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Pfister R, Kaur R, Maesom G, Hager RL. Associations between Multiple Health Indicators and Carotid Artery Intima-Media Thickness in A Healthy and Active Elderly Population. J Cardiovasc Dev Dis 2024; 11:101. [PMID: 38667719 PMCID: PMC11050605 DOI: 10.3390/jcdd11040101] [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: 02/28/2024] [Revised: 03/23/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
The purpose of this study was to examine correlations between health indicators (age, BMI, blood pressure (BP), functional strength (FS), handgrip strength, and predicted VO2 max) and carotid intima-media thickness (cIMT) in an active 50 years+ population. Study participants' mean cIMT was also compared to the cIMT mean of the general population. Health screenings were conducted on 1818 participants at the Huntsman World Senior Games from 2016 to 2019. Pearson's correlations, Spearman's correlations, and ANOVA were performed using SPSS. Weak but significant correlations were evident between cIMT and age (r = 0.283, p < 0.001), systolic BP (r = 0.253, p = 0.001), diastolic BP (r = 0.074, p = 0.016), weight (r = 0.170, p < 0.001), height (r = 0.153, p < 0.001), handgrip L (r = 0.132, p < 0.001), handgrip R (r = 0.074, p < 0.029), and BMI (r = 0.07, p = 0.029); non-significant correlations were evident with predicted VO2 max (r = -0.035, p = 0.382), and FS (r = -0.025, p = 0.597). When controlling for age, systolic BP, and sex, only handgrip L (r = 0.225, p = 0.014) was significantly correlated with cIMT. Mean cIMT for this cohort was lower across all sexes and age-matched groups (cIMT = 0.6967 mm (±0.129)). Physical activity is linked to reduced cIMT. Most health-related indicators in this study were significantly but weakly correlated with cIMT. Additional research is needed before common indicators can be used as a surrogate for cIMT and CVD risk. Results from this study can provide clinicians with additional information to reduce CVD risk through modifiable risk factors. Classic CVD risk factors such as systolic BP and BMI should be considered in patients regardless of lifestyle.
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Affiliation(s)
- Robin Pfister
- Sydney Medical School, University of Sydney, City Rd, Level 2 & 3, Sydney, NSW 2050, Australia;
| | - Rajneesh Kaur
- Sydney Medical School, University of Sydney, City Rd, Level 2 & 3, Sydney, NSW 2050, Australia;
| | - Gary Maesom
- Department of Nursing/Health Professions, Utah Valley University, 800 West University Parkway, Orem, UT 84058, USA;
| | - Ronald L. Hager
- Department of Exercise Sciences, College of Life Sciences, Brigham Young University, Provo, UT 84602, USA;
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Nayor M, Gajjar P, Miller P, Murthy VL, Shah RV, Houstis NE, Velagaleti RS, Larson MG, Vasan RS, Lewis GD, Mitchell GF. Arterial Stiffness and Cardiorespiratory Fitness Impairment in the Community. J Am Heart Assoc 2023; 12:e029619. [PMID: 37850464 PMCID: PMC10727403 DOI: 10.1161/jaha.123.029619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 06/13/2023] [Indexed: 10/19/2023]
Abstract
Background During exercise, a healthy arterial system facilitates increased blood flow and distributes it effectively to essential organs. Accordingly, we sought to understand how arterial stiffening might impair cardiorespiratory fitness in community-dwelling individuals. Methods and Results Arterial tonometry and maximum effort cardiopulmonary exercise testing were performed on Framingham Heart Study participants (N=2898, age 54±9 years, 53% women, body mass index 28.1±5.3 kg/m2). We related 5 arterial stiffness measures (carotid-femoral pulse wave velocity [CFPWV]: a measure of aortic wall stiffness; central pulse pressure, forward wave amplitude, characteristic impedance: measures of pressure pulsatility; and augmentation index: a measure of relative wave reflection) to multidimensional exercise responses using linear models adjusted for age, sex, resting heart rate, habitual physical activity, and clinical risk factors. Greater CFPWV, augmentation index, and characteristic impedance were associated with lower peak oxygen uptake (VO2; all P<0.0001). We observed consistency of associations of CFPWV with peak oxygen uptake across age, sex, and cardiovascular risk profile (interaction P>0.05). However, the CFPWV-peak oxygen uptake relation was attenuated in individuals with obesity (P=0.002 for obesity*CFPWV interaction). Higher CPFWV, augmentation index, and characteristic impedance were also related to cardiopulmonary exercise testing measures reflecting adverse O2 kinetics and lower stroke volume and peripheral O2 extraction but not to ventilatory efficiency, a prognostic measure of right ventricular-pulmonary vascular performance. Conclusions Our findings delineate relations of arterial stiffness and cardiorespiratory fitness in community-dwelling individuals. Future studies are warranted to evaluate whether the physiological measures implicated here may represent potential targets for improving cardiorespiratory fitness in the general population.
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Affiliation(s)
- Matthew Nayor
- Cardiovascular Medicine Section, Department of MedicineBoston University School of MedicineBostonMAUSA
- Preventive Medicine and Epidemiology Section, Department of MedicineBoston University School of MedicineBostonMAUSA
- Boston University’s and NHLBI’s Framingham Heart StudyFraminghamMAUSA
| | - Priya Gajjar
- Cardiovascular Medicine Section, Department of MedicineBoston University School of MedicineBostonMAUSA
| | - Patricia Miller
- Department of BiostatisticsBoston University School of Public HealthBostonMAUSA
| | - Venkatesh L. Murthy
- Division of Cardiovascular Medicine and Frankel Cardiovascular Center, Department of MedicineUniversity of MichiganAnn ArborMIUSA
| | - Ravi V. Shah
- Vanderbilt Translational and Clinical Research Center, Cardiology DivisionVanderbilt University Medical CenterNashvilleTNUSA
| | - Nicholas E. Houstis
- Cardiology Division, Department of MedicineMassachusetts General Hospital, Harvard Medical SchoolBostonMAUSA
| | - Raghava S. Velagaleti
- Boston University’s and NHLBI’s Framingham Heart StudyFraminghamMAUSA
- Cardiology Section, Department of MedicineBoston VA Healthcare SystemWest RoxburyMAUSA
| | - Martin G. Larson
- Boston University’s and NHLBI’s Framingham Heart StudyFraminghamMAUSA
- Department of BiostatisticsBoston University School of Public HealthBostonMAUSA
| | - Ramachandran S. Vasan
- Boston University’s and NHLBI’s Framingham Heart StudyFraminghamMAUSA
- University of Texas School of Public Health San AntonioUniversity of Texas Health Science CenterSan AntonioTXUSA
- Departments of Medicine and Population Health SciencesUniversity of Texas Health Science CenterSan AntonioTXUSA
| | - Gregory D. Lewis
- Cardiology Division, Department of MedicineMassachusetts General Hospital, Harvard Medical SchoolBostonMAUSA
- Pulmonary Critical Care Unit, Department of MedicineMassachusetts General Hospital, Harvard Medical SchoolBostonMAUSA
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Diaz-Canestro C, Sehgal A, Montero D. Acute regulation of erythropoietin via lower body negative pressure: Influence of sex and age. Scand J Med Sci Sports 2023; 33:535-541. [PMID: 36632690 DOI: 10.1111/sms.14314] [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: 07/27/2022] [Revised: 12/10/2022] [Accepted: 01/07/2023] [Indexed: 01/13/2023]
Abstract
The regulation of erythropoiesis via hemodynamic stimuli such as reduced central blood volume (CBV) remains uncertain in women and elderly individuals. This study assessed the acute effects of lower body negative pressure (LBNP) on key endocrine biomarkers regulating erythropoiesis, that is, erythropoietin (EPO) and copeptin, in young and older women and men (n = 87). Transthoracic echocardiography and hemodynamics were assessed throughout incremental LBNP levels for 1 hour, or until presyncope, with established methods. Venous blood samples were collected at baseline and immediately after termination of the orthostatic tolerance (OT) test for subsequent hormone analyses. The average age of young women and men (33.1 ± 6.0 vs. 29.5 ± 6.9 yr) and older women and men (63.8 ± 8.0 vs. 65.3 ± 8.9 yr) as well as their physical activity levels were matched within each age and sex group. CBV, as determined by right atrial volume, was reduced in all individuals at the end of the OT test (p < 0.001). The average OT time ranged from 50.1 to 58.1 min in all individuals. LBNP increased circulating EPO in young women (p = 0.023) but not in young men or older individuals. Copeptin was increased in all individuals with LBNP but was exclusively associated with EPO in men (r = 0.39, p = 0.013). The present study indicates that the acute hemodynamic regulation of EPO production is both sex- and age-dependent.
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Affiliation(s)
- Candela Diaz-Canestro
- Faculty of Medicine, Department of Medicine, University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Arshia Sehgal
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - David Montero
- Faculty of Medicine, School of Public Health, Division of Kinesiology, University of Hong Kong, Hong Kong, Hong Kong SAR.,Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
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Cardiorespiratory Fitness Is Inversely Associated With Aortic Arterial Stiffness in Firefighters. J Occup Environ Med 2022; 64:e641-e646. [DOI: 10.1097/jom.0000000000002657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mancini A, Martone D, Vitucci D, Capobianco A, Alfieri A, Buono P, Orrù S. Influence of Sport Practice and Body Weight on Physical Fitness in Schoolchildren Living in the Campania Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127412. [PMID: 35742659 PMCID: PMC9223406 DOI: 10.3390/ijerph19127412] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/12/2022] [Accepted: 06/14/2022] [Indexed: 02/01/2023]
Abstract
Background: Physical fitness (PF) levels correlate with health hallmarks at all ages. In this study, w aimed to determine the PF level of schoolchildren from the Campania Region (Italy) through health-related PF (HRPF) components, taking into account body weight and sport practice (SP). Methods: PF level was determined in 565 schoolchildren aged 10−13 (11.7 ± 1.0 yrs; m: 353, f: 212) using some of the Eurofit battery tests. Results: 77% children practiced sport, boys more than girls (86% vs. 63%, respectively; p < 0.05). Boys performed better than girls (p < 0.05) in the Plate Tapping, Standing Broad Jump, Bent-Arm Hang, and 10 × 5 m Shuttle Run tests; girls performed better in the Sit-and-Reach Test (p < 0.05). Conclusion: Overweight/obese status negatively affects the muscular strength of lower limbs, even if it progressively improves during growth. SP was revealed to be a determinant in performance only in some PF tests, likely due to the heterogeneous training level among boys and girls who practice sport.
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Affiliation(s)
- Annamaria Mancini
- Dipartimento di Scienze Motorie e del Benessere, Università degli Studi di Napoli Parthenope, 80133 Naples, Italy; (A.M.); (D.M.); (D.V.); (A.C.); (A.A.); (P.B.)
- CEINGE Biotecnologia Avanzate “Franco Salvatore”, 80145 Naples, Italy
| | - Domenico Martone
- Dipartimento di Scienze Motorie e del Benessere, Università degli Studi di Napoli Parthenope, 80133 Naples, Italy; (A.M.); (D.M.); (D.V.); (A.C.); (A.A.); (P.B.)
- CEINGE Biotecnologia Avanzate “Franco Salvatore”, 80145 Naples, Italy
| | - Daniela Vitucci
- Dipartimento di Scienze Motorie e del Benessere, Università degli Studi di Napoli Parthenope, 80133 Naples, Italy; (A.M.); (D.M.); (D.V.); (A.C.); (A.A.); (P.B.)
- CEINGE Biotecnologia Avanzate “Franco Salvatore”, 80145 Naples, Italy
| | - Adriano Capobianco
- Dipartimento di Scienze Motorie e del Benessere, Università degli Studi di Napoli Parthenope, 80133 Naples, Italy; (A.M.); (D.M.); (D.V.); (A.C.); (A.A.); (P.B.)
| | - Andreina Alfieri
- Dipartimento di Scienze Motorie e del Benessere, Università degli Studi di Napoli Parthenope, 80133 Naples, Italy; (A.M.); (D.M.); (D.V.); (A.C.); (A.A.); (P.B.)
- CEINGE Biotecnologia Avanzate “Franco Salvatore”, 80145 Naples, Italy
| | - Pasqualina Buono
- Dipartimento di Scienze Motorie e del Benessere, Università degli Studi di Napoli Parthenope, 80133 Naples, Italy; (A.M.); (D.M.); (D.V.); (A.C.); (A.A.); (P.B.)
- CEINGE Biotecnologia Avanzate “Franco Salvatore”, 80145 Naples, Italy
| | - Stefania Orrù
- Dipartimento di Scienze Motorie e del Benessere, Università degli Studi di Napoli Parthenope, 80133 Naples, Italy; (A.M.); (D.M.); (D.V.); (A.C.); (A.A.); (P.B.)
- CEINGE Biotecnologia Avanzate “Franco Salvatore”, 80145 Naples, Italy
- Correspondence:
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Haapala EA, Leppänen MH, Lehti M, Lintu N, Tompuri T, Viitasalo A, Schwab U, Lakka TA. Cross-sectional associations between cardiorespiratory fitness and NMR-derived metabolic biomarkers in children - the PANIC study. Front Endocrinol (Lausanne) 2022; 13:954418. [PMID: 36213296 PMCID: PMC9538338 DOI: 10.3389/fendo.2022.954418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/12/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Cardiorespiratory fitness has been inversely associated with cardiovascular risk across the lifespan. Some studies in adults suggest that higher cardiorespiratory fitness is associated with cardioprotective metabolite profile, but the evidence in children is lacking. Therefore, we investigated the cross-sectional association of cardiorespiratory fitness with serum nuclear magnetic resonance derived metabolic biomarkers in children. METHODS A population sample of 450 children aged 6-8 years was examined. Cardiorespiratory fitness was assessed by a maximal exercise test on a cycle ergometer and quantified as maximal power output normalised for lean body mass assessed by dual-energy X-ray absorbtiometry. Serum metabolites were assessed using a high throughput nuclear magnetic resonance platform. The data were analysed using linear regression analyses adjusted for age and sex and subsequently for body fat percentage (BF%) assessed by DXA. RESULTS Cardiorespiratory fitness was directly associated with high density lipoprotein (HDL) cholesterol (β=0.138, 95% CI=0.042 to 0.135, p=0.005), average HDL particle diameter (β=0.102, 95% CI=0.004 to 0.199, p=0.041), and the concentrations of extra-large HDL particles (β=0.103, 95% CI=0.006 to 0.201, p=0.038), large HDL particles (β=0.122, 95% CI=0.025 to 0.220, p=0.014), and medium HDL particles (β=0.143, 95% CI=0.047 to 0.239, p=0.004) after adjustment for age and sex. Higher cardiorespiratory fitness was also associated with higher concentrations of ApoA1 (β=0.145, 95% CI=0.047 to 0.242, p=0.003), glutamine (β=0.161, 95% CI=0.064 to 0.257, p=0.001), and phenylalanine (β=0.187, 95% CI=0.091 to 0.283, p<0.001). However, only the direct associations of cardiorespiratory fitness with the concentrations of HDL cholesterol (β=0.114, 95% CI=0.018 to 0.210, p=0.021), medium HDL particles (β=0.126, 95% CI=0.030 to 0.223, p=0.010), ApoA1 (β=0.126, 95% CI=0.030 to 0.223, p=0.011), glutamine (β=0.147, 95% CI=0.050 to 0.224, p=0.003), and phenylalanine (β=0.217, 95% CI=0.122 to 0.311, p<0.001) remained statistically significant after further adjustment for BF%. CONCLUSIONS Higher cardiorespiratory fitness was associated with a cardioprotective biomarker profile in children. Most associations were independent of BF% suggesting that the differences in serum metabolites between children are driven by cardiorespiratory fitness and not adiposity.
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Affiliation(s)
- Eero A. Haapala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- *Correspondence: Eero A. Haapala,
| | - Marja H. Leppänen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Maarit Lehti
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Niina Lintu
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Tuomo Tompuri
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Anna Viitasalo
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
| | - Timo A. Lakka
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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Diaz-Canestro C, Pentz B, Sehgal A, Montero D. Blood withdrawal acutely impairs cardiac filling, output and aerobic capacity in proportion to induced hypovolemia in middle-aged and older women. Appl Physiol Nutr Metab 2021; 47:1-8. [PMID: 34875180 DOI: 10.1139/apnm-2021-0196] [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: 11/22/2022]
Abstract
Blood donation entails acute reductions of cardiorespiratory fitness in healthy men. Whether these effects can be extrapolated to blood donor populations comprising women remains uncertain. The purpose of this study was to comprehensively assess the acute impact of blood withdrawal on cardiac function, central hemodynamics and aerobic capacity in women throughout the mature adult lifespan. Transthoracic echocardiography and O2 uptake were assessed at rest and throughout incremental exercise (cycle ergometry) in healthy women (n = 30, age: 47-77 yr). Left ventricular end-diastolic volume (LVEDV), stroke volume (SV), cardiac output (Q̇) and peak O2 uptake (V̇O2peak), and blood volume (BV) were determined with established methods. Measurements were repeated following a 10% reduction of BV within a week period. Individuals were non-smokers, non-obese and moderately fit (V̇O2peak = 31.4 ± 7.3 mL·min-1·kg-1). Hematocrit and BV ranged from 38.0 to 44.8% and from 3.8 to 6.6 L, respectively. The standard 10% reduction in BV resulted in 0.5 ± 0.1 L withdrawal of blood, which did not alter hematocrit (P = 0.953). Blood withdrawal substantially reduced cardiac LVEDV and SV at rest as well as during incremental exercise (≥10% decrements, P ≤ 0.009). Peak Q̇ was proportionally decreased after blood withdrawal (P < 0.001). Blood withdrawal induced a 10% decrement in V̇O2peak (P < 0.001). In conclusion, blood withdrawal impairs cardiac filling, Q̇ and aerobic capacity in proportion to the magnitude of hypovolemia in healthy mature women. Novelty: The filling of the heart and therefore cardiac output are impaired by blood withdrawal in women. Oxygen delivery and aerobic capacity are reduced in proportion to blood withdrawal.
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Affiliation(s)
- Candela Diaz-Canestro
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
| | - Brandon Pentz
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Arshia Sehgal
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - David Montero
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
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Zubac D, Obad A, Ivančev V, Valić Z. Acute flywheel exercise does not impair the brachial artery vasodilation in healthy men of varying aerobic fitness. Blood Press Monit 2021; 26:215-223. [PMID: 33590994 DOI: 10.1097/mbp.0000000000000523] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The cardiovascular response to variable load exercise on a flywheel ergometer is still unknown. OBJECTIVE This study examined the effects of flywheel exercise on cardiovascular response and brachial artery vasodilation capacity in healthy, active men. METHODS In this cross-sectional study, nineteen men (20-57 years old) completed three laboratory visits, including a ramp exercise test to determine their maximal oxygen uptake JOURNAL/blpmo/04.03/00126097-202106000-00008/inline-graphic1/v/2021-04-27T091817Z/r/image-tiff max, and exercise intervention on a flywheel ergometer set at 0.075 kg·m2 moment of inertia. After the ramp test cessation, all participants were allocated into aerobically untrained (n = 10) and trained (n = 9) groups. Throughout the flywheel exercise, cardiovascular demands were continuously monitored via Finapres, while a pre/postflow-mediated dilation (FMD) assessment was performed using ultrasound imaging. RESULTS There were no differences observed between the groups in their anthropometrics, age or resting brachial artery diameter, while the JOURNAL/blpmo/04.03/00126097-202106000-00008/inline-graphic2/v/2021-04-27T091817Z/r/image-tiff max was ~15% higher (P = 0.001) in trained compared to aerobically untrained group. The cardiovascular response to the flywheel exercise was similar between the groups, with peak mean arterial pressure and heart rate readings reaching ~160 mmHg and ~140 bpm, respectively. The flywheel exercise did not impair the FMD (%) response, which was comparable between the groups (P = 0.256). When these data were pooled, the regression analysis showed an inverse relationship among FMD (%), age (β = -0.936, P = 0.001) and JOURNAL/blpmo/04.03/00126097-202106000-00008/inline-graphic3/v/2021-04-27T091817Z/r/image-tiffmax. (β = -0.359, P = 0.045). CONCLUSION Although aerobic fitness alone does not directly explain the FMD response to flywheel exercise, aerobically untrained individuals, as they get older, tend to have lower brachial artery FMD.
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Affiliation(s)
- Damir Zubac
- Science and Research Center Koper, Institute for Kinesiology Research, Koper, Slovenia
- University of Split, Faculty of Kinesiology
| | - Ante Obad
- University Department of Health Sciences
| | | | - Zoran Valić
- Department of Integrative Physiology, School of Medicine, University of Split, Split, Croatia
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Pool LR, Aguayo L, Brzezinski M, Perak AM, Davis MM, Greenland P, Hou L, Marino BS, Van Horn L, Wakschlag L, Labarthe D, Lloyd-Jones D, Allen NB. Childhood Risk Factors and Adulthood Cardiovascular Disease: A Systematic Review. J Pediatr 2021; 232:118-126.e23. [PMID: 33516680 DOI: 10.1016/j.jpeds.2021.01.053] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To conduct a comprehensive review of the literature on childhood risk factors and their associations with adulthood subclinical and clinical cardiovascular disease (CVD). STUDY DESIGN A systematic search was performed using the MEDLINE, EMBASE, PsycINFO, CINAHL, and Web of Science databases to identify English-language articles published through June 2018. Articles were included if they were longitudinal studies in community-based populations, the primary exposure occurred during childhood, and the primary outcome was either a measure of subclinical CVD or a clinical CVD event occurring in adulthood. Two independent reviewers screened determined whether eligibility criteria were met. RESULTS There were 210 articles that met the predefined criteria. The greatest number of publications examined associations of clinical risk factors, including childhood adiposity, blood pressure, and cholesterol, with the development of adult CVD. Few studies examined childhood lifestyle factors including diet quality, physical activity, and tobacco exposure. Domains of risk beyond "traditional" cardiovascular risk factors, such as childhood psychosocial adversity, seemed to have strong published associations with the development of CVD. CONCLUSIONS Although the evidence was fairly consistent in direction and magnitude for exposures such as childhood adiposity, hypertension, and hyperlipidemia, significant gaps remain in the understanding of how childhood health and behaviors translate to the risk of adulthood CVD, particularly in lesser studied exposures like glycemic indicators, physical activity, diet quality, very early life course exposure, and population subgroups.
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Affiliation(s)
- Lindsay R Pool
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
| | - Liliana Aguayo
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Michal Brzezinski
- Department of Public Health and Social Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Amanda M Perak
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Cardiology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Matthew M Davis
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Lifang Hou
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Bradley S Marino
- Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Division of Cardiology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Institute for Innovations in Developmental Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Lauren Wakschlag
- Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Darwin Labarthe
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Donald Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
| | - Norrina B Allen
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Academic General Pediatrics, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
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Okamoto T, Kobayashi R, Hashimoto Y, Kikuchi N, Ogoh S. Is individual day-to-day variation of arterial stiffness associated with variation of maximal aerobic performance? BMC Sports Sci Med Rehabil 2021; 13:4. [PMID: 33422135 PMCID: PMC7797097 DOI: 10.1186/s13102-021-00231-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 01/01/2021] [Indexed: 11/10/2022]
Abstract
Background Maximal aerobic capacity, e.g. maximal oxygen uptake (V̇O2max), is not constant, and it has a time-dependent variation based on the condition of individual. On the other hand, arterial properties play an important role in determining aerobic performance, and lower arterial stiffness is associated with higher cardiorespiratory fitness levels. This study examined whether individual variations in maximal aerobic performance are associated with arterial stiffness. Methods Twenty-four (mean age, 19.8 ± 0.2 y) and 10 (mean age, 21.2 ± 0.2 y) recreationally active young men and women participated in Experiment 1 (Ex1) and in Experiment 2 (Ex2), respectively. Aerobic performance was assessed using a graded power test (Ex1) or a 1500-m time trial (Ex2). Simultaneously, brachial-ankle pulse wave velocity (baPWV) was measured as an index of arterial stiffness in both Ex1 and Ex2 before the exercise trials. In both experiments, subjects returned for measurement of baPWV and V̇O2max or 1500-m time trial at 1 month after first measurements. Results No significant differences in mean baPWV, V̇O2max or 1500-m run time were seen between first and second visits. Mean baPWV was significantly lower on days when participants showed higher V̇O2max or better 1500-m run time (P = 0.001 each) than on days when participants showed lower V̇O2max or worse 1500-m run time. In addition, a significant relationship was seen between individual changes in baPWV from first to second visits and changes in V̇O2max (P=0.0001) or 1500-m run time (P=0.04). Conclusion These findings suggest that individual day-to-day variations in maximal aerobic performance are associated with variations in arterial stiffness. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-021-00231-1.
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Affiliation(s)
- Takanobu Okamoto
- Department of Exercise Physiology, Nippon Sport Science University, 7-1-1, Fukasawa, Setagaya-ku, Tokyo, 158-8508, Japan.
| | - Ryota Kobayashi
- Center for Fundamental Education, Teikyo University of Science, Tokyo, Japan
| | - Yuto Hashimoto
- Department of Exercise Physiology, Nippon Sport Science University, 7-1-1, Fukasawa, Setagaya-ku, Tokyo, 158-8508, Japan
| | - Naoki Kikuchi
- Department of Training Science, Nippon Sport Science University, Tokyo, Japan
| | - Shigehiko Ogoh
- Department of Biomedical Engineering, Toyo University, Saitama, Japan
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11
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Rael B, Barba-Moreno L, Romero-Parra N, Alfaro-Magallanes VM, Castro EA, Cupeiro R, Peinado AB. Cardiorespiratory response to exercise in endurance-trained premenopausal and postmenopausal females. Eur J Appl Physiol 2021; 121:903-913. [PMID: 33389018 DOI: 10.1007/s00421-020-04574-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 11/27/2020] [Indexed: 12/01/2022]
Abstract
PURPOSE To assess the influence of different hormonal profiles on the cardiorespiratory response to exercise in endurance-trained females. METHODS Forty-seven eumenorrheic females, 38 low-dose monophasic oral contraceptive (OC) users and 13 postmenopausal women, all of them endurance-trained, participated in this study. A DXA scan, blood sample tests and a maximal aerobic test were performed under similar low-sex hormone levels: early follicular phase for the eumenorrheic females; withdrawal phase for the OC group and at any time for postmenopausal women. Cardiorespiratory variables were measured at resting and throughout the maximal aerobic test (ventilatory threshold 1, 2 and peak values). Heart rate (HR) was continuously monitored with a 12-lead ECG. Blood pressure (BP) was measured with an auscultatory method and a calibrated mercury sphygmomanometer. Expired gases were measured breath-by-breath with the gas analyser Jaeger Oxycon Pro. RESULTS One-way ANCOVA reported a lower peak HR in postmenopausal women (172.4 ± 11.7 bpm) than in eumenorrheic females (180.9 ± 10.6 bpm) (p = 0.024). In addition, postmenopausal women exhibited lower VO2 (39.1 ± 4.9 ml/kg/min) compared to eumenorrheic females (45.1 ± 4.4 ml/kg/min) in ventilatory threshold 2 (p = 0.009). Nonetheless, respiratory variables did not show differences between groups at peak values. Finally, no differences between OC users and eumenorrheic females' cardiorespiratory response were observed in endurance-trained females. CONCLUSIONS Cardiorespiratory system is impaired in postmenopausal women due to physiological changes caused by age and sex hormones' decrement. Although these alterations appear not to be fully compensated by exercise, endurance training could effectively mitigate them. In addition, monophasic OC pills appear not to impact cardiorespiratory response to an incremental running test in endurance-trained females.
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Affiliation(s)
- Beatriz Rael
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Martín Fierro, 28040, Madrid, Spain
| | - Laura Barba-Moreno
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Martín Fierro, 28040, Madrid, Spain.
| | - Nuria Romero-Parra
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Martín Fierro, 28040, Madrid, Spain
| | - Víctor M Alfaro-Magallanes
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Martín Fierro, 28040, Madrid, Spain
| | - Eliane A Castro
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Martín Fierro, 28040, Madrid, Spain.,Department of Sports Sciences and Physical Conditioning, Faculty of Education, Universidad Católica de La Santísima Concepción, Concepción, Chile
| | - Rocío Cupeiro
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Martín Fierro, 28040, Madrid, Spain
| | - Ana B Peinado
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid, Martín Fierro, 28040, Madrid, Spain
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12
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Maxa KM, Hoffman C, Rivera-Rivera LA, Motovylyak A, Turski PA, Mitchell CKC, Ma Y, Berman SE, Gallagher CL, Bendlin BB, Asthana S, Sager MA, Hermann BP, Johnson SC, Cook DB, Wieben O, Okonkwo OC. Cardiorespiratory Fitness Associates with Cerebral Vessel Pulsatility in a Cohort Enriched with Risk for Alzheimer's Disease. Brain Plast 2020; 5:175-184. [PMID: 33282680 PMCID: PMC7685671 DOI: 10.3233/bpl-190096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND There is increasing evidence that vascular disease risk factors contribute to evolution of the dementia syndrome of Alzheimer's disease (AD). One important measure of cerebrovascular health is pulsatility index (PI) which is thought to represent distal vascular resistance, and has previously been reported to be elevated in AD clinical syndrome. Physical inactivity has emerged as an independent risk factor for cardiovascular disease. OBJECTIVE This study aims to examine the relationship between a measure of habitual physical activity, cardiorespiratory fitness (CRF), and PI in the large cerebral vessels. METHODS Ninety-two cognitively-healthy adults (age = 65.34±5.95, 72% female) enrolled in the Wisconsin Registry for Alzheimer's Prevention participated in this study. Participants underwent 4D flow brain MRI to measure PI in the internal carotid artery (ICA), basilar artery, middle cerebral artery (MCA), and superior sagittal sinus. Participants also completed a self-report physical activity questionnaire. CRF was calculated using a previously-validated equation that incorporates sex, age, body-mass index, resting heart rate, and self-reported physical activity. A series of linear regression models adjusted for age, sex, APOE4 status, and 10-year atherosclerotic cardiovascular disease risk were used to analyze the relationship between CRF and PI. RESULTS Inverse associations were found between CRF and mean PI in the inferior ICA (p = .001), superior ICA (p = .035), and basilar artery (p = .040). No other cerebral vessels revealed significant associations between CRF and PI (p≥.228). CONCLUSIONS Higher CRF was associated with lower PI in several large cerebral vessels. Since increased pulsatility has been associated with poor brain health and reported in persons with AD, this suggests that aerobic fitness might provide protection against cerebrovascular changes related to the progression of AD clinical syndrome.
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Affiliation(s)
- Kaitlin M. Maxa
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Carson Hoffman
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Leonardo A. Rivera-Rivera
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Alice Motovylyak
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Patrick A. Turski
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Carol K. C. Mitchell
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Yue Ma
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Sara E. Berman
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- UW-Madison Medical Scientist and Neuroscience Training Programs, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Catherine L. Gallagher
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial VA Hospital, Madison, WI, USA
| | - Barbara B. Bendlin
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial VA Hospital, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Sanjay Asthana
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial VA Hospital, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Mark A. Sager
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Bruce P. Hermann
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial VA Hospital, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial VA Hospital, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Dane B. Cook
- Department of Kinesiology, University of Wisconsin School of Education, Madison, WI, USA
- Research Service, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Oliver Wieben
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Ozioma C. Okonkwo
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial VA Hospital, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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13
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Raghuveer G, Hartz J, Lubans DR, Takken T, Wiltz JL, Mietus-Snyder M, Perak AM, Baker-Smith C, Pietris N, Edwards NM. Cardiorespiratory Fitness in Youth: An Important Marker of Health: A Scientific Statement From the American Heart Association. Circulation 2020; 142:e101-e118. [PMID: 32686505 DOI: 10.1161/cir.0000000000000866] [Citation(s) in RCA: 204] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Cardiorespiratory fitness (CRF) refers to the capacity of the circulatory and respiratory systems to supply oxygen to skeletal muscle mitochondria for energy production needed during physical activity. CRF is an important marker of physical and mental health and academic achievement in youth. However, only 40% of US youth are currently believed to have healthy CRF. In this statement, we review the physiological principles that determine CRF, the tools that are available to assess CRF, the modifiable and nonmodifiable factors influencing CRF, the association of CRF with markers of health in otherwise healthy youth, and the temporal trends in CRF both in the United States and internationally. Development of a cost-effective CRF measurement process that could readily be incorporated into office visits and in field settings to screen all youth periodically could help identify those at increased risk.
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14
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Talbot JS, Lord RN, Wakeham DJ, Dawkins TG, Curry BA, Brown M, Lodge FM, Pugh CJA. The influence of habitual endurance exercise on carotid artery strain and strain rate in young and middle-aged men. Exp Physiol 2020; 105:1396-1407. [PMID: 32578897 DOI: 10.1113/ep088384] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 06/19/2020] [Indexed: 12/16/2022]
Abstract
NEW FINDINGS What is the central question of this study? Carotid artery peak circumferential strain (PCS) and strain rate attenuate with age, but appear to be modulated by cardiorespiratory fitness status in young males. However, the relationship between habitual endurance exercise (running) and these parameters has not been studied in young and middle-aged men. What is the main finding and its importance? Young and middle-aged runners exhibited elevated PCS and systolic strain rate (S-SR) compared with non-runners, but habitual running did not influence diastolic strain rate (D-SR). Habitual exercise is associated with comparable improvements in carotid strain parameters in young and middle-aged men, but the age-related decline in PCS and S-SR might be more amenable to habitual endurance exercise than D-SR. ABSTRACT Central arterial stiffness is an independent predictor of cardiovascular risk that can be modified by exercise training. However, conventional local measures of carotid artery stiffness display conflicting responses to habitual endurance exercise in young and older adults. Two-dimensional (2D)-Strain imaging of the common carotid artery (CCA) quantifies circumferential deformation (strain) of the arterial wall across the cardiac cycle, which is more sensitive at detecting age-related alterations in CCA stiffness than conventional methods. Therefore, the study was designed to examine the relationship between habitual endurance exercise (running) and CCA 2D-Strain parameters in young and middle-aged men. Short-axis ultrasound images of the CCA were obtained from 13 young non-runners [23 years of age (95% confidence interval: 21, 26 years of age)], 19 young runners [24 (22, 26) years of age], 13 middle-aged non-runners [54 (52, 56) years of age] and 19 middle-aged runners [56 (54, 58) years of age]. Images were analysed for peak circumferential strain (PCS; magnitude of deformation) and systolic and diastolic strain rates (S-SR and D-SR; deformation velocity), and group differences were examined via two-way ANOVA. PCS, S-SR and D-SR were attenuated in middle-aged men compared with young men (all P ≤ 0.001). PCS and S-SR were elevated in young and middle-aged runners when compared with non-runners (P = 0.002 and P = 0.009, respectively), but no age × training status interaction was observed. In contrast, there was no influence of habitual running on D-SR. Habitual exercise is associated with comparable improvements in CCA 2D-Strain parameters in young and middle-aged men, but the age-related decline in PCS and S-SR might be more amenable to habitual endurance exercise than D-SR.
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Affiliation(s)
- Jack S Talbot
- Cardiff School of Sport & Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Rachel N Lord
- Cardiff School of Sport & Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Denis J Wakeham
- Cardiff School of Sport & Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Tony G Dawkins
- Cardiff School of Sport & Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Bryony A Curry
- Cardiff School of Sport & Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Megan Brown
- Cardiff School of Sport & Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Freya M Lodge
- Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, UK
| | - Christopher J A Pugh
- Cardiff School of Sport & Health Sciences, Cardiff Metropolitan University, Cardiff, UK
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15
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Ångström L, Hörnberg K, Sundström B, Jonsson SW, Södergren A. Aerobic capacity is associated with disease activity and cardiovascular risk factors in early rheumatoid arthritis. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2020; 25:e1833. [PMID: 31913553 PMCID: PMC7378948 DOI: 10.1002/pri.1833] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 11/12/2019] [Accepted: 12/13/2019] [Indexed: 12/21/2022]
Abstract
Objectives The aim of this study was to investigate aerobic capacity and its associations with disease activity and risk factors for cardiovascular disease (CVD) in early rheumatoid arthritis (RA). Methods This cross‐sectional study included 67 patients with early RA. Aerobic capacity was estimated with the Åstrand submaximal test adjusted according to the Nord‐Tröndelag Health Study formula. The following were also assessed: subclinical atherosclerosis by carotid intima‐media thickness and pulse wave analysis; body composition by dual X‐ray absorptiometry; estimated CVD mortality risk by the Systematic Coronary Risk Evaluation; disease activity by the Disease Activity Score 28, C‐reactive protein and erythrocyte sedimentation rate; blood lipids by total cholesterol, low‐density lipoproteins, high‐density lipoproteins, and triglycerides; and functional ability by the Stanford health assessment questionnaire. Univariate and multiple linear regression analyses were performed to explore the associations between variables. Results The mean (SD) aerobic capacity was 31.6 (8.7) ml O2−1 kg min−1. Disease activity and risk factors for CVD were more favourable for patients with aerobic capacity above the median value. Aerobic capacity was associated with ESR and several CVD risk factors, independent of age and sex. In a multiple regression model that was adjusted for age and sex, aerobic capacity was significantly associated with per cent body fat (β = −0.502, 95% CI [−0.671, −0.333]) and triglycerides (β = −2.365, 95% CI [−4.252, −0.479]). Conclusions Disease activity and risk factors for CVD were in favour for patients with a higher aerobic capacity. Aerobic capacity was associated with disease activity and several risk factors for CVD, independent of age and sex. In RA, these findings may provide insights into the benefits of using aerobic capacity as a marker to prevent CVD.
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Affiliation(s)
- Lars Ångström
- Department of Public Health and Clinical Medicine/Rheumatology, Umeå University, Umeå, Sweden
| | - Kristina Hörnberg
- Department of Public Health and Clinical Medicine/Rheumatology, Umeå University, Umeå, Sweden
| | - Björn Sundström
- Department of Public Health and Clinical Medicine/Rheumatology, Umeå University, Umeå, Sweden
| | | | - Anna Södergren
- Department of Public Health and Clinical Medicine/Rheumatology, Umeå University, Umeå, Sweden.,Wallenberg Centre for Molecular Medicine (WCMM), Umeå University, Umeå, Sweden
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16
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Mury P, Chirico EN, Mura M, Millon A, Canet-Soulas E, Pialoux V. Oxidative Stress and Inflammation, Key Targets of Atherosclerotic Plaque Progression and Vulnerability: Potential Impact of Physical Activity. Sports Med 2019; 48:2725-2741. [PMID: 30302720 DOI: 10.1007/s40279-018-0996-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Atherosclerosis, a complex cardiovascular disease, is a leading cause of mortality and morbidity worldwide. Oxidative stress and inflammation are both involved in the development of atherosclerotic plaque as they increase the biological processes associated with this pathology, such as endothelial dysfunction and macrophage recruitment and adhesion. Atherosclerotic plaque rupture leading to major ischemic events is the result of vulnerable plaque progression, which is a result of the detrimental effect of oxidative stress and inflammation on risk factors for atherosclerotic plaque rupture, such as intraplaque hemorrhage, neovascularization, and fibrous cap thickness. Thus, both are key targets for primary and secondary interventions. It is well recognized that chronic physical activity attenuates oxidative stress in healthy subjects via the improvement of antioxidant enzyme capacities and inflammation via the enhancement of anti-inflammatory molecules. Moreover, it was recently shown that chronic physical activity could decrease oxidative stress and inflammation in atherosclerotic patients. The aim of this review is to summarize the role of oxidative stress and inflammation in atherosclerosis and the results of therapeutic interventions targeting them in both preclinical and clinical studies. The effects of chronic physical activity on these two key processes are then reviewed in vulnerable atherosclerotic plaques in both coronary and carotid arteries.
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Affiliation(s)
- Pauline Mury
- Team Vascular Biology and Red Blood Cell, Interuniversity Laboratory of Human Movement Biology, University Claude Bernard Lyon 1, University of Lyon, Faculté de Médecine Lyon Est, 8 Avenue Rockefeller, 69008, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Erica N Chirico
- Department of Biomedical Sciences, Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Mathilde Mura
- Team Vascular Biology and Red Blood Cell, Interuniversity Laboratory of Human Movement Biology, University Claude Bernard Lyon 1, University of Lyon, Faculté de Médecine Lyon Est, 8 Avenue Rockefeller, 69008, Lyon, France.,Laboratory of Excellence GR-Ex, Paris, France
| | - Antoine Millon
- University of Lyon, University Claude Bernard Lyon 1, CarMeN Laboratory, INSERM U1060, Bron, France.,Department of Vascular Surgery, Edouard Herriot Hospital, Lyon, France
| | - Emmanuelle Canet-Soulas
- University of Lyon, University Claude Bernard Lyon 1, CarMeN Laboratory, INSERM U1060, Bron, France
| | - Vincent Pialoux
- Team Vascular Biology and Red Blood Cell, Interuniversity Laboratory of Human Movement Biology, University Claude Bernard Lyon 1, University of Lyon, Faculté de Médecine Lyon Est, 8 Avenue Rockefeller, 69008, Lyon, France. .,Laboratory of Excellence GR-Ex, Paris, France. .,Institut Universitaire de France, Paris, France.
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Associations of Cardiorespiratory Fitness and Adiposity With Arterial Stiffness and Arterial Dilatation Capacity in Response to a Bout of Exercise in Children. Pediatr Exerc Sci 2019; 31:238-247. [PMID: 30626267 DOI: 10.1123/pes.2018-0145] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Purpose: To investigate the associations of directly measured peak oxygen uptake ( V˙O2peak ) and body fat percentage (BF%) with arterial stiffness and arterial dilatation capacity in children. Methods: Findings are based on 329 children (177 boys and 152 girls) aged 8-11 years. V˙O2peak was assessed by a maximal cardiopulmonary exercise test on a cycle ergometer and scaled by lean body mass (LM). BF% and LM were measured by bioelectrical impedance. Stiffness index (measure of arterial stiffness) and change in reflection index (ΔRI, measure of arterial dilatation capacity) were assessed by pulse contour analysis. Data were analyzed by linear regression models. Results:V˙O2peak/LM was positively associated with ΔRI in boys adjusted for age and BF% (β = 0.169, P = .03). Further adjustments for systolic blood pressure, heart rate, and the study group had no effect on this association, but additional adjustment for clinical puberty attenuated it (β = 0.171, P = .07). BF% was inversely related to ΔRI in boys adjusted for age and V˙O2peak/LM (β = -0.171, P = .03). V˙O2peak or BF% was not associated with ΔRI in girls or with stiffness index in either boys or girls. Conclusion: Increasing cardiorespiratory fitness and decreasing adiposity may improve arterial health in childhood, especially among boys.
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18
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What Do We Know about Diet and Markers of Cardiovascular Health in Children: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16040548. [PMID: 30769798 PMCID: PMC6406429 DOI: 10.3390/ijerph16040548] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 02/07/2019] [Accepted: 02/11/2019] [Indexed: 02/07/2023]
Abstract
Chronic diseases such as cancer, diabetes, and cardiovascular diseases (CVD) are the main health concerns in the 21st century, with CVD as the number one cause of mortality worldwide. Although CVD hard endpoints such as stroke or heart attack do not usually occur in children, evidence shows that the manifestation of CVD risk factors begins in childhood, preceding clinical complications of CVD in adulthood. Dietary intake is a modifiable risk factor that has been shown to make a substantial contribution to the risk of CVD in adulthood. However, less is known about the association between dietary intake and markers of cardiovascular health in children. This review summarises the current evidence on the relationship between dietary intake and markers of cardiovascular health including traditional CVD risk factors, physical fitness, and indices of arterial stiffness and wave reflection in children. Original research published in English, between January 2008 and December 2018 fulfilling the objective of this review were screened and included. Findings show that adaptation of a healthy lifestyle early in life can be beneficial for reducing the risk of CVD later in life. Furthermore, keeping arterial stiffness low from a young age could be a potential CVD prevention strategy. However, limited studies are available on diet-arterial stiffness relationship in children, and future research is required to better understand this association to aid the development and implementation of evidence-based strategies for preventing CVD-related complications later in life.
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Endes K, Köchli S, Zahner L, Hanssen H. Exercise and Arterial Modulation in Children: The EXAMIN YOUTH Study. Front Physiol 2019; 10:43. [PMID: 30774601 PMCID: PMC6367232 DOI: 10.3389/fphys.2019.00043] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 01/16/2019] [Indexed: 12/26/2022] Open
Abstract
Background: Cardiovascular disease (CVD) remains to be one of the most frequent causes of death worldwide. Cardiovascular (CV) risk factors such as hypertension and obesity often manifest in childhood. The study examines the associations of blood pressure, body mass index and physical activity with cardiopulmonary, metabolic, and psychosocial health of children in a systems physiology approach. Methods/Design: This cross-sectional study will be performed in a cohort of 6 to 8 year old school children (n = 1000). As a measure of vascular health, retinal microvascular diameters and large artery pulse wave velocity will be examined. Anthropometric parameters, such as weight, height, body mass index, and blood pressure will be assessed according to standardized protocols for children. Physical fitness and activity will be measured by a 20 m shuttle run, a 20 m sprint and a proxy-reported questionnaire on lifestyle behavior. Spirometry, assessment of heart rate variability and skin advanced glycation end products as well as a flanker test will be performed to determine systemic end organ alterations. Discussion: The study offers a unique integrative primary prevention concept that aims to set the grounds for a healthy and active lifestyle approach during childhood. It will help optimize CV risk stratification to identify children at risk of disease progression later in life. The study will demonstrate the importance of specific CV screening programs in children to reduce the growing burden of CV disease in adulthood. Prospective follow-up studies will have to prove the efficacy of primary prevention programs in children to achieve healthier aging as a long-term goal.
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Affiliation(s)
| | | | | | - Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
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20
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Sung J, Cho SJ, Hong KP. Relationship between fitness and arterial stiffness according to hypertensive state. Clin Exp Hypertens 2018; 41:733-738. [PMID: 30501136 DOI: 10.1080/10641963.2018.1545849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: There is a well-established relationship between cardiorespiratory fitness (CRF) and arterial stiffness. However, it is unclear whether this relationship differs significantly between hypertensive and non-hypertensive patients.Methods: Adults without a history of ischemic heart disease or stroke and normal exercise test results who underwent health screening were included. Cardiopulmonary function test was performed using the Bruce protocol. Peak oxygen consumption (VO2peak) was measured. Arterial stiffness was evaluated using the brachial-ankle pulse wave velocity (baPWV).Results: Study subjects were 9232 participants (M:F = 71:29%) with a mean age of 53 ± 6 years. Thirty-four percent had hypertension. There was an inverse relationship between the peak oxygen consumption and baPWV (r = - 0.21, p < 0.001) This relationship persisted after adjusting for age, gender, body mass index, smoking, diabetes mellitus, hemoglobin A1c, LDL-cholesterol, mean blood pressure, and hypertension (p < 0.0001). The regression coefficient of VO2peak was significantly more negative among hypertensive subjects than it was in non-hypertensive subjects in the regression coefficient (-9.2 vs. -4.2, p for interaction <0.001). The difference in arterial stiffness between hypertensive and non-hypertensive groups decreased as the CRF increased.Conclusion: Arterial stiffness decreased as CRF increased among participants without overt cardiovascular disease. The effect of hypertension on arterial stiffness also decreased as the CRF increased.
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Affiliation(s)
- Jidong Sung
- Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine, Prevention & Rehabilitation Center, Heart Vascular & Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Soo Jin Cho
- Department of Medicine, Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyong Pyo Hong
- Division of Cardiology, Department of Medicine, Sungkyunkwan University School of Medicine, Prevention & Rehabilitation Center, Heart Vascular & Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea
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21
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Haapala EA, Laukkanen JA, Takken T, Kujala UM, Finni T. Peak oxygen uptake, ventilatory threshold, and arterial stiffness in adolescents. Eur J Appl Physiol 2018; 118:2367-2376. [DOI: 10.1007/s00421-018-3963-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 08/05/2018] [Indexed: 02/04/2023]
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22
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Pugh CJA, Stone KJ, Stöhr EJ, McDonnell BJ, Thompson JES, Talbot JS, Wakeham DJ, Cockcroft JR, Shave R. Carotid artery wall mechanics in young males with high cardiorespiratory fitness. Exp Physiol 2018; 103:1277-1286. [DOI: 10.1113/ep087067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 06/28/2018] [Indexed: 01/10/2023]
Affiliation(s)
| | - Keeron J. Stone
- Cardiff School of Sport & Health Science; Cardiff Metropolitan University; Cardiff UK
- School of Sport & Exercise; University of Gloucester; Gloucester UK
| | - Eric J. Stöhr
- Cardiff School of Sport & Health Science; Cardiff Metropolitan University; Cardiff UK
- Columbia University Irving Medical Center; Columbia University in the City of New York; New York NY USA
| | - Barry J. McDonnell
- Cardiff School of Sport & Health Science; Cardiff Metropolitan University; Cardiff UK
| | - Jane E. S. Thompson
- Cardiff School of Sport & Health Science; Cardiff Metropolitan University; Cardiff UK
| | - Jack S. Talbot
- Cardiff School of Sport & Health Science; Cardiff Metropolitan University; Cardiff UK
| | - Denis J. Wakeham
- Cardiff School of Sport & Health Science; Cardiff Metropolitan University; Cardiff UK
| | - John R. Cockcroft
- Cardiff School of Sport & Health Science; Cardiff Metropolitan University; Cardiff UK
| | - Robert Shave
- Cardiff School of Sport & Health Science; Cardiff Metropolitan University; Cardiff UK
- Centre for Heart, Lung & Vascular Health; University of British Columbia; Kelowna BC Canada
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23
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Zeigler ZS, Birchfield N, Moreno K, James D, Swan P. Fatness and Fluctuating Body Weight: Effect on Central Vasculature. Biores Open Access 2018; 7:90-100. [PMID: 29892497 PMCID: PMC5994146 DOI: 10.1089/biores.2017.0044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Weight Cycling (WC) is a prevalent behavior associated with adverse cardiovascular (CV) health. However, a 2010 review on the effects of WC and blood pressure (BP) determined that there was not enough evidence to draw definitive conclusions. Central BP is the principal predictor of CV risk compared to peripheral BP. The influence that WC may have specifically on central BP is unknown. Cross-sectional observation of self-reported history of WC on measures of CV health was undertaken. Seventy-five women completed a Weight and Lifestyle Inventory questionnaire, which is considered a reliable index of WC (r = 0.87, p < 0.001). Measures of visceral fat, BP, arterial stiffness, and VO2peak were taken. Regression equations were used to assess primary predictors of these outcomes. Seventy-five middle aged (39 ± 11 years), obese (32 ± 7 kg/m2), and relatively unfit (24 ± 8 ml·kg-1 min-1) women completed the study. Visceral fat was the strongest predictor of brachial systolic blood pressure (SBP; r2 = 0.283), brachial diastolic blood pressure (DBP; r2 = 0.176), central SBP (r2 = 0.375), and augmentation index (AIx; r2 = 0.535, all p < 0.001). VO2peak was the strongest predictor of central DBP (r2 = 0.062, p = 0.036) and augmentation pressure (AP; r2 = 0.491, p < 0.001). Weight cycling index was associated with visceral fat (r = 0.521, p < 0.001). Visceral fat was a mediator between WC and central SBP (confidence interval [CI] = 0.0053-0.0602), AP (CI = 0.0507-0.4915), AIx (CI = 0.0025-0.0699), and carotid-femoral pulse wave velocity (CI = 0.0115-0.1227; all p < 0.05). WC may increase visceral fat accumulation, which was associated with increased central SBP and measures of arterial stiffness.
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Affiliation(s)
- Zachary S. Zeigler
- College of Science, Engineering, and Technology, Grand Canyon University, Phoenix, Arizona
| | - Natasha Birchfield
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona
| | - Karen Moreno
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona
| | - Darith James
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona
| | - Pamela Swan
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona
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Haapala EA, Lankhorst K, de Groot J, Zwinkels M, Verschuren O, Wittink H, Backx FJ, Visser-Meily A, Takken T. The associations of cardiorespiratory fitness, adiposity and sports participation with arterial stiffness in youth with chronic diseases or physical disabilities. Eur J Prev Cardiol 2017; 24:1102-1111. [PMID: 28374647 PMCID: PMC5495431 DOI: 10.1177/2047487317702792] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background The evidence on the associations of cardiorespiratory fitness, body adiposity and sports participation with arterial stiffness in children and adolescents with chronic diseases or physical disabilities is limited. Methods Altogether 140 children and adolescents with chronic diseases or physical disabilities participated in this cross-sectional study. Cardiorespiratory fitness was assessed using maximal exercise test with respiratory gas analyses either using shuttle run, shuttle ride, or cycle ergometer test. Cardiorespiratory fitness was defined as peak oxygen uptake by body weight or fat-free mass. Body adiposity was assessed using waist circumference, body mass index standard deviation score and body fat percentage. Sports participation was assessed by a questionnaire. Aortic pulse wave velocity and augmentation index were assessed by a non-invasive oscillometric tonometry device. Results Peak oxygen uptake/body weight (standardised regression coefficient β −0.222, 95% confidence interval (CI) −0.386 to −0.059, P = 0.002) and peak oxygen uptake/fat-free mass (β −0.173, 95% CI −0.329 to −0.017, P = 0.030) were inversely and waist circumference directly (β 0.245, 95% CI 0.093 to 0.414, P = 0.002) associated with aortic pulse wave velocity. However, the associations of the measures of cardiorespiratory fitness with aortic pulse wave velocity were attenuated after further adjustment for waist circumference. A higher waist circumference (β −0.215, 95% CI −0.381 to −0.049, P = 0.012) and a higher body mass index standard deviation score (β 0.218, 95% CI −0.382 to −0.054, P = 0.010) were related to lower augmentation index. Conclusions Poor cardiorespiratory fitness and higher waist circumference were associated with increased arterial stiffness in children and adolescents with chronic diseases and physical disabilities. The association between cardiorespiratory fitness and arterial stiffness was partly explained by waist circumference.
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Affiliation(s)
- Eero A Haapala
- 1 Faculty of Sport and Health Sciences, University of Jyväskylä, Finland.,2 Institute of Biomedicine, University of Eastern Finland, Finland.,3 Child Development and Exercise Center, Wilhelmina Children's Hospital, the Netherlands
| | - Kristel Lankhorst
- 4 Research Group Lifestyle and Health, University of Applied Sciences, the Netherlands.,5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands
| | - Janke de Groot
- 3 Child Development and Exercise Center, Wilhelmina Children's Hospital, the Netherlands.,4 Research Group Lifestyle and Health, University of Applied Sciences, the Netherlands.,5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands
| | - Maremka Zwinkels
- 5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands.,6 Center of Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, the Netherlands
| | - Olaf Verschuren
- 5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands.,6 Center of Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, the Netherlands
| | - Harriet Wittink
- 4 Research Group Lifestyle and Health, University of Applied Sciences, the Netherlands
| | - Frank Jg Backx
- 7 Department of Rehabilitation, University Medical Center Utrecht, the Netherlands
| | - Anne Visser-Meily
- 6 Center of Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, the Netherlands.,7 Department of Rehabilitation, University Medical Center Utrecht, the Netherlands
| | - Tim Takken
- 3 Child Development and Exercise Center, Wilhelmina Children's Hospital, the Netherlands.,5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands
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Abstract
Low cardiorespiratory fitness is associated with higher cardiovascular risk, whereas high levels of cardiorespiratory fitness protect the cardiovascular system. Carotid intima-media thickness and arterial distensibility are well-established parameters to identify subclinical cardiovascular disease. Therefore, this study investigated the influence of cardiorespiratory fitness and muscular strength on carotid intima-media thickness and arterial distensibility in 697 children and adolescents (376 girls), aged 7-17 years. Cardiorespiratory fitness and strength were measured with the test battery FITNESSGRAM; carotid intima-media thickness, arterial compliance, elastic modulus, stiffness index β, and pulse wave velocity β were assessed by B- and M-mode ultrasound at the common carotid artery. In bivariate correlation, cardiorespiratory fitness was significantly associated with all cardiovascular parameters and was an independent predictor in multivariate regression analysis. No significant associations were obtained for muscular strength. In a one-way variance analysis, very fit boys and girls (58 boys and 74 girls>80th percentile for cardiorespiratory fitness) had significantly decreased stiffness parameters (expressed in standard deviation scores) compared with low fit subjects (71 boys and 77 girls<20th percentile for cardiorespiratory fitness): elastic modulus -0.16±1.02 versus 0.19±1.17, p=0.009; stiffness index β -0.15±1.08 versus 0.16±1.1, p=0.03; and pulse wave velocity β -0.19±1.02 versus 0.19±1.14, p=0.005. Cardiorespiratory fitness was associated with healthier arteries in children and adolescents. Comparison of very fit with unfit subjects revealed better distensibility parameters in very fit boys and girls.
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26
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Nieboer D, Douw L, van Dijk BW, Heymans MW, Stam CJ, Twisk JWR. Relation between carotid stiffness, cognitive performance and brain connectivity in a healthy middle-aged population: an observational neurophysiological cohort study with magnetoencephalography. BMJ Open 2016; 6:e013441. [PMID: 27979838 PMCID: PMC5168642 DOI: 10.1136/bmjopen-2016-013441] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE Impaired blood flow of the carotid artery can result in cognitive impairment, but how these vascular impairments lead to global cognitive disturbances is largely unknown. Problems in functional connectivity between brain areas may be responsible for these widespread effects. Therefore, the aim of this study was to examine the association between carotid stiffness, functional connectivity and cognitive performance in relatively young and healthy adults before clinical vascular pathology occurs. DESIGN The Amsterdam Growth and Health Longitudinal Study: an observational study. SETTING Participants were included by attending 1 of the 2 selected secondary schools in The Netherlands. PARTICIPANTS Men (n=110) and women (n=120) aged 41-44 years (42±0.7). PRIMARY AND SECONDARY OUTCOME MEASURES Data were obtained with regard to local carotid stiffness captured measured with the Young's elastic modulus (YEM). All participants underwent a commonly used Dutch intelligence test and resting-state eyes-closed magnetoencephalography (MEG). Five artefact-free epochs were analysed. The phase lag index (PLI) was used as a measure of functional connectivity between all sensors and was assessed in six frequency bands (δ-γ). RESULTS Carotid stiffness was significantly associated with increased functional connectivity in the α2 band in men (β: 0.287; p=0.008). The same results were found for women in the β band (β: 0.216; p=0.040). Furthermore, carotid stiffness was associated with superior cognitive function in men (β: 0.238; p=0.007). In addition, there was neither a significant association nor a consistent pattern between cognitive function and functional connectivity. CONCLUSIONS The increased connectivity might be a maladaptive phenomenon caused by disinhibition of neurons which may explain the direction of the results. This study suggests that detection of increased (local) carotid stiffness may be promising to identify a disturbance in the organisation of the functional brain network, even before clinical vascular pathology occurs.
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Affiliation(s)
- Dagmar Nieboer
- Department of Methodology and Applied Biostatistics, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - Linda Douw
- Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, The Netherlands
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA
| | - Bob W van Dijk
- Department of Clinical Neurophysiology and MEG Center, VU University Medical Center, Amsterdam, The Netherlands
- Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands
| | - Martijn W Heymans
- Department of Methodology and Applied Biostatistics, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Cornelis J Stam
- Department of Clinical Neurophysiology and MEG Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
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27
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Montero D, Diaz-Cañestro C, Flammer A, Lundby C. Unexplained Anemia in the Elderly: Potential Role of Arterial Stiffness. Front Physiol 2016; 7:485. [PMID: 27826252 PMCID: PMC5078728 DOI: 10.3389/fphys.2016.00485] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 10/10/2016] [Indexed: 12/02/2022] Open
Affiliation(s)
- David Montero
- Department of Cardiology, University Heart Center, University Hospital Zurich Zurich, Switzerland
| | | | - Andreas Flammer
- Department of Cardiology, University Heart Center, University Hospital Zurich Zurich, Switzerland
| | - Carsten Lundby
- Zurich Center for Integrative Human Physiology, Institute of Physiology, University of Zurich Zurich, Switzerland
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28
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Cardiorespiratory fitness cut points to avoid cardiovascular disease risk in children and adolescents; what level of fitness should raise a red flag? A systematic review and meta-analysis. Br J Sports Med 2016; 50:1451-1458. [DOI: 10.1136/bjsports-2015-095903] [Citation(s) in RCA: 185] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2016] [Indexed: 02/06/2023]
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29
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Montero D, Diaz-Cañestro C, Keiser S, Lundby C. Arterial stiffness is strongly and negatively associated with the total volume of red blood cells. Int J Cardiol 2016; 221:77-80. [PMID: 27400301 DOI: 10.1016/j.ijcard.2016.06.265] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 05/24/2016] [Accepted: 06/27/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND Erythropoiesis is partly regulated through classic feedback pathways that govern blood volume (BV) as sensed by veno-atrial but also arterial stretch receptors. Hence, the total volume of red blood cells (RBCV) could be associated with arterial stiffness (AS), although such hypothesis has not yet been tested. Therefore, we sought to investigate the association of AS with hematological variables including RBCV. METHODS Fourteen healthy physically active individuals volunteered for the study (age=23±2). RBCV, plasma volume (PV), and BV were calculated from measures of hematocrit and total hemoglobin mass (Hbmass) determined by CO-rebreathing. Carotid compliance with ultrasonography and carotid-ankle pulse wave velocity (PWV) were determined at rest and immediately after a maximal exercise test. The rationale for assessment of AS after exercise derives from the potential marked role of AS in the regulation of erythropoiesis in the setting of reduced central venous pressure. RESULTS At rest, carotid compliance was positively associated with Hbmass, RBCV, BV, but not PV, with coefficients of determination (R(2)) ranging from 0.39 to 0.57. Following exercise, closer positive associations were observed between carotid compliance and Hbmass, RBCV, or BV. Moreover, carotid-ankle PWV was negatively associated with all hematological variables after exercise except for PV, with R(2) ranging from 0.49 to 0.75. Similar results were observed when adjusted by body weight. CONCLUSIONS AS is strongly and inversely associated with RBCV in healthy individuals. These findings suggest that AS may adversely intercede in the regulation of erythropoiesis through the alteration of mechanisms that control BV.
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Affiliation(s)
- David Montero
- Zurich Center for Integrative Human Physiology (ZIHP), Institute of Physiology, University of Zurich, Zurich, Switzerland.
| | | | - Stefanie Keiser
- Zurich Center for Integrative Human Physiology (ZIHP), Institute of Physiology, University of Zurich, Zurich, Switzerland
| | - Carsten Lundby
- Zurich Center for Integrative Human Physiology (ZIHP), Institute of Physiology, University of Zurich, Zurich, Switzerland
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30
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Effects on carotid-femoral pulse wave velocity 24 h post exercise in young healthy adults. Hypertens Res 2016; 39:435-9. [PMID: 26763854 DOI: 10.1038/hr.2015.161] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 11/11/2015] [Accepted: 12/08/2015] [Indexed: 01/25/2023]
Abstract
Arterial stiffness, often measured by carotid-femoral pulse wave velocity (cfPWV), is a subclinical marker of cardiovascular disease that is known to be reduced by exercise training. Exercise is also known to have acute vascular effects, yet it is unclear whether exercise 24 h before cfPWV testing influences this outcome. Thirty healthy, young adults completed a supervised, 30-min bout of moderate-to-vigorous intensity treadmill running. cfPWV, systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were measured both before (after 48 h of abstaining from exercise) and 24 h after (with no additional exercise) the exercise session. From pre-exercise to 24 h post exercise, cfPWV decreased from 6.05±0.82 to 5.84±0.87 m s(-1) (P=0.02), SBP from 119.7±13.8 to 116.8±11.4 mm Hg (P=0.03) and DBP from 65.1±5.7 to 63.2±5.4 mm Hg (P=0.02), with no significant changes in HR. cfPWV was positively correlated with SBP pre-exercise (r=0.54, P<0.01) and post exercise (r=0.53, P<0.01). Changes in blood pressure explained 4-5% of the variability in cfPWV change; adjustments slightly attenuated the 24-h effects of exercise on cfPWV. Some evidence of gender differences was observed with higher cfPWV in males across assessments (P<0.05) and statistically significant reductions in cfPWV in males (-0.36±0.54 m s(-1) (P=0.02)) but not in females (-0.07±0.31 m s(-1) (P=0.41)). In conclusion, cfPWV decreased 24 h after an exercise bout, suggesting that exercise completed in the past 24 h should be considered before cfPWV testing.
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31
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Doumas M, Boutari C, Athyros V, Karagiannis A. Fitness: The "Secret" of Vascular Youth. J Clin Hypertens (Greenwich) 2015; 18:290-1. [PMID: 26663850 DOI: 10.1111/jch.12752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Michael Doumas
- 2nd Propedeutic Department of Internal Medicine, Aristotle University, Thessaloniki, Greece.,Department of Veterans Affairs and George Washington University, Washington, DC
| | - Chrysoula Boutari
- 2nd Propedeutic Department of Internal Medicine, Aristotle University, Thessaloniki, Greece
| | - Vasilios Athyros
- 2nd Propedeutic Department of Internal Medicine, Aristotle University, Thessaloniki, Greece
| | - Asterios Karagiannis
- 2nd Propedeutic Department of Internal Medicine, Aristotle University, Thessaloniki, Greece
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32
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Gando Y, Murakami H, Kawakami R, Yamamoto K, Kawano H, Tanaka N, Sawada SS, Miyatake N, Miyachi M. Cardiorespiratory Fitness Suppresses Age-Related Arterial Stiffening in Healthy Adults: A 2-Year Longitudinal Observational Study. J Clin Hypertens (Greenwich) 2015; 18:292-8. [DOI: 10.1111/jch.12753] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 09/09/2015] [Accepted: 09/22/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Yuko Gando
- Department of Health Promotion and Exercise; National Institutes of Biomedical Innovation, Health and Nutrition; Tokyo Japan
| | - Haruka Murakami
- Department of Health Promotion and Exercise; National Institutes of Biomedical Innovation, Health and Nutrition; Tokyo Japan
| | - Ryoko Kawakami
- Department of Health Promotion and Exercise; National Institutes of Biomedical Innovation, Health and Nutrition; Tokyo Japan
- Faculty of Sport Sciences; Waseda University; Saitama Japan
| | - Kenta Yamamoto
- Department of Health Promotion and Exercise; National Institutes of Biomedical Innovation, Health and Nutrition; Tokyo Japan
- Faculty of Pharmaceutical Sciences; Teikyo Heisei University; Tokyo Japan
| | - Hiroshi Kawano
- Department of Health Promotion and Exercise; National Institutes of Biomedical Innovation, Health and Nutrition; Tokyo Japan
- Faculty of Letters; Kokushikan University; Tokyo Japan
| | - Noriko Tanaka
- Department of Health Promotion and Exercise; National Institutes of Biomedical Innovation, Health and Nutrition; Tokyo Japan
- Research Center of Health, Physical Fitness and Sports; Nagoya University; Nagoya Japan
| | - Susumu S. Sawada
- Department of Health Promotion and Exercise; National Institutes of Biomedical Innovation, Health and Nutrition; Tokyo Japan
| | - Nobuyuki Miyatake
- Department of Hygiene; Faculty of Medicine; Kagawa University; Miki Kagawa Japan
| | - Motohiko Miyachi
- Department of Health Promotion and Exercise; National Institutes of Biomedical Innovation, Health and Nutrition; Tokyo Japan
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El Hraiech A, Abdennebi K, Amah G. [Short-term impact of an ambulatory cardiac rehabilitation program on arterial rigidity]. Ann Cardiol Angeiol (Paris) 2015; 64:210-5. [PMID: 26047872 DOI: 10.1016/j.ancard.2015.04.013] [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: 04/27/2015] [Accepted: 04/28/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND If the positive impact of cardiac rehabilitation on metabolic profile and exercise tolerance is well documented in the literature, very few studies evaluated the impact of these rehabilitation programs on arterial rigidity. PURPOSE The main objective of this study was to determine if a short and intense 4-week cardiac rehabilitation program could yield a positive impact on arterial rigidity. METHOD A cohort study was performed on Leopold Bellan Foundation. All patients referred for cardiac rehabilitation program after an acute event (surgery, technical gesture or acute decompensate heart failure) were included in this study. Our CR program consists of four sessions per week for five weeks (total of 20 sessions) and includes both exercise and health and nutrition education sessions. In addition to clinical and therapeutic data collection, biochemical analysis for carbohydrate and lipid metabolism and exercise capacity measurements, carotid femoral pulse wave velocity (PWV) were measured in a quiet room in the morning of their first and last day prior to any exercise. RESULTS One hundred and ninety-eight cardiac patients have participated in this study, of which 79% were male, mean age 60 ± 10, 50 (25%) were diabetic, 103 (52%) were hypertensive, 60 (30%) were current smokers, 98 (50%) had dyslipidemia, and 140 (71%) were referred for cardiac rehabilitation after acute coronary syndrome. Arterial stiffness is defined by a VPWV value greater or equal to 10. At the beginning, 59% of our patients have rigid arteries. After 20 sessions of cardiac rehabilitation, this number is significantly reduced to 51% (P=0.12). Patients with arterial stiffness have accumulated more major cardiovascular risk factors, and have had less exercise capacity than others. However they benefit similarly from the cardiovascular rehabilitation program. CONCLUSION In the present study, we observed that arterial stiffness, as reflected by the PWV, tends to decrease after short-term ambulatory cardiac rehabilitation program.
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Affiliation(s)
- A El Hraiech
- Unité de réadaptation cardiaque, hôpital Léopold-Bellan, 75010 Paris, France.
| | - K Abdennebi
- Unité de réadaptation cardiaque, hôpital Léopold-Bellan, 75010 Paris, France
| | - G Amah
- Unité de réadaptation cardiaque, hôpital Léopold-Bellan, 75010 Paris, France
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34
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Melo X, Santa-Clara H, Santos DA, Pimenta NM, Minderico CS, Fernhall B, Sardinha LB. Linking cardiorespiratory fitness classification criteria to early subclinical atherosclerosis in children. Appl Physiol Nutr Metab 2015; 40:386-92. [PMID: 25794238 DOI: 10.1139/apnm-2014-0378] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
It is unclear if cardiorespiratory fitness (CRF) can be used as a screening tool for premature changes in carotid intima-media thickness (cIMT) in paediatric populations. The purpose of this cross-sectional study was 3-fold: (i) to determine if CRF can be used to screen increased cIMT; (ii) to determine an optimal CRF cut-off to predict increased cIMT; and (iii) to evaluate its ability to predict increased cIMT among children in comparison with existent CRF cut-offs. cIMT was assessed with high-resolution ultrasonography and CRF was determined using a maximal cycle test. Receiver operating characteristic analyses were conducted in boys (n = 211) and girls (n = 202) aged 11-12 years to define the optimal sex-specific CRF cut-off to classify increased cIMT (≥75th percentile). Logistic regression was used to examine the association between the CRF cut-offs with the risk of having an increased cIMT. The optimal CRF cut-offs to predict increased cIMT were 45.81 and 34.46 mL·kg(-1)·min(-1) for boys and girls, respectively. The odds-ratios for having increased cIMT among children who were unfit was up to 2.8 times the odds among those who were fit (95% confidence interval: 1.40-5.53). Considering current CRF cut-offs, only those suggested by Adegboye et al. 2011. (Br. J. Sports Med. 45(9): 722-728) and Boddy et al. 2012 (PLoS One, 7(9): e45755) were significant in predicting increased cIMT. In conclusion, CRF cut-offs (boys: ≤ 45.8; girls: ≤ 34.5 mL·kg(-1)·min(-1)) are associated with thickening of the arterial wall in 11- to 12-year-old children. Low CRF is an important cardiovascular risk factor in children and our data highlight the importance of obtaining an adequate CRF.
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Affiliation(s)
- Xavier Melo
- Faculty of Human Kinetics, University of Lisbon, CIPER - Exercise and Health Laboratory, Estrada da Costa, Cruz Quebrada, 1495-688 Lisbon, Portugal
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Iemitsu M, Fujie S, Murakami H, Sanada K, Kawano H, Gando Y, Kawakami R, Tanaka N, Miyachi M. Higher cardiorespiratory fitness attenuates the risk of atherosclerosis associated with ADRB3 Trp64Arg polymorphism. Eur J Appl Physiol 2014; 114:1421-8. [PMID: 24658877 DOI: 10.1007/s00421-014-2862-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 02/25/2014] [Indexed: 11/24/2022]
Abstract
PURPOSE β3-Adrenergic receptor (ADRB3) Trp64Arg polymorphism is associated with atherogenic risk factors that include weight gain, insulin resistance, and diabetes. Habitual exercise brings higher cardiorespiratory fitness and results in the amelioration of atherosclerotic risk factors. However, the effects of cardiorespiratory fitness level and ADRB3 Trp64Arg polymorphism on the risk of cardiovascular disease remain unclear. A cross-sectional investigation of 877 Japanese men and women (18-75 years old) was performed to clarify the effects of cardiorespiratory fitness on the relationship between ADRB3 Trp64Arg polymorphism and risk of cardiovascular disease. METHOD Common carotid intima-media thickness (ccIMT) and blood lipid profiles were assessed as surrogate markers of atherosclerosis. We measured peak oxygen uptake (V̇O(2peak)) during incremental cycle ergometer exercise testing. Subjects were divided into groups with high (High-Fit) and low (Low-Fit) levels of cardiorespiratory fitness based on the median value of V̇O(2peak) for sex and decade. RESULTS Levels of body fat, triglycerides, and plasma glucose were lower and high-density lipoprotein cholesterol levels and V̇O(2peak) were higher in High-Fit subjects than Low-Fit subjects. ADRB3 Trp64Arg polymorphism did not significantly affect ccIMT or blood lipid profiles. In Low-Fit subjects, ccIMT was higher in individuals with the Arg/Arg genotype compared to the Trp/Trp and Trp/Arg genotypes (each P < 0.0001); however, ADRB3 polymorphism had no effect in High-Fit subjects. CONCLUSION Higher levels of cardiorespiratory fitness may attenuate the risk of atherosclerosis associated with ADRB3 Trp64Arg polymorphism.
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Affiliation(s)
- Motoyuki Iemitsu
- Faculty of Sport and Health Science, Ritsumeikan University, 1-1-1 Noji-Higashi, Kusatsu, Shiga, 525-8577, Japan
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When to prevent cardiovascular disease? As early as possible: lessons from prospective cohorts beginning in childhood. Curr Opin Cardiol 2014; 28:561-8. [PMID: 23928921 DOI: 10.1097/hco.0b013e32836428f4] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW To detail recent developments linking modifiable youth risk factors with preclinical markers of cardiovascular disease such as carotid artery intima-media thickness, pulse-wave velocity (PVW) and large artery stiffness, brachial artery flow-mediated dilatation, left ventricular geometry, and coronary artery calcification in adulthood. RECENT FINDINGS Population-based data from prospective cohort studies beginning in youth with follow-up into adulthood have shown that the modifiable youth risk factors of elevated blood lipids, blood pressure, and adiposity, smoking (active and passive), metabolic disorders, physical inactivity, low cardiorespiratory fitness, and diet associate with preclinical markers of cardiovascular disease in adulthood. The data suggest that, in some instances, those who amend their trajectory by not maintaining these risk factors into adulthood experience reductions in preclinical markers to levels associated with never having had the risk factor. SUMMARY Though avoidance of risk factors in youth is ideal, there is still a window for intervention where long-lasting cardiovascular effects might be avoided. Health-enhancing changes in the rates of active and passive smoking, adiposity, increased physical activity, accentuated fitness, modified diet, and socioeconomic position in the transition from youth to adulthood might be important in modifying an individual's trajectory from high risk in youth to low risk in adulthood.
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What the Long Term Cohort Studies that Began in Childhood Have Taught Us about the Origins of Coronary Heart Disease. CURRENT CARDIOVASCULAR RISK REPORTS 2014. [DOI: 10.1007/s12170-014-0373-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Pahkala K, Laitinen TT, Heinonen OJ, Viikari JSA, Rönnemaa T, Niinikoski H, Helajärvi H, Juonala M, Simell O, Raitakari OT. Association of fitness with vascular intima-media thickness and elasticity in adolescence. Pediatrics 2013; 132:e77-84. [PMID: 23753102 DOI: 10.1542/peds.2013-0041] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Vascular intima-media thickness (IMT) and elasticity are surrogate markers of atherosclerosis. Data on the effect of cardiorespiratory fitness on these measures of vascular health in adolescence are scarce. The aim was to examine the association of fitness with aortic and carotid artery IMT and elasticity in adolescents. METHODS Aortic (n = 449) and carotid (n = 467) IMT and elasticity were measured ultrasonographically in 17-year-old adolescents participating in a prospective, longitudinal atherosclerosis prevention study (Special Turku Coronary Risk Factor Intervention Project). Distensibility and Young's elastic modulus (YEM) were used as measures of arterial elasticity. Cardiorespiratory fitness (maximum oxygen uptake, mL/kg/min) was measured with a maximal cycle ergometer test. Data on fitness were available for 341 of adolescents with aortic and 355 with carotid ultrasound measures. RESULTS Fitness was inversely associated with aortic IMT (β[SE] = -0.0029[0.0013]; P = .031) and YEM (β[SE] = -0.012[0.0053]; P = .025) after adjusting for gender, physical activity, high-density lipoprotein/total cholesterol, triglycerides, high-sensitivity C-reactive protein, homeostasis model of assessment-insulin resistance, BMI, systolic blood pressure, and smoking. Risk of having low aortic distensibility (≤10th percentile) decreased with increasing fitness (odds ratio = 0.89, 95% confidence interval 0.82-0.98); P = .014). The increase in aortic IMT and YEM between ages 11 and 17 years was smaller in adolescents who were fit at age 17 compared with adolescents who had the lowest fitness level (P for IMT = .015, P for YEM = .0072). Fitness was not associated with carotid IMT or elasticity. Lifestyle counseling given in the Special Turku Coronary Risk Factor Intervention Project was not associated with fitness. CONCLUSIONS Fitness was favorably associated with aortic IMT and elasticity in adolescents. No association of fitness with the respective carotid indices was found. These data suggest that fitness in part enhances vascular health in healthy adolescents.
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Affiliation(s)
- Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku and Turku University Hospital, Turku, Finland.
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Ried-Larsen M, Grøntved A, Kristensen PL, Froberg K, Andersen LB. Moderate-and-vigorous physical activity from adolescence to adulthood and subclinical atherosclerosis in adulthood: prospective observations from the European Youth Heart Study. Br J Sports Med 2013; 49:107-12. [PMID: 23584827 DOI: 10.1136/bjsports-2013-092409] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
AIM To investigate the independent associations between mean exposure to or the change in moderate-and-vigorous physical activity (PA) from adolescence to adulthood and subclinical atherosclerosis in adulthood. METHODS This was a prospective cohort study among Danish boys and girls (N=277) followed for up to 12 years (age 15.7 (0.4) at baseline) enrolled in the European Youth Heart Study. PA intensity was objectively measured at baseline and follow-up, and ultrasonography was performed on the Carotid arteries at follow-up. Data on carotid intima-media thickness (cIMT), Carotid Compliance and Young's Elastic Modules were used as outcome measures. RESULTS In the multivariable analyses (adjusted for personal-lifestyle and demographic factors) the mean exposure to moderate-and-vigorous PA from adolescence to adulthood was negatively associated with Young's Elastic Modules (β=-0.001×10(3) kPa (95% CI -0.0015 to -0.0002), p=0.02) and positively associated with Carotid Compliance (β=0.004 mm(2) kPa(-1) (95% CI 0.002 to 0.008), p=0.003) and cIMT (β=0.0003 mm (95% CI 0.00001 to 0.0007), p=0.013). Increases in moderate-and-vigorous PA from adolescence to adulthood were negatively associated with Young's Elastic Modules in adulthood (β=-0.00007×10(3) kPa (95% CI -0.0012 to -0.0001), p=0.01). Furthermore, participants with the largest decline in moderate-and-vigorous PA from adolescence to adulthood displayed significantly less compliant arteries compared with the remaining sample (p<0.05). CONCLUSIONS High mean exposure to moderate-and-vigorous PA levels and increases herein were independently associated with lower levels of carotid arterial stiffness in adulthood.
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Affiliation(s)
- Mathias Ried-Larsen
- Research Unit for Exercise Epidemiology, Institute of Sport Science and Clinical Biomechanics, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
| | - Anders Grøntved
- Research Unit for Exercise Epidemiology, Institute of Sport Science and Clinical Biomechanics, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
| | - Peter Lund Kristensen
- Research Unit for Exercise Epidemiology, Institute of Sport Science and Clinical Biomechanics, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
| | - Karsten Froberg
- Research Unit for Exercise Epidemiology, Institute of Sport Science and Clinical Biomechanics, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark
| | - Lars Bo Andersen
- Research Unit for Exercise Epidemiology, Institute of Sport Science and Clinical Biomechanics, Centre of Research in Childhood Health, University of Southern Denmark, Odense, Denmark Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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Fujie S, Iemitsu M, Murakami H, Sanada K, Kawano H, Gando Y, Kawakami R, Miyachi M. Higher cardiorespiratory fitness attenuates arterial stiffening associated with the Ala54Thr polymorphism in FABP2. Physiol Genomics 2013; 45:237-42. [PMID: 23362142 DOI: 10.1152/physiolgenomics.00089.2012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Fatty acid binding protein 2 (FABP2) Ala54Thr polymorphism is a candidate gene associated with the risk of cardiovascular disease. Habitual exercise brings higher cardiorespiratory fitness and results in the improvement of cardiovascular disease risk. However, the effect of cardiorespiratory fitness level and FABP2 Ala54Thr polymorphism on the risk of cardiovascular diseases remains unclear. In the present study, a cross-sectional investigation of 837 Japanese men and women was performed to clarify the effects of cardiorespiratory fitness on the relationship between risk of cardiovascular disease and FABP2 Ala54Thr gene polymorphism. The study subjects were divided into high-cardiorespiratory fitness (High-Fit) and low-cardiorespiratory fitness (Low-Fit) groups based on the median value of peak oxygen uptake in each sex and decade. The FABP2 Ala54Thr polymorphism did not significantly affect carotid β-stiffness or blood pressure. In the Low-Fit group, carotid β-stiffness, systolic blood pressure, and diastolic blood pressure were higher for individuals with the Ala/Ala genotype compared with those with the Ala/Thr or Thr/Thr genotype, whereas no differences were observed in the High-Fit group. Additionally, serum triglyceride and plasma glucose levels were lower and serum high-density lipoprotein cholesterol levels were higher in the High-Fit group compared with the Low-Fit group; the FABP2 Ala54Thr polymorphism did not significantly affect these parameters. These results suggest that the higher cardiorespiratory fitness may attenuate the changes in central arterial stiffness and blood pressure that are associated with the FABP2 genotype.
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Affiliation(s)
- Shumpei Fujie
- Faculty of Sport and Health Science, Ritsumeikan University, Shiga, Japan
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Ried-Larsen M, Grøntved A, Froberg K, Ekelund U, Andersen LB. Physical activity intensity and subclinical atherosclerosis in Danish adolescents: The European Youth Heart Study. Scand J Med Sci Sports 2013; 23:e168-77. [PMID: 23336399 DOI: 10.1111/sms.12046] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2012] [Indexed: 11/28/2022]
Affiliation(s)
- M. Ried-Larsen
- Institute of Sport Science and Clinical Biomechanics; Research unit for Exercise Epidemiology; Centre of Research in Childhood Health; University of Southern Denmark; Odense; Denmark
| | - A. Grøntved
- Institute of Sport Science and Clinical Biomechanics; Research unit for Exercise Epidemiology; Centre of Research in Childhood Health; University of Southern Denmark; Odense; Denmark
| | - K. Froberg
- Institute of Sport Science and Clinical Biomechanics; Research unit for Exercise Epidemiology; Centre of Research in Childhood Health; University of Southern Denmark; Odense; Denmark
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Bori Z, Zhao Z, Koltai E, Fatouros IG, Jamurtas AZ, Douroudos II, Terzis G, Chatzinikolaou A, Sovatzidis A, Draganidis D, Boldogh I, Radak Z. The effects of aging, physical training, and a single bout of exercise on mitochondrial protein expression in human skeletal muscle. Exp Gerontol 2012; 47:417-24. [PMID: 22449457 DOI: 10.1016/j.exger.2012.03.004] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 02/21/2012] [Accepted: 03/11/2012] [Indexed: 01/10/2023]
Abstract
Aging results in a significant decline in aerobic capacity and impaired mitochondrial function. We have tested the effects of moderate physical activity on aerobic capacity and a single bout of exercise on the expression profile of mitochondrial biogenesis, and fusion and fission related genes in skeletal muscle of human subjects. Physical activity attenuated the aging-associated decline in VO2 max (p<0.05). Aging increased and a single exercise bout decreased the expression of nuclear respiratory factor-1 (NRF1), while the transcription factor A (TFAM) expression showed a strong relationship with VO(2max) and increased significantly in the young physically active group. Mitochondrial fission representing FIS1 was induced by regular physical activity, while a bout of exercise decreased fusion-associated gene expression. The expression of polynucleotide phosphorylase (PNPase) changed inversely in young and old groups and decreased with aging. The A2 subunit of cyclic AMP-activated protein kinase (AMPK) was induced by a single bout of exercise in skeletal muscle samples of both young and old subjects (p<0.05). Our data suggest that moderate levels of regular physical activity increases a larger number of mitochondrial biogenesis-related gene expressions in young individuals than in aged subjects. Mitochondrial fission is impaired by aging and could be one of the most sensitive markers of the age-associated decline in the adaptive response to physical activity.
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Affiliation(s)
- Zoltan Bori
- Research Institute of Sport Science, Semmelweis University, Budapest, Hungary
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Development of youth aerobic-capacity standards using receiver operating characteristic curves. Am J Prev Med 2011; 41:S111-6. [PMID: 21961610 DOI: 10.1016/j.amepre.2011.07.007] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Revised: 06/24/2011] [Accepted: 07/10/2011] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cardiovascular fitness has important implications for current and future health in children. PURPOSE In this paper, criterion-referenced standards are developed for aerobic capacity (an indicator of cardiovascular fitness) based on receiver operating characteristic (ROC) curves. METHODS The sample was drawn from participants aged 12-18 years in the National Health and Nutrition Examination Survey (1999-2002, N=1966). Subjects completed a treadmill exercise test from which maximal oxygen uptake (VO(2)max) was estimated from heart rate response. Metabolic syndrome was classified using previously published standards based on the National Cholesterol Education Program/Adult Treatment Panel III adult values at age 20 years. Using aerobic fitness z-scores as the test and metabolic syndrome as the criterion, ROC curve analysis was used to identify aerobic-capacity thresholds. RESULTS The area under the curve (AUC) value for boys (83.1%) was high, indicating good utility for detecting risk of metabolic syndrome with aerobic fitness values. The AUC for girls (77.2%) was slightly below the recommended value of 80%. Although the ROC plots identified a defensible point for classifying levels of fitness, the approach in the present study was to establish two independent thresholds, one aimed at high specificity and one aimed at high sensitivity. The resulting z values for the low- and higher-risk threshold lines were then converted back to VO(2)max estimates using published LMS (L=skewness, M=median, and S=coefficient of variation) parameters. Values at the low-risk threshold ranged from 40 to 44 mL/kg/min for boys and from 38 to 40 mL/kg/min for girls. CONCLUSIONS In summary, aerobic fitness can be used with moderate accuracy to differentiate between adolescents with and without metabolic syndrome. Age- and gender-specific aerobic-capacity thresholds for creating separate risk groups were identified using nationally representative growth percentiles.
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Are we there yet? Pediatric screening for inflammatory biomarkers and low cardiorespiratory fitness to identify youth at increased risk of cardiovascular disease. J Adolesc Health 2010; 47:319-21. [PMID: 20863999 DOI: 10.1016/j.jadohealth.2010.07.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Accepted: 07/30/2010] [Indexed: 11/21/2022]
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Iemitsu M, Murakami H, Sanada K, Yamamoto K, Kawano H, Gando Y, Miyachi M. Lack of carotid stiffening associated with MTHFR 677TT genotype in cardiorespiratory fit adults. Physiol Genomics 2010; 42:259-65. [PMID: 20406848 DOI: 10.1152/physiolgenomics.00039.2010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The TT genotype of C677T polymorphism in 5,10-methylenetetrahydrofolate reductase (MTHFR) induces elevation of homocysteine level and leads to atherosclerosis and arterial stiffening. Furthermore, cardiorespiratory fitness level is also associated with arterial stiffness. In the present study, a cross-sectional investigation of 763 Japanese men and women (18-70 yr old) was performed to clarify the effects of cardiorespiratory fitness on the relationship between arterial stiffness and MTHFR C677T gene polymorphism. Arterial stiffness was assessed by carotid beta-stiffness with ultrasonography and tonometry. The study subjects were divided into high-cardiorespiratory fitness (High-Fit) and low-cardiorespiratory fitness (Low-Fit) groups based on the median value of peak oxygen uptake in each sex and decade. The plasma homocysteine level was higher in the TT genotype of MTHFR C677T polymorphism compared with CC and CT genotype individuals. MTHFR C677T polymorphism showed no effect on carotid beta-stiffness, but there was a significant interaction effect between fitness and MTHFR C677T polymorphism on carotid beta-stiffness (P = 0.0017). In the Low-Fit subjects, carotid beta-stiffness was significantly higher in individuals with the TT genotype than the CC and CT genotypes. However, there were no such differences in High-Fit subjects. In addition, beta-stiffness and plasma homocysteine levels were positively correlated in Low-Fit subjects with the TT genotype (r = 0.71, P < 0.0001), but no such correlations were observed in High-Fit subjects. In CC and CT genotype individuals, there were also no such correlations in either fitness level. These results suggest that the higher cardiorespiratory fitness may attenuate central artery stiffening associated with MTHFR C677T polymorphism.
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Affiliation(s)
- Motoyuki Iemitsu
- Health Promotion and Exercise Program, National Institute of Health and Nutrition, 1-23-1 Toyana, Shinjuku, Tokyo, Japan
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The Effects of Endurance and Recreational Exercise on Subclinical Evidence of Atherosclerosis in Young Adults. Am J Med Sci 2010; 339:332-6. [DOI: 10.1097/maj.0b013e3181cefbb9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Castro-Pinero J, Mora J, Gonzalez-Montesinos JL, Sjostrom M, Ruiz JR. Criterion-related validity of the one-mile run/walk test in children aged 8-17 years. J Sports Sci 2009; 27:405-13. [PMID: 19191063 DOI: 10.1080/02640410802603889] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We assessed the criterion-related validity of Cureton's equation for estimating peak oxygen consumption (VO(2peak)) from the one-mile run/walk test in endurance-trained children aged 8-17 years. Altogether, 66 physically active white children and adolescents (32 girls, 34 boys) completed a graded exercise test to volitional exhaustion and the one-mile run/walk test. Cureton's equation was used to estimate VO(2peak), and was assessed using several error measures. Agreement between measured VO(2peak) and estimated VO(2peak) was analysed by the Bland and Altman method. The correlation coefficient between measured VO(2peak) and one-mile run/walk time was -0.59 (P < 0.001) and that between measured and estimated VO(2peak) was 0.70 (P < 0.001). The mean difference between measured and estimated VO(2peak) was 10 ml . kg(-1) . min(-1) (95% CI = 9.2-11.8; P < 0.001). The standard error of the estimate was 3 ml . kg(-1) . min(-1), and the percentage error was 32%. There was a positive association between the measured and estimated VO(2peak) difference and the measured and estimated VO(2peak) mean, which indicates that the higher the VO(2peak) the higher the error of the estimate. These findings did not change markedly when the analyses were performed by sex, age group or body mass status. These results suggest that Cureton's equation systematically underestimates VO(2peak) in endurance-trained children with high VO(2peak).
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Affiliation(s)
- Jose Castro-Pinero
- Department of Physical Education, School of Education, University of Cadiz, Cadiz, Spain
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Associations of birth size and duration of breast feeding with cardiorespiratory fitness in childhood: findings from the Avon Longitudinal Study of Parents and Children (ALSPAC). Eur J Epidemiol 2008; 23:411-22. [PMID: 18470625 DOI: 10.1007/s10654-008-9259-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2007] [Accepted: 04/17/2008] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To explore the developmental origins of cardiorespiratory fitness. METHODS We examined the associations of birth size and duration of breast feeding with cardiorespiratory fitness assessed at the 9 year follow-up examination in 3612 participants of the Avon Longitudinal Study of Parents and Children (ALSPAC). We used physical work capacity at a heart rate of 170 beats per minute (PWC(170)) as our assessment of cardiorespiratory fitness. This was estimated using standard regression methods from parameters measured using an electronically braked cycle ergometer. RESULTS Birth weight, length and ponderal index were all positively associated with cardiorespiratory fitness in both sexes, with no strong evidence of a difference in effect between girls and boys. Work capacity increased by 1.12 W (95% CI: 0.83, 1.40) on average per 1 standard deviation (SD) greater birth weight. This association was not affected by adjustment for socioeconomic position and maternal smoking during pregnancy; there was some attenuation with adjustment for both maternal and paternal height and body mass index and more marked attenuation with adjustment for the child's height and body mass index. In the fully adjusted model work capacity increased by 0.51 W (95% CI: 0.21, 0.81) per SD birth weight. Whether an individual had been breastfed and duration of breastfeeding were not associated with cardiorespiratory fitness in any models. CONCLUSION Our results provide some support for a role of intrauterine factors in determining cardiorespiratory fitness in childhood.
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Exercise and Carotid Atherosclerosis. Eur J Vasc Endovasc Surg 2008; 35:264-72. [DOI: 10.1016/j.ejvs.2007.08.022] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2007] [Accepted: 08/08/2007] [Indexed: 11/22/2022]
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