science, University College London, UK.,Barts Heart Centre, St Bartholomew's Hospital, UK
| | - Andrea Faini
- Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Italy
| | - Joao B Augusto
- Institute of Cardiovascular Science, University College London, UK.,Barts Heart Centre, St Bartholomew's Hospital, UK
| | - Kristopher D Knott
- Institute of Cardiovascular Science, University College London, UK.,Barts Heart Centre, St Bartholomew's Hospital, UK
| | | | - Siana Jones
- Institute of Cardiovascular Science, University College London, UK
| | - Jet Van Zalen
- Institute of Cardiovascular Science, University College London, UK
| | - Paul Scully
- Institute of Cardiovascular Science, University College London, UK.,Barts Heart Centre, St Bartholomew's Hospital, UK
| | | | - Gianfranco Parati
- Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Italy.,Department of Medicine and Surgery, University of Milano-Bicocca, Italy
| | - Guy Lloyd
- Institute of Cardiovascular Science, University College London, UK
| | - Alun D Hughes
- Institute of Cardiovascular Science, University College London, UK.,MRC Unit for Lifelong Health and Ageing, University College London, UK
| | - Charlotte H Manisty
- Institute of Cardiovascular Science, University College London, UK.,Barts Heart Centre, St Bartholomew's Hospital, UK
| | - Sanjay Sharma
- Cardiovascular Sciences Research Centre, St George's University of London, UK
| | - James C Moon
- Institute of Cardiovascular Science, University College London, UK.,Barts Heart Centre, St Bartholomew's Hospital, UK
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11
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Stenner HT, Eigendorf J, Kerling A, Kueck M, Hanke AA, Boyen J, Nelius AK, Melk A, Boethig D, Bara C, Hilfiker A, Berliner D, Bauersachs J, Hilfiker-Kleiner D, Eberhard J, Stiesch M, Schippert C, Haverich A, Tegtbur U, Haufe S. Effects of six month personalized endurance training on work ability in middle-aged sedentary women: a secondary analysis of a randomized controlled trial. J Occup Med Toxicol 2020; 15:8. [PMID: 32391068 PMCID: PMC7201966 DOI: 10.1186/s12995-020-00261-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 04/23/2020] [Indexed: 11/10/2022] Open
Abstract
Background To test the effects of guided endurance training on work ability in middle-aged female hospital workers of various occupations. Methods We randomized 265 healthy, sedentary, middle-aged women (45–65 years) to an endurance training group (EG 210 min/week) or a wait-list control group (CG). At baseline and at 6-month follow-up, we assessed work ability (Work Ability Index [WAI]), physical activity (Freiburger activity questionnaire) and peak oxygen uptake (VO2peak) by cardiopulmonary exercise testing. To examine the influence of baseline work ability, participants were divided into poor-moderate (WAI 1, 7–36 points, n = 83), good (WAI 2, 37–43 points, n = 136) and excellent (WAI 3, 44–49 points, n = 46) WAI subgroups. Results Cardiorespiratory fitness improved significantly after 6 months in the EG but not in the CG. The WAI total score increased significantly in the EG (38.3 ± 5.0 to 39.8 ± 4.9 points) but not in the CG (39.4 ± 4.7 to 39.3 ± 4.9 points), with a significant difference between groups (p < 0.01). In the EG, only the poor-moderate subgroup (WAI 1, 33.0 ± 2.9 to 36.6 ± 4.8 points, p < 0.05) increased the WAI total score, with this increase being significantly higher compared to the good (WAI 2, 40.2 ± 2.1 to, 40.4 ± 3.7 points) and excellent (WAI 3, 45.6 ± 1.5 to 45.7 ± 1.8 points) subgroup. Conclusions A 6-month guided exercise training intervention significantly increases cardiorespiratory fitness with concomitant improvements in work ability in middle-aged previously sedentary hospital employees. Women with low baseline work ability seem to particularly benefit from the intervention, which implies that similar interventions may be particularly beneficial for this group of individuals. Trial registration German Clinical Trails Register Identifier: DRKS00005159. Registered 25 September 2013.
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Affiliation(s)
- Hedwig T Stenner
- 1Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Julian Eigendorf
- 1Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Arno Kerling
- 1Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Momme Kueck
- 1Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Alexander A Hanke
- 1Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Johanna Boyen
- 1Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Anne-Katrin Nelius
- 1Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Anette Melk
- 2Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Dietmar Boethig
- 3Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Christoph Bara
- 3Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Andres Hilfiker
- 3Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Dominik Berliner
- 4Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Johann Bauersachs
- 4Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Denise Hilfiker-Kleiner
- 4Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Jörg Eberhard
- 5Department of Prosthetic Dentistry and Biomedical Material Sciences, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Meike Stiesch
- 5Department of Prosthetic Dentistry and Biomedical Material Sciences, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Cordula Schippert
- 6Department of Obstetrics and Gynecology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Axel Haverich
- 3Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Uwe Tegtbur
- 1Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Sven Haufe
- 1Institute of Sports Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
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Lam CSP, Arnott C, Beale AL, Chandramouli C, Hilfiker-Kleiner D, Kaye DM, Ky B, Santema BT, Sliwa K, Voors AA. Sex differences in heart failure. Eur Heart J 2019; 40:3859-3868c. [DOI: 10.1093/eurheartj/ehz835] [Citation(s) in RCA: 212] [Impact Index Per Article: 42.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 08/08/2019] [Accepted: 11/28/2019] [Indexed: 12/28/2022] Open
Abstract
Abstract
The overall lifetime risk of heart failure (HF) is similar between men and women, however, there are marked sex differences in the landscape of this condition that are both important and under-recognized. Men are predisposed to HF with reduced ejection fraction (HFrEF), whereas women predominate in HF with preserved ejection fraction (HFpEF). Sex differences are also notable in the penetrance of genetic cardiomyopathies, risk factors, e.g. breast cancer which may be associated with cancer treatment-induced cardiomyopathy, as well as sex-specific conditions such as peripartum cardiomyopathy (PPCM). This review outlines the key sex differences with respect to clinical characteristics, pathophysiology, and therapeutic responses to HF treatments. Finally, we address important differences in the prognosis of HF. A central hypothesis is that the higher risk of HFrEF in men compared to women may be attributable to their predisposition to macrovascular coronary artery disease and myocardial infarction, whereas coronary microvascular dysfunction/endothelial inflammation has been postulated to play a key role in HFpEF and maybe the common link among HF syndromes that women are predisposed to Takotsubo cardiomyopathy, PPCM, and breast cancer radiotherapy-induced cardiomyopathy. Under-pinning current sex disparities in HF, there is a paucity of women recruited to HF clinical trials (20–25% of cohorts) and thus treatment guidelines are predominantly based on male-derived data. Large gaps in knowledge exist in sex-specific mechanisms, optimal drug doses for women and sex-specific criteria for device therapy.
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Affiliation(s)
- Carolyn S P Lam
- National Heart Centre Singapore, 5 Hospital Drive, Singapore, Singapore
- Duke-National University of Singapore, 8 College Rd, Singapore, Singapore
- University Medical Centre Groningen, Hanzeplein 1, GZ Groningen, The Netherlands
- The George Institute, Level 5/1 King St, Newtown NSW, Sydney, Australia
| | - Clare Arnott
- The George Institute, Level 5/1 King St, Newtown NSW, Sydney, Australia
| | - Anna L Beale
- Baker Heart & Diabetes Institute, 75 Commercial Rd, Melbourne VIC, Australia
| | | | | | - David M Kaye
- Baker Heart & Diabetes Institute, 75 Commercial Rd, Melbourne VIC, Australia
| | - Bonnie Ky
- Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, USA
| | - Bernadet T Santema
- University Medical Centre Groningen, Hanzeplein 1, GZ Groningen, The Netherlands
| | - Karen Sliwa
- Hatter Institute for Cardiovascular Research in Africa, University of Cape Town, Private Bag X3 7935 Observatory, Cape Town, South Africa
| | - Adriaan A Voors
- University Medical Centre Groningen, Hanzeplein 1, GZ Groningen, The Netherlands
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