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Kirsch M, Vitiello D, Trachsel LD, Boidin M, Lalongé J, Juneau M, Bherer L, Nigam A, Gayda M. Cardiac hemodynamics phenotypes and individual responses to training in coronary heart disease patients. Scand J Med Sci Sports 2024; 34:e14633. [PMID: 38650385 DOI: 10.1111/sms.14633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/18/2024] [Accepted: 04/04/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND In patients with coronary heart disease (CHD), individualized exercise training (ET) programs are strongly recommended to optimize peak oxygen uptake (V ̇ $$ \dot{\mathrm{V}} $$ O2peak) improvement and prognosis. However, the cardiac hemodynamic factors responsible for a positive response to training remain unclear. The aim of this study was to compare cardiac hemodynamic changes after an ET program in responder (R) versus non-responder (NR) CHD patients. METHODS A total of 72 CHD patients completed a 3-month ET program and were assessed by cycle ergometer cardiopulmonary exercise test (CPET:V ̇ $$ \dot{\mathrm{V}} $$ O2peak assessment) with impedance cardiography (ICG) for hemodynamic measurements before and after training. Cardiac hemodynamics (e.g., CO, CI, SV, ESV, EDV, and SVR) were measured by ICG during CPET. The R and NR groups were classified using the median change inV ̇ $$ \dot{\mathrm{V}} $$ O2peak (>the median for R and ≤the median for NR). RESULTS In the R group,V ̇ $$ \dot{\mathrm{V}} $$ O2peak (+17%, p < 0.001), CO, CI, SV, and HR increased by 17%, 17%, 13%, and 5%, respectively (p < 0.05) after the training program. In the NR group,V ̇ $$ \dot{\mathrm{V}} $$ O2peak, CO, CI, and SV increased by 0.5%, 5%, 8%, and 6%, respectively (p < 0.01). The SVR decreased in both groups (-19% in R and -11% in NR, p < 0.001). CONCLUSION Among CHD patients, the R group showed a better improvement in peak cardiac output via an increase in peak stroke volume and heart rate and a reduced systemic vascular resistance than the NR group. Different cardiac phenotype adaptations and clinical individual responses were identified in CHD patients according to the aerobic fitness responder's status.
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Affiliation(s)
- Marine Kirsch
- Preventive Medicine and Physical Activity Center (ÉPIC) & Research Center, Montreal Heart Institute and Université de Montréal, Montréal, Quebec, Canada
- Université Paris Cité, Institut des Sciences du Sport Santé de Paris (I3SP), URP 3625, Paris, France
| | - Damien Vitiello
- Université Paris Cité, Institut des Sciences du Sport Santé de Paris (I3SP), URP 3625, Paris, France
| | - Lukas-Daniel Trachsel
- University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Maxime Boidin
- Liverpool Centre for Cardiovascular Science, Liverpool John Moores University, Liverpool, UK
| | - Julie Lalongé
- Preventive Medicine and Physical Activity Center (ÉPIC) & Research Center, Montreal Heart Institute and Université de Montréal, Montréal, Quebec, Canada
| | - Martin Juneau
- Preventive Medicine and Physical Activity Center (ÉPIC) & Research Center, Montreal Heart Institute and Université de Montréal, Montréal, Quebec, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Louis Bherer
- Preventive Medicine and Physical Activity Center (ÉPIC) & Research Center, Montreal Heart Institute and Université de Montréal, Montréal, Quebec, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Anil Nigam
- Preventive Medicine and Physical Activity Center (ÉPIC) & Research Center, Montreal Heart Institute and Université de Montréal, Montréal, Quebec, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Mathieu Gayda
- Preventive Medicine and Physical Activity Center (ÉPIC) & Research Center, Montreal Heart Institute and Université de Montréal, Montréal, Quebec, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
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Girault A, Leprêtre PM, Trachsel LD, Besnier F, Boidin M, Lalongé J, Juneau M, Bherer L, Nigam A, Gayda M. Determinants of V̇+O2peak Changes After Aerobic Training in Coronary Heart Disease Patients. Int J Sports Med 2024. [PMID: 38267005 DOI: 10.1055/a-2253-1807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
This study aimed to highlight the ventilatory and circulatory determinants of changes in ˙VO2peak after exercise-based cardiac rehabilitation (ECR) in patients with coronary heart disease (CHD). Eighty-two CHD patients performed, before and after a 3-month ECR, a cardiopulmonary exercise testing (CPET) on a bike with gas exchanges measurements (˙VO2peak, minute ventilation, i. e., ˙VE), and cardiac output (Q˙c). The arteriovenous difference in O2 (C(a-v¯)O2) and the alveolar capillary gradient in O2 (PAi-aO2) were calculated using Fick's laws. Oxygen uptake efficiency slope (OUES) was calculated. A 5.0% cut off was applied for differentiating non- (NR: ˙VO2<0.0%), low (LR: 0.0≤ ∆˙VO2<5.0%), moderate (MR: 5.0≤∆˙VO2 < 10.0%), and high responders (HR: ∆˙VO2≥10.0%) to ECR. A total of 44% of patients were HR (n=36), 20% MR (n=16), 23% LR (n=19), and 13% NR (n=11). For HR, the ˙VO2peak increase (p<0.01) was associated with increases in ˙VE (+12.8±13.0 L/min, p<0.01), (+1.0±0.9 L/min, p<0.01), and C(a-v¯)O2 (+2.3±2.5 mLO2/100 mL, p<0.01). MR patients were characterized by+6.7±19.7 L/min increase in ˙VE (p=0.04) and+0.7±1.0 L/min of Q˙c (p<0.01). ECR induced decreases in ˙VE (p=0.04) and C(a-v¯)O2 (p<0.01) and a Q˙c increase in LR and NR patients (p<0.01). Peripheral and ventilatory responses more than central adaptations could be responsible for the ˙VO2peak change with ECR in CHD patients.
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Affiliation(s)
- Axel Girault
- Preventive medicine and physical activity Center (ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Canada
- Unit Research Physiological Adaptations to Exercise and Physical Rehabilitation, Université de Picardie Jules Verne, Amiens, France
| | - Pierre-Marie Leprêtre
- Unit Research Physiological Adaptations to Exercise and Physical Rehabilitation, Université de Picardie Jules Verne, Amiens, France
- Unit of Cardiac Rehabilitation, Hospital Center of Corbie, Corbie, France
| | - Lukas-Daniel Trachsel
- University Clinic for Cardiology, Inselspital University Hospital Bern, Bern, Switzerland
| | - Florent Besnier
- Preventive medicine and physical activity Center (ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Canada
| | - Maxime Boidin
- Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom of Great Britain and Northern Ireland
| | - Julie Lalongé
- Preventive medicine and physical activity Center (ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Canada
| | - Martin Juneau
- Preventive medicine and physical activity Center (ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Canada
| | - Louis Bherer
- Preventive medicine and physical activity Center (ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Canada
| | - Anil Nigam
- Preventive medicine and physical activity Center (ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Canada
| | - Mathieu Gayda
- Preventive medicine and physical activity Center (ÉPIC), Montreal Heart Institute, Université de Montréal, Montréal, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Canada
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Iglesies-Grau J, Dionne V, Latour É, Gayda M, Besnier F, Gagnon D, Debray A, Gagnon C, Pelletier V, Nigam A, L'Allier PL, Juneau M, Bouabdallaoui N, Bherer L. Mediterranean diet and time-restricted eating as a cardiac rehabilitation approach for patients with coronary heart disease and pre-diabetes: the DIABEPIC-1 protocol of a feasibility trial. BMJ Open 2023; 13:e073763. [PMID: 37848307 PMCID: PMC10582969 DOI: 10.1136/bmjopen-2023-073763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 09/06/2023] [Indexed: 10/19/2023] Open
Abstract
INTRODUCTION Despite proven programmes, implementing lifestyle interventions for pre-diabetes and type 2 diabetes is challenging. Cardiac rehabilitation, provide a valuable opportunity to promote the adoption of healthy lifestyle behaviours for patients with atherosclerotic cardiovascular disease (ASCVD). However, only a limited number of studies have explored the potential for reversing the underlying causes of ASCVD in this setting. OBJECTIVES The DIABEPIC1 study is an ongoing single-arm lifestyle clinical trial to assess the feasibility of an upgraded 6-month intensive cardiac rehabilitation programme combining an innovative diet assignment with exercise training to reverse newly onset pre-diabetes (glycated haemoglobin 5.7%-6.4%) to normal glucose concentrations in patients with coronary heart disease. METHODS AND ANALYSIS 36 patients referred from the Montreal Heart Institute for cardiac rehabilitation, aged ≥40 years with a recent diagnosis of pre-diabetes in the last 6 months, will be offered to participate in the upgraded programme. Interventions will include four sessions of nutritional counselling on ultra-processed foods intake reduction and a moderate-carbohydrate (<40%) ad libitum Mediterranean diet coupled with 36 1-hour sessions of supervised exercise training (continuous and interval aerobic training, and resistance training) and educational intervention. Phase 2 will continue the same interventions adding 8:16 hour time-restricting eating (TRE) at least 5 days per week. During this second phase, exercise training will be performed with autonomy. The primary objectives will be to evaluate the recruitment rate, the completion rates at 3 and 6 months, and the compliance of participants. The secondary objectives will be to assess the proportion of prediabetic participants in remission of pre-diabetes at the programme's end and to characterise the factors associated with remission. ETHICS AND DISSEMINATION The DIABEPIC1 feasibility study is approved by the Research Ethics Board of the Montreal Heart Institute (Project Number ICM 2022-3005). Written informed consent will be obtained from each participant prior to inclusion. Results will be available through research articles and conferences. CONCLUSIONS The DIABEPIC1 trial will examine the feasibility and effectiveness of an enhanced cardiac rehabilitation programme combining exercise training with an ultra-processed food reduction intervention, a Mediterranean diet, and TRE counselling to remit pre-diabetes to normal glucose concentrations. TRIAL REGISTRATION NUMBER NCT05459987.
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Affiliation(s)
- Josep Iglesies-Grau
- Department of Medicine, Université de Montréal, Montreal, Québec, Canada
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
| | - Valérie Dionne
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
| | - Élise Latour
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
| | - Mathieu Gayda
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
- Université de Montréal, Montreal, Québec, Canada
| | | | - Daniel Gagnon
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
- Université de Montréal, Montreal, Québec, Canada
| | - Amélie Debray
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
| | - Christine Gagnon
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
| | - Véronique Pelletier
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
| | - Anil Nigam
- Department of Medicine, Université de Montréal, Montreal, Québec, Canada
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
| | - Philippe L L'Allier
- Department of Medicine, Université de Montréal, Montreal, Québec, Canada
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
| | - Martin Juneau
- Department of Medicine, Université de Montréal, Montreal, Québec, Canada
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
| | - Nadia Bouabdallaoui
- Department of Medicine, Université de Montréal, Montreal, Québec, Canada
- Montreal Heart Institute, Montreal, Québec, Canada
| | - Louis Bherer
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, Québec, Canada
- Université de Montréal, Montreal, Québec, Canada
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
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Debray A, Gravel H, Garceau L, Bartlett AA, Chaseling GK, Barry H, Behzadi P, Ravanelli N, Iglesies-Grau J, Nigam A, Juneau M, Gagnon D. Finnish sauna bathing and vascular health of adults with coronary artery disease: a randomized controlled trial. J Appl Physiol (1985) 2023; 135:795-804. [PMID: 37650138 DOI: 10.1152/japplphysiol.00322.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 09/01/2023] Open
Abstract
Regular Finnish sauna use is associated with a reduced risk of cardiovascular mortality. However, physiological mechanisms underlying this association remain unknown. This study determined if an 8-wk Finnish sauna intervention improves peripheral endothelial function, microvascular function, central arterial stiffness, and blood pressure in adults with coronary artery disease (CAD). Forty-one adults (62 ± 6 yr, 33 men/8 women) with stable CAD were randomized to 8 wk of Finnish sauna use (n = 21, 4 sessions/wk, 20-30 min/session, 79°C, 13% relative humidity) or a control intervention (n = 20, lifestyle maintenance). Brachial artery flow-mediated dilation (FMD), carotid-femoral pulse wave velocity (cf-PWV), total (area under the curve) and peak postocclusion forearm reactive hyperemia, and blood pressure (automated auscultation) were measured before and after the intervention. After the sauna intervention, resting core temperature was lower (-0.27°C [-0.54, -0.01], P = 0.046) and sweat rate during sauna exposure was greater (0.3 L/h [0.1, 0.5], P = 0.003). The change in brachial artery FMD did not differ between interventions (control: 0.07% [-0.99, +1.14] vs. sauna: 0.15% [-0.89, +1.19], interaction P = 0.909). The change in total (P = 0.031) and peak (P = 0.024) reactive hyperemia differed between interventions due to a nonsignificant decrease in response to the sauna intervention and an increase in response to control. The change in cf-PWV (P = 0.816), systolic (P = 0.951), and diastolic (P = 0.292) blood pressure did not differ between interventions. These results demonstrate that four sessions of Finnish sauna bathing per week for 8 wk does not improve markers of vascular health in adults with stable CAD.NEW & NOTEWORTHY This study determined if unsupervised Finnish sauna bathing for 8 wk improves markers of vascular health in adults with coronary artery disease. Finnish sauna bathing reduced resting core temperature and improved sweating capacity, indicative of heat acclimation. Despite evidence of heat acclimation, Finnish sauna bathing did not improve markers of endothelial function, microvascular function, arterial stiffness, or blood pressure.
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Affiliation(s)
- Amélie Debray
- Montreal Heart Institute, Montreal, Quebec, Canada
- School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Hugo Gravel
- Montreal Heart Institute, Montreal, Quebec, Canada
- School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | | | - Audrey-Ann Bartlett
- Montreal Heart Institute, Montreal, Quebec, Canada
- School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Georgia K Chaseling
- Engagement and Co-design Research Hub, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | | | | | - Nicholas Ravanelli
- School of Kinesiology, Lakehead University, Thunder Bay, Ontario, Canada
| | | | - Anil Nigam
- Montreal Heart Institute, Montreal, Quebec, Canada
| | | | - Daniel Gagnon
- Montreal Heart Institute, Montreal, Quebec, Canada
- School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
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Besnier F, Gagnon C, Monnet M, Dupuy O, Nigam A, Juneau M, Bherer L, Gayda M. Acute Effects of a Maximal Cardiopulmonary Exercise Test on Cardiac Hemodynamic and Cerebrovascular Response and Their Relationship with Cognitive Performance in Individuals with Type 2 Diabetes. Int J Environ Res Public Health 2023; 20:ijerph20085552. [PMID: 37107835 PMCID: PMC10138481 DOI: 10.3390/ijerph20085552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/20/2023] [Accepted: 04/07/2023] [Indexed: 05/11/2023]
Abstract
Cardiovascular and cerebrovascular diseases are prevalent in individuals with type 2 diabetes (T2D). Among people with T2D aged over 70 years, up to 45% might have cognitive dysfunction. Cardiorespiratory fitness (V˙O2max) correlates with cognitive performances in healthy younger and older adults, and individuals with cardiovascular diseases (CVD). The relationship between cognitive performances, V˙O2max, cardiac output and cerebral oxygenation/perfusion responses during exercise has not been studied in patients with T2D. Studying cardiac hemodynamics and cerebrovascular responses during a maximal cardiopulmonary exercise test (CPET) and during the recovery phase, as well as studying their relationship with cognitive performances could be useful to detect patients at greater risk of future cognitive impairment. Purposes: (1) to compare cerebral oxygenation/perfusion during a CPET and during its post-exercise period (recovery); (2) to compare cognitive performances in patients with T2D to those in healthy controls; and (3) to examine if V˙O2max, maximal cardiac output and cerebral oxygenation/perfusion are associated with cognitive function in individuals with T2D and healthy controls. Nineteen patients with T2D (61.9 ± 7 years old) and 22 healthy controls (HC) (61.8 ± 10 years old) were evaluated on the following: a CPET test with impedance cardiography and cerebral oxygenation/perfusion using a near-infrared spectroscopy. Prior to the CPET, the cognitive performance assessment was performed, targeting: short-term and working memory, processing speed, executive functions, and long-term verbal memory. Patients with T2D had lower V˙O2max values compared to HC (34.5 ± 5.6 vs. 46.4 ± 7.6 mL/kg fat free mass/min; p < 0.001). Compared to HC, patients with T2D showed lower maximal cardiac index (6.27 ± 2.09 vs. 8.70 ± 1.09 L/min/m2, p < 0.05) and higher values of systemic vascular resistance index (826.21 ± 308.21 vs. 583.35 ± 90.36 Dyn·s/cm5·m2) and systolic blood pressure at maximal exercise (204.94 ± 26.21 vs. 183.61 ± 19.09 mmHg, p = 0.005). Cerebral HHb during the 1st and 2nd min of recovery was significantly higher in HC compared to T2D (p < 0.05). Executive functions performance (Z score) was significantly lower in patients with T2D compared to HC (-0.18 ± 0.7 vs. -0.40 ± 0.60, p = 0.016). Processing speed, working and verbal memory performances were similar in both groups. Brain tHb during exercise and recovery (-0.50, -0.68, p < 0.05), and O2Hb during recovery (-0.68, p < 0.05) only negatively correlated with executive functions performance in patients with T2D (lower tHb values associated with longer response times, indicating a lower performance). In addition to reduced V˙O2max, cardiac index and elevated vascular resistance, patients with T2D showed reduced cerebral hemoglobin (O2Hb and HHb) during early recovery (0-2 min) after the CPET, and lower performances in executive functions compared to healthy controls. Cerebrovascular responses to the CPET and during the recovery phase could be a biological marker of cognitive impairment in T2D.
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Affiliation(s)
- Florent Besnier
- Research Centre and Centre ÉPIC, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montreal, Montreal, QC H3T 1J4, Canada
| | - Christine Gagnon
- Research Centre and Centre ÉPIC, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada
| | - Meghann Monnet
- Laboratory MOVE (UR 20296), Faculty of Sport Sciences, Université de Poitiers, 86073 Poitiers, France
| | - Olivier Dupuy
- Laboratory MOVE (UR 20296), Faculty of Sport Sciences, Université de Poitiers, 86073 Poitiers, France
- School of Kinesiology and Physical Activity Sciences (EKSAP), Faculty of Medicine, Université de Montreal, Montreal, QC H3T 1J4, Canada
| | - Anil Nigam
- Research Centre and Centre ÉPIC, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montreal, Montreal, QC H3T 1J4, Canada
| | - Martin Juneau
- Research Centre and Centre ÉPIC, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montreal, Montreal, QC H3T 1J4, Canada
| | - Louis Bherer
- Research Centre and Centre ÉPIC, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montreal, Montreal, QC H3T 1J4, Canada
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montreal, QC H3W 1W5, Canada
| | - Mathieu Gayda
- Research Centre and Centre ÉPIC, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montreal, Montreal, QC H3T 1J4, Canada
- Correspondence:
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Iglesies-Grau J, Dionne V, Latour É, Lamoureux K, Pelletier V, Bisaillon M, Tessier G, Bertholet J, Guilbeault V, Berthiaume A, Aubut L, Hamrioui N, Morissette MH, Gagnon C, Simard F, Nigam A, L'Allier PL, Bherer L, Bouabdallaoui N, Juneau M. IMPACT OF MULTIPLE LIFESTYLE INTERVENTIONS ON METABOLIC HEALTH AND REMISSION OF PREDIABETES AND TYPE 2 DIABETES: A TWO-YEAR CLINICAL EXPERIENCE. Am J Prev Cardiol 2023. [DOI: 10.1016/j.ajpc.2022.100397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Iglesies-Grau J, Dionne V, Bherer L, Bouabdallaoui N, Aubut L, Besnier F, Bertholet J, Berthiaume A, Bisaillon M, Gayda M, Gagnon C, Hamrioui N, Latour É, L'Allier PL, Marie-Hélène MC, Nigam A, Pelletier V, Tessier G, Juneau M. Metabolic Improvements and Remission of Prediabetes and Type 2 Diabetes: Results From a Multidomain Lifestyle Intervention Clinic. Can J Diabetes 2023; 47:185-189. [PMID: 36402709 DOI: 10.1016/j.jcjd.2022.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 10/12/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Although lifestyle interventions are first-line treatment for individuals living with prediabetes and type 2 diabetes (T2D), they are rarely implemented effectively in routine clinical care. METHODS We present a retrospective analysis of a 12-month, single-centre, structured multidomain lifestyle intervention clinic offered to individuals living with prediabetes and type 2 diabetes. The intervention consisted of expert-guided educational and nutritional counselling combined with a personalized physical exercise prescription, with the main goal of improving metabolic health and reaching remission. Anthropometric parameters, glucose, basal insulin, glycated hemoglobin (A1C), and lipid levels were measured at baseline and at 3, 6, and 12 months after the lifestyle intervention initiation. Remission of prediabetes and T2D were defined as a return of A1C at 6 months to <6.5% (or <5.7% for prediabetes) and persisting for at least 3 months in the absence of glucose-lowering pharmacotherapy. RESULTS After a multidomain, expert-guided lifestyle intervention, 117 individuals living with prediabetes and T2D had significantly improved metabolic profiles: Mean weight change at 12 months was -4.9 kg (95% confidence interval [CI], -4.0 to -5.7; p<0.001), and mean change in A1C at 12 months was -0.6% (95% CI, -0.4 to -0.7; p<0.001). A substantial proportion of individuals reached the criteria for remission (20% among participants with prediabetes and 12% among those with T2D). CONCLUSIONS The results of this study suggest that prioritizing lifestyle changes in a multifaceted, progressive, 12-month intervention in this population improves anthropometric and insulin resistance measures, and has the potential to normalize metabolic values, even to the point of reaching the criteria of remission.
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Affiliation(s)
- Josep Iglesies-Grau
- Centre EPIC and Research Centre, Montréal Heart Institute, Montréal, Québec, Canada.
| | - Valérie Dionne
- Centre EPIC and Research Centre, Montréal Heart Institute, Montréal, Québec, Canada
| | - Louis Bherer
- Centre EPIC and Research Centre, Montréal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Université de Montréal, Montréal, Québec, Canada; Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Nadia Bouabdallaoui
- Centre EPIC and Research Centre, Montréal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Lise Aubut
- Centre EPIC and Research Centre, Montréal Heart Institute, Montréal, Québec, Canada
| | - Florent Besnier
- Centre EPIC and Research Centre, Montréal Heart Institute, Montréal, Québec, Canada
| | - Johanne Bertholet
- Centre EPIC and Research Centre, Montréal Heart Institute, Montréal, Québec, Canada
| | - Annie Berthiaume
- Centre EPIC and Research Centre, Montréal Heart Institute, Montréal, Québec, Canada
| | - Marc Bisaillon
- Centre EPIC and Research Centre, Montréal Heart Institute, Montréal, Québec, Canada
| | - Mathieu Gayda
- Centre EPIC and Research Centre, Montréal Heart Institute, Montréal, Québec, Canada
| | - Christine Gagnon
- Centre EPIC and Research Centre, Montréal Heart Institute, Montréal, Québec, Canada
| | - Nacima Hamrioui
- Centre EPIC and Research Centre, Montréal Heart Institute, Montréal, Québec, Canada
| | - Élise Latour
- Centre EPIC and Research Centre, Montréal Heart Institute, Montréal, Québec, Canada
| | - Philippe L L'Allier
- Centre EPIC and Research Centre, Montréal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Université de Montréal, Montréal, Québec, Canada
| | | | - Anil Nigam
- Centre EPIC and Research Centre, Montréal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Véronique Pelletier
- Centre EPIC and Research Centre, Montréal Heart Institute, Montréal, Québec, Canada
| | - Geneviève Tessier
- Centre EPIC and Research Centre, Montréal Heart Institute, Montréal, Québec, Canada
| | - Martin Juneau
- Centre EPIC and Research Centre, Montréal Heart Institute, Montréal, Québec, Canada; Department of Medicine, Université de Montréal, Montréal, Québec, Canada
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Gabrielle Dupuy E, Besnier F, Gagnon C, Breton J, Vincent T, Grégoire CA, Lecchino C, Payer M, Bérubé B, Olmand M, Levesque M, Bouabdallaoui N, Iglesies-Grau J, Juneau M, Vitali P, Gayda M, Nigam A, Bherer L. Cardiorespiratory Fitness Moderates the Age-Related Association Between Executive Functioning and Mobility: Evidence From Remote Assessments. Innov Aging 2022; 7:igac077. [PMID: 36846304 PMCID: PMC9950718 DOI: 10.1093/geroni/igac077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Indexed: 12/24/2022] Open
Abstract
Background and Objectives In older adults, executive functions are important for daily-life function and mobility. Evidence suggests that the relationship between cognition and mobility is dynamic and could vary according to individual factors, but whether cardiorespiratory fitness reduces the age-related increase of interdependence between mobility and cognition remains unexplored. Research Design and Methods One hundred eighty-nine participants (aged 50-87) were divided into 3 groups according to their age: middle-aged (MA; <65), young older adults (YOA; 65-74), and old older adults (OOA; ≥75). Participants performed Timed Up and Go and executive functioning assessments (Oral Trail Making Test and Phonologic verbal fluency) remotely by videoconference. Participants completed the Matthews questionnaire to estimate their cardiorespiratory fitness (VO2 max in ml/min/kg). A 3-way moderation was used to address whether cardiorespiratory fitness interacts with age to moderate the relationship between cognition and mobility. Results Results showed that the cardiorespiratory fitness × age interaction moderated the association between executive functioning and mobility (β = -0.05; p = .048; R 2 = 17.6; p < .001). At lower levels of physical fitness (<19.16 ml/min/kg), executive functioning significantly influenced YOA's mobility (β = -0.48, p = .004) and to a greater extent OOA's mobility (β = -0.96, p = .002). Discussion and Implications Our results support the idea of a dynamic relationship between mobility and executive functioning during aging and suggest that physical fitness could play a significant role in reducing their interdependency.
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Affiliation(s)
- Emma Gabrielle Dupuy
- Address correspondence to: Emma Gabrielle Dupuy, PhD, Centre ÉPIC of the Montreal Heart Institute, 5055 rue St Zotique Est, Montréal, Qc, H1T 1N6, Canada. E-mail:
| | - Florent Besnier
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Christine Gagnon
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Juliana Breton
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Thomas Vincent
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada
| | | | - Catia Lecchino
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Marie Payer
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Béatrice Bérubé
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Miloudza Olmand
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Marianne Levesque
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Psychology, Université de Montréal, Montreal, Quebec, Canada
| | - Nadia Bouabdallaoui
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Josep Iglesies-Grau
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Martin Juneau
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Paolo Vitali
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Mathieu Gayda
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Anil Nigam
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Louis Bherer
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada,Department of Medicine, Université de Montréal, Montreal, Quebec, Canada
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9
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Downey R, Bherer L, Pothier K, Vrinceanu T, Intzandt B, Berryman N, Lussier M, Vincent T, Karelis AD, Nigam A, Vu TTM, Bosquet L, Li KZH. Multiple routes to help you roam: A comparison of training interventions to improve cognitive-motor dual-tasking in healthy older adults. Front Aging Neurosci 2022; 14:710958. [PMID: 36408116 PMCID: PMC9670126 DOI: 10.3389/fnagi.2022.710958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
Abstract
Cognitive-motor dual-tasking is a complex activity that predicts falls risk and cognitive impairment in older adults. Cognitive and physical training can both lead to improvements in dual-tasking; however, less is known about what mechanisms underlie these changes. To investigate this, 33 healthy older adults were randomized to one of three training arms: Executive function (EF; n = 10), Aerobic Exercise (AE; n = 10), Gross Motor Abilities (GMA; n = 13) over 12 weeks (1 h, 3×/week). Single and dual-task performance (gait speed, m/s; cognitive accuracy, %) was evaluated before and after training, using the 2-back as concurrent cognitive load. Training arms were designed to improve cognitive and motor functioning, through different mechanisms (i.e., executive functioning – EF, cardiorespiratory fitness – CRF, and energy cost of walking – ECW). Compared to baseline, we observed few changes in dual-task gait speed following training (small effect). However, dual-task cognitive accuracy improved significantly, becoming facilitated by walking (large effect). There were no differences in the magnitude of improvements across training arms. We also found that older adults with lower cognitive ability (i.e., MoCA score < 26; n = 14) improved more on the dual-task cognitive accuracy following training, compared to older adults with higher cognitive ability (i.e., MoCA ≥26; n = 18). Taken together, the results suggest that regardless of the type of intervention, training appears to strengthen cognitive efficiency during dual-tasking, particularly for older adults with lower baseline cognitive status. These gains appear to occur via different mechanisms depending on the form of intervention. Implications of this research are paramount, as we demonstrate multiple routes for improving cognitive-motor dual-tasking in older adults, which may help reduce risk of cognitive impairment.
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Affiliation(s)
- Rachel Downey
- Department of Psychology, Concordia University, Montréal, QC, Canada
- PERFORM Centre, Concordia University, Montréal, QC, Canada
- *Correspondence: Rachel Downey, ; Karen Z. H. Li
| | - Louis Bherer
- PERFORM Centre, Concordia University, Montréal, QC, Canada
- Département de Médecine, Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut de cardiologie de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Kristell Pothier
- PERFORM Centre, Concordia University, Montréal, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
- Psychologie des Ages de la Vie et Adaptation, University of Tours, Tours, France
| | - Tudor Vrinceanu
- PERFORM Centre, Concordia University, Montréal, QC, Canada
- Département de Médecine, Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut de cardiologie de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Brittany Intzandt
- PERFORM Centre, Concordia University, Montréal, QC, Canada
- Centre de recherche de l’Institut de cardiologie de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Nicolas Berryman
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
- Département des sciences de l’activité physique, Université du Québec à Montréal, Montréal, QC, Canada
| | - Maxime Lussier
- Département de Médecine, Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Thomas Vincent
- PERFORM Centre, Concordia University, Montréal, QC, Canada
- Département de Médecine, Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut de cardiologie de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Antony D. Karelis
- Département des sciences de l’activité physique, Université du Québec à Montréal, Montréal, QC, Canada
| | - Anil Nigam
- Département de Médecine, Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l’Institut de cardiologie de Montréal, Montréal, QC, Canada
| | | | - Laurent Bosquet
- Faculté des sciences du sport, Université de Poitiers, Poitiers, France
| | - Karen Z. H. Li
- Department of Psychology, Concordia University, Montréal, QC, Canada
- PERFORM Centre, Concordia University, Montréal, QC, Canada
- *Correspondence: Rachel Downey, ; Karen Z. H. Li
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10
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Singh TB, Kumar R, Nigam A, Devi TR. AN OBSERVATIONAL STUDY TO FIND RELATIONSHIP OF ACUTE APPENDICITIS TO MENSTRUATION CYCLE IN NORTHERN AND NORTHEASTERN PART OF INDIA. IJMMR 2022. [DOI: 10.11603/ijmmr.2413-6077.2022.1.13083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background. Diagnosing acute appendicitis correctly in a female patient is a challenge for a practicing surgeon. Rate of misdiagnosis of acute appendicitis is very high among female patients. There are many studies carried out to find incidence of acute appendicitis as per various phases of menstruation cycle but the results were conflicting.
Objective. The study was conducted to find the relationship of acute appendicitis with the different phases of the menstruation cycle.
Methods. This research was an observational study carried out in two regional hospitals in northern and north-eastern part of India. Duration of study was 24 months between 01 June 2019 and 31 May 2021. Inclusion Criteria were for all female patients, non-pregnant and menstruating, who were histopathologically confirmed as acute appendicitis. All pathologically proven negative appendectomy patients were excluded from this study. All female patients taking oral contraceptive pills (OCP) were excluded from the study.
Results. A total of 96 females were hospitalized in both hospitals during the study period; 12 of them did not attain menarche (12.5%), 6 had menopause (6.3%) and 78 were menstruating (81.25%). Of those 78 patients, who had physiological menstrual cycles, 6 were in menstrual phase (7.6%), 18 were in proliferative phase (23%), and 54 in luteal phase (69.2%). In our study, there were only 6 cases of acute appendicitis during menstruation. therefore, the expected ratio of cases was 6/14=0.42. The corresponding expected rate for the proliferative phase was 2.78×9=25 cases, whereas for the luteal phase it was 2.78×14=38.92. The expected ratio was 18/25=0.72 for the proliferative phase and 54/39=1.38 for the luteal phase. There was a significant increase in number of cases of acute appendicitis among the menstruating women in luteal phase with p value <0.05. Mean age of the study participants was 28.31±9.56.
Conclusions. According to the result of the study, the incidence of acute appendicitis significantly differs in different phases of menstruation cycle with highest incidence in luteal phase. Hence, female hormones (estrogen and progesterone) are significant in causing acute appendicitis.
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11
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Talamonti D, Gagnon C, Vincent T, Nigam A, Lesage F, Bherer L, Fraser S. Exploring cognitive and brain oxygenation changes over a 1-year period in physically active individuals with mild cognitive impairment: a longitudinal fNIRS pilot study. BMC Geriatr 2022; 22:648. [PMID: 35941561 PMCID: PMC9361664 DOI: 10.1186/s12877-022-03306-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aging is associated with an increased likelihood of developing dementia, but a growing body of evidence suggests that certain modifiable risk factors may help prevent or delay dementia onset. Among these, physical activity (PA) has been linked to better cognitive performance and brain functions in healthy older adults and may contribute to preventing dementia. The current pilot study investigated changes in behavioral and brain activation patterns over a 1-year period in individuals with mild cognitive impairment (MCI) and healthy controls taking part in regular PA. METHODS Frontal cortical response during a dual-task walking paradigm was investigated at baseline, at 6 months (T6), and at 12 months (T12) by means of a portable functional Near-Infrared Spectroscopy (fNIRS) system. The dual-task paradigm included a single cognitive task (2-back), a single motor task (walking), and a dual-task condition (2-back whilst walking). RESULTS Both groups showed progressive improvement in cognitive performance at follow-up visits compared to baseline. Gait speed remained stable throughout the duration of the study in the control group and increased at T6 for those with MCI. A significant decrease in cortical activity was observed in both groups during the cognitive component of the dual-task at follow-up visits compared to baseline, with MCI individuals showing the greatest improvement. CONCLUSIONS The observations of this pilot study suggest that taking part in regular PA may be especially beneficial for both cognitive performance and brain functions in older adulthood and, especially, in individuals with MCI. Our findings may serve as preliminary evidence for the use of PA as a potential intervention to prevent cognitive decline in individuals at greater risk of dementia.
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Affiliation(s)
- Deborah Talamonti
- Research center and EPIC Center, Montreal Heart Institute, Montreal, QC, Canada
| | - Christine Gagnon
- Research center and EPIC Center, Montreal Heart Institute, Montreal, QC, Canada
| | - Thomas Vincent
- Research center and EPIC Center, Montreal Heart Institute, Montreal, QC, Canada
| | - Anil Nigam
- Research center and EPIC Center, Montreal Heart Institute, Montreal, QC, Canada.,Department of Medicine, University of Montreal, Montreal, QC, Canada
| | - Frederic Lesage
- Research center and EPIC Center, Montreal Heart Institute, Montreal, QC, Canada.,École Polytechnique de Montréal, Montreal, QC, Canada
| | - Louis Bherer
- Research center and EPIC Center, Montreal Heart Institute, Montreal, QC, Canada.,Department of Medicine, University of Montreal, Montreal, QC, Canada.,Centre de recherche, Institute universitaire de gériatrie de Montréal, Montreal, QC, Canada
| | - Sarah Fraser
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
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12
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Bartlett A, Garceau L, Gravel H, Debray A, Nigam A, Gagnon D. Can Finnish Sauna Bathing Induce Heat Acclimation in Adults with Stable Coronary Artery Disease? FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r3829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Laurence Garceau
- Montreal Heart InstituteMontrealQC
- Université de MontréalMontrealQC
| | - Hugo Gravel
- Montreal Heart InstituteMontrealQC
- Université de MontréalMontrealQC
| | - Amélie Debray
- Montreal Heart InstituteMontrealQC
- Université de PoitiersPoitiers
| | | | - Daniel Gagnon
- Montreal Heart InstituteMontrealQC
- Université de MontréalMontrealQC
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13
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Chaseling G, Batlett A, Capon A, Crandall C, Fiatarone Singh M, Bi P, Nigam A, Jay O, Gagnon D. Effects of Beta‐Blockers on Thermal and Cardiovascular Strain of Adults With Coronary Artery Disease During Extreme Heat Events. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r3555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | | | | | - Peng Bi
- University of AdelaideAdelaide
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14
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Iglesies-Grau J, Dionne V, Latour É, Pelletier V, Bisaillon M, Tessier G, Aubut L, Hamrioui N, Gagnon C, Simard F, Nigam A, L Allier PL, Bherer L, Bouabdallaoui N, Juneau M. The short-term impact and sustainability of multiple lifestyle interventions on metabolic health and remission of prediabetes and type 2 diabetes: a two-year experience. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Different intensive lifestyle interventions have been shown to be useful for effective control and even reversal of prediabetes and type 2 diabetes (T2D).
Objectives
Our heart institute cardiovascular prevention center started a comprehensive lifestyle clinic in 2019 to study the impact of 6 and 12-month non-pharmacological interventions on metabolic health and remission of these two conditions.
Methods
Between January 2019 and December 2020, 81 prediabetic (HbA1c ≥ 5.7%) and 184 T2D (HbA1c ≥ 6.5%) were recruited. All participants received regular nutritional counselling (therapeutic moderate carbohydrate restriction Mediterranean diet) and personalized physical exercise prescription (≥30 minutes of moderate aerobic training, 5 times a week, and strength training). Anthropometric measures and fasting blood analysis were measured at 0, 3, 6 and 12 months. Glucose-lowering therapies were not modified, unless necessary.
Complete remission of prediabetes and T2D was defined as HbA1c <5.7%, whereas partial remission of T2D was defined as HbA1c <6.5% for at least 3 months, and it was calculated for all the participants that completed the 12-month program. Remission was further evaluated according to pharmacological status (drug-naïve or on glucose-lowering therapy).
Results
231 participants completed the short-term program (87%) and 117 were followed-up to 12 months. Mean age was 67.1 (9.1) years, 67% male, 48.3% with CHD, 53.5% with glucose-lowering therapies. All metabolic health measures were improved, particularly among T2D participants (Table 1). Gains were achieved at 3 months and were maintained during the remainder of the program without significant change.
Complete remission of prediabetes was achieved in 24% (95CI: 10.7 to 45.4%) of participants. Complete and partial remission of T2D were achieved in 5.4% (95CI: 2.2 to 12.5%) and 41.3% (95CI: 31.6 to 51.7%) of participants respectively and was observed in both with or without glucose-lowering therapies subgroups (Table 2).
Conclusions
Prioritizing lifestyle changes were shown to improve metabolic health measures even to the point of achieving remission among subjects with prediabetes or T2D. These metabolic changes were mostly achieved after 3 months and persisted throughout the intervention. Future research is required to better understand which non-pharmacological interventions work best among subjects with varying metabolic profiles and pharmacotherapy, how long should the interventions last and how partial or complete normalization of glucose impacts long-term outcomes.
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Affiliation(s)
| | - V Dionne
- Montreal Heart Institute, Montreal, Canada
| | - É Latour
- Montreal Heart Institute, Montreal, Canada
| | | | | | - G Tessier
- Montreal Heart Institute, Montreal, Canada
| | - L Aubut
- Montreal Heart Institute, Montreal, Canada
| | - N Hamrioui
- Montreal Heart Institute, Montreal, Canada
| | - C Gagnon
- Montreal Heart Institute, Montreal, Canada
| | - F Simard
- Montreal Heart Institute, Montreal, Canada
| | - A Nigam
- Montreal Heart Institute, Montreal, Canada
| | | | - L Bherer
- Montreal Heart Institute, Montreal, Canada
| | | | - M Juneau
- Montreal Heart Institute, Montreal, Canada
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15
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Mahaseth D, Sah J, Yadav R, Mandal F, Nigam A, Magar A, Magar A. M183 Establishment of reference intervals for thyroid function tests in Chitwan district, Nepal. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Talamonti D, Dupuy EG, Boudaa S, Vincent T, Fraser S, Nigam A, Lesage F, Belleville S, Gagnon C, Bherer L. Prefrontal hyperactivation during dual-task walking related to apathy symptoms in older individuals. PLoS One 2022; 17:e0266553. [PMID: 35468172 PMCID: PMC9037904 DOI: 10.1371/journal.pone.0266553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/22/2022] [Indexed: 01/29/2023] Open
Abstract
Increasing evidence associates apathy with worsening in cognitive performance and greater risk of dementia, in both clinical and healthy older populations. In older adults with neurocognitive disorders, apathy has also been related to specific fronto-subcortical structural abnormalities, thus differentiating apathy and major depressive disorder. Yet, the neural mechanisms associated with apathy in healthy older adults are still unclear. In the present study, we investigated the frontal cortical response during a dual-task walking paradigm in forty-one healthy older adults with and without apathy symptoms, controlling for depressive symptoms. The dual-task walking paradigm included a single cognitive task (2-back), a single motor task (walking), and a dual-task condition (2-back whilst walking). The cortical response was measured by means of functional Near-Infrared Spectroscopy (fNIRS). The results revealed that participants with apathy symptoms showed greater activation of subregions of the prefrontal cortex and of the premotor cortex compared to healthy controls during the single cognitive component of the dual-task paradigm, whilst cognitive performance was equivalent between groups. Moreover, increased cortical response during the cognitive task was associated with higher odds of exhibiting apathy symptoms, independently of depressive symptoms. These findings suggest that apathy may be related to differential brain activation patterns in healthy older individuals and are in line with previous evidence of the distinctiveness between apathy and depression. Future research may explore the long-term effects of apathy on the cortical response in healthy older adults.
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Affiliation(s)
- Deborah Talamonti
- Research Centre and Centre EPIC, Montreal Heart Institute, Montreal, Canada
- Department of Medicine, Université de Montreal, Montreal, Canada
| | - Emma Gabrielle Dupuy
- Research Centre and Centre EPIC, Montreal Heart Institute, Montreal, Canada
- Department of Medicine, Université de Montreal, Montreal, Canada
| | - Sarah Boudaa
- Research Centre and Centre EPIC, Montreal Heart Institute, Montreal, Canada
| | - Thomas Vincent
- Research Centre and Centre EPIC, Montreal Heart Institute, Montreal, Canada
| | - Sarah Fraser
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Anil Nigam
- Research Centre and Centre EPIC, Montreal Heart Institute, Montreal, Canada
- Department of Medicine, Université de Montreal, Montreal, Canada
| | - Frédéric Lesage
- Research Centre and Centre EPIC, Montreal Heart Institute, Montreal, Canada
- École Polytechnique de Montréal, Montréal, Canada
| | - Sylvie Belleville
- Centre de recherche, Institut universitaire de gériatrie de Montréal, Montréal, Canada
- Department of Psychology, Université de Montréal, Montréal, Canada
| | - Christine Gagnon
- Research Centre and Centre EPIC, Montreal Heart Institute, Montreal, Canada
| | - Louis Bherer
- Research Centre and Centre EPIC, Montreal Heart Institute, Montreal, Canada
- Department of Medicine, Université de Montreal, Montreal, Canada
- Centre de recherche, Institut universitaire de gériatrie de Montréal, Montréal, Canada
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17
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Besnier F, Bérubé B, Malo J, Gagnon C, Grégoire CA, Juneau M, Simard F, L’Allier P, Nigam A, Iglésies-Grau J, Vincent T, Talamonti D, Dupuy EG, Mohammadi H, Gayda M, Bherer L. Cardiopulmonary Rehabilitation in Long-COVID-19 Patients with Persistent Breathlessness and Fatigue: The COVID-Rehab Study. Int J Environ Res Public Health 2022; 19:ijerph19074133. [PMID: 35409815 PMCID: PMC8998214 DOI: 10.3390/ijerph19074133] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/16/2022] [Accepted: 03/24/2022] [Indexed: 01/27/2023]
Abstract
(1) Background: Cardiopulmonary and brain functions are frequently impaired after COVID-19 infection. Exercise rehabilitation could have a major impact on the healing process of patients affected by long COVID-19. (2) Methods: The COVID-Rehab study will investigate the effectiveness of an eight-week cardiopulmonary rehabilitation program on cardiorespiratory fitness (V˙O2max) in long-COVID-19 individuals. Secondary objectives will include functional capacity, quality of life, perceived stress, sleep quality (questionnaires), respiratory capacity (spirometry test), coagulation, inflammatory and oxidative-stress profile (blood draw), cognition (neuropsychological tests), neurovascular coupling and pulsatility (fNIRS). The COVID-Rehab project was a randomised clinical trial with two intervention arms (1:1 ratio) that will be blindly evaluated. It will recruit a total of 40 individuals: (1) rehabilitation: centre-based exercise-training program (eight weeks, three times per week); (2) control: individuals will have to maintain their daily habits. (3) Conclusions: Currently, there are no specific rehabilitation guidelines for long-COVID-19 patients, but preliminary studies show encouraging results. Clinicaltrials.gov (NCT05035628).
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Affiliation(s)
- Florent Besnier
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC H1T 1N6, Canada; (F.B.); (B.B.); (J.M.); (C.G.); (C.-A.G.); (M.J.); (F.S.); (P.L.); (A.N.); (J.I.-G.); (T.V.); (D.T.); (E.G.D.); (H.M.); (L.B.)
- Department of Medicine, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Béatrice Bérubé
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC H1T 1N6, Canada; (F.B.); (B.B.); (J.M.); (C.G.); (C.-A.G.); (M.J.); (F.S.); (P.L.); (A.N.); (J.I.-G.); (T.V.); (D.T.); (E.G.D.); (H.M.); (L.B.)
- Department of Psychology, Université du Québec à Montréal, Montréal, QC H3C 3P8, Canada
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, QC H3W 1W5, Canada
| | - Jacques Malo
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC H1T 1N6, Canada; (F.B.); (B.B.); (J.M.); (C.G.); (C.-A.G.); (M.J.); (F.S.); (P.L.); (A.N.); (J.I.-G.); (T.V.); (D.T.); (E.G.D.); (H.M.); (L.B.)
- Department of Medicine, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Christine Gagnon
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC H1T 1N6, Canada; (F.B.); (B.B.); (J.M.); (C.G.); (C.-A.G.); (M.J.); (F.S.); (P.L.); (A.N.); (J.I.-G.); (T.V.); (D.T.); (E.G.D.); (H.M.); (L.B.)
| | - Catherine-Alexandra Grégoire
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC H1T 1N6, Canada; (F.B.); (B.B.); (J.M.); (C.G.); (C.-A.G.); (M.J.); (F.S.); (P.L.); (A.N.); (J.I.-G.); (T.V.); (D.T.); (E.G.D.); (H.M.); (L.B.)
| | - Martin Juneau
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC H1T 1N6, Canada; (F.B.); (B.B.); (J.M.); (C.G.); (C.-A.G.); (M.J.); (F.S.); (P.L.); (A.N.); (J.I.-G.); (T.V.); (D.T.); (E.G.D.); (H.M.); (L.B.)
- Department of Medicine, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - François Simard
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC H1T 1N6, Canada; (F.B.); (B.B.); (J.M.); (C.G.); (C.-A.G.); (M.J.); (F.S.); (P.L.); (A.N.); (J.I.-G.); (T.V.); (D.T.); (E.G.D.); (H.M.); (L.B.)
- Department of Medicine, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Philippe L’Allier
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC H1T 1N6, Canada; (F.B.); (B.B.); (J.M.); (C.G.); (C.-A.G.); (M.J.); (F.S.); (P.L.); (A.N.); (J.I.-G.); (T.V.); (D.T.); (E.G.D.); (H.M.); (L.B.)
- Department of Medicine, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Anil Nigam
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC H1T 1N6, Canada; (F.B.); (B.B.); (J.M.); (C.G.); (C.-A.G.); (M.J.); (F.S.); (P.L.); (A.N.); (J.I.-G.); (T.V.); (D.T.); (E.G.D.); (H.M.); (L.B.)
- Department of Medicine, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Josep Iglésies-Grau
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC H1T 1N6, Canada; (F.B.); (B.B.); (J.M.); (C.G.); (C.-A.G.); (M.J.); (F.S.); (P.L.); (A.N.); (J.I.-G.); (T.V.); (D.T.); (E.G.D.); (H.M.); (L.B.)
- Department of Medicine, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Thomas Vincent
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC H1T 1N6, Canada; (F.B.); (B.B.); (J.M.); (C.G.); (C.-A.G.); (M.J.); (F.S.); (P.L.); (A.N.); (J.I.-G.); (T.V.); (D.T.); (E.G.D.); (H.M.); (L.B.)
| | - Deborah Talamonti
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC H1T 1N6, Canada; (F.B.); (B.B.); (J.M.); (C.G.); (C.-A.G.); (M.J.); (F.S.); (P.L.); (A.N.); (J.I.-G.); (T.V.); (D.T.); (E.G.D.); (H.M.); (L.B.)
| | - Emma Gabrielle Dupuy
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC H1T 1N6, Canada; (F.B.); (B.B.); (J.M.); (C.G.); (C.-A.G.); (M.J.); (F.S.); (P.L.); (A.N.); (J.I.-G.); (T.V.); (D.T.); (E.G.D.); (H.M.); (L.B.)
- Department of Medicine, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Hânieh Mohammadi
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC H1T 1N6, Canada; (F.B.); (B.B.); (J.M.); (C.G.); (C.-A.G.); (M.J.); (F.S.); (P.L.); (A.N.); (J.I.-G.); (T.V.); (D.T.); (E.G.D.); (H.M.); (L.B.)
| | - Mathieu Gayda
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC H1T 1N6, Canada; (F.B.); (B.B.); (J.M.); (C.G.); (C.-A.G.); (M.J.); (F.S.); (P.L.); (A.N.); (J.I.-G.); (T.V.); (D.T.); (E.G.D.); (H.M.); (L.B.)
- Department of Medicine, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Correspondence:
| | - Louis Bherer
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC H1T 1N6, Canada; (F.B.); (B.B.); (J.M.); (C.G.); (C.-A.G.); (M.J.); (F.S.); (P.L.); (A.N.); (J.I.-G.); (T.V.); (D.T.); (E.G.D.); (H.M.); (L.B.)
- Department of Medicine, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, QC H3W 1W5, Canada
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18
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Behzadi P, Ravanelli N, Gravel H, Barry H, Debray A, Chaseling GK, Jacquemet V, Neagoe PE, Nigam A, Carpentier AC, Sirois MG, Gagnon D. Acute effect of passive heat exposure on markers of cardiometabolic function in adults with type 2 diabetes mellitus. J Appl Physiol (1985) 2022; 132:1154-1166. [PMID: 35323077 DOI: 10.1152/japplphysiol.00800.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
AIM Heat therapy is a promising strategy to improve cardiometabolic health. This study evaluated the acute physiological responses to hot water immersion in adults with type 2 diabetes mellitus (T2DM). METHODS On separate days in randomized order, 13 adults with T2DM (8 males/5 females, 62 ± 12 yrs, BMI: 30.1 ± 4.6 kg/m2) were immersed in thermoneutral (34°C, 90 minutes) or hot (41°C, core temperature ≥38.5°C for 60 minutes) water. Insulin sensitivity was quantified via the minimal oral model during an oral glucose tolerance test (OGTT) performed 60 minutes after immersion. Brachial artery flow-mediated dilation (FMD) and reactive hyperemia were evaluated before and 40 minutes after immersion. Blood samples were drawn to quantify protein concentrations and mRNA levels of HSP70 and 90, and circulating concentrations of cytokines. RESULTS Relative to thermoneutral water immersion, hot water immersion increased core temperature (+1.66°C [+1.47, +1.87], P<0.01), heart rate (+34 bpm [+24, +44], P<0.01), antegrade shear rate (+96 s-1 [+57, +134], P<0.01), and IL-6 (+1.38 pg/mL [+0.31, +2.45], P=0.01). Hot water immersion did not exert an acute change in insulin sensitivity (-0.3 dl/kg/min/μU/ml [-0.9, +0.2], P=0.18), FMD (-1.0% [-3.6, +1.6], P=0.56), peak (+0.36 mL/min/mmHg [-0.71, +1.43], P=0.64) and total (+0.11 mL/min/mmHg x min [-0.46, +0.68], P=0.87) reactive hyperemia. There was also no change in eHSP70 (P=0.64), iHSP70 (P=0.06), eHSP90 (P=0.80), iHSP90 (P=0.51), IL1-RA (P=0.11), GLP-1 (P=0.59) and NFkB (P=0.56) after hot water immersion. CONCLUSION The physiological responses elicited by hot water immersion do not acutely improve markers of cardiometabolic function in adults with T2DM.
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Affiliation(s)
- Parya Behzadi
- Montreal Heart Institute, Montreal, Canada.,Department of pharmacology and physiology, Université de Montréal, Montréal, Canada
| | | | - Hugo Gravel
- Montreal Heart Institute, Montreal, Canada.,School of Kinesiology and Exercise Science, Université de Montréal, Montréal, Canada
| | - Hadiatou Barry
- Montreal Heart Institute, Montreal, Canada.,Department of pharmacology and physiology, Université de Montréal, Montréal, Canada
| | - Amelie Debray
- Montreal Heart Institute, Montreal, Canada.,Department of Medicine, Université de Montréal, Montréal, Canada
| | - Georgia K Chaseling
- Montreal Heart Institute, Montreal, Canada.,Department of pharmacology and physiology, Université de Montréal, Montréal, Canada
| | - Vincent Jacquemet
- Department of pharmacology and physiology, Université de Montréal, Montréal, Canada
| | | | - Anil Nigam
- Montreal Heart Institute, Montreal, Canada.,Department of Medicine, Université de Montréal, Montréal, Canada
| | - André C Carpentier
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Canada
| | - Martin G Sirois
- Montreal Heart Institute, Montreal, Canada.,Department of pharmacology and physiology, Université de Montréal, Montréal, Canada
| | - Daniel Gagnon
- Montreal Heart Institute, Montreal, Canada.,Department of pharmacology and physiology, Université de Montréal, Montréal, Canada.,School of Kinesiology and Exercise Science, Université de Montréal, Montréal, Canada
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19
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Gagnon C, Olmand M, Dupuy EG, Besnier F, Vincent T, Grégoire CA, Lévesque M, Payer M, Bérubé B, Breton J, Lecchino C, Bouabdallaoui N, Iglesies-Grau J, Gayda M, Vitali P, Nigam A, Juneau M, Hudon C, Bherer L. Videoconference version of the Montreal Cognitive Assessment: normative data for Quebec-French people aged 50 years and older. Aging Clin Exp Res 2022; 34:1627-1633. [PMID: 35178685 PMCID: PMC8853900 DOI: 10.1007/s40520-022-02092-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/02/2022] [Indexed: 11/29/2022]
Abstract
Background The COVID-19 pandemic forced health professionals to rapidly develop and implement telepractice and remote assessments. Recent reviews appear to confirm the validity of a wide range of neuropsychological tests for teleneuropsychology and among these, the Montreal Cognitive Assessment (MoCA), a cognitive screening test widely used in clinical settings. The normative data specific to the context of videoconference administration is essential, particularly that consider sociodemographic characteristics. Aims This study had for objective to develop French-Quebec normative data for videoconference-administration of the MoCA that consider sociodemographic characteristics. Methods A total of 230 community-dwelling adults aged 50 years and older taking part in clinical trials completed the MoCA by videoconference. Regression analyses were run with sex, education, and age as predictors of the total MoCA scores, based on previously published norms. As an exploratory analysis, a second regression analysis was also run with cardiovascular disease as a predictor. Results Regression analyses revealed that older age and lower education were associated with poorer total MoCA scores, for medium effect size (p < 0.001, R2 = 0.17). Neither sex nor cardiovascular disease, were significant predictors in our analyses. For clinicians, a regression equation was proposed to calculate Z scores. Discussion This study provides normative data for the MoCA administered via videoconference in Quebec-French individuals aged 50 years and over. Conclusions The present normative data will not only allow clinicians to continue to perform assessments remotely in this pandemic period but will also allow them to perform cognitive assessments to patients located in remote areas. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-022-02092-1.
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Affiliation(s)
- Christine Gagnon
- Centre ÉPIC and Research Center, Montreal Heart Institute, 5055 rue St Zotique Est, Montréal, QC, H1T 1N6, Canada.
| | - Miloudza Olmand
- Centre ÉPIC and Research Center, Montreal Heart Institute, 5055 rue St Zotique Est, Montréal, QC, H1T 1N6, Canada
- Department of Psychology, Université de Montréal, Montréal, Canada
| | - Emma Gabrielle Dupuy
- Centre ÉPIC and Research Center, Montreal Heart Institute, 5055 rue St Zotique Est, Montréal, QC, H1T 1N6, Canada
- Department of Medicine, Université de Montréal, Montreal, Canada
| | - Florent Besnier
- Centre ÉPIC and Research Center, Montreal Heart Institute, 5055 rue St Zotique Est, Montréal, QC, H1T 1N6, Canada
- Department of Medicine, Université de Montréal, Montreal, Canada
| | - Thomas Vincent
- Centre ÉPIC and Research Center, Montreal Heart Institute, 5055 rue St Zotique Est, Montréal, QC, H1T 1N6, Canada
| | - Catherine-Alexandra Grégoire
- Centre ÉPIC and Research Center, Montreal Heart Institute, 5055 rue St Zotique Est, Montréal, QC, H1T 1N6, Canada
| | - Marianne Lévesque
- Centre ÉPIC and Research Center, Montreal Heart Institute, 5055 rue St Zotique Est, Montréal, QC, H1T 1N6, Canada
- Department of Psychology, Université de Montréal, Montréal, Canada
| | - Marie Payer
- Centre ÉPIC and Research Center, Montreal Heart Institute, 5055 rue St Zotique Est, Montréal, QC, H1T 1N6, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada
- Research Center, Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, H1N 3M5, Canada
| | - Béatrice Bérubé
- Centre ÉPIC and Research Center, Montreal Heart Institute, 5055 rue St Zotique Est, Montréal, QC, H1T 1N6, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada
| | - Juliana Breton
- Centre ÉPIC and Research Center, Montreal Heart Institute, 5055 rue St Zotique Est, Montréal, QC, H1T 1N6, Canada
| | - Catia Lecchino
- Centre ÉPIC and Research Center, Montreal Heart Institute, 5055 rue St Zotique Est, Montréal, QC, H1T 1N6, Canada
- Department of Psychology, Université de Montréal, Montréal, Canada
| | - Nadia Bouabdallaoui
- Centre ÉPIC and Research Center, Montreal Heart Institute, 5055 rue St Zotique Est, Montréal, QC, H1T 1N6, Canada
- Department of Medicine, Université de Montréal, Montreal, Canada
| | - Josep Iglesies-Grau
- Centre ÉPIC and Research Center, Montreal Heart Institute, 5055 rue St Zotique Est, Montréal, QC, H1T 1N6, Canada
- Department of Medicine, Université de Montréal, Montreal, Canada
| | - Mathieu Gayda
- Centre ÉPIC and Research Center, Montreal Heart Institute, 5055 rue St Zotique Est, Montréal, QC, H1T 1N6, Canada
- Department of Medicine, Université de Montréal, Montreal, Canada
| | - Paolo Vitali
- Research Centre for Studies on Aging, McGill University, Montréal, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Canada
| | - Anil Nigam
- Centre ÉPIC and Research Center, Montreal Heart Institute, 5055 rue St Zotique Est, Montréal, QC, H1T 1N6, Canada
- Department of Medicine, Université de Montréal, Montreal, Canada
| | - Martin Juneau
- Centre ÉPIC and Research Center, Montreal Heart Institute, 5055 rue St Zotique Est, Montréal, QC, H1T 1N6, Canada
- Department of Medicine, Université de Montréal, Montreal, Canada
| | - Carol Hudon
- École de Psychologie, Université Laval, Québec, Canada
- Centre de Recherche CERVO, Québec, Canada
| | - Louis Bherer
- Centre ÉPIC and Research Center, Montreal Heart Institute, 5055 rue St Zotique Est, Montréal, QC, H1T 1N6, Canada
- Department of Medicine, Université de Montréal, Montreal, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Canada
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20
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Besnier F, Dupuy EG, Gagnon C, Vincent T, Grégoire CA, Blanchette CA, Saillant K, Bouabdallaoui N, Grau JI, Bérubé B, Olmand M, Marin MF, Belleville S, Juneau M, Vitali P, Gayda M, Nigam A, Bherer L. Investigation of the Effects of Home-Based Exercise and Cognitive Training on Cognitive and Physical Functions in Cardiac Patients: The COVEPICARDIO Study Protocol of a Randomized Clinical Trial. Front Cardiovasc Med 2021; 8:740834. [PMID: 34938780 PMCID: PMC8685268 DOI: 10.3389/fcvm.2021.740834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/19/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction: During the COVID-19 pandemic, confinement measures are likely to produce collateral damage to health (stress, confusion, anxiety), especially in frail individuals and those living with cardiovascular disease (CVD). In cardiac patients in particular, these measures dramatically increase the level of physical inactivity and sedentary lifestyle, which can decrease cardiorespiratory capacity and increase the risk of acute events, rehospitalization, and depressive syndromes. Maintaining a minimum level of physical activity and cognitive stimulation during the COVID-19 crisis is essential for cardiac patients. This study is designed to document the effects of 6 months of home-based physical exercise alone or combined with cognitive training on cognitive and physical functions in patients with CVD over 50 years old. Methods and Analysis: 122 patients (>50 years old) with stable CVD and no contraindication to perform physical exercise training will be recruited and randomly assigned to one of the 2 following arms: (1) Home-based physical exercise alone, (2) Home-based physical exercise combined with cognitive training. The intervention lasts 6 months, with remote assessments performed prior to, mid and post-training. A follow-up 6 months after the end of the intervention (12 month) is also proposed. The primary outcome is cognition, including general functioning (Montreal Cognitive Assessment (MoCA) score), as well as performances on measures of executive functions, processing speed, and episodic memory. The secondary outcome is physical performance, including balance, gait and mobility, leg muscle strength and estimated cardiorespiratory fitness. Tertiary outcomes include mood, anxiety, and health-related quality of life as assessed by self-reported online questionnaires. Discussion: With the COVID-19 crisis, there is a critical need for remote exercise and cognitive training, and to further investigate this topic, in particular for cardiac patients. The present context can be viewed as an opportunity to perform a major shift from center-based programs to home-based physical exercise. This is especially important to reach out to older adults living in remote areas, where access to such interventions is limited. ClinicalTrials.gov: [https://clinicaltrials.gov/ct2/show/NCT04661189], NCT04661189.
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Affiliation(s)
- Florent Besnier
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Emma Gabrielle Dupuy
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Christine Gagnon
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada
| | - Thomas Vincent
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada
| | | | - Caroll-Ann Blanchette
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Kathia Saillant
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Psychologie, Université du Québec à Montréal, Montréal, QC, Canada
| | - Nadia Bouabdallaoui
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Josep Iglésies Grau
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Béatrice Bérubé
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Psychologie, Université du Québec à Montréal, Montréal, QC, Canada.,Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
| | - Miloudza Olmand
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Marie-France Marin
- Department of Psychologie, Université du Québec à Montréal, Montréal, QC, Canada.,Research Center of the Montreal Mental Health University Institute, Montréal, QC, Canada
| | - Sylvie Belleville
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada.,Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Martin Juneau
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Paolo Vitali
- McGill University Research Centre for Studies on Aging, Montréal, QC, Canada.,McGill University Department of Neurology and Neurosurgery, Faculty of Medicine, Montréal, QC, Canada
| | - Mathieu Gayda
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Anil Nigam
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Louis Bherer
- Research Center and Centre ÉPIC, Montreal Heart Institute, Montréal, QC, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.,Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
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21
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Bérubé B, Boidin M, Gayda M, Vincent T, Tremblay J, Juneau M, Nigam A, Bherer L. Acute effects of exercise on cerebrovascular response and cognitive performance in individuals with stable coronary heart disease. Brain Res 2021; 1772:147671. [PMID: 34606749 DOI: 10.1016/j.brainres.2021.147671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Individuals with coronary heart disease (CHD) exhibit cognitive deficits and cerebrovascular dysfunctions, and are at higher risk of developing dementia. Cognitive function in individuals with CHD has never been studied during acute aerobic exercise. Given the increasing popularity of training at high peak power output (PPO), its impact on cerebrovascular and cognitive functions in individuals with CHD should be further studied. METHOD Thirty-eight individuals with CHD and 16 healthy controls completed two exercise bouts at 30% and 70% of their individualized PPO on an ergocycle while performing a cognitive task including non-executive and executive conditions. Variations of oxy- deoxy-hemoglobin, and total hemoglobin concentrations were measured on left prefrontal cortex at both PPO using near-infrared spectroscopy. RESULTS Cognitive task performances were equivalent between groups at all intensity levels. Individuals with CHD exhibited larger variation of deoxyhemoglobin in the executive condition and larger variation in total hemoglobin concentration in all task conditions compared to healthy controls at 70% of PPO. CONCLUSION Exercising at high intensity seems to have a larger impact on cerebral blood volume in CHD patients compared to healthy age-matched controls. Higher exercise intensity has negative impacts on cerebral blood volume variations during a cognitive task in CHD patients and could potentially lead to other neurocognitive dysfunctions. Other studies are needed to determine if a cognitive task administered during an exercise test could help identify individuals with CHD at higher risk of developing cognitive decline.
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Affiliation(s)
- B Bérubé
- Research Center and Preventive Medicine and Physical Activity Center (EPIC), Montreal Heart Institute, Montréal, Québec, Canada; Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada; Department of Psychology, Université de Montréal, Montréal, Québec, Canada.
| | - M Boidin
- Research Center and Preventive Medicine and Physical Activity Center (EPIC), Montreal Heart Institute, Montréal, Québec, Canada; School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - M Gayda
- Research Center and Preventive Medicine and Physical Activity Center (EPIC), Montreal Heart Institute, Montréal, Québec, Canada; Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - T Vincent
- Research Center and Preventive Medicine and Physical Activity Center (EPIC), Montreal Heart Institute, Montréal, Québec, Canada; Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - J Tremblay
- School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - M Juneau
- Research Center and Preventive Medicine and Physical Activity Center (EPIC), Montreal Heart Institute, Montréal, Québec, Canada; Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - A Nigam
- Research Center and Preventive Medicine and Physical Activity Center (EPIC), Montreal Heart Institute, Montréal, Québec, Canada; Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - L Bherer
- Research Center and Preventive Medicine and Physical Activity Center (EPIC), Montreal Heart Institute, Montréal, Québec, Canada; Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada; Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
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22
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Vrinceanu T, Blanchette CA, Intzandt B, Lussier M, Pothier K, Vu TTM, Nigam A, Bosquet L, Karelis AD, Li KZH, Berryman N, Bherer L. A Comparison of the Effect of Physical Activity and Cognitive Training on Dual-Task Performance in Older Adults. J Gerontol B Psychol Sci Soc Sci 2021; 77:1069-1079. [PMID: 34865009 PMCID: PMC9159062 DOI: 10.1093/geronb/gbab216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES Studies suggest that cognitive training and physical activity can improve age-related deficits in dual-task performances. However, both of these interventions have never been compared in the same study. This article investigates the improvement in dual-task performance in 2 types of exercise training groups and a cognitive training group and explores if there are specific dual-task components that are more sensitive or more likely to improve following each type of training. METHODS Seventy-eight healthy inactive participants older than the age of 60 (M = 69.98, SD = 5.56) were randomized to one of three 12-week training programs: aerobic training (AET) = 26, gross motor abilities (GMA) = 27, and cognition (COG) = 25. Before and after the training program, the participants underwent physical fitness tests, and cognitive evaluations involving a computerized cognitive dual task. The AET consisted of high- and low-intensity aerobic training, the GMA of full-body exercises focusing on agility, balance, coordination, and stretching, and the COG of tablet-based exercises focusing on executive functions. RESULTS Repeated-measures analysis of variance on reaction time data revealed a group × time interaction (F(2,75) = 11.91, p < .01) with COG having the greatest improvement, followed by a significant improvement in the GMA group. Secondary analysis revealed the COG to also improve the intraindividual variability in reaction time (F(1,24) = 8.62, p < .01), while the GMA improved the dual-task cost (F(1,26) = 12.74, p < .01). DISCUSSION The results show that physical and cognitive training can help enhance dual-task performance by improving different aspects of the task, suggesting that different mechanisms are in play.
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Affiliation(s)
- Tudor Vrinceanu
- Department of Medicine, University of Montréal, Montréal, Quebec, Canada,Research Centre, Montreal Heart Institute, Montréal, Quebec, Canada
| | - Caroll-Ann Blanchette
- Department of Medicine, University of Montréal, Montréal, Quebec, Canada,Research Centre, Montreal Heart Institute, Montréal, Quebec, Canada
| | - Brittany Intzandt
- Research Centre, Montreal Heart Institute, Montréal, Quebec, Canada,School of Graduate Studies, Concordia University, Montreal, Quebec, Canada
| | - Maxime Lussier
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Quebec, Canada,Rehabilitation Science, Faculty of Medicine, University of Montréal, Montréal, Quebec, Canada
| | - Kristell Pothier
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Quebec, Canada,EA 2114, Psychologie des Âges de la Vie et Adaptation, University of Tours, Tours, France
| | - Thien Tuong Minh Vu
- Department of Medicine, University of Montréal, Montréal, Quebec, Canada,Research Centre, Centre hospitalier de l’Université de Montréal, Montréal, Quebec, Canada
| | - Anil Nigam
- Department of Medicine, University of Montréal, Montréal, Quebec, Canada,Research Centre, Montreal Heart Institute, Montréal, Quebec, Canada
| | - Laurent Bosquet
- Laboratoire MOVE (EA6314), Université de Poitiers, Faculté des sciences du sport, Poitiers, France,Ecole de kinésiologie et des sciences de l’activité physique, Faculté de médecine, Université de Montréal, Montreal, Quebec, Canada
| | - Antony D Karelis
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Quebec, Canada,Département des Sciences de l’Activité Physique, Université du Québec à Montréal, Montréal, Quebec, Canada
| | - Karen Z H Li
- PERFORM Centre, Concordia University, Montréal, Quebec, Canada,Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - Nicolas Berryman
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Quebec, Canada,Département des Sciences de l’Activité Physique, Université du Québec à Montréal, Montréal, Quebec, Canada
| | - Louis Bherer
- Address correspondence to: Louis Bherer, PhD, Centre de Recherche, Institut de Cardiologie de Montréal, 5000 Belanger, Montréal, QC H1T 1C8, Canada. E-mail:
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Iglesies-Grau J, Dionne V, Latour E, Pelletier V, Bisaillon M, Aubut L, Hamrioui N, Bherer L, Bouabdallaoui N, Nigam A, Juneau M. IMPACT OF MULTIPLE LIFESTYLE INTERVENTION ON BODY WEIGHT, INSULIN SENSITIVITY AND REMISSION OF TYPE 2 DIABETES: A SINGLE-CENTER EXPERIENCE. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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24
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Mohammadi H, Vincent T, Peng K, Nigam A, Gayda M, Fraser S, Joanette Y, Lesage F, Bherer L. Coronary artery disease and its impact on the pulsatile brain: A functional NIRS study. Hum Brain Mapp 2021; 42:3760-3776. [PMID: 33991155 PMCID: PMC8288102 DOI: 10.1002/hbm.25463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 04/12/2021] [Accepted: 04/14/2021] [Indexed: 12/16/2022] Open
Abstract
Recent studies have reported that optical indices of cerebral pulsatility are associated with cerebrovascular health in older adults. Such indices, including cerebral pulse amplitude and the pulse relaxation function (PRF), have been previously applied to quantify global and regional cerebral pulsatility. The aim of the present study was to determine whether these indices are modulated by cardiovascular status and whether they differ between individuals with low or high cardiovascular risk factors (LCVRF and HCVRF) and coronary artery disease (CAD). A total of 60 older adults aged 57-79 were enrolled in the study. Participants were grouped as LCVRF, HCVRF, and CAD. Participants were asked to walk freely on a gym track while a near-infrared spectroscopy (NIRS) device recorded hemodynamics data. Low-intensity, short-duration walking was used to test whether a brief cardiovascular challenge could increase the difference of pulsatility indices with respect to cardiovascular status. Results indicated that CAD individuals have higher global cerebral pulse amplitude compared with the other groups. Walking reduced global cerebral pulse amplitude and PRF in all groups but did not increase the difference across the groups. Instead, walking extended the spatial distribution of cerebral pulse amplitude to the anterior prefrontal cortex when CAD was compared to the CVRF groups. Further research is needed to determine whether cerebral pulse amplitude extracted from data acquired with NIRS, which is a noninvasive, inexpensive method, can provide an index to characterize the cerebrovascular status associated with CAD.
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Affiliation(s)
- Hanieh Mohammadi
- Laboratory of Optical and Molecular ImagingBiomedical Engineering Institute, Polytechnique MontrealQuebecCanada
- Research CenterUniversity Institute of Geriatrics of MontrealMontrealQuebecCanada
- Research CenterEPIC Centre of Montreal Heart InstituteMontrealQuebecCanada
| | - Thomas Vincent
- Research CenterEPIC Centre of Montreal Heart InstituteMontrealQuebecCanada
| | - Ke Peng
- Center for Pain and the BrainBoston Children's Hospital and Harvard Medical SchoolBostonMassachusettsUSA
- Research CenterUniversity of Montreal Health CentreMontrealQuebecCanada
| | - Anil Nigam
- Research CenterEPIC Centre of Montreal Heart InstituteMontrealQuebecCanada
| | - Mathieu Gayda
- Research CenterEPIC Centre of Montreal Heart InstituteMontrealQuebecCanada
| | - Sarah Fraser
- Interdisciplinary School of Health Sciences, Faculty of Health SciencesUniversity of OttawaOttawaOntarioCanada
| | - Yves Joanette
- Research CenterUniversity Institute of Geriatrics of MontrealMontrealQuebecCanada
- Faculty of MedicineUniversity of MontrealMontrealQuebecCanada
| | - Frédéric Lesage
- Laboratory of Optical and Molecular ImagingBiomedical Engineering Institute, Polytechnique MontrealQuebecCanada
- Research CenterEPIC Centre of Montreal Heart InstituteMontrealQuebecCanada
| | - Louis Bherer
- Research CenterUniversity Institute of Geriatrics of MontrealMontrealQuebecCanada
- Research CenterEPIC Centre of Montreal Heart InstituteMontrealQuebecCanada
- Faculty of MedicineUniversity of MontrealMontrealQuebecCanada
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Dupuy EG, Besnier F, Gagnon C, Vincent T, Grégoire CA, Blanchette CA, Saillant K, Bouabdallaoui N, Iglesies-Grau J, Payer M, Marin MF, Belleville S, Juneau M, Vitali P, Gayda M, Nigam A, Bherer L. COVEPIC (Cognitive and spOrt Virtual EPIC training) investigating the effects of home-based physical exercise and cognitive training on cognitive and physical functions in community-dwelling older adults: study protocol of a randomized single-blinded clinical trial. Trials 2021; 22:505. [PMID: 34325710 PMCID: PMC8319877 DOI: 10.1186/s13063-021-05476-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/21/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In the context of the COVID-19 pandemic, lockdown and social distancing measures are applied to prevent the spread of the virus. It is well known that confinement and social isolation can have a negative impact on physical and mental health, including cognition. Physical activity and cognitive training can help enhance older adults' cognitive and physical health and prevent the negative collateral impacts of social isolation and physical inactivity. The COVEPIC study aims to document the effects of 6 months of home-based physical exercise alone versus home-based physical exercise combined with cognitive training on cognitive and physical functions in adults 50 years and older. METHODS One hundred twenty-two healthy older adults (> 50 years old) will be recruited from the community and randomized to one of the two arms for 6 months: (1) home-based physical exercises monitoring alone and (2) combined physical exercises monitoring with home-based cognitive training. The primary outcome is cognition, including general functioning (Montreal Cognitive Assessment (MoCA) score), as well as executive functions, processing speed, and episodic memory (composite Z-scores based on validated neuropsychological tests and computerized tasks). The secondary outcome is physical functions, including balance (one-leg stance test), gait and mobility performance (Timed Up and Go, 4-meter walk test), leg muscle strength (5-time sit-to-stand), and estimated cardiorespiratory fitness (Matthews' questionnaire). Exploratory outcomes include mood, anxiety, and health-related quality of life as assessed by self-reported questionnaires (i.e., Geriatric depression scale-30 items, Perceived stress scale, State-trait anxiety inventory-36 items, Perseverative thinking questionnaire, Connor-Davidson Resilience Scale 10, and 12-item Short Form Survey). DISCUSSION This trial will document the remote monitoring of home-based physical exercise alone and home-based physical combined with cognitive training to enhance cognitive and physical health of older adults during the COVID-19 pandemic period. Remote interventions represent a promising strategy to help maintain or enhance health and cognition in seniors, and potentially an opportunity to reach older adults in remote areas, where access to such interventions is limited. TRIAL REGISTRATION Clinical trial Identifier NCT04635462 . COVEPIC was retrospectively registered on November 19, 2020.
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Affiliation(s)
- Emma Gabrielle Dupuy
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada.
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada.
| | - Florent Besnier
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada
| | - Christine Gagnon
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
| | - Thomas Vincent
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
| | - Catherine-Alexandra Grégoire
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
| | - Caroll-Ann Blanchette
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada
| | - Kathia Saillant
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, H3C 3P8, Canada
- Research Center, Institut universitaire en santé mentale de Montréal, Montréal, Québec, H1N 3 M5, Canada
| | - Nadia Bouabdallaoui
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada
| | - Josep Iglesies-Grau
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada
| | - Marie Payer
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, H3C 3P8, Canada
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, H3W 1 W5, Canada
| | - Marie-France Marin
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, H3C 3P8, Canada
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, H3W 1 W5, Canada
| | - Sylvie Belleville
- Research Center, Institut universitaire en santé mentale de Montréal, Montréal, Québec, H1N 3 M5, Canada
- Department of Psychology, Université de Montréal, Montréal, Québec, H2V 2S9, Canada
| | - Martin Juneau
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada
| | - Paolo Vitali
- CIUSSS Nord-de-l'Île-de-Montréal, Montréal, Québec, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Mathieu Gayda
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada
| | - Anil Nigam
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada
| | - Louis Bherer
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada.
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada.
- Research Center, Institut universitaire en santé mentale de Montréal, Montréal, Québec, H1N 3 M5, Canada.
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Trachsel LD, David LP, Gayda M, Boidin M, Lalongé J, Juneau M, Nigam A, Henri C. Impact of aerobic training periodisation on global and regional right ventricular strain in coronary heart disease. Appl Physiol Nutr Metab 2021; 46:1502-1509. [PMID: 34310883 DOI: 10.1139/apnm-2021-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Linear aerobic training periodisation (LP) is recommended for patients with coronary heart disease (CHD). However, the effects of training periodisation on the right heart mechanics in patients with CHD have never been examined. This study aimed to explore the effects of LP and non-linear periodisation (NLP) on right heart mechanics. We prospectively randomised CHD patients to 12 weeks of aerobic training with LP or NLP. While there was a weekly increase in energy expenditure with LP, there was a steeper increase during the first 3 weeks, followed by a decrease in the fourth week with NLP. Echocardiography was performed at baseline and after the training period to assess the right ventricular free wall (RVFW) and right atrial strain. Thirty patients with CHD were included (NLP, n = 16; LP, n = 14). The traditional right and left heart parameters showed no significant time effects. There was a decrease of RVFW strain with time in both groups (+1.3 ± 0.9% with NLP, and +1.5 ± 0.8% with LP; p = 0.033). Mid-ventricular RVFW strain changed significantly with time (+2.0 ± 1.3% with NLP, and from +2.3 ± 1.2% with LP; p = 0.025). There was no time effect on the right atrial strain. In stable CHD patients, LP and NLP resulted in right ventricular strain decrements with a segment-specific pattern. This study was registered at ClinicalTrials.gov (identifier number: NCT03414996). Novelty: In stable coronary heart disease patients, both linear and non-linear aerobic training periodisation programs result in right ventricular strain decrements with time, particularly in the mid-ventricular segment. Traditional right and left heart parameters and right atrial strain showed no significant time effect in both 12 weeks aerobic training periodisation programs.
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Affiliation(s)
- Lukas D Trachsel
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Louis-Philippe David
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Mathieu Gayda
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Research Centre, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Maxime Boidin
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada.,School of Kinesiology & Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Julie Lalongé
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada
| | - Martin Juneau
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Research Centre, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Anil Nigam
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Research Centre, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Christine Henri
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Research Centre, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
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Mohammadi H, Gagnon C, Vincent T, Kassab A, Fraser S, Nigam A, Lesage F, Bherer L. Longitudinal Impact of Physical Activity on Brain Pulsatility Index and Cognition in Older Adults with Cardiovascular Risk Factors: A NIRS Study. Brain Sci 2021; 11:730. [PMID: 34072651 PMCID: PMC8230110 DOI: 10.3390/brainsci11060730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/19/2021] [Accepted: 05/26/2021] [Indexed: 12/11/2022] Open
Abstract
Recent studies have shown that optical indices of cerebral pulsatility, including cerebral pulse amplitude, are linked to cerebrovascular health. A chronically higher cerebral pulsatility is associated with cognitive decline. Although it is widely known that regular physical activity improves cognitive functions, little is known about the association between physical activity and the optical index of cerebral pulsatility. This study assessed the impact of 12 months of regular physical activity on the changes in the optical index of cerebral pulsatility and explored its association with cognition. A total of 19 older adults (aged 59-79 years) with cardiovascular risk factors (CVRF) completed the study. Low-intensity, short-duration walking as a brief cardiovascular challenge was used to study the impact of regular physical activity on post-walking changes in cerebral pulsatility index. The participants walked on a gym track while a near-infrared spectroscopy (NIRS) device recorded hemodynamics data from the frontal and motor cortex subregions. Our data indicated that 12 months of physical activity was associated with lower global cerebral pulse amplitude, which was associated with higher cognitive scores in executive functions. Further, the global cerebral pulsatility index was reduced after short-duration walking, and this reduction was greater after 12 months of regular physical activity compared with the baseline. This may be an indication of improvement in cerebrovascular response to the cardiovascular challenge after regular physical activity. This study suggests that 12 months of physical activity may support cognitive functions through improving cerebral pulsatility in older adults with CVRF.
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Affiliation(s)
- Hanieh Mohammadi
- Montreal Heart Institute, Montreal, QC H1T 1C8, Canada; (H.M.); (C.G.); (T.V.); (A.N.); (F.L.)
- Department of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Christine Gagnon
- Montreal Heart Institute, Montreal, QC H1T 1C8, Canada; (H.M.); (C.G.); (T.V.); (A.N.); (F.L.)
| | - Thomas Vincent
- Montreal Heart Institute, Montreal, QC H1T 1C8, Canada; (H.M.); (C.G.); (T.V.); (A.N.); (F.L.)
| | - Ali Kassab
- Research Center, University of Montreal Health Centre, Montreal, QC H2X 3E4, Canada;
| | - Sarah Fraser
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Anil Nigam
- Montreal Heart Institute, Montreal, QC H1T 1C8, Canada; (H.M.); (C.G.); (T.V.); (A.N.); (F.L.)
| | - Frédéric Lesage
- Montreal Heart Institute, Montreal, QC H1T 1C8, Canada; (H.M.); (C.G.); (T.V.); (A.N.); (F.L.)
- Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC H3T 1J4, Canada
| | - Louis Bherer
- Montreal Heart Institute, Montreal, QC H1T 1C8, Canada; (H.M.); (C.G.); (T.V.); (A.N.); (F.L.)
- Department of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada
- Institut Universitaire de Gériatrie de Montréal, Montreal, QC H3W 1W4, Canada
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Gagnon C, Saillant K, Olmand M, Gayda M, Nigam A, Bouabdallaoui N, Rouleau JL, Desjardins-Crépeau L, Bherer L. Performances on the Montreal Cognitive Assessment Along the Cardiovascular Disease Continuum. Arch Clin Neuropsychol 2021; 37:117-124. [PMID: 33960374 DOI: 10.1093/arclin/acab029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2021] [Indexed: 11/14/2022] Open
Abstract
Cardiovascular diseases involve a continuum starting with risk factors, which can progress to coronary heart disease and eventually, to heart failure. Cognitive impairment (CI) is observed as early as cardiovascular risk factors, and in up to 50% of patients with heart failure. Because CI in cardiovascular disease is linked to poorer clinical outcomes, early detection is essential. The Montreal Cognitive Assessment (MoCA) is a screening tool widely used in clinical setting. To date, little is known about MoCA scores along the cardiovascular disease continuum. OBJECTIVE This study compared performances of different cardiovascular disease profiles on the MoCA and its subscores. METHOD Eighty participants (>50 years) from two studies conducted at the Montreal Heart Institute were separated into four groups: low cardiovascular risk factors (<2), high cardiovascular risk factors (>2), coronary heart disease, and stable heart failure. ANCOVAs were performed on the total score and on subscores, with sex, age, and education as covariates. RESULTS Group differences were observed on the MoCA total score (heart failure < low cardiovascular risk), verbal fluency (heart failure < low cardiovascular risk), memory (coronary heart disease < low cardiovascular risk), and orientation (coronary heart disease < low and high cardiovascular risk) subscores. CONCLUSION Results suggest that the MoCA, particularly verbal fluency and memory subscores, can detect cognitive changes in later stages of the cardiovascular disease continuum, such as heart failure. Detecting cognitive changes earlier on the cardiovascular disease continuum may require more in depth neuropsychological assessments.
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Affiliation(s)
- Christine Gagnon
- Preventive Medicine and Physical Activity Centre and Research Center, Montreal Heart Institute, Montreal, Canada
| | - Kathia Saillant
- Preventive Medicine and Physical Activity Centre and Research Center, Montreal Heart Institute, Montreal, Canada.,Department of Psychology, Université du Québec à Montréal, Montréal, Canada
| | - Miloudza Olmand
- Preventive Medicine and Physical Activity Centre and Research Center, Montreal Heart Institute, Montreal, Canada.,Deparment of Psychology, Université de Montréal, Montréal, Canada
| | - Mathieu Gayda
- Preventive Medicine and Physical Activity Centre and Research Center, Montreal Heart Institute, Montreal, Canada.,Department of Medicine, Université de Montréal, Montreal, Canada
| | - Anil Nigam
- Preventive Medicine and Physical Activity Centre and Research Center, Montreal Heart Institute, Montreal, Canada.,Montreal Heart Institute, Montreal, Canada
| | | | - Jean-Lucien Rouleau
- Department of Medicine, Université de Montréal, Montreal, Canada.,Montreal Heart Institute, Montreal, Canada
| | | | - Louis Bherer
- Preventive Medicine and Physical Activity Centre and Research Center, Montreal Heart Institute, Montreal, Canada.,Department of Medicine, Université de Montréal, Montreal, Canada.,Research Centre, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada
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29
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Gravel H, Barry H, Chaseling G, Debray A, Behzadi P, Nigam A, Juneau M, Sirois M, Gagnon D. Finnish Sauna Bathing and Vascular Function in Adults with Coronary Artery Disease: Preliminary Analysis of a Randomized Controlled Trial. FASEB J 2021. [DOI: 10.1096/fasebj.2021.35.s1.03590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Hugo Gravel
- Cardiovascular Rehabilitation and Prevention CentreMontreal Heart InstituteMontrealQC
- Pharmacology and PhysiologyMontreal Heart InstituteMontrealQC
| | - Hadiatou Barry
- Cardiovascular Rehabilitation and Prevention CentreMontreal Heart InstituteMontrealQC
- Pharmacology and PhysiologyMontreal Heart InstituteMontrealQC
| | - Georgia Chaseling
- Cardiovascular Rehabilitation and Prevention CentreMontreal Heart InstituteMontrealQC
- Pharmacology and PhysiologyMontreal Heart InstituteMontrealQC
| | - Amélie Debray
- Cardiovascular Rehabilitation and Prevention CentreMontreal Heart InstituteMontrealQC
- Montreal Heart InstituteMontrealQC
| | - Parya Behzadi
- Cardiovascular Rehabilitation and Prevention CentreMontreal Heart InstituteMontrealQC
- Montreal Heart InstituteMontrealQC
| | - Anil Nigam
- Cardiovascular Rehabilitation and Prevention CentreMontreal Heart InstituteMontrealQC
| | - Martin Juneau
- Cardiovascular Rehabilitation and Prevention CentreMontreal Heart InstituteMontrealQC
| | - Martin Sirois
- Research CentreMontreal Heart InstituteMontréalQC
- Montreal Heart InstituteMontréalQC
| | - Daniel Gagnon
- Cardiovascular Rehabilitation and Prevention CentreMontreal Heart InstituteMontrealQC
- Montreal Heart InstituteMontrealQC
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Pothier K, Vrinceanu T, Intzandt B, Bosquet L, Karelis AD, Lussier M, Vu TTM, Nigam A, Li KZH, Berryman N, Bherer L. A comparison of physical exercise and cognitive training interventions to improve determinants of functional mobility in healthy older adults. Exp Gerontol 2021; 149:111331. [PMID: 33774144 DOI: 10.1016/j.exger.2021.111331] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/12/2021] [Accepted: 03/22/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Mobility is a complex but crucial clinical outcome in older adults. Past observational studies have highlighted that cardiorespiratory fitness (CRF), energy cost of walking (ECW), and cognitive switching abilities are associated with mobility performance, making these key determinants of mobility intervention targets to enhance mobility in older adults. The objective of this study was to compare, in the same design, the impact of three training methods - each known to improve either CRF, ECW, or cognitive switching abilities - on mobility in healthy older adults. METHODS Seventy-eight participants (69.28 ± 4.85yo) were randomly assigned to one of three twelve-week interventions: Aerobic Exercise (AE; n = 26), Gross Motor Abilities (GMA; n = 27), or Cognitive (COG; n = 25) training. Each intervention was designed to improve one of the three key determinants of mobility (CRF, ECW, and cognitive switching). Primary outcomes (usual gait speed, and TUG performance) and the three mobility determinants were measured before and after the intervention. RESULTS Repeated-measures ANOVAs showed a time effect for TUG performance (F(1,75) = 14.92, p < .001): all groups equally improved after the intervention (ΔTUGpost-pre, in seconds, with 95% CI: AE = -0.44 [-0.81 to -0.08]; GMA = -0.60 [-1.10 to -0.10]; COG = -0.33 [-0.71 to 0.05]). No significant between group differences were observed. CRF was improved in the AE group only (Hedges' G = 0.27, small effect), ECW and cognitive switching improved the most in the GMA (Hedges' G = -0.78, moderate effect) and COG groups (Hedges' G = -1.93, large effect) respectively. Smaller improvements in ECW were observed following AE and COG trainings (Hedges' G: AE = -0.39, COG = -0.36, both small effects) as well as in cognitive switching following AE and GMA training (Hedges' G: AE = -0.42, GMA = -0.21, both small effects). DISCUSSION This study provides further support to the notion that multiple interventional approaches (aerobic, gross motor exercise, or cognitive training) can be employed to improve functional mobility in older adults, giving them, and professionals, more options to promote healthy ageing.
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Affiliation(s)
- Kristell Pothier
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; PERFORM Centre, Concordia University, Montréal, Canada; EA 2114, Psychologie des Âges de la Vie et Adaptation, University of Tours, Tours, France.
| | - Tudor Vrinceanu
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; Research Centre, Montreal Heart Institute, Montréal, Canada; Department of Medicine, University of Montréal, Montréal, Canada
| | - Brittany Intzandt
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; PERFORM Centre, Concordia University, Montréal, Canada; Research Centre, Montreal Heart Institute, Montréal, Canada
| | - Laurent Bosquet
- Laboratory MOVE (EA 6314), Faculty of Sport Sciences, University of Poitiers, Poitiers, France
| | - Antony D Karelis
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; Département des Sciences de l'Activité Physique, Université du Québec à Montréal, Montréal, QC, Canada
| | - Maxime Lussier
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; Rehabilitation Science, Faculty of Medicine, University of Montréal, Montréal, Canada
| | - T T Minh Vu
- Department of Medicine, University of Montréal, Montréal, Canada; Research Centre, Centre hospitalier de l'Université de Montréal, Montréal, Canada
| | - Anil Nigam
- Research Centre, Montreal Heart Institute, Montréal, Canada; Department of Medicine, University of Montréal, Montréal, Canada
| | - Karen Z H Li
- PERFORM Centre, Concordia University, Montréal, Canada; Department of Psychology, Concordia University, Montreal, QC, Canada; Centre for Research in Human Development, Concordia University, Montreal, QC, Canada
| | - Nicolas Berryman
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; Laboratory MOVE (EA 6314), Faculty of Sport Sciences, University of Poitiers, Poitiers, France; Département des Sciences de l'Activité Physique, Université du Québec à Montréal, Montréal, QC, Canada; Department of Sports Studies, Bishop's University, Sherbrooke, Canada
| | - Louis Bherer
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; PERFORM Centre, Concordia University, Montréal, Canada; Research Centre, Montreal Heart Institute, Montréal, Canada; Department of Medicine, University of Montréal, Montréal, Canada.
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Gravel H, Behzadi P, Cardinal S, Barry H, Neagoe PE, Juneau M, Nigam A, Sirois MG, Gagnon D. Acute Vascular Benefits of Finnish Sauna Bathing in Patients With Stable Coronary Artery Disease. Can J Cardiol 2021; 37:493-499. [DOI: 10.1016/j.cjca.2020.06.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/26/2020] [Accepted: 06/25/2020] [Indexed: 01/20/2023] Open
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Saillant K, Langeard A, Kaushal N, Vu TTM, Pothier K, Langlois F, Nigam A, Juneau M, Bherer L. Statin use moderates the beneficial effects of aerobic exercise on older adults' performances on the Stroop test: A subanalysis. Exp Gerontol 2021; 147:111277. [PMID: 33600874 DOI: 10.1016/j.exger.2021.111277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 01/31/2021] [Accepted: 02/11/2021] [Indexed: 12/22/2022]
Abstract
Aerobic training can lead to improved cognition in older adults and this effect can be explained by enhanced cardiorespiratory fitness. However, statins could limit the physical benefits of aerobic training by altering the mechanisms through which exercise improves cognition. Whether statins could have an effect on the cognitive benefits associated with aerobic training remains to be elucidated. The objective of this study was to determine whether the cognitive benefits of aerobic training were comparable in statin users and non-users. A total of 144 sedentary participants (>60 y.o.; 106 non-users, 38 statin users) were included. Participants were either part of an aerobic training group (n = 75) or a control group (n = 69). Cognition was assessed using the Stroop test. Analyses were performed on z-score changes from pre to post-intervention of Stroop reaction time (RT) and number of errors, using Two-factor ANCOVAs, while controlling for potential confounding factors (age, education, BMI, Charlson Comorbidity Index, sex, protocol and handgrip strength). The moderating effect of statins on the cognitive changes associated with aerobic training was determined through moderation analyses. An interaction effect on the Stroop switching condition was detected between intervention and statin intake (F [1, 140] = 5.659, P < 0.01). The intervention effect on switching RT was moderated by statin intake, where intervention improved switching RT only in non-users (Effect = 0.1678; P < 0.01). Statins could limit the cognitive benefits of aerobic training on switching capacities in some patients. Future randomized studies including a larger number of participants and looking at different types of statins should be conducted to confirm these results.
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Affiliation(s)
- Kathia Saillant
- Departement of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada; Centre de recherche de l'Institut de Cardiologie de Montréal, Montreal, Quebec, Canada; Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada.
| | | | - Navin Kaushal
- Department of Health Sciences, School of Health and Human Sciences, Indiana University, Indianapolis, IN, United States
| | - Thien Tuong Minh Vu
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada; Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | | | - Francis Langlois
- CSSS de l'Estrie Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Anil Nigam
- Montreal Heart Institute, Montreal, Quebec, Canada
| | | | - Louis Bherer
- Centre de recherche de l'Institut de Cardiologie de Montréal, Montreal, Quebec, Canada; Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Quebec, Canada; Department of Medicine, Université de Montréal, Montreal, Quebec, Canada.
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Talamonti D, Vincent T, Fraser S, Nigam A, Lesage F, Bherer L. The Benefits of Physical Activity in Individuals with Cardiovascular Risk Factors: A Longitudinal Investigation Using fNIRS and Dual-Task Walking. J Clin Med 2021; 10:jcm10040579. [PMID: 33557109 PMCID: PMC7913805 DOI: 10.3390/jcm10040579] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/26/2021] [Accepted: 01/30/2021] [Indexed: 11/16/2022] Open
Abstract
Cardiovascular fitness is linked to better executive functions, preserved gait speed, and efficient cortical activity. Older adults with cardiovascular risk factors (CVRFs) typically show poor cognitive performance, low physical fitness, and altered brain functioning compared with healthy individuals. In the current study, the impact of regular physical activity on cognition, locomotion, and brain functions was explored in a cohort of older adults with low or high CVRFs. Cortical activation of the frontal areas was investigated using functional Near-Infrared Spectroscopy (fNIRS) at baseline, at 6 months and at 12 months. Evoked cortical response and behavioral performance were assessed using the dual-task walking paradigm, consisting of three conditions: single cognitive task (2-back task), single walking task (walking), and dual-task (2-back whilst walking). Results show greater task-related cortical response at baseline in individuals with high CVRFs compared to those with low CVRFs. Moreover, participants with high CVRFs benefitted the most from participating in regular physical activity, as their cortical response decreased at the 12-month follow-up and became comparable to that of participants with low CVRFs. These changes were observed in conjunction with improved cognitive performance and stable gait speed throughout the 12-month period in both groups. Our findings provide evidence that participation in regular physical activity may be especially beneficial in individuals with CVRFs by promoting brain and cognitive health, thus potentially contributing to prevention of cognitive decline. Future research may explore whether such effects are maintained in the long-term in order to design ad-hoc interventions in this specific population.
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Affiliation(s)
- Deborah Talamonti
- Montreal Heart Institute, Research Centre and Centre EPIC, Montreal, QC H1T 1N6, Canada; (T.V.); (A.N.); (F.L.); (L.B.)
- Correspondence:
| | - Thomas Vincent
- Montreal Heart Institute, Research Centre and Centre EPIC, Montreal, QC H1T 1N6, Canada; (T.V.); (A.N.); (F.L.); (L.B.)
| | - Sarah Fraser
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Anil Nigam
- Montreal Heart Institute, Research Centre and Centre EPIC, Montreal, QC H1T 1N6, Canada; (T.V.); (A.N.); (F.L.); (L.B.)
- Department of Medicine, Université de Montreal, Montreal, QC H3T 1J4, Canada
| | - Frédéric Lesage
- Montreal Heart Institute, Research Centre and Centre EPIC, Montreal, QC H1T 1N6, Canada; (T.V.); (A.N.); (F.L.); (L.B.)
- École Polytechnique de Montreal, Montreal, QC H3T 1J4, Canada
| | - Louis Bherer
- Montreal Heart Institute, Research Centre and Centre EPIC, Montreal, QC H1T 1N6, Canada; (T.V.); (A.N.); (F.L.); (L.B.)
- Department of Medicine, Université de Montreal, Montreal, QC H3T 1J4, Canada
- Centre de Recherche, Institut Universitaire de Gériatrie de Montréal, Montréal, QC H3W 1W5, Canada
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Langeard A, Cloutier SO, Olmand M, Saillant K, Gagnon C, Grégoire CA, Fortier A, Lacroix M, Lalongé J, Gayda M, Besnier F, Gagnon D, Bherer L, Nigam A. High-intensity interval training vs. hydrochlorothiazide on blood pressure, cardiovascular health and cognition: Protocol of a non-inferiority trial. Contemp Clin Trials 2021; 102:106286. [PMID: 33484896 DOI: 10.1016/j.cct.2021.106286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/05/2021] [Accepted: 01/15/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND While the number of people with hypertension (HBP) continues to increase, the therapeutic target for optimal blood pressure (BP) has been revised to a lower level. Studies have suggested that High-Intensity Interval Training (HIIT) could be as efficient as BP-lowering drugs, but no study has compared their efficacy in a randomized trial. The aim of this protocol is to determine if HIIT is as efficient as Hydrochlorothiazide (HCTZ) in lowering 24 h ambulatory BP in prehypertensive older adults. Moreover, the secondary aim is to determine if HIIT is associated with greater cardiovascular and cognitive benefits than HCTZ. METHODS This study is an interventional, single-center, non-inferiority trial, with two randomized parallel groups of prehypertensive participants aged 60 years or more. One group will be prescribed daily doses of 12.5 mg of HCTZ for 12 weeks, and the other group will follow thrice-weekly HIIT for 12 weeks. Each group will be composed of 30 participants. The primary outcome is 24 h ambulatory BP. Secondary outcomes are scores on neuropsychological assessments, balance and gait performances, maximal oxygen uptake, peripheral endothelial function, and arterial stiffness. Non-inferiority tests will be performed on the primary outcome, and secondary outcomes will be compared using independent t-tests. CONCLUSION This study will determine if HIIT is at least as efficient as HCTZ in lowering BP in prehypertensive older adults. This study will also determine if HIIT provides greater benefits in terms of cardiovascular and cognitive status (NCT04103411).
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Affiliation(s)
- Antoine Langeard
- Department of Medicine, Université de Montréal, Montréal, Québec, Canada; Preventive Medicine and Physical Activity Center (centre EPIC), Canada; Research Center, Montreal Heart Institute, Montréal, Québec, Canada; Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada.
| | - Simon-Olivier Cloutier
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada; Preventive Medicine and Physical Activity Center (centre EPIC), Canada
| | - Miloudza Olmand
- Department of Psychology, Université de Montréal, Montréal, Québec, Canada; Preventive Medicine and Physical Activity Center (centre EPIC), Canada
| | - Kathia Saillant
- Preventive Medicine and Physical Activity Center (centre EPIC), Canada; Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada; Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Christine Gagnon
- Preventive Medicine and Physical Activity Center (centre EPIC), Canada; Research Center, Montreal Heart Institute, Montréal, Québec, Canada
| | - Catherine-Alexandra Grégoire
- Preventive Medicine and Physical Activity Center (centre EPIC), Canada; Research Center, Montreal Heart Institute, Montréal, Québec, Canada
| | - Annick Fortier
- Montreal Health Innovations Coordinating Center (MHICC), Canada
| | - Martine Lacroix
- Research Center, Montreal Heart Institute, Montréal, Québec, Canada
| | - Julie Lalongé
- Preventive Medicine and Physical Activity Center (centre EPIC), Canada
| | - Mathieu Gayda
- Preventive Medicine and Physical Activity Center (centre EPIC), Canada
| | - Florent Besnier
- Department of Medicine, Université de Montréal, Montréal, Québec, Canada; Preventive Medicine and Physical Activity Center (centre EPIC), Canada; Research Center, Montreal Heart Institute, Montréal, Québec, Canada
| | - Daniel Gagnon
- Department of Kinesiology and Exercise Science, Université de Montréal, Québec, Canada; Preventive Medicine and Physical Activity Center (centre EPIC), Canada
| | - Louis Bherer
- Department of Medicine, Université de Montréal, Montréal, Québec, Canada; Preventive Medicine and Physical Activity Center (centre EPIC), Canada; Research Center, Montreal Heart Institute, Montréal, Québec, Canada; Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada.
| | - Anil Nigam
- Preventive Medicine and Physical Activity Center (centre EPIC), Canada; Research Center, Montreal Heart Institute, Montréal, Québec, Canada
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Boidin M, Handfield N, Ribeiro PA, Desjardins-Crépeau L, Gagnon C, Lapierre G, Gremeaux V, Lalongé J, Nigam A, Juneau M, Gayda M, Bherer L. Obese but Fit: The Benefits of Fitness on Cognition in Obese Older Adults. Can J Cardiol 2020; 36:1747-1753. [DOI: 10.1016/j.cjca.2020.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/23/2019] [Accepted: 01/06/2020] [Indexed: 12/13/2022] Open
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Boidin M, David LP, Trachsel LD, Gayda M, Tremblay J, Lalongé J, Juneau M, Nigam A, Henri C. Impact of 2 different aerobic periodization training protocols on left ventricular function in patients with stable coronary artery disease: an exploratory study. Appl Physiol Nutr Metab 2020; 46:436-442. [PMID: 33108743 DOI: 10.1139/apnm-2020-0423] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We compared the impacts of linear (LP) and nonlinear (NLP) aerobic training periodizations on left ventricular (LV) function and geometry in coronary artery disease (CAD) patients. Thirty-nine CAD patients were randomized to either a 3-month isoenergetic supervised LP or NLP. All underwent standard echocardiography with assessment of 3D LV ejection fraction (LVEF), diastolic function, strain (global longitudinal, radial, and circumferential), and strain rate at baseline and study end. Training was performed 3 times/week and included high-intensity interval and moderate-intensity continuous training sessions. Training load was progressively increased in the LP group, while it was deeply increased and intercepted with a recovery week each fourth week in the NLP group. For the 34 analyzed patients, we found similar improvements for 3D LVEF (effect size (ES): LP, 0.29; NLP, 0.77), radial strain (ES: LP, 0.58; NLP, 0.48), and radial strain rate (ES: LP, 0.87; NLP, 0.17) in both groups (time for all: p ≤ 0.01). All other parameters of cardiac function remained similar. In conclusion, NLP and LP led to similar improvements in 3D LVEF and radial strain, suggesting a favourable positive cardiac remodelling through myofibers reorganization. These findings must be investigated in patients with more severe cardiac dysfunction. The study was registered on ClinicalTrials.gov (NCT03443193). Novelty: Linear and nonlinear periodization programs improved radial strain, accompanied by improvement of ejection fraction. Both aerobic periodization programs did not negatively impact cardiac function in coronary artery disease patients.
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Affiliation(s)
- Maxime Boidin
- School of Kinesiology and Exercise Science, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada.,Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada
| | - Louis-Philippe David
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Lukas D Trachsel
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada.,University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, 3010 Switzerland
| | - Mathieu Gayda
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada.,Research Centre, Montreal Heart Institute, Montreal, QC H1T 1C8, Canada
| | - Jonathan Tremblay
- School of Kinesiology and Exercise Science, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Julie Lalongé
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada.,Research Centre, Montreal Heart Institute, Montreal, QC H1T 1C8, Canada
| | - Martin Juneau
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada.,Research Centre, Montreal Heart Institute, Montreal, QC H1T 1C8, Canada
| | - Anil Nigam
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada.,Research Centre, Montreal Heart Institute, Montreal, QC H1T 1C8, Canada
| | - Christine Henri
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada.,Research Centre, Montreal Heart Institute, Montreal, QC H1T 1C8, Canada
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Trachsel LD, Boidin M, Henri C, Fortier A, Lalongé J, Juneau M, Nigam A, Gayda M. Women and men with coronary heart disease respond similarly to different aerobic exercise training modalities: a pooled analysis of prospective randomized trials. Appl Physiol Nutr Metab 2020; 46:417-425. [PMID: 33096006 DOI: 10.1139/apnm-2020-0650] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We aimed to compare cardiopulmonary exercise test (CPET) parameters, cardiac adaptations, and proportion of responders after different aerobic training programs amongst women and men with coronary heart disease (CHD). Patients with CHD were evaluated with a CPET and echocardiography before and after 3 months of aerobic exercise training. Peak oxygen uptake exercise training response was assessed according to the median peak oxygen uptake change for post- versus pretraining in the whole cohort (stratification non/low responders (NLR) vs. high-responders) and normalized for lean body mass (LBM). Eighty-three CHD patients were included (19 women, 64 men; 27 patients with interval, 19 with continuous, and 37 with combination exercises). Peak oxygen uptake, peak workload normalized for LBM, pulmonary variables (i.e., ventilation and oxygen uptake efficiency slope), and O2 pulse were significantly lower in women versus men. These parameters improved similarly with training in both sexes (p < 0.05). There were no differences in the proportion of NLR among women and men with CHD (7/19 (37%) vs. 35/64 (55%), p = 0.1719). Left ventricular ejection fraction and mean peak early diastolic mitral annulus velocity improved similarly with training in both sexes (p < 0.05). Women and men with CHD have a similar exercise training response regarding key CPET and echocardiographic parameters. The proportion of responders is similar. ClinicalTrials.gov: NCT03414996, NCT02048696, NCT03443193. Novelty: Cardiopulmonary adaptations to exercise training are similar among CHD men and women. Proportion of peak oxygen uptake for non/low/high responders is similar in CHD men and women. Left ventricular systolic and diastolic function improved similarly after exercise training in CHD men and women.
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Affiliation(s)
- Lukas-Daniel Trachsel
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1N6, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada.,University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, CH-3010 Switzerland
| | - Maxime Boidin
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1N6, Canada.,Research Centre, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1C8, Canada.,School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Christine Henri
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada.,Research Centre, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1C8, Canada
| | - Annik Fortier
- Montreal Health Innovations Coordinating Center, Montreal Heart Institute, Montreal, QC H1T 1C8, Canada
| | - Julie Lalongé
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1N6, Canada.,Research Centre, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1C8, Canada
| | - Martin Juneau
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1N6, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada.,Research Centre, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1C8, Canada
| | - Anil Nigam
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1N6, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada.,Research Centre, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1C8, Canada
| | - Mathieu Gayda
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1N6, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada.,Research Centre, Montreal Heart Institute, Université de Montréal, Montreal, QC H1T 1C8, Canada
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Vrinceanu T, Lagacé-Lavoie G, Kaushal N, Esmail A, Vu TTM, Berryman N, Nigam A, Bherer L. Mind the Rhythm: ECG QT Dispersion and Cognition in Healthy Older Adults. Front Psychol 2020; 11:566341. [PMID: 33117235 PMCID: PMC7561416 DOI: 10.3389/fpsyg.2020.566341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 09/14/2020] [Indexed: 12/19/2022] Open
Abstract
Background Autonomic function has been linked to cognitive abilities in aging. Even in non-clinical states, a certain variability in heart rhythm regulation can be measured with QT dispersion (QTcD), an ECG marker of ventricular repolarization which has been linked to autonomic function and cardiovascular health. QTcD has been shown to be higher in individuals with mild cognitive impairment, and the highest in individuals with Alzheimer’s disease. The goal of this study was to see if QTcD is associated with cognitive performance in healthy individuals. Methods Sixty-three healthy inactive older adults (> 60 years) completed an extensive cognitive assessment (including inhibition, divided attention, updating, working memory, and processing speed), a physical fitness assessment, and underwent a resting ECG. Results After controlling for age, sex, and education, QTcD significantly predicted global cognition (MoCA) scores (R2 = 0.17, F(4.58) = 3.00, p < 0.03, β = −0.36). Exploratory analysis on the MoCA subcomponents revealed a significant association between the visual/executive subcomponent and QTcD (R2 = 0.12, F(1.61) = 7.99, p < 0.01, β = −0.34). In individuals with high QTcD, QTcD values were linked to executive functions (R2 = 0.37), processing speed (R2 = 0.34), and dual-task performances (R2 = 0.47). No significant associations were found within the low QTcD group. Conclusion This study shows an association between ventricular repolarization (QTcD) and cognitive performance, in particular speed and executive functions, in healthy older adults. The results provide further support for linking autonomic heart regulation and age-related cognitive changes, and suggest that deviations on ECG, even within-normal range, could help detect early cognitive deficits.
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Affiliation(s)
- Tudor Vrinceanu
- Department of Medicine, Université de Montréal, Montreal, QC, Canada.,Research Centre, Montreal Heart Institute, Montreal, QC, Canada.,Research Centre, Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | | | - Navin Kaushal
- Department of Health Sciences, School of Health & Human Sciences, Indiana University, Indianapolis, IN, United States
| | - Alida Esmail
- École de Réadaptation, Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
| | - T T Minh Vu
- Department of Medicine, Université de Montréal, Montreal, QC, Canada.,Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.,Centre de Recherché du CHUM, Montreal, QC, Canada
| | - Nicolas Berryman
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada.,Département des Sciences de l'Activité Physique, Université du Québec à Montréal, Montreal, QC, Canada
| | - Anil Nigam
- Department of Medicine, Université de Montréal, Montreal, QC, Canada.,Research Centre, Montreal Heart Institute, Montreal, QC, Canada
| | - Louis Bherer
- Department of Medicine, Université de Montréal, Montreal, QC, Canada.,Research Centre, Montreal Heart Institute, Montreal, QC, Canada.,Research Centre, Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
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Jarjour M, Henri C, de Denus S, Fortier A, Bouabdallaoui N, Nigam A, O'Meara E, Ahnadi C, White M, Garceau P, Racine N, Parent MC, Liszkowski M, Giraldeau G, Rouleau JL, Ducharme A. Care Gaps in Adherence to Heart Failure Guidelines: Clinical Inertia or Physiological Limitations? JACC Heart Fail 2020; 8:725-738. [PMID: 32800509 DOI: 10.1016/j.jchf.2020.04.019] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 04/13/2020] [Accepted: 04/30/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVES This study evaluated the impact of clinical and physiological factors limiting treatment optimization toward recommended medical therapy in heart failure (HF). BACKGROUND Although guidelines aim to assist physicians in prescribing evidence-based therapies and to improve outcomes of patients with HF and reduced ejection fraction (HFrEF), gaps in clinical care persist. METHODS Medical records of all patients with HFrEF followed for at least 6 months at the authors' HF clinic (n = 511) allowed for drug optimization and were reviewed regarding the prescription rates of recommended pharmacological agents and devices (implantable cardioverter-defibrillator [ICD] or cardiac resynchronization therapy [CRT]). Then, an algorithm integrating clinical (New York Heart Association [NYHA] functional class, heart rate, blood pressure and biologic parameters (creatinine, serum potassium) based on the inclusion/exclusion criteria of landmark trials guiding these recommendations) was applied for each agent and device to identify potential explanations for treatment gaps. RESULTS Gross prescription rates were high for beta-blockers (98.6%), mineralocorticoid receptor antagonist (MRA) (93.4%), vasodilators (90.3%), ICDs (75.1%), and CRT (82.1%) among those eligible, except for ivabradine (46.3%, n = 41). However, achievement of target physiological doses was lower (beta-blockers, 67.5%; MRA, 58.9%; and vasodilators, 63.4%), and one-fifth of patient dosages were still being up-titrated. Suboptimal doses were associated with older age (odds ratio [OR]: 1.221; p < 0.0001) and history of stroke or transient ischemic attack (TIA) (no vs. yes, OR: 0.264; p = 0.0336). CONCLUSIONS Gaps in adherence to guidelines exist in specialized HF setting and are mostly explained by limiting physiological factors rather than inertia. Older age and history of stroke/TIA, potential markers of frailty, are associated with suboptimal doses of guideline-directed medical therapy, suggesting that an individualized rather than a "one-size-fits-all" approach may be required.
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Affiliation(s)
- Marilyne Jarjour
- Department of Medicine, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Christine Henri
- Department of Medicine, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Simon de Denus
- Department of Medicine, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Annik Fortier
- Biostatistics, Montreal Health Innovation Coordinating Center, Montreal, Quebec, Canada
| | | | - Anil Nigam
- Department of Medicine, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Eileen O'Meara
- Department of Medicine, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Charaf Ahnadi
- Collaborative Research for Effective Diagnostics, University Hospital Center of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Michel White
- Department of Medicine, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Patrick Garceau
- Department of Medicine, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Normand Racine
- Department of Medicine, Montreal Heart Institute, Montreal, Quebec, Canada
| | | | - Mark Liszkowski
- Department of Medicine, Montreal Heart Institute, Montreal, Quebec, Canada
| | | | | | - Anique Ducharme
- Department of Medicine, Montreal Heart Institute, Montreal, Quebec, Canada.
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Intzandt B, Vrinceanu T, Pothier K, Nigam A, Vu TTM, Li K, Berryman N, Gauthier C, Bherer L. Systolic Blood Pressure And Heart Rate Recovery Are Related To Cognition In Healthy Older Adults. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000670028.56653.08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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41
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Langeard A, Saillant K, Charlebois Cloutier E, Gayda M, Lesage F, Nigam A, Bherer L, Fraser SA. Association between Statin Use and Balance in Older Adults. Int J Environ Res Public Health 2020; 17:ijerph17134662. [PMID: 32610434 PMCID: PMC7369856 DOI: 10.3390/ijerph17134662] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/23/2020] [Accepted: 06/26/2020] [Indexed: 01/03/2023]
Abstract
Background: Several medications have been associated with an increased risk of balance deficits and greater likelihood to sustain a fall, representing a large health and economic issue. Statins are regularly prescribed to prevent strokes and heart attacks, but their impact on balance is unknown. The aim of this paper was to determine whether statin use is associated with poorer balance performances in older adults. Methods: All participants, one group taking statins (n = 34), and the other group not taking statins (n = 31), completed a balance assessment with their eyes closed and their eyes opened on a MatScan Pressure Sensing Mat. Center of Pressure (CoP) velocity, peak-to-peak distance, and standard deviation were collected in both anteroposterior (AP) and mediolateral (ML) directions. Multiple linear regression analyses were performed for each balance outcome, testing the statin use status as a predictor and controlling for appropriate factors including participants characteristics, lipid profile, and cardiovascular disease. Results: After controlling for confounding factors, statin use significantly predicted both CoP ML-Amplitude (β = 0.638, p = 0.004) and ML-Velocity (β = 0.653, p = 0.002) in the eyes-opened condition. Conclusions: The present study detected a negative association between statin use and balance control in the ML direction, suggesting that caution should be taken when prescribing statins in older adults, as this could decrease ML stability and ultimately increase fall and fracture risks.
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Affiliation(s)
- Antoine Langeard
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, QC H3W 1W5, Canada; (K.S.); (E.C.C.); (L.B.); (S.A.F.)
- Department of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada; (M.G.); (A.N.)
- EPIC Center, Montreal Heart Institute and University of Montreal, Montreal, QC H1T 1N6, Canada
- Research Center, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada;
- Correspondence:
| | - Kathia Saillant
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, QC H3W 1W5, Canada; (K.S.); (E.C.C.); (L.B.); (S.A.F.)
- Department of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada; (M.G.); (A.N.)
- EPIC Center, Montreal Heart Institute and University of Montreal, Montreal, QC H1T 1N6, Canada
- Research Center, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada;
| | - Elisabeth Charlebois Cloutier
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, QC H3W 1W5, Canada; (K.S.); (E.C.C.); (L.B.); (S.A.F.)
- Department of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada; (M.G.); (A.N.)
- EPIC Center, Montreal Heart Institute and University of Montreal, Montreal, QC H1T 1N6, Canada
- Research Center, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada;
| | - Mathieu Gayda
- Department of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada; (M.G.); (A.N.)
- EPIC Center, Montreal Heart Institute and University of Montreal, Montreal, QC H1T 1N6, Canada
- Research Center, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada;
| | - Frédéric Lesage
- Research Center, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada;
- Department of Electrical Engineering, Polytechnique Montreal, Montreal, QC H3T 1J4, Canada
| | - Anil Nigam
- Department of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada; (M.G.); (A.N.)
- EPIC Center, Montreal Heart Institute and University of Montreal, Montreal, QC H1T 1N6, Canada
- Research Center, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada;
| | - Louis Bherer
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, QC H3W 1W5, Canada; (K.S.); (E.C.C.); (L.B.); (S.A.F.)
- Department of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada; (M.G.); (A.N.)
- EPIC Center, Montreal Heart Institute and University of Montreal, Montreal, QC H1T 1N6, Canada
- Research Center, Montreal Heart Institute, Montreal, QC H1T 1N6, Canada;
| | - Sarah A. Fraser
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, QC H3W 1W5, Canada; (K.S.); (E.C.C.); (L.B.); (S.A.F.)
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
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Besnier F, Gayda M, Nigam A, Juneau M, Bherer L. Cardiac Rehabilitation During Quarantine in COVID-19 Pandemic: Challenges for Center-Based Programs. Arch Phys Med Rehabil 2020; 101:1835-1838. [PMID: 32599060 PMCID: PMC7319913 DOI: 10.1016/j.apmr.2020.06.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/16/2020] [Accepted: 06/19/2020] [Indexed: 12/20/2022]
Abstract
Because of the coronavirus disease 2019 (COVID-19) epidemic, many cardiac rehabilitation (CR) services and programs are stopped. Because CR is a class I level A recommendation with clinical benefits that are now well documented, the cessation of CR programs can lead to dramatic consequences in terms of public health. We propose here a viewpoint of significant interest about the sudden need to develop remote home-based CR programs both in clinical research and in clinical care routine. This last decade, the literature on remote home-based CR programs has been increasing, but to date only clinical research experiences have been implemented. Benefits are numerous and the relevance of this approach has obviously increased with the actual health emergency. The COVID-19 crisis, the important prevalence of smartphones, and high-speed Internet during confinement should be viewed as an opportunity to promote a major shift in CR programs with the use of telemedicine to advance the health of a larger number of individuals with cardiac disease.
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Affiliation(s)
- Florent Besnier
- Preventive Medicine and Physical Activity Centre and Research Center, Montreal Heart Institute, Université de Montréal, Montreal, QC; Department of Medicine, Université de Montréal, Montreal, QC.
| | - Mathieu Gayda
- Preventive Medicine and Physical Activity Centre and Research Center, Montreal Heart Institute, Université de Montréal, Montreal, QC; Department of Medicine, Université de Montréal, Montreal, QC
| | - Anil Nigam
- Preventive Medicine and Physical Activity Centre and Research Center, Montreal Heart Institute, Université de Montréal, Montreal, QC; Department of Medicine, Université de Montréal, Montreal, QC
| | - Martin Juneau
- Preventive Medicine and Physical Activity Centre and Research Center, Montreal Heart Institute, Université de Montréal, Montreal, QC; Department of Medicine, Université de Montréal, Montreal, QC
| | - Louis Bherer
- Preventive Medicine and Physical Activity Centre and Research Center, Montreal Heart Institute, Université de Montréal, Montreal, QC; Department of Medicine, Université de Montréal, Montreal, QC; Research Centre, Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
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Gravel H, Coombs GB, Behzadi P, Marcoux-Clément V, Barry H, Juneau M, Nigam A, Gagnon D. Acute effect of Finnish sauna bathing on brachial artery flow-mediated dilation and reactive hyperemia in healthy middle-aged and older adults. Physiol Rep 2020; 7:e14166. [PMID: 31293098 PMCID: PMC6640592 DOI: 10.14814/phy2.14166] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/11/2019] [Accepted: 06/13/2019] [Indexed: 12/14/2022] Open
Abstract
Regular Finnish sauna bathing is associated with a reduced risk of all‐cause and cardiovascular mortality in middle‐aged and older adults. Potential acute physiological adaptations induced by sauna bathing that underlie this relationship remain to be fully elucidated. The purpose of this study was to determine if typical Finnish sauna sessions acutely improve brachial artery flow‐mediated dilation (FMD) and reactive hyperemia (RH) in healthy middle‐aged and older adults. Using a randomized crossover design, FMD and RH were evaluated in 21 healthy adults (66 ± 6 years, 10 men/11 women) before and after each of the following conditions: (1) 1 × 10 min of Finnish sauna bathing (80.2 ± 3.2°C, 23 ± 2% humidity); (2) 2 × 10 min of sauna bathing separated by 10 min of rest outside the sauna; (3) a time control period (10 min of seated rest outside the sauna). FMD was taken as the peak change from baseline in brachial artery diameter following 5 min of forearm ischemia, whereas RH was quantified as both peak and area‐under‐the‐curve forearm vascular conductance postischemia. FMD was statistically similar pre to post 1 × 10 min (4.69 ± 2.46 to 5.41 ± 2.64%, P = 0.20) and 2 × 10 min of sauna bathing (4.16 ± 1.79 to 4.55 ± 2.14%, P = 0.58). Peak and area‐under‐the‐curve forearm vascular conductance were also similar following both sauna interventions. These results suggest that typical Finnish sauna bathing sessions do not acutely improve brachial artery FMD and RH in healthy middle‐aged and older adults.
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Affiliation(s)
- Hugo Gravel
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montréal, Canada.,Département de Pharmacologie et Physiologie, Université de Montréal, Montréal, Canada
| | - Geoff B Coombs
- School of Health and Exercise Sciences, University of British Columbia - Okanagan, Kelowna, Canada
| | - Parya Behzadi
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montréal, Canada.,Département de Pharmacologie et Physiologie, Université de Montréal, Montréal, Canada
| | - Virginie Marcoux-Clément
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montréal, Canada.,Département de Pharmacologie et Physiologie, Université de Montréal, Montréal, Canada
| | - Hadiatou Barry
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montréal, Canada.,Département de Pharmacologie et Physiologie, Université de Montréal, Montréal, Canada
| | - Martin Juneau
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montréal, Canada
| | - Anil Nigam
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montréal, Canada
| | - Daniel Gagnon
- Cardiovascular Prevention and Rehabilitation Centre, Montreal Heart Institute, Montréal, Canada.,Département de Pharmacologie et Physiologie, Université de Montréal, Montréal, Canada
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Boidin M, Nigam A, Guilbeault V, Latour E, Langeard A, Juneau M, Gayda M. Eighteen months of combined Mediterranean diet and high-intensity interval training successfully maintained body mass loss in obese individuals. Ann Phys Rehabil Med 2020; 63:245-248. [PMID: 31981831 DOI: 10.1016/j.rehab.2019.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 11/14/2019] [Accepted: 12/09/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Maxime Boidin
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute and Université de Montréal, Montreal, Canada; Research Center, Montreal Heart Institute and University of Montreal, Montreal, Canada; Faculty of Medicine, Department of Medicine, University of Montreal, Montreal Quebec, Canada; School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Anil Nigam
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute and Université de Montréal, Montreal, Canada; Research Center, Montreal Heart Institute and University of Montreal, Montreal, Canada; Faculty of Medicine, Department of Medicine, University of Montreal, Montreal Quebec, Canada
| | - Valérie Guilbeault
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute and Université de Montréal, Montreal, Canada
| | - Elise Latour
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute and Université de Montréal, Montreal, Canada
| | - Antoine Langeard
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute and Université de Montréal, Montreal, Canada; Research Center, Montreal Heart Institute and University of Montreal, Montreal, Canada; Faculty of Medicine, Department of Medicine, University of Montreal, Montreal Quebec, Canada
| | - Martin Juneau
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute and Université de Montréal, Montreal, Canada; Research Center, Montreal Heart Institute and University of Montreal, Montreal, Canada; Faculty of Medicine, Department of Medicine, University of Montreal, Montreal Quebec, Canada
| | - Mathieu Gayda
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute and Université de Montréal, Montreal, Canada; Research Center, Montreal Heart Institute and University of Montreal, Montreal, Canada; Faculty of Medicine, Department of Medicine, University of Montreal, Montreal Quebec, Canada.
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Langeard A, Saillant K, Charlebois Cloutier E, Gayda M, Lesage F, Nigam A, Bherer L, Fraser S. Statin use is associated with poorer static balance performance in older adults. Neurophysiol Clin 2019. [DOI: 10.1016/j.neucli.2019.10.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Boidin M, Trachsel LD, Nigam A, Juneau M, Tremblay J, Gayda M. Non-linear is not superior to linear aerobic training periodization in coronary heart disease patients. Eur J Prev Cardiol 2019; 27:1691-1698. [DOI: 10.1177/2047487319891778] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background We aimed to compare: (1) two different periodized aerobic training protocols (linear (LP) versus non-linear (NLP)) on the cardiopulmonary exercise response in patients with coronary heart disease; (2) the proportion of responders between both training protocols. Design A randomized controlled trial. Methods A total of 39 coronary heart disease patients completed either LP ( n = 20, 65 ± 10 years) or NLP ( n = 19, 66 ± 5 years). All patients completed a cardiopulmonary exercise testing with gas exchange measurements. Patients underwent a 12-week supervised exercise program including an isoenergetic aerobic periodized training and a similar resistance training program, 3 times/week. Weekly energy expenditure was constantly increased in the LP group for the aerobic training, while it was deeply increased and intercepted with a recovery week each fourth week in the NLP group. Peak oxygen uptake (peak V̇O2), oxygen uptake efficiency slope, ventilatory efficiency slope (V̇E/V̇CO2 slope), V̇O2 at the first (VT1) and second (VT2) ventilatory thresholds, and oxygen pulse (O2 pulse) were measured. Responders were determined according the median value of the Δpeak V̇O2 (mL.min−1.kg−1). Results We found similar improvement for peak V̇O2 (LP: +8.1%, NLP: +5.3%, interaction: p = 0.37; time: p < 0.001) and for oxygen uptake efficiency slope, VT1, VT2 and O2 pulse in both groups (interaction: p > 0.05; time: p < 0.05) with a greater effect size in the LP group. The proportion of non-, low and high responders was similar between groups ( p = 0.29). Conclusion In contrast to the athletes, more variation (NLP) does not seem necessary for greater cardiopulmonary adaptations in coronary heart disease patients.
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Affiliation(s)
- Maxime Boidin
- Cardiovascular Prevention and Rehabilitation (EPIC) Center, Montreal Heart Institute and Université de Montréal, Canada
- Research Center, Montreal Heart Institute and Université de Montréal, Canada
- School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Canada
| | - Lukas-Daniel Trachsel
- Cardiovascular Prevention and Rehabilitation (EPIC) Center, Montreal Heart Institute and Université de Montréal, Canada
- Research Center, Montreal Heart Institute and Université de Montréal, Canada
- Faculty of Medicine, Department of Medicine, Université de Montréal, Canada
| | - Anil Nigam
- Cardiovascular Prevention and Rehabilitation (EPIC) Center, Montreal Heart Institute and Université de Montréal, Canada
- Research Center, Montreal Heart Institute and Université de Montréal, Canada
- Faculty of Medicine, Department of Medicine, Université de Montréal, Canada
| | - Martin Juneau
- Cardiovascular Prevention and Rehabilitation (EPIC) Center, Montreal Heart Institute and Université de Montréal, Canada
- Research Center, Montreal Heart Institute and Université de Montréal, Canada
- Faculty of Medicine, Department of Medicine, Université de Montréal, Canada
| | - Jonathan Tremblay
- School of Kinesiology and Exercise Science, Faculty of Medicine, Université de Montréal, Canada
| | - Mathieu Gayda
- Cardiovascular Prevention and Rehabilitation (EPIC) Center, Montreal Heart Institute and Université de Montréal, Canada
- Research Center, Montreal Heart Institute and Université de Montréal, Canada
- Faculty of Medicine, Department of Medicine, Université de Montréal, Canada
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Trachsel LD, David LP, Gayda M, Henri C, Hayami D, Thorin-Trescases N, Thorin É, Blain MA, Cossette M, Lalongé J, Juneau M, Nigam A. The impact of high-intensity interval training on ventricular remodeling in patients with a recent acute myocardial infarction-A randomized training intervention pilot study. Clin Cardiol 2019; 42:1222-1231. [PMID: 31599994 PMCID: PMC6906981 DOI: 10.1002/clc.23277] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 09/16/2019] [Accepted: 09/19/2019] [Indexed: 12/18/2022] Open
Abstract
Background Aerobic exercise training is associated with beneficial ventricular remodeling and an improvement in cardiac biomarkers in chronic stable heart failure. High‐intensity interval training (HIIT) is a time‐efficient method to improve V˙O2peak in stable coronary heart disease patients. This pilot study aimed to compare the effect of HIIT on ventricular remodeling in patients with a recent acute myocardial infarction (AMI). Methods Nineteen post‐AMI patients were randomized to either HIIT (n = 9) or usual care (n = 10). A cardiopulmonary exercise test (CPET), transthoracic echocardiography, and cardiac biomarker assessment (ie, N‐terminal pro B‐type natriuretic peptide levels and G protein‐coupled receptor kinase 2 expression) were performed before and after a 12‐week training intervention. CPET parameters including oxygen uptake efficiency slope (OUES) and V˙O2 at the first ventilatory threshold (V˙O2 VT1) were calculated. left ventricular (LV) structural and functional echocardiographic parameters including myocardial strain imaging were assessed. Results V˙O2peak and OUES improved solely in the HIIT group (P < .05 for group/time, respectively). There was a significant training effect for the improvement of peak work load in both groups (P < .05). O2 pulse and V˙O2 at VT1 both improved only in the HIIT group (P < .05 for time, no interaction). HIIT improved radial strain and pulsed‐wave tissue Doppler imaging derived e′ (P < .05 for time, no interaction). Cardiac biomarkers did not change in either group. Conclusions In post‐AMI patients, HIIT lead to significant improvements in prognostic CPET parameters compared to usual care. HIIT was associated with favorable ventricular remodeling regarding certain echocardiographic parameters of LV function.
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Affiliation(s)
- Lukas-Daniel Trachsel
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,University Clinic for Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Louis-Philippe David
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Mathieu Gayda
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Research Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Christine Henri
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Research Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Douglas Hayami
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | | | - Éric Thorin
- Research Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.,Department of Surgery, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Mélissa-Anne Blain
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Mariève Cossette
- Montreal Health Innovations Coordinating Center, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Julie Lalongé
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Martin Juneau
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Research Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
| | - Anil Nigam
- Cardiovascular Prevention and Rehabilitation (ÉPIC) Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.,Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Research Center, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada
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Boidin M, Trachsel L, Nigam A, Juneau M, Tremblay J, M Gayda. NON-LINEAR IS NOT SUPERIOR TO LINEAR AEROBIC PERIODIZATION IN CORONARY PATIENTS. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Nigam A, Sharma S, Varun N, Munjal YP, Prakash A. Comparative analysis of 2‐week glycaemic profile of healthy versus mild gestational diabetic pregnant women using flash glucose monitoring system: an observational study. BJOG 2019; 126 Suppl 4:27-33. [DOI: 10.1111/1471-0528.15849] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2019] [Indexed: 12/16/2022]
Affiliation(s)
- A Nigam
- Department of Obstetrics and Gynaecology Hamdard Institute of Medical Sciences and Research New Delhi India
| | - S Sharma
- Department of Obstetrics and Gynaecology Hamdard Institute of Medical Sciences and Research New Delhi India
| | - N Varun
- Department of Obstetrics and Gynaecology Hamdard Institute of Medical Sciences and Research New Delhi India
| | - YP Munjal
- Physician Research Foundation Artemis Hospital Gurugram Gurugram India
| | - A Prakash
- Department of Medicine Lady Hardinge Medical College & Associated SSK Hospital New Delhi India
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Ferland G, Chahine S, Presse N, Dube MP, Nigam A, Blostein M, deDenus S, Perreault S, Tardif JC. Increasing Dietary Vitamin K Intake Stabilizes Anticoagulation Therapy in Warfarin-Treated Patients with a History of Instability: A 24-week Randomized Controlled Trial (OR36-04-19). Curr Dev Nutr 2019. [DOI: 10.1093/cdn/nzz035.or36-04-19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
Warfarin (W) is a highly prescribed anticoagulant for the treatment and prevention of thromboembolic diseases. However, anticoagulation stability is often a challenge due to the narrow therapeutic range of the drug. In recent years, dietary vitamin K (VK) has emerged as an important modulator of long-term anticoagulation stability. In trials, patients receiving small doses of supplemental VK (100–150 mg/d) spend significantly more time in the therapeutic range (%TTR) and present fewer bleeding and thrombotic complications. Whether similar beneficial effects can be achieved through diet remains unknown. We determined whether increasing dietary VK intake by ≥150 µg/day improves anticoagulation stability of W-treated patients with a history of INR instability.
Methods
We conducted a 24-week randomized controlled trial at the Anticoagulation Clinics of the Montreal Heart Institute and the Jewish General Hospital (Montreal). The main inclusion criteria were: 1) be anticoagulated for >6 months with a target international normalized ratio (INR) range of 2.0–3.0 or 2.5–3.5, and 2) present a %TTR <50% in the previous 6 months. Patients randomized to the intervention group (VK) received dietary counsel to increase their VK intake by ≥150 µd/day through specific food choices, recipes and cooking strategies. Patients from the control (C) group received general dietary information of similar intensity. Warfarin therapy was monitored weekly by INR. The primary clinical outcome was anticoagulation stability as defined by %TTR ˃ 70% during weeks 4 through 24. Groups were compared in an intention-to-treat method using the exact Fisher test.
Results
In total, 49 patients aged 32–85 years completed the study. Mean (±SEM) %TTR over the assessment period were 67.7 ± 3.4 and 61.4 ± 3.5 for the VK and C groups, respectively (ns). Increasing dietary VK intakes resulted in a greater proportion of patients with %TTR ˃ 70% over the assessment period. Specifically, 14 of the 28 patients (50%) from the VK group met the criteria versus 4 of the 21 patients (19%) from the C group (P = 0.026).
Conclusions
Increasing VK intake ≥150 µd/day through diet strategies improves anticoagulation stability of W-treated patients with a history of anticoagulation instability.
Funding Sources
This study was funded by the CIHR.
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