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Sample records for fit heart results

  1. Higher Fitness Is Strongly Protective in Patients with Family History of Heart Disease: The FIT Project.

    PubMed

    Al Rifai, Mahmoud; Patel, Jaideep; Hung, Rupert K; Nasir, Khurram; Keteyian, Steven J; Brawner, Clinton A; Ehrman, Jonathan K; Sakr, Sherif; Blumenthal, Roger S; Blaha, Michael J; Al-Mallah, Mouaz H

    2017-03-01

    Cardiorespiratory fitness protects against mortality; however, little is known about the benefits of improved fitness in individuals with a family history of coronary heart disease. We studied the association between cardiorespiratory fitness and risk of incident coronary heart disease and all-cause mortality, hypothesizing an inverse relationship similar to individuals without a family history of coronary heart disease. We included 57,999 patients (aged 53 ± 13 years; 49% were female; 29% were black) from the Henry Ford Exercise Testing (FIT) Project. Cardiorespiratory fitness was expressed in metabolic equivalents of task based on exercise stress testing. Family history was determined as self-reported coronary heart disease in a first-degree relative at any age. We used Cox proportional hazards models adjusted for demographics and cardiovascular disease risk factors to examine the association between cardiorespiratory fitness and risk of incident coronary heart disease and mortality over a median (interquartile range) follow-up of 5.5 (5.6) and 10.4 (6.8) years, respectively. Overall, 51% reported a positive family history. Each 1-unit metabolic equivalent increase was associated with lower incident coronary heart disease and mortality risk regardless of family history status. The hazard ratio and 95% confidence interval for a negative family history and a positive family history were 0.87 (0.84-0.89) and 0.87 (0.85-0.89) for incident coronary heart disease and 0.83 (0.82-0.84) and 0.83 (0.82-0.85) for mortality, respectively. There was no significant interaction between family history and categoric cardiorespiratory fitness, sex, or age (P >.05 for all). Higher cardiorespiratory fitness is strongly protective in all patients regardless of family history status, supporting recommendations for regular exercise in those with a family history. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Estimation of heart rate and heart rate variability from pulse oximeter recordings using localized model fitting.

    PubMed

    Wadehn, Federico; Carnal, David; Loeliger, Hans-Andrea

    2015-08-01

    Heart rate variability is one of the key parameters for assessing the health status of a subject's cardiovascular system. This paper presents a local model fitting algorithm used for finding single heart beats in photoplethysmogram recordings. The local fit of exponentially decaying cosines of frequencies within the physiological range is used to detect the presence of a heart beat. Using 42 subjects from the CapnoBase database, the average heart rate error was 0.16 BPM and the standard deviation of the absolute estimation error was 0.24 BPM.

  3. Cognitive Performance and Heart Rate Variability: The Influence of Fitness Level

    PubMed Central

    Luque-Casado, Antonio; Zabala, Mikel; Morales, Esther; Mateo-March, Manuel; Sanabria, Daniel

    2013-01-01

    In the present study, we investigated the relation between cognitive performance and heart rate variability as a function of fitness level. We measured the effect of three cognitive tasks (the psychomotor vigilance task, a temporal orienting task, and a duration discrimination task) on the heart rate variability of two groups of participants: a high-fit group and a low-fit group. Two major novel findings emerged from this study. First, the lowest values of heart rate variability were found during performance of the duration discrimination task, compared to the other two tasks. Second, the results showed a decrement in heart rate variability as a function of the time on task, although only in the low-fit group. Moreover, the high-fit group showed overall faster reaction times than the low-fit group in the psychomotor vigilance task, while there were not significant differences in performance between the two groups of participants in the other two cognitive tasks. In sum, our results highlighted the influence of cognitive processing on heart rate variability. Importantly, both behavioral and physiological results suggested that the main benefit obtained as a result of fitness level appeared to be associated with processes involving sustained attention. PMID:23437276

  4. Health Activities Project (HAP): Heart Fitness and Action Module.

    ERIC Educational Resources Information Center

    Buller, Dave; And Others

    Contained within this Health Activities Project (HAP) learning packet are activities for children in grades 5-8. Design of the activities centers around the idea that students can control their own health and safety. Within the Heart Fitness and Action Module are teacher and student folios describing five activities which involve students in…

  5. Anatomic fitting of total artificial hearts for in vivo evaluation.

    PubMed

    Gregory, Shaun D; Loechel, Nicole; Pearcy, Mark J; Fraser, John; Parnis, Steven; Cohn, William E; Timms, Daniel

    2013-08-01

    Successful anatomic fitting of a total artificial heart (TAH) is vital to achieve optimal pump hemodynamics after device implantation. Although many anatomic fitting studies have been completed in humans prior to clinical trials, few reports exist that detail the experience in animals for in vivo device evaluation. Optimal hemodynamics are crucial throughout the in vivo phase to direct design iterations and ultimately validate device performance prior to pivotal human trials. In vivo evaluation in a sheep model allows a realistically sized representation of a smaller patient, for which smaller third-generation TAHs have the potential to treat. Our study aimed to assess the anatomic fit of a single device rotary TAH in sheep prior to animal trials and to use the data to develop a three-dimensional, computer-aided design (CAD)-operated anatomic fitting tool for future TAH development. Following excision of the native ventricles above the atrio-ventricular groove, a prototype TAH was inserted within the chest cavity of six sheep (28-40 kg). Adjustable rods representing inlet and outlet conduits were oriented toward the center of each atrial chamber and the great vessels, with conduit lengths and angles recorded for future analysis. A three-dimensional, CAD-operated anatomic fitting tool was then developed, based on the results of this study, and used to determine the inflow and outflow conduit orientation of the TAH. The mean diameters of the sheep left atrium, right atrium, aorta, and pulmonary artery were 39, 33, 12, and 11 mm, respectively. The center-to-center distance and outer-edge-to-outer-edge distance between the atria, found to be 39 ± 9 mm and 72 ± 17 mm in this study, were identified as the most critical geometries for successful TAH connection. This geometric constraint restricts the maximum separation allowable between left and right inlet ports of a TAH to ensure successful alignment within the available atrial circumference. © 2013

  6. Exercise videogames for physical activity and fitness: Design and rationale of the Wii Heart Fitness trial.

    PubMed

    Bock, Beth C; Thind, Herpreet; Dunsiger, Shira I; Serber, Eva R; Ciccolo, Joseph T; Cobb, Victoria; Palmer, Kathy; Abernathy, Sean; Marcus, Bess H

    2015-05-01

    Despite numerous health benefits, less than half of American adults engage in regular physical activity. Exercise videogames (EVG) may be a practical and attractive alternative to traditional forms of exercise. However there is insufficient research to determine whether EVG play alone is sufficient to produce prolonged engagement in physical activity or improvements in cardiovascular fitness and overall health risk. The goal of the present study is to test the efficacy of exercise videogames to increase time spent in moderate to vigorous physical activity (MVPA) and to improve cardiovascular risk indices among adults. Wii Heart Fitness is a rigorous 3-arm randomized controlled trial with adults comparing three 12-week programs: (1) supervised EVGs, (2) supervised standard exercise, and (3) a control condition. Heart rate is monitored continuously throughout all exercise sessions. Assessments are conducted at baseline, end of intervention (week 12), 6 and 9 months. The primary outcome is time spent in MVPA physical activity. Secondary outcomes include changes in cardiovascular fitness, body composition, blood lipid profiles and maintenance of physical activity through six months post-treatment. Changes in cognitive and affective constructs derived from Self Determination and Social Cognitive Theories will be examined to explain the differential outcomes between the two active treatment conditions. The Wii Heart Fitness study is designed to test whether regular participation in EVGs can be an adequate source of physical activity for adults. This study will produce new data on the effect of EVGs on cardiovascular fitness indices and prolonged engagement with physical activity. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Aerobic Fitness, Heart Rate Recovery and Heart Rate Recovery Time in Indian School Children.

    PubMed

    Fernando, Rajesh Jeniton; Ravichandran, K; Vaz, Mario

    2015-01-01

    Data on aerobic fitness and heart rate recovery in children are limited. This study was done to evaluate the relation between them in Indian school going children. Three hundred children of 7 to 10.5 years were recruited and their aerobic fitness was predicted using modified Harvard's step test (VO₂max) and 20 meter shuttle test (VO₂peak). The heart rate was monitored for 12 minutes post modified Harvard's step test. The difference between the maximum and the 1st minute HR was noted as HRR1 and the time taken to reach the resting heart rate was also recorded. VO₂max was inversely correlated with HRR1 (r = -0.64, p<0.001). However, the partial correlation of the two was not significant (r(partial) = -0.037, p = 0.55), indicating children with higher basal HR had higher HRR1 and that accounted for the observed association with aerobic fitness. Cox regression analysis showed that the recovery rate per unit time was 3% greater with increasing VO₂max (HR = 1.03, 95% CI:1.01 to 1.05, p = 0.013). The heart rate parameters did not show any associat with VO₂peak This study demonstrates that there is no relation between VO₂max and HRR1 after 3 minutes of modified Harvard's step test in Indian children of 7 to 10.5 years. However, aerobic fitness is a positive predictor of heart rate recovery time in this group.

  8. Comparison of Traditional and Alternative Fitness Teaching Formats on Heart Rate Intensity and Perceived Enjoyment.

    ERIC Educational Resources Information Center

    Ha, Amy Sau-ching; Heung-Sang Wong, Stephen

    2002-01-01

    Compared a traditional and an alternative (skill-fitness- music) fitness teaching format to determine whether there would be differences on Hong Kong middle school students' heart rate intensity and perceived enjoyment. Data from heart rate monitors and student surveys indicated that the two formats did not produce differences in heart rates.…

  9. A comparison between heart rate and heart rate variability as indicators of cardiac health and fitness.

    PubMed

    Grant, Catharina C; Murray, Carien; Janse van Rensburg, Dina C; Fletcher, Lizelle

    2013-01-01

    Quantification of cardiac autonomic activity and control via heart rate (HR) and heart rate variability (HRV) is known to provide prognostic information in clinical populations. Issues with regard to standardization and interpretation of HRV data make the use of the more easily accessible HR on its own as an indicator of autonomic cardiac control very appealing. The aim of this study was to investigate the strength of associations between an important cardio vascular health metric such as VO2max and the following: HR, HRV indicators, and HR normalized HRV indicators. A cross sectional descriptive study was done including 145 healthy volunteers aged between 18 and 22 years. HRV was quantified by time domain, frequency domain and Poincaré plot analysis. Indirect VO2max was determined using the Multistage Coopers test. The Pearson correlation coefficient was calculated to quantify the strength of the associations. Both simple linear and multiple stepwise regressions were performed to be able to discriminate between the role of the individual indicators as well as their combined association with VO2max. Only HR, RR interval, and pNN50 showed significant (p < 0.01, p < 0.01, and p = 0.03) correlations with VO2max. Stepwise multiple regression indicated that, when combining all HRV indicators the most important predictor of cardio vascular fitness as represented by VO2max, is HR. HR explains 17% of the variation, while the inclusion of HF (high frequency HRV indicator) added only an additional 3.1% to the coefficient of determination. Results also showed when testing the normalized indicators, HR explained of the largest percentage of the changes in VO2max (16.5%). Thus, HR on its own is the most important predictor of changes in an important cardiac health metric such as VO2max. These results may indicate that during investigation of exercise ability (VO2max) phenomena, quantification of HRV may not add significant value.

  10. FIT Kids: Time in target heart zone and cognitive performance.

    PubMed

    Castelli, Darla M; Hillman, Charles H; Hirsch, Jennifer; Hirsch, Alayna; Drollette, Eric

    2011-06-01

    This present study examined time spent in the target heart zone (THZ) and its relationship to tasks requiring variable amounts of executive control function in prepubescent children participating in a 9-month randomized controlled physical activity program. A sample of 59 participants performed the Stroop Color-Word Test and the Comprehensive Trail Making Test cognitive assessments. Heart rate data were collected during participation in the physical activity program using E600 heart rate monitors (Polar, Finland). There was a significant difference, F(1, 58)=7.44, p <.009, between males and females for relative VO2max, but not absolute (p=.69) or percent VO2max (p=.73). Regression analysis identified KBIT, age, and mean time above the THZ as significant predictors of performance in the Stroop Color-Word condition, F(1, 56)=5.21, p=.02. KBIT and mean time above the THZ were significant predictors for Trails B, F(1, 56)=7.60. These results suggest that heart rate, as a measure of physical activity intensity, should be closely monitored during research that is intended to make inferences about its effects on cognitive performance as participation in vigorous activities may have specific benefits over lower intensities among prepubescent children. Copyright © 2011. Published by Elsevier Inc.

  11. Fitness Assessment Results--Some Concepts and Analogies.

    ERIC Educational Resources Information Center

    Whitehead, James R.

    1989-01-01

    The aim of this article is to provide teachers with interesting and intelligible ways of interpreting fitness test results to students. Also shown are ways that fitness testing can be used to diagnose fitness needs, provide a basis for exercise prescription, help monitor progress, and individualize fitness education concepts. (IAH)

  12. Fitness, Heart Disease, and High-Density Lipoproteins: A Look at the Relationships.

    ERIC Educational Resources Information Center

    McCunney, Robert J.

    1987-01-01

    The role of fitness in preventing coronary heart disease is explored. Research on high-density lipoprotein, which has been found to be one of the most critical determinants of risk, is reviewed. The relationship between fitness, high-density lipoprotein, and coronary heart disease is assessed, and clinical implications are spelled out. (MT)

  13. Fitness, Heart Disease, and High-Density Lipoproteins: A Look at the Relationships.

    ERIC Educational Resources Information Center

    McCunney, Robert J.

    1987-01-01

    The role of fitness in preventing coronary heart disease is explored. Research on high-density lipoprotein, which has been found to be one of the most critical determinants of risk, is reviewed. The relationship between fitness, high-density lipoprotein, and coronary heart disease is assessed, and clinical implications are spelled out. (MT)

  14. Heart Rates of High School Physical Education Students during Team Sports, Individual Sports, and Fitness Activities

    ERIC Educational Resources Information Center

    Laurson, Kelly R.; Brown, Dale D.; Cullen, Robert W.; Dennis, Karen K.

    2008-01-01

    This study examined how activity type influenced heart rates and time spent in target heart rate zones of high school students participating in physical education classes. Significantly higher average heart rates existed for fitness (142 plus or minus 24 beats per minute [bpm]) compared to team (118 plus or minus 24 bpm) or individual (114 plus or…

  15. Heart Rates of High School Physical Education Students during Team Sports, Individual Sports, and Fitness Activities

    ERIC Educational Resources Information Center

    Laurson, Kelly R.; Brown, Dale D.; Cullen, Robert W.; Dennis, Karen K.

    2008-01-01

    This study examined how activity type influenced heart rates and time spent in target heart rate zones of high school students participating in physical education classes. Significantly higher average heart rates existed for fitness (142 plus or minus 24 beats per minute [bpm]) compared to team (118 plus or minus 24 bpm) or individual (114 plus or…

  16. Cardiorespiratory fitness and incident heart failure: The Henry Ford ExercIse Testing (FIT) Project.

    PubMed

    Kupsky, Daniel F; Ahmed, Amjad M; Sakr, Sherif; Qureshi, Waqas T; Brawner, Clinton A; Blaha, Michael J; Ehrman, Jonathan K; Keteyian, Steven J; Al-Mallah, Mouaz H

    2017-03-01

    Prior studies have demonstrated cardiorespiratory fitness (CRF) to be a strong marker of cardiovascular health. However, there are limited data investigating the association between CRF and risk of progression to heart failure (HF). The purpose of this study was to determine the relationship between CRF and incident HF. We included 66,329 patients (53.8% men, mean age 55 years) free of HF who underwent exercise treadmill stress testing at Henry Ford Health Systems between 1991 and 2009. Incident HF was determined using International Classification of Diseases, Ninth Revision codes from electronic medical records or administrative claim files. Cox proportional hazards models were performed to determine the association between CRF and incident HF. A total of 4,652 patients developed HF after a median follow-up duration of 6.8 (±3) years. Patients with incident HF were older (63 vs 54 years, P<.001) and had higher prevalence of known coronary artery disease (42.3% vs 11%, P<.001). Peak metabolic equivalents (METs) of task were 6.3 (±2.9) and 9.1 (±3) in the HF and non-HF groups, respectively. After adjustment for potential confounders, patients able to achieve ≥12 METs had an 81% lower risk of incident HF compared with those achieving <6 METs (hazard ratio 0.19 [95% CI 0.14-0.29], P for trend < .001). Each 1 MET achieved was associated with a 16% lower risk (hazard ratio 0.84 [95% CI 0.82-0.86], P<.001) of incident HF. Our analysis demonstrates that higher level of fitness is associated with a lower incidence of HF independent of HF risk factors. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Cardiorespiratory fitness and heart rate recovery in obese premenopausal women.

    PubMed

    Carroll, S; Marshall, P; Ingle, L; Borkoles, E

    2012-12-01

    Post-exercise heart rate recovery (HRR) has been proposed as a measure of cardiac autonomic dysfunction in apparently healthy adults. We aimed to determine the effects of a lifestyle intervention on HRR among clinically obese premenopausal women. A randomized controlled trial was conducted to investigate the effects of a 3-month non-dieting lifestyle intervention program on cardiorespiratory fitness (CRF) and HRR among healthy clinically obese premenopausal women. Thirty-one were randomly assigned to 3-month intensive lifestyle intervention and 31 served as controls. Sixty-one participants performed a maximal treadmill walking test with metabolic gas exchange. Baseline anthropometric measures were closely related to HRR at 1 min, which may indicate reduced parasympathetic reactivation. Post-exercise HRR at 60 s (HRR60) increased from 21.3 ± 6.2 to 27.8 ± 10.2 bpm in the intervention group compared with a smaller reduction (26.8 ± 12.3 to 24.5 ± 9.9 bpm) in controls (test for interaction P = 0.0001). HRR120 showed a significant effect of time (P = 0.0002) with no significant interaction with lifestyle intervention. A significant increase in VO2 peak was evident in the lifestyle group (21.6 to 23.6 mL/kg/min) compared with a modest reduction in the controls (22.6 to 21.6 mL/kg/min; test for interaction, P = 0.001). Clinically obese healthy premenopausal women achieved significant improvements in HRR60 and VO peak following a 3-month intensive lifestyle intervention. © 2012 John Wiley & Sons A/S.

  18. Midlife exercise blood pressure, heart rate, and fitness relate to brain volume 2 decades later

    PubMed Central

    Himali, Jayandra J.; Beiser, Alexa S.; Lewis, Gregory D.; DeCarli, Charles; Vasan, Ramachandran S.; Seshadri, Sudha

    2016-01-01

    Objective: To determine whether poor cardiovascular (CV) fitness and exaggerated exercise blood pressure (BP) and heart rate (HR) were associated with worse brain morphology in later life. Methods: Framingham Offspring participants (n = 1,094, 53.9% female) free from dementia and CV disease (CVD) underwent an exercise treadmill test at a mean age of 40 ± 9 years. A second treadmill test and MRI scans of the brain were administered 2 decades later at mean age of 58 ± 8 years. Results: Poor CV fitness and greater diastolic BP and HR response to exercise at baseline were associated with a smaller total cerebral brain volume (TCBV) almost 2 decades later (all p < 0.05) in multivariable adjusted models; the effect of 1 SD lower fitness was equivalent to approximately 1 additional year of brain aging in individuals free of CVD. In participants with prehypertension or hypertension at baseline, exercise systolic BP was also associated with smaller TCBV (p < 0.05). Conclusion: Our results suggest that lower CV fitness and exaggerated exercise BP and HR responses in middle-aged adults are associated with smaller brain volume nearly 2 decades later. Promotion of midlife CV fitness may be an important step towards ensuring healthy brain aging. PMID:26865519

  19. Jump Start the Heart: Teaching Children Cardiovascular Fitness

    ERIC Educational Resources Information Center

    McCollum, Starla; Maina, Michael P.; Maina, Julie Schlegel; Griffin, Mike

    2004-01-01

    Quality physical education classes are an important avenue for teaching children about lifetime fitness participation. Specific fitness information and habits can be taught as part of physical education classes. Physical education, however, should not be the only source of physical activity for children. Children need opportunities to participate…

  20. Midlife exercise blood pressure, heart rate, and fitness relate to brain volume 2 decades later.

    PubMed

    Spartano, Nicole L; Himali, Jayandra J; Beiser, Alexa S; Lewis, Gregory D; DeCarli, Charles; Vasan, Ramachandran S; Seshadri, Sudha

    2016-04-05

    To determine whether poor cardiovascular (CV) fitness and exaggerated exercise blood pressure (BP) and heart rate (HR) were associated with worse brain morphology in later life. Framingham Offspring participants (n = 1,094, 53.9% female) free from dementia and CV disease (CVD) underwent an exercise treadmill test at a mean age of 40 ± 9 years. A second treadmill test and MRI scans of the brain were administered 2 decades later at mean age of 58 ± 8 years. Poor CV fitness and greater diastolic BP and HR response to exercise at baseline were associated with a smaller total cerebral brain volume (TCBV) almost 2 decades later (all p < 0.05) in multivariable adjusted models; the effect of 1 SD lower fitness was equivalent to approximately 1 additional year of brain aging in individuals free of CVD. In participants with prehypertension or hypertension at baseline, exercise systolic BP was also associated with smaller TCBV (p < 0.05). Our results suggest that lower CV fitness and exaggerated exercise BP and HR responses in middle-aged adults are associated with smaller brain volume nearly 2 decades later. Promotion of midlife CV fitness may be an important step towards ensuring healthy brain aging. © 2016 American Academy of Neurology.

  1. [Hungarian Heart Failure Registry 2015-2016. Preliminary results].

    PubMed

    Nyolczas, Noémi; Heltai, Krisztina; Borbély, Attila; Habon, Tamás; Járai, Zoltán; Sziliczei, Erzsébet; Stadler, Péter; Faludi, Réka; Herczeg, Béla; Papp, Előd; Lakatos, Ferenc; Nagy, Katalin; Katona, András; Kovács, Imre; Tomcsányi, János; Nagy, András; Sepp, Róbert

    2017-01-01

    Heart failure is associated with a poor prognosis despite significant advances in the pharmacological and device therapy and incurs very high cost because of frequent hospitalizations. Therefore, professional high-quality care is essential for both patients and the healthcare system. The best way to evaluate the quality of care for a particular disease is the use of disease-specific registries. Until now, there has not been a registry evaluating characteristics and management of heart failure patients in Hungary. For that reason, the Hungarian Society of Cardiology initiated the set-up of the Hungarian Heart Failure Registry. The Aim of this paper is to present the goals, methods and first year results of the Hungarian Heart Failure Registry. The goal of the Registry is to create a modern, web-based database that summarizes the data of large number of patients who are currently or were previously admitted to hospital or who are currently or were previously patients in an outpatient department due to severe heart failure (NYHA III-IV). Currently 17 cardiology departments participate in the development of the Registry. The planned number of patients is 2000. Initially follow-up was planned for one year (pilot study). After the evaluation of the relevant experiences of the pilot study, long-term follow-up is planned. The Registry collects information about the type of heart failure (heart failure with reduced - LVEF≤45% - vs. preserved - LVEF>45% - ejection fraction), etiology, co-morbidities, diagnostic methods, treatment as well as morbidity and mortality. After the first year, assessing the baseline parameters of 698 patients enrolled in the Registry we found that the majority of patients (87.8%) has heart failure with reduced ejection fraction and in 39.8% of the patients heart failure has an ischaemic origin. The most frequent co-morbidity was hypertension followed by diabetes, renal insufficiency and COPD. The patients were treated with ACE inhibitors or ARBs

  2. Heart Rate and Cardiovascular Responses to Commercial Flights: Relationships with Physical Fitness

    PubMed Central

    Oliveira-Silva, Iransé; Leicht, Anthony S.; Moraes, Milton R.; Simões, Herbert G.; Del Rosso, Sebastián; Córdova, Cláudio; Boullosa, Daniel A.

    2016-01-01

    The aim of this study was to examine the influence of physical fitness on cardiac autonomic control in passengers prior to, during and following commercial flights. Twenty-two, physically active men (36.4 ± 6.4 years) undertook assessments of physical fitness followed by recordings of 24-h heart rate (HR), heart rate variability (HRV), and blood pressure (BP) on a Control (no flight) and Experimental (flight) day. Recordings were analyzed using a two-way analysis of variance for repeated measures with relationships between variables examined via Pearson product-moment correlation coefficients. Compared to the Control day, 24-h HR was significantly greater (>7%) and HRV measures (5–39%) significantly lower on the Experimental day. During the 1-h flight, HR (24%), and BP (6%) were increased while measures of HRV (26–45%) were reduced. Absolute values of HRV during the Experimental day and relative changes in HRV measures (Control-Experimental) were significantly correlated with measures of aerobic fitness (r = 0.43 to 0.51; −0.53 to −0.52) and body composition (r = −0.63 to −0.43; 0.48–0.61). The current results demonstrated that short-term commercial flying significantly altered cardiovascular function including the reduction of parasympathetic modulations. Further, greater physical fitness and lower body fat composition were associated with greater cardiac autonomic control for passengers during flights. Enhanced physical fitness and leaner body composition may enable passengers to cope better with the cardiovascular stress and high allostatic load associated with air travel for enhanced passenger well-being. PMID:28082914

  3. Heart Rate and Cardiovascular Responses to Commercial Flights: Relationships with Physical Fitness.

    PubMed

    Oliveira-Silva, Iransé; Leicht, Anthony S; Moraes, Milton R; Simões, Herbert G; Del Rosso, Sebastián; Córdova, Cláudio; Boullosa, Daniel A

    2016-01-01

    The aim of this study was to examine the influence of physical fitness on cardiac autonomic control in passengers prior to, during and following commercial flights. Twenty-two, physically active men (36.4 ± 6.4 years) undertook assessments of physical fitness followed by recordings of 24-h heart rate (HR), heart rate variability (HRV), and blood pressure (BP) on a Control (no flight) and Experimental (flight) day. Recordings were analyzed using a two-way analysis of variance for repeated measures with relationships between variables examined via Pearson product-moment correlation coefficients. Compared to the Control day, 24-h HR was significantly greater (>7%) and HRV measures (5-39%) significantly lower on the Experimental day. During the 1-h flight, HR (24%), and BP (6%) were increased while measures of HRV (26-45%) were reduced. Absolute values of HRV during the Experimental day and relative changes in HRV measures (Control-Experimental) were significantly correlated with measures of aerobic fitness (r = 0.43 to 0.51; -0.53 to -0.52) and body composition (r = -0.63 to -0.43; 0.48-0.61). The current results demonstrated that short-term commercial flying significantly altered cardiovascular function including the reduction of parasympathetic modulations. Further, greater physical fitness and lower body fat composition were associated with greater cardiac autonomic control for passengers during flights. Enhanced physical fitness and leaner body composition may enable passengers to cope better with the cardiovascular stress and high allostatic load associated with air travel for enhanced passenger well-being.

  4. Reduced Physical Fitness in Patients With Heart Failure as a Possible Risk Factor for Impaired Driving Performance

    PubMed Central

    Alosco, Michael L.; Penn, Marc S.; Spitznagel, Mary Beth; Cleveland, Mary Jo; Ott, Brian R.

    2015-01-01

    OBJECTIVE. Reduced physical fitness secondary to heart failure (HF) may contribute to poor driving; reduced physical fitness is a known correlate of cognitive impairment and has been associated with decreased independence in driving. No study has examined the associations among physical fitness, cognition, and driving performance in people with HF. METHOD. Eighteen people with HF completed a physical fitness assessment, a cognitive test battery, and a validated driving simulator scenario. RESULTS. Partial correlations showed that poorer physical fitness was correlated with more collisions and stop signs missed and lower scores on a composite score of attention, executive function, and psychomotor speed. Cognitive dysfunction predicted reduced driving simulation performance. CONCLUSION. Reduced physical fitness in participants with HF was associated with worse simulated driving, possibly because of cognitive dysfunction. Larger studies using on-road testing are needed to confirm our findings and identify clinical interventions to maximize safe driving. PMID:26122681

  5. Association of Cardiorespiratory Fitness With Coronary Heart Disease in Asymptomatic Men

    PubMed Central

    Gander, Jennifer C.; Sui, Xuemei; Hébert, James R.; Hazlett, Linda J.; Cai, Bo; Lavie, Carl J.; Blair, Steven N.

    2016-01-01

    Objective To examine the association of cardiorespiratory fitness (CRF) with risk of coronary heart disease (CHD) while controlling for an individual’s Framingham Risk Score (FRS)–predicted CHD risk. Patients and Methods The study included 29,854 men from the Aerobics Center Longitudinal Study, who received a baseline examination from January 1, 1979, to December 31, 2002. Coronary heart disease events included self-reported myocardial infarction or revascularization or CHD death. Multivariable survival analysis investigated the association between CRF, FRS, and CHD. Cardiorespiratory fitness was analyzed as both a continuous and a categorical variable. The population was stratified by “low” and “moderate or high” risk of CHD to test for differences in the FRS stratified by CRF. Results Compared with men without incident CHD, men with incident CHD were older (mean age, 51.6 years vs 44.6 years), had lower average maximally achieved fitness (10.9 metabolic equivalent of tasks vs 12.0 metabolic equivalent of tasks [METs]), and were more likely to have moderate or high 10-year CHD risk (P<.001). Cardiorespiratory fitness, defined as maximal METs, exhibited a 20% lower risk of CHD (hazard ratio, 0.80; 95% CI, 0.77–0.83) for each 1-unit MET increase. Among men in the low CRF strata, individuals with moderate or high 10-year CHD risk, according to the FRS, had a higher CHD risk (hazard ratio, 6.55; 95% CI, 3.64–11.82) than men with low CHD risk according to the FRS. Conclusion Clinicians should promote physical activity to improve CRF so as to reduce CHD risk, even to patients with otherwise low CHD risk. PMID:26434963

  6. Understanding the Heart's Electrical System and EKG Results

    MedlinePlus

    ... the NHLBI on Twitter. Understanding the Heart's Electrical System and EKG Results Doctors use a test called ... The animation below shows how your heart's electrical system works and how an EKG records your heart's ...

  7. Fitness, fatness, and estimated coronary heart disease risk: the HERITAGE Family Study.

    PubMed

    Katzmarzyk, P T; Gagnon, J; Leon, A S; Skinner, J S; Wilmore, J H; Rao, D C; Bouchard, C

    2001-04-01

    To determine the contributions of fatness and fitness to the estimated risk of future coronary heart disease (CHD). The sample consisted of 212 black and 411 white adult sedentary participants. Percent body fat (%BF) was measured using densitometry, whereas maximal oxygen uptake (VO(2max)) was measured on a cycle ergometer. Risk of future CHD was estimated using the revised Framingham Heart Study algorithm. For fatness, the odds ratios for risk of future CHD were 1.83 and 1.70 for the moderate and high tertiles, respectively, compared with the low tertile. Similarly, the odds ratios for VO(2max) were 1.29 (NS) and 1.62, for the moderate and low tertiles, respectively. Removing VO(2max) from the full model had no effect; however, removing %BF resulted in a significantly weaker model (chi(2) = 10.38, P < 0.01). Both fatness and fitness are important predictors of risk of future CHD, based on the Framingham index.

  8. Effects of aerobic exercise on the resting heart rate, physical fitness, and arterial stiffness of female patients with metabolic syndrome

    PubMed Central

    Kang, Seol-Jung; Kim,, Eon-ho; Ko, Kwang-Jun

    2016-01-01

    [Purpose] The purpose of this study was to investigate the effects of aerobic exercise on the resting heart rate, physical fitness, and arterial stiffness or female patients with metabolic syndrome. [Subjects and Methods] Subjects were randomly assigned to an exercise group (n=12) or a control group (n=11). Subjects in the exercise group performed aerobic exercise at 60–80% of maximum heart rate for 40 min 5 times a week for 12 weeks. The changes in metabolic syndrome risk factors, resting heart rate, physical fitness, and arterial stiffness were measured and analyzed before and after initiation of the exercise program to determine the effect of exercise. Arterial stiffness was assessed based on brachial-ankle pulse wave velocity (ba-PWV). [Results] Compared to the control group; The metabolic syndrome risk factors (weight, % body fat, waist circumference, systolic blood pressure, diastolic blood pressure, and HDL-Cholesterol) were significantly improved in the exercise: resting heart rate was significantly decreased; VO2max, muscle strength and muscle endurance were significantly increased; and ba-PWV was significantly decreased. [Conclusion] Aerobic exercise had beneficial effects on the resting heart rate, physical fitness, and arterial stiffness of patients with metabolic syndrome. PMID:27390411

  9. Effects of aerobic exercise on the resting heart rate, physical fitness, and arterial stiffness of female patients with metabolic syndrome.

    PubMed

    Kang, Seol-Jung; Kim, Eon-Ho; Ko, Kwang-Jun

    2016-06-01

    [Purpose] The purpose of this study was to investigate the effects of aerobic exercise on the resting heart rate, physical fitness, and arterial stiffness or female patients with metabolic syndrome. [Subjects and Methods] Subjects were randomly assigned to an exercise group (n=12) or a control group (n=11). Subjects in the exercise group performed aerobic exercise at 60-80% of maximum heart rate for 40 min 5 times a week for 12 weeks. The changes in metabolic syndrome risk factors, resting heart rate, physical fitness, and arterial stiffness were measured and analyzed before and after initiation of the exercise program to determine the effect of exercise. Arterial stiffness was assessed based on brachial-ankle pulse wave velocity (ba-PWV). [Results] Compared to the control group; The metabolic syndrome risk factors (weight, % body fat, waist circumference, systolic blood pressure, diastolic blood pressure, and HDL-Cholesterol) were significantly improved in the exercise: resting heart rate was significantly decreased; VO2max, muscle strength and muscle endurance were significantly increased; and ba-PWV was significantly decreased. [Conclusion] Aerobic exercise had beneficial effects on the resting heart rate, physical fitness, and arterial stiffness of patients with metabolic syndrome.

  10. Ventricular Fibrillation in Mammalian Hearts: Experimental Results

    NASA Astrophysics Data System (ADS)

    Gray, Richard A.

    2002-03-01

    Ventricular fibrillation (VF) is sustained by the continuous “breakup” of rapidly rotating spiral waves. The rate dependence of action potential duration (APD), i.e. APD restitution, plays a role in the induction and breakup of spiral waves. However, the role of conduction velocity (CV) and spatial heterogeneities, in VF induction and maintenance is not clear. We studied restitution, its spatial dispersion, and VF in small (rabbit) and large (pig) hearts using a video imaging system. We studied the effect of two drugs, diacetyl monoxime (DAM) and cytochalasinD (Cyto), in rabbit hearts. Control APDs were shorter than for Cyto but longer than for DAM. CV was greater for Cyto compared to DAM and APD dispersion increased with increasing rate for both drugs. VF was sustained in control, non-sustained with CytoD, and converted to a stable reentry (VT) with DAM. The slight increase of APD with Cyto increased the wavelength and probably prevented VF from being sustained. The DAM results can be explained by the reduction of wavelength and slope of the APD restitution curve. Except for VF, CytoD results were similar to controls. We performed similar studies in larger (pig) hearts with Cyto. APD and restitution slope at rapid rates were smaller for the pig compared to the rabbit. In the pig, APDs recorded during pacing induction protocols, VF and VT demonstrated that during periods of transition, APDs did not fall on the restitution curve. However, the deviations were predictable. During rapid pacing and VT/VF induction, APDs were longer than predicted from the restitution curve, while they were shorter for the conversions of VF to VT and their terminations. Overall, these studies are beginning to elucidate the dynamics and factors involved in the complex spatio-temporal patterns and their transitions that occur at rapid rates such as VT and VF.

  11. Cortisol, blood pressure, and heart rate responses to food intake were independent of physical fitness levels in women.

    PubMed

    Jayasinghe, Sisitha U; Torres, Susan J; Fraser, Steve F; Turner, Anne I

    2015-11-01

    This research tested the hypothesis that women who had higher levels of physical fitness will have lower hypothalamo-pituitary-adrenal axis (cortisol) and sympatho-adrenal medullary system (blood pressure and heart rate) responses to food intake compared with women who had low levels of physical fitness. Lower fitness (n = 22; maximal oxygen consumption = 27.4 ± 1.0 mL∙kg(-1)·min(-1)) and higher fitness (n = 22; maximal oxygen consumption = 41.9 ± 1.6 mL∙kg(-1)·min(-1)) women (aged 30-50 years; in the follicular phase of the menstrual cycle) who participated in levels of physical activity that met (lower fitness = 2.7 ± 0.5 h/week) or considerably exceeded (higher fitness = 7.1 ± 1.4 h/week) physical activity guidelines made their own lunch using standardised ingredients at 1200 h. Concentrations of cortisol were measured in blood samples collected every 15 min from 1145-1400 h. Blood pressures and heart rate were also measured every 15 min between 1145 h and 1400 h. The meal consumed by the participants consisted of 20% protein, 61% carbohydrates, and 19% fat. There was a significant overall response to lunch in all of the parameters measured (time effect for all, p < 0.01). The cortisol response to lunch was not significantly different between the groups (time × treatment, p = 0.882). Overall, both groups showed the same pattern of cortisol secretion (treatment p = 0.839). Systolic blood pressure, diastolic blood pressure, mean arterial pressure, or heart rate responses (time × treatment, p = 0.726, 0.898, 0.713, and 0.620, respectively) were also similar between higher and lower fitness women. Results suggest that the physiological response to food intake in women is quite resistant to modification by elevated physical fitness levels.

  12. Relation between cardiorespiratory fitness and selected risk factors for coronary heart disease in a population of Canadian men and women.

    PubMed Central

    Jetté, M; Sidney, K; Quenneville, J; Landry, F

    1992-01-01

    OBJECTIVE: To determine the relation between cardiorespiratory fitness, as determined with the Canadian Aerobic Fitness Test (CAFT), and selected risk factors for coronary heart disease (CHD) in a Canadian population. DESIGN: Cross-sectional study. On the basis of age-specific and sex-specific national percentile scores, subjects were classified as being in the low-fitness, moderate-fitness or high-fitness category according to maximum oxygen consumption (VO2 max) predicted from performance on the CAFT. PARTICIPANTS: A total of 4082 male and 1205 female Canadian federal public servants aged 30 to 59 years who participated in a voluntary fitness testing program between 1984 and 1991. OUTCOME MEASURES: Body composition (body mass index, triceps skinfold thickness, sum of four skinfold measurements, predicted percentage of body fat and waist-hip ratio), blood lipid levels (total cholesterol, triglycerides, high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol and ratio of total cholesterol to HDL-C) and hemodynamic measurements (heart rate and blood pressure at rest and during exercise and predicted VO2 max). MAIN RESULTS: For both men and women the mean anthropometric measurements, blood lipid levels and blood pressure measurements at rest and after exercise were significantly associated with fitness category (p less than 0.05). CONCLUSIONS: In both men and women a higher level of aerobic fitness, as defined by VO2 max predicted from performance on the CAFT, is associated with a more favourable CHD risk profile. The results support the use of VO2 max predicted from performance on the CAFT as a valid procedure for classifying people according to fitness level. PMID:1555164

  13. Initial Results from Fitting Resolved Modes using HMI Intensity Observations

    NASA Astrophysics Data System (ADS)

    Korzennik, Sylvain G.

    2017-08-01

    The HMI project recently started processing the continuum intensity images following global helioseismology procedures similar to those used to process the velocity images. The spatial decomposition of these images has produced time series of spherical harmonic coefficients for degrees up to l=300, using a different apodization than the one used for velocity observations. The first 360 days of observations were processed and made available. I present initial results from fitting these time series using my state of the art fitting methodology and compare the derived mode characteristics to those estimated using co-eval velocity observations.

  14. Can a first-order exponential decay model fit heart rate recovery after resistance exercise?

    PubMed

    Bartels-Ferreira, Rhenan; de Sousa, Élder D; Trevizani, Gabriela A; Silva, Lilian P; Nakamura, Fábio Y; Forjaz, Cláudia L M; Lima, Jorge Roberto P; Peçanha, Tiago

    2015-03-01

    The time-constant of postexercise heart rate recovery (HRRτ ) obtained by fitting heart rate decay curve by a first-order exponential fitting has being used to assess cardiac autonomic recovery after endurance exercise. The feasibility of this model was not tested after resistance exercise (RE). The aim of this study was to test the goodness of fit of the first-order exponential decay model to fit heart rate recovery (HRR) after RE. Ten healthy subjects participated in the study. The experimental sessions occurred in two separated days and consisted of performance of 1 set of 10 repetitions at 50% or 80% of the load achieved on the one-repetition maximum test [low-intensity (LI) and high-intensity (HI) sessions, respectively]. Heart rate (HR) was continuously registered before and during exercise and also for 10 min of recovery. A monoexponential equation was used to fit the HRR curve during the postexercise period using different time windows (i.e. 30, 60, 90, … 600 s). For each time window, (i) HRRτ was calculated and (ii) variation of HR explained by the model (R(2) goodness of fit index) was assessed. The HRRτ showed stabilization from 360 and 420 s on LI and HI, respectively. Acceptable R(2) values were observed from the 360 s on LI (R(2) > 0.65) and at all tested time windows on HI (R(2) > 0.75). In conclusion, this study showed that using a minimum length of monitoring (~420 s) HRR after RE can be adequately modelled by a first-order exponential fitting. © 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  15. Fitness, chance, and myths: an objective view on soccer results

    NASA Astrophysics Data System (ADS)

    Heuer, A.; Rubner, O.

    2009-02-01

    We analyze the time series of soccer matches in a model-free way using data for the German soccer league (Bundesliga). We argue that the goal difference is a better measure for the overall fitness of a team than the number of points. It is shown that the time evolution of the table during a season can be interpreted as a random walk with an underlying constant drift. Variations of the overall fitness mainly occur during the summer break but not during a season. The fitness correlation shows a long-time decay on the scale of a quarter century. Some typical soccer myths are analyzed in detail. It is shown that losing but no winning streaks exist. For this analysis ideas from multidimensional NMR experiments have been borrowed. Furthermore, beyond the general home advantage there is no statistically relevant indication of a team-specific home fitness. Based on these insights a framework for a statistical characterization of the results of a soccer league is introduced and some general consequences for the prediction of soccer results are formulated.

  16. Exercise-induced improvements in cardiorespiratory fitness and heart rate response to exercise are impaired in overweight/obese postmenopausal women

    PubMed Central

    Ciolac, Emmanuel Gomes; Greve, Júlia Maria D'Andréa

    2011-01-01

    OBJECTIVE: The purpose of this study was to compare the heart rate response to exercise and the exercise-induced improvements in muscle strength, cardiorespiratory fitness and heart rate response between normal-weight and overweight/obese postmenopausal women. METHODS: Sedentary women (n = 155) were divided into normal-weight (n = 79; BMI <25 kg/m2; 58.3±8.6 years) and overweight/obese (n = 76; BMI ≥25 kg/m2; 58.3±8.6 years) groups, and have their 1-repetition maximum strength (adjusted for body mass), cardiorespiratory fitness and heart rate response to a graded exercise test compared before and after 12 months of a three times-per-week exercise-training program. RESULTS: Overweight/obese women displayed decreased upper and lower extremity muscle strengths, decreased cardiorespiratory fitness, and lower peak and reserve heart rates compared to normal-weight women. After follow-up, both groups improved their upper (32.9% and 41.5% in normal-weight and overweight/obese women, respectively) and lower extremity(49.5% and 47.8% in normal-weight and overweight/obese women, respectively) muscle strength. However, only normal-weight women improved their cardiorespiratory fitness (6.6%) and recovery heart rate (5 bpm). Resting, reserve and peak heart rates did not change in either group. CONCLUSIONS: Overweight/obese women displayed impaired heart rate response to exercise. Both groups improved muscle strength, but only normal-weight women improved cardiorespiratory fitness and heart rate response to exercise. These results suggest that exercise-induced improvements in cardiorespiratory fitness and heart rate response to exercise may be impaired in overweight/obese postmenopausal women. PMID:21655751

  17. Ventricular Fibrillation in Mammalian Hearts: Simulation Results

    NASA Astrophysics Data System (ADS)

    Fenton, Flavio H.

    2002-03-01

    The computational approach to understanding the initiation and evolution of cardiac arrhythmias forms a necessary link between experiment and theory. Numerical simulations combine useful mathematical models and complex geometry while offering clean and comprehensive data acquisition, reproducible results that can be compared to experiments, and the flexibility of exploring parameter space systematically. However, because cardiac dynamics occurs on many scales (on the order of 10^9 cells of size 10-100 microns with more than 40 ionic currents and time scales as fast as 0.01ms), roughly 10^17 operations are required to simulate just one second of real time. These intense computational requirements lead to significant implementation challenges even on existing supercomputers. Nevertheless, progress over the last decade in understanding the effects of some spatial scales and spatio-temporal dynamics on cardiac cell and tissue behavior justifies the use of certain simplifications which, along with improved models for cellular dynamics and detailed digital models of cardiac anatomy, are allowing simulation studies of full-size ventricles and atria. We describe this simulation problem from a combined numerical, physical and biological point of view, with an emphasis on the dynamics and stability of scroll waves of electrical activity in mammalian hearts and their relation to tachycardia, fibrillation and sudden death. Detailed simulations of electrical activity in ventricles including complex anatomy, anisotropic fiber structure, and electrophysiological effects of two drugs (DAM and CytoD) are presented and compared with experimental results.

  18. Short-Term Heart Rate Recovery is Related to Aerobic Fitness in Elite Intermittent Sport Athletes.

    PubMed

    Watson, Andrew M; Brickson, Stacey L; Prawda, Evan R; Sanfilippo, Jenifer L

    2017-04-01

    Watson, AM, Brickson, SL, Prawda, ER, and Sanfilippo, JL. Short-term heart rate recovery is related to aerobic fitness in elite intermittent sport athletes. J Strength Cond Res 31(4): 1055-1061, 2017-Although heart rate recovery (HRR) has been suggested as a measure of fitness, minimal data exist among athletes. The purpose of this study was to determine if HRR is related to aerobic fitness in elite athletes and whether this relationship is influenced by sex or body composition. Eighty-four collegiate athletes (45 male athletes) underwent body fat percentage (BF%) determination by dual-energy x-ray absorptiometry and maximal treadmill testing followed by 5 minutes of recovery. V[Combining Dot Above]O2max and heart rate (HRmax) were determined, and HRR was calculated as a percentage of HRmax at 10 seconds, 30 seconds, and 1, 2, 3, 4, and 5 minutes after test completion. After stratifying by sex, participants were grouped as high fit or low fit based on V[Combining Dot Above]O2max median split. Heart rate recovery was compared between sexes and fitness level at each time point. Multivariable regression analysis was used to identify independent predictors of HRR using V[Combining Dot Above]O2max, BF%, and sex as covariates. Heart rate recovery did not differ significantly between sexes and was faster among high-fit participants at 10 and 30 seconds, but at no other time. V[Combining Dot Above]O2max was significantly correlated with HRR at 10 and 30 seconds (r = -0.34, p < 0.001 and r = -0.28, p = 0.008) only. After controlling for BF% and sex, V[Combining Dot Above]O2max remained significantly associated with HRR at 10 seconds (p = 0.007) but not at 30 seconds (p = 0.067) or any time thereafter. Aerobic capacity is related to faster HRR during the first 30 seconds only, suggesting that only very short term HRR should be used as a measure of aerobic fitness in intermittent sport athletes.

  19. Heart-Healthy Families. Helping Your Kids Stay Fit Could Prevent Heart Disease in Their Futures.

    ERIC Educational Resources Information Center

    Vagnini, Frederic J.; Malone, Mary Jo

    1994-01-01

    The conditions and habits that lead to heart disease begin early in life. Obesity is the predecessor of a host of cardiovascular-related diseases; childhood obesity poses serious physical and psychological roadblocks for youngsters as they mature. The article suggests how families can adopt fitter lifestyles and instill good eating and exercise…

  20. Heart-Healthy Families. Helping Your Kids Stay Fit Could Prevent Heart Disease in Their Futures.

    ERIC Educational Resources Information Center

    Vagnini, Frederic J.; Malone, Mary Jo

    1994-01-01

    The conditions and habits that lead to heart disease begin early in life. Obesity is the predecessor of a host of cardiovascular-related diseases; childhood obesity poses serious physical and psychological roadblocks for youngsters as they mature. The article suggests how families can adopt fitter lifestyles and instill good eating and exercise…

  1. Differential baroreflex control of heart rate in sedentary and aerobically fit individuals

    NASA Technical Reports Server (NTRS)

    Smith, S. A.; Querry, R. G.; Fadel, P. J.; Welch-O'Connor, R. M.; Olivencia-Yurvati, A.; Shi, X.; Raven, P. B.

    2000-01-01

    PURPOSE: We compared arterial, aortic, and carotid-cardiac baroreflex sensitivity in eight average fit (maximal oxygen uptake, VO2max = 42.2+/-1.9 mL x kg(-1) x min(-1)) and eight high fit (VO2max = 61.9+/-2.2 mL x kg(-1) x min(-1)) healthy young adults. METHODS: Arterial and aortic (ABR) baroreflex functions were assessed utilizing hypo- and hyper-tensive challenges induced by graded bolus injections of sodium nitroprusside (SN) and phenylephrine (PE), respectively. Carotid baroreflex (CBR) sensitivity was determined using ramped 5-s pulses of both pressure and suction delivered to the carotid sinus via a neck chamber collar, independent of drug administration. RESULTS: During vasoactive drug injection, mean arterial pressure (MAP) was similarly altered in average fit (AF) and high fit (HF) groups. However, the heart rate (HR) response range of the arterial baroreflex was significantly attenuated (P < 0.05) in HF (31+/-4 beats x min(-1)) compared with AF individuals (46+/-4 beats x min(-1)). When sustained neck suction and pressure were applied to counteract altered carotid sinus pressure during SN and PE administration, isolating the ABR response, the response range remained diminished (P < 0.05) in the HF population (24+/-3 beats x min(-1)) compared with the AF group (41+/-4 beats x min(-1)). During CBR perturbation, the HF (14+/-1 beats-min(-1)) and AF (16+/-1 beats-min(-1)) response ranges were similar. The arterial baroreflex response range was significantly less than the simple sum of the CBR and ABR (HF, 38+/-3 beats x min(-1) and AF, 57+/-4 beats x min(-1)) in both fitness groups. CONCLUSIONS: These data confirm that reductions in arterial-cardiac reflex sensitivity are mediated by diminished ABR function. More importantly, these data suggest that the integrative relationship between the ABR and CBR contributing to arterial baroreflex control of HR is inhibitory in nature and not altered by exercise training.

  2. Differential baroreflex control of heart rate in sedentary and aerobically fit individuals

    NASA Technical Reports Server (NTRS)

    Smith, S. A.; Querry, R. G.; Fadel, P. J.; Welch-O'Connor, R. M.; Olivencia-Yurvati, A.; Shi, X.; Raven, P. B.

    2000-01-01

    PURPOSE: We compared arterial, aortic, and carotid-cardiac baroreflex sensitivity in eight average fit (maximal oxygen uptake, VO2max = 42.2+/-1.9 mL x kg(-1) x min(-1)) and eight high fit (VO2max = 61.9+/-2.2 mL x kg(-1) x min(-1)) healthy young adults. METHODS: Arterial and aortic (ABR) baroreflex functions were assessed utilizing hypo- and hyper-tensive challenges induced by graded bolus injections of sodium nitroprusside (SN) and phenylephrine (PE), respectively. Carotid baroreflex (CBR) sensitivity was determined using ramped 5-s pulses of both pressure and suction delivered to the carotid sinus via a neck chamber collar, independent of drug administration. RESULTS: During vasoactive drug injection, mean arterial pressure (MAP) was similarly altered in average fit (AF) and high fit (HF) groups. However, the heart rate (HR) response range of the arterial baroreflex was significantly attenuated (P < 0.05) in HF (31+/-4 beats x min(-1)) compared with AF individuals (46+/-4 beats x min(-1)). When sustained neck suction and pressure were applied to counteract altered carotid sinus pressure during SN and PE administration, isolating the ABR response, the response range remained diminished (P < 0.05) in the HF population (24+/-3 beats x min(-1)) compared with the AF group (41+/-4 beats x min(-1)). During CBR perturbation, the HF (14+/-1 beats-min(-1)) and AF (16+/-1 beats-min(-1)) response ranges were similar. The arterial baroreflex response range was significantly less than the simple sum of the CBR and ABR (HF, 38+/-3 beats x min(-1) and AF, 57+/-4 beats x min(-1)) in both fitness groups. CONCLUSIONS: These data confirm that reductions in arterial-cardiac reflex sensitivity are mediated by diminished ABR function. More importantly, these data suggest that the integrative relationship between the ABR and CBR contributing to arterial baroreflex control of HR is inhibitory in nature and not altered by exercise training.

  3. Exercise-induced improvements in cardiorespiratory fitness and heart rate response to exercise are impaired in overweight/obese postmenopausal women.

    PubMed

    Ciolac, Emmanuel Gomes; Greve, Júlia Maria D'Andréa

    2011-01-01

    The purpose of this study was to compare the heart rate response to exercise and the exercise-induced improvements in muscle strength, cardiorespiratory fitness and heart rate response between normal-weight and overweight/obese postmenopausal women. Sedentary women (n = 155) were divided into normal-weight (n = 79; BMI <25 kg/m(2); 58.3 ± 8.6 years) and overweight/obese (n = 76; BMI >25 kg/m(2); 58.3 ± 8.6 years) groups, and have their 1-repetition maximum strength (adjusted for body mass), cardiorespiratory fitness and heart rate response to a graded exercise test compared before and after 12 months of a three times-per-week exercise-training program. Overweight/obese women displayed decreased upper and lower extremity muscle strengths, decreased cardiorespiratory fitness, and lower peak and reserve heart rates compared to normal-weight women. After follow-up, both groups improved their upper (32.9% and 41.5% in normal-weight and overweight/obese women, respectively) and lower extremity(49.5% and 47.8% in normal-weight and overweight/obese women, respectively) muscle strength. However, only normal-weight women improved their cardiorespiratory fitness (6.6%) and recovery heart rate (5 bpm). Resting, reserve and peak heart rates did not change in either group. Overweight/obese women displayed impaired heart rate response to exercise. Both groups improved muscle strength, but only normal-weight women improved cardiorespiratory fitness and heart rate response to exercise. These results suggest that exercise-induced improvements in cardiorespiratory fitness and heart rate response to exercise may be impaired in overweight/obese postmenopausal women.

  4. Heart rate prescribed walking training improves cardiorespiratory fitness but not glycaemic control in people with type 2 diabetes.

    PubMed

    Morton, Richard D; West, Daniel J; Stephens, Jeffrey W; Bain, Stephen C; Bracken, Richard M

    2010-01-01

    In this study, we examined the effects of a supervised, heart rate intensity prescribed walking training programme on cardiorespiratory fitness and glycaemic control in people with type 2 diabetes mellitus. After receiving local ethics approval, 27 individuals (21 males, 6 females) with type 2 diabetes were randomly assigned to an experimental ("walking") or control group. Participants completed a Balke-Ware test to determine peak heart rate, peak oxygen consumption (VO(2peak)), and peak gradient. The walking group then completed a 7-week (four sessions a week) supervised, heart rate prescribed walking training programme, whereas the control group continued daily life. After training, participants completed another Balke-Ware test. Fasting blood glucose and glycosylated haemoglobin were measured at rest. The results showed that walking training elicited 80% (s = 2) of peak heart rate and a rating of perceived exertion of 11 (s = 1). Peak heart rate and VO(2peak) were higher in the walking than in the control group after training (P < 0.05). Based on the peak gradient before training, the respiratory exchange ratio was significantly lower (P < 0.05) and there was a strong trend for VO(2) (P = 0.09) and heart rate (P = 0.09) to be lower after training at the same gradient in the walking compared with the control group. These improvements increased walking peak gradient by 5 min (s = 4 min) compared with the control (P < 0.05). There was no change in fasting blood glucose or glycosylated haemoglobin after training. Despite no change in glycaemic control, heart rate prescribed walking improved peak and sub-maximal cardiorespiratory responses. The beneficial adaptations support the use of heart rate monitoring during walking in people with type 2 diabetes mellitus.

  5. Poorer physical fitness is associated with reduced structural brain integrity in heart failure.

    PubMed

    Alosco, Michael L; Brickman, Adam M; Spitznagel, Mary Beth; Griffith, Erica Y; Narkhede, Atul; Raz, Naftali; Cohen, Ronald; Sweet, Lawrence H; Colbert, Lisa H; Josephson, Richard; Hughes, Joel; Rosneck, Jim; Gunstad, John

    2013-05-15

    Physical fitness is an important correlate of structural and functional integrity of the brain in healthy adults. In heart failure (HF) patients, poor physical fitness may contribute to cognitive dysfunction and we examined the unique contribution of physical fitness to brain structural integrity among patients with HF. Sixty-nine HF patients performed the Modified Mini Mental State examination (3MS) and underwent brain magnetic resonance imaging. All participants completed the 2-minute step test (2MST), a brief measure of physical fitness. We examined the associations between cognitive performance, physical fitness, and three indices of global brain integrity: total cortical gray matter volume, total white matter volume, and whole brain cortical thickness. Regression analyses adjusting for demographic characteristics, medical variables (e.g., left ventricular ejection fraction), and intracranial volume revealed reduced performance on the 2MST were associated with decreased gray matter volume and thinner cortex (p<.05). Follow up analyses showed that reduced gray matter volume and decreased cortical thickness were associated with poorer 3MS scores (p<.05). Poor physical fitness is common in HF and associated with reduced structural brain integrity. Prospective studies are needed to elucidate underlying mechanisms for the influence of physical fitness on brain health in HF. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. Mapping conduction velocity of early embryonic hearts with a robust fitting algorithm

    PubMed Central

    Gu, Shi; Wang, Yves T; Ma, Pei; Werdich, Andreas A; Rollins, Andrew M; Jenkins, Michael W

    2015-01-01

    Cardiac conduction maturation is an important and integral component of heart development. Optical mapping with voltage-sensitive dyes allows sensitive measurements of electrophysiological signals over the entire heart. However, accurate measurements of conduction velocity during early cardiac development is typically hindered by low signal-to-noise ratio (SNR) measurements of action potentials. Here, we present a novel image processing approach based on least squares optimizations, which enables high-resolution, low-noise conduction velocity mapping of smaller tubular hearts. First, the action potential trace measured at each pixel is fit to a curve consisting of two cumulative normal distribution functions. Then, the activation time at each pixel is determined based on the fit, and the spatial gradient of activation time is determined with a two-dimensional (2D) linear fit over a square-shaped window. The size of the window is adaptively enlarged until the gradients can be determined within a preset precision. Finally, the conduction velocity is calculated based on the activation time gradient, and further corrected for three-dimensional (3D) geometry that can be obtained by optical coherence tomography (OCT). We validated the approach using published activation potential traces based on computer simulations. We further validated the method by adding artificially generated noise to the signal to simulate various SNR conditions using a curved simulated image (digital phantom) that resembles a tubular heart. This method proved to be robust, even at very low SNR conditions (SNR = 2-5). We also established an empirical equation to estimate the maximum conduction velocity that can be accurately measured under different conditions (e.g. sampling rate, SNR, and pixel size). Finally, we demonstrated high-resolution conduction velocity maps of the quail embryonic heart at a looping stage of development. PMID:26114034

  7. Comparison of energy expenditure and heart rate responses between three commercial group fitness classes.

    PubMed

    Wickham, James B; Mullen, Nicholas J; Whyte, Douglas G; Cannon, Jack

    2017-07-01

    The objectives of this study were to compare the energy expenditure and heart rate responses between three commercial group fitness classes (group resistance exercise [PUMP]; indoor stationary cycling [RIDE]; and step aerobics [STEP]). One-Way Repeated Measures incorporating a Latin Square Design for class randomisation. Ten participants (5 males and 5 females) completed each group fitness class in random order with energy expenditure and heart rate determined using an Actiheart monitor. STEP and RIDE produced significantly (p<0.05) higher average heart rates (HRavg) (85.8±5.1% and 86.4±4.3% of HRmax, respectively) compared to PUMP (73.7±7% of HRmax). HRpeak was also significantly (p<0.05) higher in STEP and RIDE (97.1±4.7% and 95.6±4.5% of HRmax, respectively) when compared with the PUMP class (90±5.9% of HRmax). Total energy expenditure (TEE), both absolute and relative, were significantly (p<0.05) higher for STEP (2101.7±560.2kJ and 0.59±0.07kJkg(-1)min(-1)) and RIDE (1880.4±420kJ and 0.58±0.03kJkg(-1)min(-1)) when compared with the PUMP class (1385.1±504kJ and 0.36±0.07kJkg(-1)min(-1)). These data suggest that overall exercise intensity and energy expenditure was highly comparable between RIDE and STEP, which suggests these group fitness classes are more effective for developing cardiovascular fitness and assisting with weight management compared with group resistance exercise classes when performed on a regular basis. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  8. Aerobic fitness, muscular strength and obesity in relation to risk of heart failure.

    PubMed

    Crump, Casey; Sundquist, Jan; Winkleby, Marilyn A; Sundquist, Kristina

    2017-05-12

    Low physical fitness and obesity have been associated with higher risk of developing heart failure (HF), but their interactive effects are unknown. Elucidation of interactions among these common modifiable factors may help facilitate more effective primary prevention. We conducted a national cohort study to examine the interactive effects of aerobic fitness, muscular strength and body mass index (BMI) among 1 330 610 military conscripts in Sweden during 1969-1997 (97%-98% of all 18-year-old men) on risk of HF identified from inpatient and outpatient diagnoses through 2012 (maximum age 62 years). There were 11 711 men diagnosed with HF in 37.8 million person-years of follow-up. Low aerobic fitness, low muscular strength and obesity were independently associated with higher risk of HF, after adjusting for each other, socioeconomic factors, other chronic diseases and family history of HF. The combination of low aerobic fitness and low muscular strength (lowest vs highest tertiles) was associated with a 1.7-fold risk of HF (95% CI 1.6 to 1.9; p<0.001; incidence rates per 100 000 person-years, 43.2 vs 10.8). These factors had positive additive and multiplicative interactions (p<0.001) and were associated with increased risk of HF even among men with normal BMI. Low aerobic fitness, low muscular strength and obesity at the age of 18 years were independently associated with higher risk of HF in adulthood, with interactive effects between aerobic fitness and muscular strength. These findings suggest that early-life interventions may help reduce the long-term risk of HF and should include both aerobic fitness and muscular strength, even among persons with normal BMI. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Lack of association between PCK1 polymorphisms and obesity, physical activity, and fitness in European Youth Heart Study (EYHS).

    PubMed

    Vimaleswaran, Karani S; Franks, Paul W; Brage, Soren; Grontved, Anders; Wareham, Nicholas J; Ekelund, Ulf; Loos, Ruth J F

    2010-10-01

    Phosphoenolpyruvate carboxykinase-1 (PCK1) is the rate-limiting enzyme in the hepatic gluconeogenic pathway. Studies have shown that overexpression of Pck1 in mice results in obesity-related traits and higher levels of physical activity (PA). Therefore, our aims were to investigate whether common genetic variation in the PCK1 gene influences obesity-related traits, PA, and fitness, and to examine whether PA and fitness attenuate the influence of the PCK1 polymorphisms on obesity in children. Analyses were undertaken on data from Danish and Estonian children (958 boys and 1,104 girls) from the European Youth Heart Study (EYHS), a school-based, cross-sectional study of children (mean ± s.d. age: 9.6 ± 0.4 years) and adolescents (15.5 ± 0.5 years). We genotyped eight polymorphisms that captured the common genetic variations in the PCK1 gene. The association between the PCK1 polymorphisms and BMI, waist circumference (WC), sum of four skinfolds, PA, and fitness was tested using an additive model adjusted for age, age-group, gender, maturity, and country. Interactions were tested by including interaction terms in the model. None of the polymorphisms were significantly associated with BMI, WC, sum of four skinfolds, PA, and fitness, and also with the risk of being overweight or obese (P > 0.05). The interactions between the polymorphisms and age-group, gender, PA, and fitness were not statistically significant. This is the first study to comprehensively examine the association of PCK1 polymorphisms with obesity, PA, and fitness. Despite strong evidence from animal studies, our study in the EYHS cohort failed to identify an association of PCK1 polymorphisms with obesity, PA, and fitness.

  10. A new sock electrode for recording epicardial activation from the human heart: one size fits all.

    PubMed

    Worley, S J; Ideker, R E; Mastrototaro, J; Smith, W M; Vidaillet, H; Chen, P S; Lowe, J E

    1987-01-01

    Simultaneous recording of epicardial activation from multiple sites during open heart surgery is essential for studying unstable ventricular arrhythmias. A previously described sock electrode array for this purpose requires custom-woven nylon sock material and expensive machined button electrodes. The limited compliance and elasticity of nylon requires that a new sock be individually fitted for each heart. Despite careful fitting, 17-20% of electrodes do not make satisfactory epicardial contact in dogs. Further, electrodes frequently dislodge from the sock and wires break at the button electrode solder joint. Recognizing these limitations, we formed a new sock from Xspan tubular dressing material and devised electrodes that attach securely to the sock. In six dogs, 90% +/- 3% of electrodes made satisfactory contact using the same Xspan sock, significantly (p less than .01) more than with the nylon sock despite far less labor. The same size X span sock with 60 snap electrodes was used to record from 27 human hearts of widely different dimensions. Satisfactory epicardial contact was obtained in 90% +/- 14% of electrodes in the 18 patients with Wolff-Parkinson-White syndrome (WPW) and 75% +/- 15% of electrodes in the nine patients with coronary artery disease. In no case did an accessory pathway fail to conduct following sock placement. The hemodynamic effect of the Xspan sock was evaluated in four dogs and was found to be minimal. Both the Xspan sock and the snap electrodes are easily made from inexpensive, readily available materials. The same Xspan sock accommodates a wide range of heart sizes, and the electrodes supported by the Xspan sock record significantly better and with less dislodgement and wire breakage than previous socks.

  11. Vitamin D, Muscle Function, and Cardiorespiratory Fitness in Adolescents From the Young Hearts Study.

    PubMed

    Carson, E L; Pourshahidi, L K; Hill, T R; Cashman, K D; Strain, J J; Boreham, C A; Mulhern, M S

    2015-12-01

    Vitamin D insufficiency is common among the adolescent population and may have implications for health outcomes in later life. Few studies have investigated the role of vitamin D status in muscle function and cardiorespiratory fitness (CRF) during adolescence. The aim of this study was to investigate the association between vitamin D status and fat-free mass (FFM), muscle strength, muscle power, and CRF in a representative sample of adolescents from Northern Ireland. This was a cross-sectional study involving 1015 adolescents (age 12 and 15 y), who had 25-hydroxyvitamin D [25(OH)D] data available as part of the Young Hearts Study 2000. The main outcome measures of this study were FFM (kg) and FFM corrected for height [fat-free mass index; FFM (kg)/height (m(2))], muscle strength (kg), peak muscle power (kW) and VO2 max (CRF; mL/kg/min). Multinomial regression analyses, controlling for environmental and lifestyle factors, demonstrated that boys age 15 years in the highest tertile of standardized serum 25(OH)D concentration (> 51 nmol/L) had significantly higher muscle strength (β = 3.90; P ≤ .001) compared with those in the lowest tertile (< 32 nmol/L). These results were not evident in any other age-sex group and vitamin D status was not significantly associated with muscle power or CRF in any of the four age-sex groups. These results support a role for vitamin D in muscle function in adolescent males and suggest the need for more research in this vulnerable age group.

  12. Stress resilience and physical fitness in adolescence and risk of coronary heart disease in middle age.

    PubMed

    Bergh, Cecilia; Udumyan, Ruzan; Fall, Katja; Almroth, Henrik; Montgomery, Scott

    2015-04-01

    Psychosocial stress is a suggested risk for coronary heart disease (CHD). The relationship of stress resilience in adolescence with subsequent CHD risk is underinvestigated, so our objective was to assess this and investigate the possible mediating role of physical fitness. In this register-based study, 237,980 men born between 1952 and 1956 were followed from 1987 to 2010 using information from Swedish registers. Stress resilience was measured at a compulsory military conscription examination using a semistructured interview with a psychologist. Some 10,581 diagnoses of CHD were identified. Cox regression estimated the association of stress resilience with CHD, with adjustment for established cardiovascular risk factors. Low-stress resilience was associated with increased CHD risk. The association remained after adjustment for physical fitness and other potential confounding and mediating factors, with adjusted HRs (and 95% CIs) of 1.17 (1.10 to 1.25), with some evidence of mediation by physical fitness. CHD incidence rates per 1000 person-years (and 95% CIs) for low-stress, medium-stress and high-stress resilience were 2.61 (2.52 to 2.70), 1.97 (1.92 to 2.03) and 1.59 (1.53 to 1.67) respectively. Higher physical fitness was inversely associated with CHD risk; however, this was attenuated by low-stress resilience, shown by interaction testing (p < 0.001). Low-stress resilience in adolescence was associated with increased risk of CHD in middle age and may diminish the benefit of physical fitness. This represents new evidence of the role of stress resilience in determining risk of CHD and its interrelationship with physical fitness. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Correlates of Heart Rate Measures with Incidental Physical Activity and Cardiorespiratory Fitness in Overweight Female Workers

    PubMed Central

    Tonello, Laís; Reichert, Felipe F.; Oliveira-Silva, Iransé; Del Rosso, Sebastián; Leicht, Anthony S.; Boullosa, Daniel A.

    2016-01-01

    Previous studies have suggested that physical activity (PA) levels and cardiorespiratory fitness (CRF) impact on the autonomic control of heart rate (HR). However, previous studies evaluating PA levels did not discriminate between incidental PA and regular exercise. We hypothesized that incidental PA “per se” would influence cardiac autonomic indices as assessed via HR variability (HRV) and HR recovery (HRR) in non-exercisers. Thus, the objective of this study was to investigate the relationships between objective PA levels, CRF, and cardiac autonomic indices in adult, regular non-exercising female workers. After familiarization with procedures and evaluation of body composition, 21 women completed a submaximal cycling test and evaluation of HRR on four different days. Resting (2-min seated and standing) and ambulatory (4-h) HRV were also recorded. Levels of PA were assessed by accelerometry over five consecutive days (i.e., Wednesday to Sunday). Maximum oxygen consumption (VO2max) was measured as an index of CRF. As reliability was low to moderate for most HR measures, relationships between these and PA and CRF were examined using the 4-day average measures. Significant correlations were identified between post-exercise HRR in the first min with various PA indices (daily moderate PA, daily vigorous PA, and the sum of vigorous and very vigorous daily PA). Additionally, VO2max was significantly correlated to HRV but not to HRR. The current results indicated that CRF was influential in enhancing HRV while incidental or non-exercise based PA was associated with greater autonomic reactivation in adult overweight women. Therefore, both CRF and non-exercise based PA contribute significant but diverse effects on cardiac health. The use of 4-day averages instead of single measures for evaluation of autonomic control of HR may provide a better indication of regular cardiac autonomic function that remains to be refined. PMID:26779034

  14. Correlates of Heart Rate Measures with Incidental Physical Activity and Cardiorespiratory Fitness in Overweight Female Workers.

    PubMed

    Tonello, Laís; Reichert, Felipe F; Oliveira-Silva, Iransé; Del Rosso, Sebastián; Leicht, Anthony S; Boullosa, Daniel A

    2015-01-01

    Previous studies have suggested that physical activity (PA) levels and cardiorespiratory fitness (CRF) impact on the autonomic control of heart rate (HR). However, previous studies evaluating PA levels did not discriminate between incidental PA and regular exercise. We hypothesized that incidental PA "per se" would influence cardiac autonomic indices as assessed via HR variability (HRV) and HR recovery (HRR) in non-exercisers. Thus, the objective of this study was to investigate the relationships between objective PA levels, CRF, and cardiac autonomic indices in adult, regular non-exercising female workers. After familiarization with procedures and evaluation of body composition, 21 women completed a submaximal cycling test and evaluation of HRR on four different days. Resting (2-min seated and standing) and ambulatory (4-h) HRV were also recorded. Levels of PA were assessed by accelerometry over five consecutive days (i.e., Wednesday to Sunday). Maximum oxygen consumption (VO2max) was measured as an index of CRF. As reliability was low to moderate for most HR measures, relationships between these and PA and CRF were examined using the 4-day average measures. Significant correlations were identified between post-exercise HRR in the first min with various PA indices (daily moderate PA, daily vigorous PA, and the sum of vigorous and very vigorous daily PA). Additionally, VO2max was significantly correlated to HRV but not to HRR. The current results indicated that CRF was influential in enhancing HRV while incidental or non-exercise based PA was associated with greater autonomic reactivation in adult overweight women. Therefore, both CRF and non-exercise based PA contribute significant but diverse effects on cardiac health. The use of 4-day averages instead of single measures for evaluation of autonomic control of HR may provide a better indication of regular cardiac autonomic function that remains to be refined.

  15. Human Fitting Studies of Cleveland Clinic Continuous-Flow Total Artificial Heart

    PubMed Central

    Karimov, Jamshid H.; Steffen, Robert J.; Byram, Nicole; Sunagawa, Gengo; Horvath, David; Cruz, Vincent; Golding, Leonard A.R.; Fukamachi, Kiyotaka; Moazami, Nader

    2015-01-01

    Implantation of mechanical circulatory support devices is challenging, especially in patients with a small chest cavity. We evaluated how well the Cleveland Clinic continuous-flow total artificial heart (CFTAH) fit the anatomy of patients about to receive a heart transplant. A mock pump model of the CFTAH was rapid-prototyped using biocompatible materials. The model was brought to the operative table, and the direction, length, and angulation of the inflow/outflow ports and outflow conduits were evaluated after the recipient's ventricles had been resected. Thoracic cavity measurements were based on preoperative computed tomographic data. The CFTAH fit well in all five patients (height, 170 ± 9 cm; weight, 75 ± 24 kg). Body surface area was 1.9 ± 0.3 m2 (range, 1.6-2.1 m2). The required inflow and outflow port orientation of both the left and right housings appeared consistent with the current version of the CFTAH implanted in calves. The left outflow conduit remained straight, but the right outflow direction necessitated a 73 ± 22 degree angulation to prevent potential kinking when crossing over the connected left outflow. These data support the fact that our design achieves the proper anatomical relationship of the CFTAH to a patient's native vessels. PMID:25806613

  16. Health-related fitness profiles in adolescents with complex congenital heart disease.

    PubMed

    Klausen, Susanne Hwiid; Wetterslev, Jørn; Søndergaard, Lars; Andersen, Lars L; Mikkelsen, Ulla Ramer; Dideriksen, Kasper; Zoffmann, Vibeke; Moons, Philip

    2015-04-01

    This study investigates whether subgroups of different health-related fitness (HrF) profiles exist among girls and boys with complex congenital heart disease (ConHD) and how these are associated with lifestyle behaviors. We measured the cardiorespiratory fitness, muscle strength, and body composition of 158 adolescents aged 13-16 years with previous surgery for a complex ConHD. Data on lifestyle behaviors were collected concomitantly between October 2010 and April 2013. A cluster analysis was conducted to identify profiles with similar HrF. For comparisons between clusters, multivariate analyses of covariance were used to test the differences in lifestyle behaviors. Three distinct profiles were formed: (1) Robust (43, 27%; 20 girls and 23 boys); (2) Moderately Robust (85, 54%; 37 girls and 48 boys); and (3) Less robust (30, 19%; 9 girls and 21 boys). The participants in the Robust clusters reported leading a physically active lifestyle and participants in the Less robust cluster reported leading a sedentary lifestyle. Diagnoses were evenly distributed between clusters. The cluster analysis attributed some of the variability in cardiorespiratory fitness among adolescents with complex ConHD to lifestyle behaviors and physical activity. Profiling of HrF offers a valuable new option in the management of person-centered health promotion. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  17. Obesity and cognitive dysfunction in heart failure: the role of hypertension, type 2 diabetes, and physical fitness.

    PubMed

    Alosco, Michael L; Spitznagel, Mary Beth; Cohen, Ronald; Sweet, Lawrence H; Josephson, Richard; Hughes, Joel; Rosneck, Jim; Gunstad, John

    2015-08-01

    Cognitive impairment is common in heart failure. Obesity is a known risk factor for cognitive dysfunction in heart failure, though the mechanisms remain unclear. Obesity increases risk for conditions like hypertension and type 2 diabetes mellitus (T2DM) as well as poor fitness levels, and this may serve as one possible pathway accounting for association between obesity and cognitive dysfunction. We used structural equation modeling to test whether the combination of hypertension, T2DM, and reduced fitness mediate the association between obesity and cognitive dysfunction. Two hundred heart failure patients completed neuropsychological testing and a physical fitness assessment. Hypertension and T2DM were ascertained via self-report and medical records. Body mass index (BMI) was calculated. Forty-three percent of the sample was obese. Hypertension (70%) and T2DM (36%) were common, and fitness levels were reduced. The structural equation model with these factors as mediators between BMI and cognitive function demonstrated excellent fit (comparative fit index = 0.98; root mean-square error of approximations = 0.03). Higher BMI correlated with hypertension, T2DM, and poorer fitness. Each of these factors predicted worse cognition. Models that isolated medical comorbidities and physical fitness as the mediator were weaker than the full model. Increased risk for medical comorbidities and reduced fitness levels helped to explain the negative effects of obesity on cognitive dysfunction in heart failure. Prospective studies should confirm this pattern and examine how weight loss benefits cognitive function in heart failure. © The European Society of Cardiology 2014.

  18. Cardiometabolic Disease Leading to Heart Failure: Better Fat and Fit Than Lean and Lazy.

    PubMed

    Pandey, Ambarish; Berry, Jarett D; Lavie, Carl J

    2015-10-01

    High body mass index (BMI) and low cardiorespiratory fitness (CRF) are important modifiable risk factors for heart failure (HF). While the individual contributions of CRF and BMI toward risk for HF are well established, the interrelationship between BMI and CRF in modifying long-term HF risk is more complex and not well understood. In this review, we discuss and summarize the available evidence-base on individual and joint contributions of obesity and low CRF toward HF risk, including the potential mechanisms through which these lifestyle risk factors may lead to HF. We also discuss the role of interventions aimed at intentional loss of weight or CRF improvement as potential HF preventive strategies. Finally, the article also highlights the modifying effects of CRF on survival in relation to the obesity paradox in patients with established HF.

  19. Exercise Effects on Fitness and Bone Mineral Density in Early Postmenopausal Women: 1-Year EFOPS Results.

    ERIC Educational Resources Information Center

    Kemmler, Wolfgang; Engelke, Klaus; Lauber, Dirk; Weineck, Juergen; Hensen, Johannes; Kalender, Willi A.

    2002-01-01

    Investigated the effect of intense exercise training on physical fitness, coronary heart disease, bone mineral density (BMD), and parameters related to quality of life in early postmenopausal women with osteopenia. Data on woman in control and exercise training groups indicated that the intense exercise training program was effective in improving…

  20. Exercise Effects on Fitness and Bone Mineral Density in Early Postmenopausal Women: 1-Year EFOPS Results.

    ERIC Educational Resources Information Center

    Kemmler, Wolfgang; Engelke, Klaus; Lauber, Dirk; Weineck, Juergen; Hensen, Johannes; Kalender, Willi A.

    2002-01-01

    Investigated the effect of intense exercise training on physical fitness, coronary heart disease, bone mineral density (BMD), and parameters related to quality of life in early postmenopausal women with osteopenia. Data on woman in control and exercise training groups indicated that the intense exercise training program was effective in improving…

  1. Do telemonitoring projects of heart failure fit the Chronic Care Model?

    PubMed Central

    Willemse, Evi; Adriaenssens, Jef; Dilles, Tinne; Remmen, Roy

    2014-01-01

    This study describes the characteristics of extramural and transmural telemonitoring projects on chronic heart failure in Belgium. It describes to what extent these telemonitoring projects coincide with the Chronic Care Model of Wagner. Background The Chronic Care Model describes essential components for high-quality health care. Telemonitoring can be used to optimise home care for chronic heart failure. It provides a potential prospective to change the current care organisation. Methods This qualitative study describes seven non-invasive home-care telemonitoring projects in patients with heart failure in Belgium. A qualitative design, including interviews and literature review, was used to describe the correspondence of these home-care telemonitoring projects with the dimensions of the Chronic Care Model. Results The projects were situated in primary and secondary health care. Their primary goal was to reduce the number of readmissions for chronic heart failure. None of these projects succeeded in a final implementation of telemonitoring in home care after the pilot phase. Not all the projects were initiated to accomplish all of the dimensions of the Chronic Care Model. A central role for the patient was sparse. Conclusion Limited financial resources hampered continuation after the pilot phase. Cooperation and coordination in telemonitoring appears to be major barriers but are, within primary care as well as between the lines of care, important links in follow-up. This discrepancy can be prohibitive for deployment of good chronic care. Chronic Care Model is recommended as basis for future. PMID:25114664

  2. Cardiorespiratory Fitness and Risk of Incident Atrial Fibrillation: Results From the Henry Ford Exercise Testing (FIT) Project.

    PubMed

    Qureshi, Waqas T; Alirhayim, Zaid; Blaha, Michael J; Juraschek, Stephen P; Keteyian, Steven J; Brawner, Clinton A; Al-Mallah, Mouaz H

    2015-05-26

    Poor cardiorespiratory fitness (CRF) is an independent risk factor for cardiovascular morbidity and mortality. However, the relationship between CRF and atrial fibrillation (AF) is less clear. The aim of this analysis was to investigate the association between CRF and incident AF in a large, multiracial cohort that underwent graded exercise treadmill testing. From 1991 to 2009, a total of 64 561 adults (mean age, 54.5±12.7 years; 46% female; 64% white) without AF underwent exercise treadmill testing at a tertiary care center. Baseline demographic and clinical variables were collected. Incident AF was ascertained by use of International Classification of Diseases, Ninth Revision code 427.31 and confirmed by linkage to medical claim files. Nested, multivariable Cox proportional hazards models were used to estimate the independent association of CRF with incident AF. During a median follow-up of 5.4 years (interquartile range, 3-9 years), 4616 new cases of AF were diagnosed. After adjustment for potential confounders, 1 higher metabolic equivalent achieved during treadmill testing was associated with a 7% lower risk of incident AF (hazard ratio, 0.93; 95% confidence interval, 0.92-0.94; P<0.001). This relationship remained significant after adjustment for incident coronary artery disease (hazard ratio, 0.92; 95% confidence interval, 0.91-0.93; P<0.001). The magnitude of the inverse association between CRF and incident AF was greater among obese compared with nonobese individuals (P for interaction=0.02). There is a graded, inverse relationship between cardiorespiratory fitness and incident AF, especially among obese patients. Future studies should examine whether changes in fitness increase or decrease risk of atrial fibrillation. This association was stronger for obese compared with nonobese, especially among obese patients. © 2015 American Heart Association, Inc.

  3. Evidence of the Role of Physical Activity and Cardiorespiratory Fitness in the Prevention of Coronary Heart Disease.

    ERIC Educational Resources Information Center

    Leon, Arthur S.; Norstrom, Jane

    1995-01-01

    This paper presents epidemiologic evidence on the contributions of physical inactivity and reduced cardiorespiratory fitness to risk of coronary heart disease (CHD). The types and dose of physical activity to reduce risk of CHD and plausible biologic mechanisms for the partial protective effect are reviewed. (Author/SM)

  4. Evidence of the Role of Physical Activity and Cardiorespiratory Fitness in the Prevention of Coronary Heart Disease.

    ERIC Educational Resources Information Center

    Leon, Arthur S.; Norstrom, Jane

    1995-01-01

    This paper presents epidemiologic evidence on the contributions of physical inactivity and reduced cardiorespiratory fitness to risk of coronary heart disease (CHD). The types and dose of physical activity to reduce risk of CHD and plausible biologic mechanisms for the partial protective effect are reviewed. (Author/SM)

  5. How do cardiorespiratory fitness improvements vary with physical training modality in heart failure patients? A quantitative guide

    PubMed Central

    Smart, Neil A

    2013-01-01

    BACKGROUND: Peak oxygen consumption (VO2) is the gold standard measure of cardiorespiratory fitness and a reliable predictor of survival in chronic heart failure patients. Furthermore, any form of physical training usually improves cardiorespiratory fitness, although the magnitude of improvement in peak VO2 may vary across different training prescriptions. OBJECTIVE: To quantify, and subsequently rank, the magnitude of improvement in peak VO2 for different physical training prescriptions using data from published meta-analyses and randomized controlled trials. METHODS: Prospective randomized controlled parallel trials and meta-analyses of exercise training in chronic heart failure patients that provided data on change in peak VO2 for nine a priori comparative analyses were examined. RESULTS: All forms of physical training were beneficial, although the improvement in peak VO2 varied with modality. High-intensity interval exercise yielded the largest increase in peak VO2, followed in descending order by moderate-intensity aerobic exercise, functional electrical stimulation, inspiratory muscle training, combined aerobic and resistance training, and isolated resistance training. With regard to setting, the present study was unable to determine whether outpatient or unsupervised home exercise provided greater benefits in terms of peak VO2 improvment. CONCLUSIONS: Interval exercise is not suitable for all patients, especially the high-intensity variety; however, when indicated, this form of exercise should be adopted to optimize peak VO2 adaptations. Other forms of activity, such as functional electrical stimulation, may be more appropriate for patients who are not capable of high-intensity interval training, especially for severely deconditioned patients who are initially unable to exercise. PMID:24294043

  6. Effects of exercise intensity on physical fitness and risk factors for coronary heart disease.

    PubMed

    Okura, Tomohiro; Nakata, Yoshio; Tanaka, Kiyoji

    2003-09-01

    To determine whether "low-intensity" exercise (walking) and "high-intensity" exercise (aerobic dance), when added to a weight loss diet, have different effects on coronary heart disease (CHD) risk factors and physical fitness. Ninety obese women were divided into diet only (DO), diet plus walking (DW), and diet plus aerobic dance (DA) groups. DXA was used to evaluate segmental body composition. Leg-extension strength and maximal oxygen uptake (VO2max) were the indicators of physical fitness. Blood pressure, lipoproteins, and fasting glucose were used as indices for CHD risk factors. These items were measured before and after a 14-week intervention period. Whole-body plus all segmental fat masses were significantly reduced (p < 0.001). Reductions in whole-body and lower-limb fat- and bone-free masses were significantly less (p < 0.01) in the DA group (-1.5 and -0.1 kg, respectively) compared with the DO (-2.1 and -0.4 kg, respectively) and DW (-2.5 and -0.5 kg, respectively) groups. Improvements in leg-extension strength and VO2max were significantly greater (p < 0.05) in the DA group compared with the DO group. The CHD risk factors clearly improved (p < 0.05) within each group. Reductions in low density lipoprotein-cholesterol and fasting glucose were significantly greater (p < 0.05) in the DA group compared with the DO and DW groups. Adding higher intensity aerobic dance to a weight-loss diet program may help maintain fat- and bone-free mass and may be more effective in improving CHD risk factors compared with low-intensity walking.

  7. ["Fitness for public service" - results of standardised acceptance examinations].

    PubMed

    Arndt, K- H; Roth, M

    2002-01-01

    From Nov. 1 1990 to Dec. 31 2001 4928 applicants (61 % female, 39 % male) were examined, totalling 6580 pre-employment examinations, to decide whether they fulfilled the health requirement criteria for civil servants. Standardised aptitude criteria were used, career-specific requirements taken into account. To exclude with a high probability were any risks of premature disability for service or frequent disorders. In 394 cases (= 5.99 %) the results were negative. This assessment was final in 298 cases (= 4.53 % of all examinations) or was confirmed negative in repeated examinations even after special conditions had been imposed. Main reasons for disqualification were second- and third-degree adipositas with additional risk factors or a metabolic syndrome, chronic cardio-vascular and metabolic diseases requiring permanent treatment, malignant neoplasms or non-fulfilment of the criteria for special careers. The comparatively high rate of disqualification is mainly due to the high average age of the applicants examined (40 % of all applicants were over 40, 13 % were older than 50). Purpose, sensitivity and specifics of such examinations are discussed. Taking into consideration the high rate of civil servants prematurely unfit for work, such pre-employment examinations are regarded as highly justified. Moreover, it is necessary to have clear guidelines, aptitude criteria and examination procedures for individual careers. It is also important to adhere strictly to local responsibility for pre-employment examinations.

  8. Tracking of physical activity, fitness, body composition and diet from adolescence to young adulthood: The Young Hearts Project, Northern Ireland.

    PubMed

    Boreham, Colin; Robson, Paula J; Gallagher, Alison M; Cran, Gordon W; Savage, J Maurice; Murray, Liam J

    2004-10-05

    BACKGROUND: The assumption that lifestyles formed early in life track into adulthood has been used to justify the targeting of health promotion programmes towards children and adolescents. The aim of the current study was to use data from the Northern Ireland Young Hearts Project to ascertain the extent of tracking, between adolescence and young adulthood, of physical activity, aerobic fitness, selected anthropometric variables, and diet. METHODS: Males (n 245) and females (n 231) were assessed at age 15 y, and again in young adulthood [mean (SD) age 22 (1.6) y]. At both timepoints, height, weight and skinfold thicknesses were measured, and physical activity and diet were assessed by questionnaire and diet history method respectively. At 15y, fitness was assessed using the 20 metre shuttle run, while at young adulthood, the PWC170 cycle ergometer test was used. For each measurement made at 15y, subjects were ranked into 'low' (L1; lowest 25%), 'medium' (M1; middle 50%) or 'high' (H1; highest 25%) categories. At young adulthood, similar categories (L2, M2, H2) were created. The extent of tracking of each variable over time was calculated using 3 x 3 matrices constructed using these two sets of categories, and summarised using kappa (kappa) statistics. RESULTS: Tracking of diet and fitness was poor (kappa fitness and diet in both sexes, and physical activity in females, suggests that these aspects of adolescent lifestyle are unlikely to be predictive of behaviours in

  9. Cardiac Transplantation: Current Results at the Texas Heart Institute

    PubMed Central

    Okereke, O. U. John; Frazier, O. H.; Cooley, Denton A.; Waldenberger, Ferdinand; Radovancevic, Branislav

    1984-01-01

    The first series of cardiac transplants at the Texas Heart Institute began in May of 1968 but was discontinued because of the complications of infection and rejection. A second series of cardiac transplants was initiated in July of 1982 after the introduction of the immunosuppressant drug, cyclosporine. By August of 1984, 30 patients had undergone orthotopic cardiac transplantation for end-stage cardiac disease. Of the patients in this series, four have died of rejection, two of infectious complications, and one of an unknown cause. The remainder have all returned to Class I New York Heart Association (NYHA) cardiac status. All patients were reviewed in detail for suitability of cardiac transplantation and presented to a cardiac transplant review board. All transplanted patients were functional Class IV. Donor hearts were obtained locally or by long-distance procurement. Ten of the hearts were obtained from an average distance of 250 miles from Houston. Donors ranged in age from 16 to 37 years. Requirements were normal cardiac function with minimal use of inotropic support, no history of cardiac disease, absence of cardiac arrest and absence of active infection. Although only one of the patients in the initial group of transplants survived 1 year, to date there have been 11 survivors for more than 1 year in the current series. Advances in cardiac transplantation have resulted in an improved prognosis for the terminal cardiomyopathic patients requiring transplantation. The use of cyclosporine, an immunosuppressant that spares the nonspecific immune system, has been helpful in allowing patients to survive infections. The use of the drug must be carefully monitored, however, because of its numerous toxicities. PMID:15227054

  10. Association of Physical Activity or Fitness With Incident Heart Failure: A Systematic Review and Meta-Analysis.

    PubMed

    Echouffo-Tcheugui, Justin B; Butler, Javed; Yancy, Clyde W; Fonarow, Gregg C

    2015-09-01

    Previous studies have shown that high levels of physical activity are associated with lower risk of risk factors for heart failure (HF), such as coronary heart disease, hypertension, and diabetes mellitus. However, the effects of physical activity or fitness on the incidence of HF remain unclear. MEDLINE and EMBASE were systematically searched until November 30, 2014. Prospective cohort studies reporting measures of the association of physical activity (n=10) or fitness (n=2) with incident HF were included. Extracted effect estimates from the eligible studies were pooled using a random-effects model meta-analysis, with heterogeneity assessed with the I(2) statistic. Ten cohort studies on physical activity eligible for meta-analysis included a total of 282 889 participants followed for 7 to 30 years. For the physical activity studies, maximum versus minimal amount of physical activity groups were used for analyses; with a total number of participants (n=165 695). The pooled relative risk (95% confidence interval [CI]) for HF among those with a regular exercise pattern was 0.72 (95% CI, 0.67-0.79). Findings were similar for men (0.71 [95% CI, 0.61-0.83]) and women (0.72 [95% CI, 0.67-0.77]) and by type of exercise. There was no evidence of publication bias (P value for Egger test=0.34). The pooled associated effect of physical fitness on incident HF was 0.79 (95% CI, 0.75-0.83) for each unit increase in metabolic equivalent of oxygen consumption. Published literature support a significant association between increased physical activity or fitness and decreased incidence of HF. © 2015 American Heart Association, Inc.

  11. Left ventricular mechanics in humans with high aerobic fitness: adaptation independent of structural remodelling, arterial haemodynamics and heart rate

    PubMed Central

    Stöhr, Eric J; McDonnell, Barry; Thompson, Jane; Stone, Keeron; Bull, Tom; Houston, Rory; Cockcroft, John; Shave, Rob

    2012-01-01

    Individuals with high aerobic fitness have lower systolic left ventricular strain, rotation and twist (‘left ventricular (LV) mechanics’) at rest, suggesting a beneficial reduction in LV myofibre stress and more efficient systolic function. However, the mechanisms responsible for this functional adaptation are not known and the influence of aerobic fitness on LV mechanics during dynamic exercise has never been studied. We assessed LV mechanics, LV wall thickness and dimensions, central augmentation index (AIx), aortic pulse wave velocity (aPWV), blood pressure and heart rate in 28 males (age: 21 ± 2 years SD) with a consistent physical activity level (no change >6 months). Individuals were examined at rest and during exercise (40% peak exercise capacity) and separated post hoc into a moderate and high aerobic fitness group (: 49 ± 5 and 63 ± 7 ml kg−1 min−1, respectively, P < 0.0001). At rest and during exercise, there were no significant differences in gross LV structure, AIx, blood pressure or heart rate (P > 0.05). However, for the same AIx, the high group had significantly lower LV apical rotation (P = 0.002) and LV twist (P = 0.003) while basal rotation and strain indices did not differ between groups (P > 0.05). We conclude that young males with high aerobic fitness have lower LV apical rotation at rest and during submaximal exercise that can occur without changes in gross LV structure, arterial haemodynamics or heart rate. The findings suggest a previously unknown type of physiological adaptation of the left ventricle that may have important implications for exercise training in older individuals and patient populations in which exercise training has previously failed to show clear benefits for LV function. PMID:22431336

  12. Submaximal fitness and mortality risk reduction in coronary heart disease: a retrospective cohort study of community-based exercise rehabilitation

    PubMed Central

    Taylor, Claire; Tsakirides, Costas; Moxon, James; Moxon, James William; Dudfield, Michael; Witte, Klaus K; Ingle, Lee; Carroll, Sean

    2016-01-01

    Objectives To examine the association between submaximal cardiorespiratory fitness (sCRF) and all-cause mortality in a cardiac rehabilitation (CR) cohort. Design Retrospective cohort study of participants entering CR between 26 May 1993 and 16 October 2006, followed up to 1 November 2013 (median 14 years, range 1.2–19.4 years). Setting A community-based CR exercise programme in Leeds, West Yorkshire, UK. Participants A cohort of 534 men (76%) and 136 women with a clinical diagnosis of coronary heart disease (CHD), aged 22–82 years, attending CR were evaluated for the association between baseline sCRF and all-cause mortality. 416 participants with an exercise test following CR (median 14 weeks) were examined for changes in sCRF and all-cause mortality. Main outcome measures All-cause mortality and change in sCRF expressed in estimated metabolic equivalents (METs). Results Baseline sCRF was a strong predictor of all-cause mortality; compared to the lowest sCRF group (<5 METs for women and <6 METs for men), mortality risk was 41% lower in those with moderate sCRF (HR 0.59; 95% CI 0.42 to 0.83) and 60% lower (HR 0.40; 95% CI 0.25 to 0.64) in those with higher sCRF levels (≥7 METs women and ≥8 METs for men). Although improvement in sCRF at 14 weeks was not associated with a significant mortality risk reduction (HR 0.91; 95% CI 0.79 to 1.06) for the whole cohort, in those with the lowest sCRF (and highest all-cause mortality) at baseline, each 1-MET improvement was associated with a 27% age-adjusted reduction in mortality risk (HR 0.73; 95% CI 0.57 to 0.94). Conclusions Higher baseline sCRF is associated with a reduced risk of all-cause mortality over 14 years in adults with CHD. Improving fitness through exercise-based CR is associated with significant risk reduction for the least fit. PMID:27363816

  13. Orthotopic total artificial heart bridge to transplantation: preliminary results.

    PubMed

    Copeland, J G; Smith, R; Icenogle, T; Vasu, A; Rhenman, B; Williams, R; Cleavinger, M

    1989-01-01

    A detailed summary of seven patients who received eight total artificial heart implants, including one Phoenix heart, two Jarvik 7-100 ml hearts, and five Jarvik 7-70 ml hearts, and nine heart transplants, reveals that bleeding, hemolysis, and thromboembolic and infectious problems are not the limiting factors. Size of the patient and the requirement for adequate space to permit adequate systemic and pulmonary venous filling seem to be the major limitations. Patients with a reasonable expectation of receiving a transplantation within 3 weeks are the best candidates for a bridge to transplantation. After this adhesions were found to cause severe technical problems at reoperation.

  14. The effect of progressive resistance training on aerobic fitness and strength in adults with coronary heart disease: A systematic review and meta-analysis of randomised controlled trials.

    PubMed

    Hollings, Matthew; Mavros, Yorgi; Freeston, Jonathan; Fiatarone Singh, Maria

    2017-08-01

    Design We aimed to evaluate the effect of progressive resistance training on cardiorespiratory fitness and muscular strength in coronary heart disease, when compared to control or aerobic training, and when combined with aerobic training. Secondary aims were to evaluate the safety and efficacy of progressive resistance training on other physiological and clinical outcomes. Methods and results Electronic databases were searched from inception until July 2016. Designs included progressive resistance training vs control, progressive resistance training vs aerobic training, and combined training vs aerobic training. From 268,778 titles, 34 studies were included (1940 participants; 71.9% male; age 60 ± 7 years). Progressive resistance training was more effective than control for lower (standardized mean difference 0.57, 95% confidence interval (0.17-0.96)) and upper (1.43 (0.73-2.13)) body strength. Aerobic fitness improved similarly after progressive resistance training (16.9%) or aerobic training (21.0%); (standardized mean difference -0.13, 95% confidence interval (-0.35-0.08)). Combined training was more effective than aerobic training for aerobic fitness (0.21 (0.09-0.34), lower (0.62 (0.32-0.92)) and upper (0.51 (0.27-0.74)) body strength. Twenty studies reported adverse event information, with five reporting 64 cardiovascular complications, 63 during aerobic training. Conclusion Isolated progressive resistance training resulted in an increase in lower and upper body strength, and improved aerobic fitness to a similar degree as aerobic training in coronary heart disease cohorts. Importantly, when progressive resistance training was added to aerobic training, effects on both fitness and strength were enhanced compared to aerobic training alone. Reporting of adverse events was poor, and clinical gaps were identified for women, older adults, high intensity progressive resistance training and long-term outcomes, warranting future trials to confirm safety and

  15. Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association.

    PubMed

    Ross, Robert; Blair, Steven N; Arena, Ross; Church, Timothy S; Després, Jean-Pierre; Franklin, Barry A; Haskell, William L; Kaminsky, Leonard A; Levine, Benjamin D; Lavie, Carl J; Myers, Jonathan; Niebauer, Josef; Sallis, Robert; Sawada, Susumu S; Sui, Xuemei; Wisløff, Ulrik

    2016-12-13

    Mounting evidence has firmly established that low levels of cardiorespiratory fitness (CRF) are associated with a high risk of cardiovascular disease, all-cause mortality, and mortality rates attributable to various cancers. A growing body of epidemiological and clinical evidence demonstrates not only that CRF is a potentially stronger predictor of mortality than established risk factors such as smoking, hypertension, high cholesterol, and type 2 diabetes mellitus, but that the addition of CRF to traditional risk factors significantly improves the reclassification of risk for adverse outcomes. The purpose of this statement is to review current knowledge related to the association between CRF and health outcomes, increase awareness of the added value of CRF to improve risk prediction, and suggest future directions in research. Although the statement is not intended to be a comprehensive review, critical references that address important advances in the field are highlighted. The underlying premise of this statement is that the addition of CRF for risk classification presents health professionals with unique opportunities to improve patient management and to encourage lifestyle-based strategies designed to reduce cardiovascular risk. These opportunities must be realized to optimize the prevention and treatment of cardiovascular disease and hence meet the American Heart Association's 2020 goals. © 2016 American Heart Association, Inc.

  16. Resting Bradycardia, Enhanced Postexercise Heart Rate Recovery and Cardiorespiratory Fitness in Recreational Ballroom Dancers.

    PubMed

    Cruz, Carlos Janssen Gomes da; Molina, Guilherme Eckhardt; Porto, Luiz Guilherme Grossi; Junqueira, Luiz Fernando

    2017-09-01

    In a cross-sectional study design, we evaluated the resting heart rate (HRbaseline) and exercise and postexercise stress test-related chronotropic responses in male practitioners of recreational ballroom dancing (BD; n = 25, Mage = 26.6 ± 6.1 years) compared to a control group of insufficiently active nondancers (CG; n = 25, Mage = 25.9 ± 4.5 years). All participants underwent a submaximal exercise test. At 85% of the maximal predicted HR, the recovery protocol was started, and heart rate recovery (HRR) was recorded during 1-min intervals for 5 min. Compared with CG, BD showed lower HRbaseline (70 beats per minute [bpm] vs. 62 bpm, respectively, U = 143, p < .05, ES = .46), lower preexercise HR (94 bpm vs. 86 bpm, U = 157, p < .05, ES = .42), longer exercise test duration (346 s vs. 420 s, U = 95.5, p < .05, ES = .59), and higher HRR for 5 min postexercise (U = 1.29-1.89, p < .05, ES = .33-.50) as follows: 1st min (32 bpm vs. 40 bpm), 2nd min (45 bpm vs. 53 bpm), 3rd min (51 bpm vs. 58 bpm), 4th min (55 bpm vs. 59 bpm), and 5th min (59 bpm vs. 63 bpm). The coefficient of HRR from the 1st min to the 5th min postexercise was similar in both groups (U = 229-311, p > .05, ES = < .10-.22). Heightened cardiovascular functional status characterized by favorable enhanced chronotropic dynamics appears to occur in practitioners of recreational ballroom dancing, which suggests that this modality of exercise may result in health benefits.

  17. Leisure-Time Physical Activity, Sedentary Behavior, and Physical Fitness among Adolescents: Varying Definitions Yield Differing Results in Fitness Research

    ERIC Educational Resources Information Center

    Kerner, Matthew S.

    2005-01-01

    The aims of the study were (1) to assess the relationships among leisure-time physical activity, sedentary behaviors, and measures of health-related and performance-related physical fitness, and (2) to determine the primary predictors of performance-related physical fitness from the variables investigated. This study updates the literature with…

  18. Leisure-Time Physical Activity, Sedentary Behavior, and Physical Fitness among Adolescents: Varying Definitions Yield Differing Results in Fitness Research

    ERIC Educational Resources Information Center

    Kerner, Matthew S.

    2005-01-01

    The aims of the study were (1) to assess the relationships among leisure-time physical activity, sedentary behaviors, and measures of health-related and performance-related physical fitness, and (2) to determine the primary predictors of performance-related physical fitness from the variables investigated. This study updates the literature with…

  19. The Heart Truth Professional Education Campaign on Women and Heart Disease: Needs Assessment and Evaluation Results

    PubMed Central

    Freund, Karen M.; Kleinman, Mary; Phipps, Maureen G.; Fife, Rose S.; Gams, Becky; Núñez, Ana E.; Seaver, Margaret R.; Lazarus, Cathy J.; Raymond, Nancy C.; Briller, Joan; Uijtdehaage, Sebastian; Moskovic, Cindy S.; Guiton, Gretchen; David, Michele; Gabeau, Geralde V.; Geller, Stacie; Meekma, Kelli; Moore, Christopher; Robertson, Candace; Sarto, Gloria

    2009-01-01

    Abstract Background Heart disease is the leading cause of death for women in the United States. Research has identified that women are less likely than men to receive medical interventions for the prevention and treatment of heart disease. Methods and Results As part of a campaign to educate healthcare professionals, 1245 healthcare professionals in 11 states attended a structured 1-hour continuing medical education (CME) program based on the 2004 AHA Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women and completed a pretest and posttest evaluation. We identified significant knowledge deficits in the pretest: 45% of attendees would initially recommend lifestyle changes alone, rather than statin therapy, for women diagnosed with coronary artery disease (CAD); 38% identified statin therapy as less effective in women compared with men for preventing CAD events; 27% identified Asian American women at low risk (rather than high risk) for type 2 diabetes mellitus (DM); and 21% identified processed meat (rather than baked goods) as the principal dietary source of trans fatty acids. Overall, healthcare professionals answered 5.1 of 8 knowledge questions correctly in the pretest, improving to 6.8 questions in the posttest (p < 0.001). Family physicians, obstetrician/gynecologists, general internists, nurse practitioners/physician assistants, and registered nurses all statistically significantly improved knowledge and self-assessed skills and attitudes as measured by the posttest. Conclusions Significant knowledge deficits are apparent in a cross-section of healthcare providers attending a CME lecture on women and heart disease. A 1-hour presentation was successful in improving knowledge and self-assessed skills and attitudes among primary care physicians, nurse practitioners, physician assistants, and registered nurses. PMID:19772369

  20. Low physical fitness levels in older adults with ID: results of the HA-ID study.

    PubMed

    Hilgenkamp, Thessa I M; van Wijck, Ruud; Evenhuis, Heleen M

    2012-01-01

    Physical fitness is as important to aging adults with ID as in the general population, but to date, the physical fitness levels of this group are unknown. Comfortable walking speed, muscle strength (grip strength), muscle endurance (30s Chair stand) and cardiorespiratory endurance (10 m incremental shuttle walking test) were tested in a sample of 1050 older adults with ID, and results were compared with reference values from the general population. Across all age ranges, approximately two-third of the entire study population scored 'below average' or 'impaired'. Even the youngest age groups (50-59 or 50-54 years) in this sample achieve similar or worse results than age groups 20-30 years older in the general population. Low physical fitness levels in older adults with ID demonstrate that this group is prone to unnecessary premature loss of functioning and health problems, and maintaining physical fitness should have priority in practice and policy.

  1. Hearts and minds: linking vascular rigidity and aerobic fitness with cognitive aging.

    PubMed

    Gauthier, Claudine Joëlle; Lefort, Muriel; Mekary, Saïd; Desjardins-Crépeau, Laurence; Skimminge, Arnold; Iversen, Pernille; Madjar, Cécile; Desjardins, Michèle; Lesage, Frédéric; Garde, Ellen; Frouin, Frédérique; Bherer, Louis; Hoge, Richard D

    2015-01-01

    Human aging is accompanied by both vascular and cognitive changes. Although arteries throughout the body are known to become stiffer with age, this vessel hardening is believed to start at the level of the aorta and progress to other organs, including the brain. Progression of this vascular impairment may contribute to cognitive changes that arise with a similar time course during aging. Conversely, it has been proposed that regular exercise plays a protective role, attenuating the impact of age on vascular and metabolic physiology. Here, the impact of vascular degradation in the absence of disease was investigated within 2 groups of healthy younger and older adults. Age-related changes in executive function, elasticity of the aortic arch, cardiorespiratory fitness, and cerebrovascular reactivity were quantified, as well as the association between these parameters within the older group. In the cohort studied, older adults exhibited a decline in executive functions, measured as a slower performance in a modified Stroop task (1247.90 ± 204.50 vs. 898.20 ± 211.10 ms on the inhibition and/or switching component, respectively) than younger adults. Older participants also showed higher aortic pulse wave velocity (8.98 ± 3.56 vs. 3.95 ± 0.82 m/s, respectively) and lower VO₂ max (29.04 ± 6.92 vs. 42.32 ± 7.31 mL O2/kg/min, respectively) than younger adults. Within the older group, faster performance of the modified Stroop task was associated with preserved aortic elasticity (lower aortic pulse wave velocity; p = 0.046) and higher cardiorespiratory fitness (VO₂ max; p = 0.036). Furthermore, VO₂ max was found to be negatively associated with blood oxygenation level dependent cerebrovascular reactivity to CO₂ in frontal regions involved in the task (p = 0.038) but positively associated with cerebrovascular reactivity in periventricular watershed regions and within the postcentral gyrus. Overall, the results of this study support the hypothesis that cognitive

  2. Increased COUP-TFII expression in adult hearts induces mitochondrial dysfunction resulting in heart failure

    PubMed Central

    Wu, San-Pin; Kao, Chung-Yang; Wang, Leiming; Creighton, Chad J.; Yang, Jin; Donti, Taraka R.; Harmancey, Romain; Vasquez, Hernan G.; Graham, Brett H.; Bellen, Hugo J.; Taegtmeyer, Heinrich; Chang, Ching-Pin; Tsai, Ming-Jer; Tsai, Sophia Y.

    2015-01-01

    Mitochondrial dysfunction and metabolic remodelling are pivotal in the development of cardiomyopathy. Here, we show that myocardial COUP-TFII overexpression causes heart failure in mice, suggesting a causal effect of elevated COUP-TFII levels on development of dilated cardiomyopathy. COUP-TFII represses genes critical for mitochondrial electron transport chain enzyme activity, oxidative stress detoxification and mitochondrial dynamics, resulting in increased levels of reactive oxygen species and lower rates of oxygen consumption in mitochondria. COUP-TFII also suppresses the metabolic regulator PGC-1 network and decreases the expression of key glucose and lipid utilization genes, leading to a reduction in both glucose and oleate oxidation in the hearts. These data suggest that COUP-TFII affects mitochondrial function, impairs metabolic remodelling and has a key role in dilated cardiomyopathy. Last, COUP-TFII haploinsufficiency attenuates the progression of cardiac dilation and improves survival in a calcineurin transgenic mouse model, indicating that COUP-TFII may serve as a therapeutic target for the treatment of dilated cardiomyopathy. PMID:26356605

  3. Increased COUP-TFII expression in adult hearts induces mitochondrial dysfunction resulting in heart failure.

    PubMed

    Wu, San-Pin; Kao, Chung-Yang; Wang, Leiming; Creighton, Chad J; Yang, Jin; Donti, Taraka R; Harmancey, Romain; Vasquez, Hernan G; Graham, Brett H; Bellen, Hugo J; Taegtmeyer, Heinrich; Chang, Ching-Pin; Tsai, Ming-Jer; Tsai, Sophia Y

    2015-09-10

    Mitochondrial dysfunction and metabolic remodelling are pivotal in the development of cardiomyopathy. Here, we show that myocardial COUP-TFII overexpression causes heart failure in mice, suggesting a causal effect of elevated COUP-TFII levels on development of dilated cardiomyopathy. COUP-TFII represses genes critical for mitochondrial electron transport chain enzyme activity, oxidative stress detoxification and mitochondrial dynamics, resulting in increased levels of reactive oxygen species and lower rates of oxygen consumption in mitochondria. COUP-TFII also suppresses the metabolic regulator PGC-1 network and decreases the expression of key glucose and lipid utilization genes, leading to a reduction in both glucose and oleate oxidation in the hearts. These data suggest that COUP-TFII affects mitochondrial function, impairs metabolic remodelling and has a key role in dilated cardiomyopathy. Last, COUP-TFII haploinsufficiency attenuates the progression of cardiac dilation and improves survival in a calcineurin transgenic mouse model, indicating that COUP-TFII may serve as a therapeutic target for the treatment of dilated cardiomyopathy.

  4. Project Hearty Heart. A Cardiovascular Fitness Curriculum for First Grade Children.

    ERIC Educational Resources Information Center

    Harkins, Dorothy; Chrietzberg, Agnes

    This physical education and health education curriculum guide, specializing in the healthy heart, is designed for use by both classroom teachers and physical education teachers. Part 1 outlines a physical education curriculum for children in the first grade. Included are a variety of physical education program activities which focus on improving…

  5. Project Hearty Heart. A Cardiovascular Fitness Curriculum for First Grade Children.

    ERIC Educational Resources Information Center

    Harkins, Dorothy; Chrietzberg, Agnes

    This physical education and health education curriculum guide, specializing in the healthy heart, is designed for use by both classroom teachers and physical education teachers. Part 1 outlines a physical education curriculum for children in the first grade. Included are a variety of physical education program activities which focus on improving…

  6. Do telemonitoring projects of heart failure fit the Chronic Care Model?

    PubMed

    Willemse, Evi; Adriaenssens, Jef; Dilles, Tinne; Remmen, Roy

    2014-07-01

    This study describes the characteristics of extramural and transmural telemonitoring projects on chronic heart failure in Belgium. It describes to what extent these telemonitoring projects coincide with the Chronic Care Model of Wagner. The Chronic Care Model describes essential components for high-quality health care. Telemonitoring can be used to optimise home care for chronic heart failure. It provides a potential prospective to change the current care organisation. This qualitative study describes seven non-invasive home-care telemonitoring projects in patients with heart failure in Belgium. A qualitative design, including interviews and literature review, was used to describe the correspondence of these home-care telemonitoring projects with the dimensions of the Chronic Care Model. The projects were situated in primary and secondary health care. Their primary goal was to reduce the number of readmissions for chronic heart failure. None of these projects succeeded in a final implementation of telemonitoring in home care after the pilot phase. Not all the projects were initiated to accomplish all of the dimensions of the Chronic Care Model. A central role for the patient was sparse. Limited financial resources hampered continuation after the pilot phase. Cooperation and coordination in telemonitoring appears to be major barriers but are, within primary care as well as between the lines of care, important links in follow-up. This discrepancy can be prohibitive for deployment of good chronic care. Chronic Care Model is recommended as basis for future.

  7. The effects of physical fitness and body composition on oxygen consumption and heart rate recovery after high-intensity exercise.

    PubMed

    Campos, E Z; Bastos, F N; Papoti, M; Freitas Junior, I F; Gobatto, C A; Balikian Junior, P

    2012-08-01

    The aim of this study was to investigate the potential relationship between excess post-exercise oxygen consumption (EPOC), heart rate recovery (HRR) and their respective time constants (tvo2 and t HR) and body composition and aerobic fitness (VO2max) variables after an anaerobic effort. 14 professional cyclists (age=28.4±4.8 years, height=176.0±6.7 cm, body mass=74.4±8.1 kg, VO2max=66.8±7.6 mL·kg - 1·min - 1) were recruited. Each athlete made 3 visits to the laboratory with 24 h between each visit. During the first visit, a total and segmental body composition assessment was carried out. During the second, the athletes undertook an incremental test to determine VO2max. In the final visit, EPOC (15-min) and HRR were measured after an all-out 30 s Wingate test. The results showed that EPOC is positively associated with % body fat (r=0.64), total body fat (r=0.73), fat-free mass (r=0.61) and lower limb fat-free mass (r=0.55) and negatively associated with HRR (r= - 0.53, p<0.05 for all). HRR had a significant negative correlation with total body fat and % body fat (r= - 0.62, r= - 0.56 respectively, p<0.05 for all). These findings indicate that VO2max does not influence HRR or EPOC after high-intensity exercise. Even in short-term exercise, the major metabolic disturbance due to higher muscle mass and total muscle mass may increase EPOC. However, body fat impedes HRR and delays recovery of oxygen consumption after effort in highly trained athletes.

  8. Fitness Trade-offs Result in the Illusion of Social Success.

    PubMed

    Wolf, Jason B; Howie, Jennifer A; Parkinson, Katie; Gruenheit, Nicole; Melo, Diogo; Rozen, Daniel; Thompson, Christopher R L

    2015-04-20

    Cooperation is ubiquitous across the tree of life, from simple microbes to the complex social systems of animals. Individuals cooperate by engaging in costly behaviors that can be exploited by other individuals who benefit by avoiding these associated costs. Thus, if successful exploitation of social partners during cooperative interactions increases relative fitness, then we expect selection to lead to the emergence of a single optimal winning strategy in which individuals maximize their gain from cooperation while minimizing their associated costs. Such social "cheating" appears to be widespread in nature, including in several microbial systems, but despite the fitness advantages favoring social cheating, populations tend to harbor significant variation in social success rather than a single optimal winning strategy. Using the social amoeba Dictyostelium discoideum, we provide a possible explanation for the coexistence of such variation. We find that genotypes typically designated as "cheaters" because they produce a disproportionate number of spores in chimeric fruiting bodies do not actually gain higher fitness as a result of this apparent advantage because they produce smaller, less viable spores than putative "losers." As a consequence of this trade-off between spore number and viability, genotypes with different spore production strategies, which give the appearance of differential social success, ultimately have similar realized fitness. These findings highlight the limitations of using single fitness proxies in evolutionary studies and suggest that interpreting social trait variation in terms of strategies like cheating or cooperating may be misleading unless these behaviors are considered in the context of the true multidimensional nature of fitness.

  9. High cardiorespiratory fitness in early to late middle age preserves the cortical circuitry associated with brain-heart integration during volitional exercise.

    PubMed

    Wood, Katelyn N; Luchyshyn, Torri A; Shoemaker, J Kevin

    2017-04-01

    This study tested the hypothesis that high cardiorespiratory fitness (peak oxygen uptake) preserves the cortical circuitry associated with cardiac arousal during exercise in middle- to older-aged individuals. Observations of changes in heart rate (HR) and in cortical blood oxygenation level-dependent (BOLD) images were made in 52 healthy, active individuals (45-73 yr; 16 women, 36 men) across a range of fitness (26-66 ml·kg(-1)·min(-1)). Seven repeated bouts of isometric handgrip (IHG) at 40% maximal voluntary contraction force were performed with functional magnetic resonance imaging at 3 T, with each contraction lasting 20 s and separated by 40 s of rest. HR responses to IHG showed high variability across individuals. Linear regression revealed that cardiorespiratory fitness was not a strong predictor of the HR response (r(2) = 0.09). In a region-of-interest analysis both the IHG task and the HR time course correlated with increased cortical activation in the bilateral insula and decreased activation relative to baseline in the anterior and posterior cingulate and medial prefrontal cortex (MPFC). t-Test results revealed greater deactivation at the MPFC with higher fitness levels beyond that of guideline-based activity. Therefore, whereas high cardiorespiratory fitness failed to affect absolute HR responses to IHG in this age range, a select effect was observed in cortical regions known to be associated with cardiovascular arousal.NEW & NOTEWORTHY Our first observation suggests that fitness does not strongly predict the heart rate (HR) response to a volitional handgrip task in middle- to older-aged adults. Second, the BOLD response associated with the handgrip task, and with the HR time course, was associated with response patterns in the cortical autonomic network. Finally, whereas high cardiorespiratory fitness failed to affect absolute HR responses to isometric handgrip in this age range, a select effect was observed in cortical regions known to be

  10. 77 FR 24459 - Stainless Steel Butt-Weld Pipe Fittings From Italy: Final Results of Antidumping Duty...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-24

    ... grades of stainless steel and ``commodity'' and ``specialty'' fittings. Specifically excluded from the... International Trade Administration Stainless Steel Butt-Weld Pipe Fittings From Italy: Final Results of... stainless steel butt-weld pipe fittings (SSBW pipe fittings) from Italy.\\1\\ This review covers...

  11. Resting Bradycardia, Enhanced Postexercise Heart Rate Recovery and Cardiorespiratory Fitness in Recreational Ballroom Dancers

    ERIC Educational Resources Information Center

    da Cruz, Carlos Janssen Gomes; Molina, Guilherme Eckhardt; Porto, Luiz Guilherme Grossi; Junqueira, Luiz Fernando, Jr.

    2017-01-01

    Purpose: In a cross-sectional study design, we evaluated the resting heart rate (HR[subscript baseline]) and exercise and postexercise stress test-related chronotropic responses in male practitioners of recreational ballroom dancing (BD; n = 25, M[subscript age] = 26.6 ± 6.1 years) compared to a control group of insufficiently active nondancers…

  12. Equestrian expertise affecting physical fitness, body compositions, lactate, heart rate and calorie consumption of elite horse riding players

    PubMed Central

    Sung, Bong-Ju; Jeon, Sang-Yong; Lim, Sung-Ro; Lee, Kyu-Eon; Jee, Hyunseok

    2015-01-01

    Horse riding (HR) is a sport harmonized with rider and horse. HR is renowned as an effective sport for young and old women and men. There is rare study regarding comparison between elite horse riders and amateurs. We aimed to investigate comprehensive ranges of parameters such as change of lactate, heart rate, calorie, VO2max, skeletal muscle mass, body water, body fat, etc between amateurs and professionals to emphasize HR not only as a sport training but also as a therapeutic aspect. We performed 3 experiments for comparing physical fitness, body compositions, lactate value, heart rate and calorie consumption change before and after riding between amateurs and elites. Around 3 yr riding experienced elites are preeminent at balance capability compared to 1 yr riding experienced amateurs. During 18 min horse riding, skeletal muscle mass and body fat were interestingly increased and decreased, respectively. Lactate response was more sensitive in elites rather than amateurs and its recovery was reversely reacted. Exercise intensity estimated from heart rate was significantly higher in elites (P<0.05). The similar pattern of calorie consumption during riding between amateurs and elites was shown. Horse riding possibly induces various physiological (muscle strength, balance, oxidative capability, flexibility, and metabolic control) changes within body and is thus highly recommended as combined exercise for women, children, and aged as therapeutic and leisure sport activity. PMID:26171385

  13. Equestrian expertise affecting physical fitness, body compositions, lactate, heart rate and calorie consumption of elite horse riding players.

    PubMed

    Sung, Bong-Ju; Jeon, Sang-Yong; Lim, Sung-Ro; Lee, Kyu-Eon; Jee, Hyunseok

    2015-06-01

    Horse riding (HR) is a sport harmonized with rider and horse. HR is renowned as an effective sport for young and old women and men. There is rare study regarding comparison between elite horse riders and amateurs. We aimed to investigate comprehensive ranges of parameters such as change of lactate, heart rate, calorie, VO2max, skeletal muscle mass, body water, body fat, etc between amateurs and professionals to emphasize HR not only as a sport training but also as a therapeutic aspect. We performed 3 experiments for comparing physical fitness, body compositions, lactate value, heart rate and calorie consumption change before and after riding between amateurs and elites. Around 3 yr riding experienced elites are preeminent at balance capability compared to 1 yr riding experienced amateurs. During 18 min horse riding, skeletal muscle mass and body fat were interestingly increased and decreased, respectively. Lactate response was more sensitive in elites rather than amateurs and its recovery was reversely reacted. Exercise intensity estimated from heart rate was significantly higher in elites (P<0.05). The similar pattern of calorie consumption during riding between amateurs and elites was shown. Horse riding possibly induces various physiological (muscle strength, balance, oxidative capability, flexibility, and metabolic control) changes within body and is thus highly recommended as combined exercise for women, children, and aged as therapeutic and leisure sport activity.

  14. Initial Results from Fitting p-Modes Using Intensity Observations from the Helioseismic and Magnetic Imager

    NASA Astrophysics Data System (ADS)

    Korzennik, Sylvain G.

    2017-09-01

    The Helioseismic and Magnetic Imager project recently started processing the continuum-intensity images following global helioseismology procedures similar to those used to process the velocity images. The spatial decomposition of these images has produced time series of spherical harmonic coefficients for degrees up to ℓ=300, using a different apodization than the one used for velocity observations. The first 360 days of observations were processed and are made available. I present initial results from fitting these time series using my fitting method and compare the derived mode characteristics to those estimated using coeval velocity observations.

  15. Primary prevention of coronary heart disease in men and women: does 1 size fit all? Yes!

    PubMed

    Amsterdam, Ezra A

    2011-11-01

    Cardiovascular disease remains the leading cause of mortality in both women and men in the industrialized nations. Coronary heart disease (CHD) accounts for the single largest share of this toll in both sexes. Although it had long been known that the number 1 cause of death in men is CHD, it was determined only relatively recently that this was also true in women. Identification of the traditional risk factors (RFs) for CHD by the Framingham Heart Study and other investigations during the last 5 decades has provided the basis of preventive cardiology. These RFs can be considered as fixed or modifiable. Numerous epidemiologic and clinical studies have demonstrated that, with few exceptions, the major RFs that increase the hazard for CHD are the same for both men and women, whether fixed (age, sex, family history) or modified (lipids, blood pressure, smoking). A number of other RFs are under investigation and await confirmation in rigorous prospective studies. Even those conditions unique to women, which can predispose patients to CHD, such as polycystic ovaries and complications of pregnancy, act through provocation of the traditional RFs. Thus, the large body of evidence that supports the similarity of RFs for CHD in men and women provides a rational foundation for similar strategies of prevention in the 2 sexes. © 2011 Wiley Periodicals, Inc.

  16. Heart sounds as a result of acoustic dipole radiation of heart valves

    NASA Astrophysics Data System (ADS)

    Kasoev, S. G.

    2005-11-01

    Heart sounds are associated with impulses of force acting on heart valves at the moment they close under the action of blood-pressure difference. A unified model for all the valves represents this impulse as an acoustic dipole. The near pressure field of this dipole creates a distribution of the normal velocity on the breast surface with features typical of auscultation practice: a pronounced localization of heart sound audibility areas, an individual area for each of the valves, and a noncoincidence of these areas with the projections of the valves onto the breast surface. In the framework of the dipole theory, the optimum size of the stethoscope’s bell is found and the spectrum of the heart sounds is estimated. The estimates are compared with the measured spectrum.

  17. 49 CFR 385.317 - Will a safety audit result in a safety fitness determination by the FMCSA?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 5 2011-10-01 2011-10-01 false Will a safety audit result in a safety fitness... SAFETY REGULATIONS SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.317 Will a safety audit result in a safety fitness determination by the FMCSA? A safety audit will not result in a safety...

  18. 49 CFR 385.317 - Will a safety audit result in a safety fitness determination by the FMCSA?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 5 2010-10-01 2010-10-01 false Will a safety audit result in a safety fitness... SAFETY REGULATIONS SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.317 Will a safety audit result in a safety fitness determination by the FMCSA? A safety audit will not result in a safety...

  19. 49 CFR 385.317 - Will a safety audit result in a safety fitness determination by the FMCSA?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 5 2012-10-01 2012-10-01 false Will a safety audit result in a safety fitness... SAFETY REGULATIONS SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.317 Will a safety audit result in a safety fitness determination by the FMCSA? A safety audit will not result in a safety...

  20. 49 CFR 385.317 - Will a safety audit result in a safety fitness determination by the FMCSA?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 5 2014-10-01 2014-10-01 false Will a safety audit result in a safety fitness... SAFETY REGULATIONS SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.317 Will a safety audit result in a safety fitness determination by the FMCSA? A safety audit will not result in a safety...

  1. 49 CFR 385.317 - Will a safety audit result in a safety fitness determination by the FMCSA?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 5 2013-10-01 2013-10-01 false Will a safety audit result in a safety fitness... SAFETY REGULATIONS SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.317 Will a safety audit result in a safety fitness determination by the FMCSA? A safety audit will not result in a safety...

  2. Elevated resting heart rate, physical fitness and all-cause mortality: a 16-year follow-up in the Copenhagen Male Study

    PubMed Central

    Jensen, Magnus Thorsten; Suadicani, Poul; Hein, Hans Ole; Gyntelberg, Finn

    2013-01-01

    Objective To examine whether elevated resting heart rate (RHR) is an independent risk factor for mortality or a mere marker of physical fitness (VO2Max). Methods This was a prospective cohort study: the Copenhagen Male Study, a longitudinal study of healthy middle-aged employed men. Subjects with sinus rhythm and without known cardiovascular disease or diabetes were included. RHR was assessed from a resting ECG at study visit in 1985–1986. VO2Max was determined by the Åstrand bicycle ergometer test in 1970–1971. Subjects were classified into categories according to level of RHR. Associations with mortality were studied in multivariate Cox models adjusted for physical fitness, leisure-time physical activity and conventional cardiovascular risk factors. Results 2798 subjects were followed for 16 years. 1082 deaths occurred. RHR was inversely related to physical fitness (p<0.001). Overall, increasing RHR was highly associated with mortality in a graded manner after adjusting for physical fitness, leisure-time physical activity and other cardiovascular risk factors. Compared to men with RHR ≤50, those with RHR >90 had an HR (95% CI) of 3.06 (1.97 to 4.75). With RHR as a continuous variable, risk of mortality increased with 16% (10–22) per 10 beats per minute (bpm). There was a borderline interaction with smoking (p=0.07); risk per 10 bpm increase in RHR was 20% (12–27) in smokers, and 14% (4–24) in non-smokers. Conclusions Elevated RHR is a risk factor for mortality independent of physical fitness, leisure-time physical activity and other major cardiovascular risk factors. PMID:23595657

  3. Effects of High-Intensity Interval Training versus Continuous Training on Physical Fitness, Cardiovascular Function and Quality of Life in Heart Failure Patients

    PubMed Central

    Benda, Nathalie M. M.; Seeger, Joost P. H.; Stevens, Guus G. C. F.; Hijmans-Kersten, Bregina T. P.; van Dijk, Arie P. J.; Bellersen, Louise; Lamfers, Evert J. P.; Hopman, Maria T. E.; Thijssen, Dick H. J.

    2015-01-01

    Introduction Physical fitness is an important prognostic factor in heart failure (HF). To improve fitness, different types of exercise have been explored, with recent focus on high-intensity interval training (HIT). We comprehensively compared effects of HIT versus continuous training (CT) in HF patients NYHA II-III on physical fitness, cardiovascular function and structure, and quality of life, and hypothesize that HIT leads to superior improvements compared to CT. Methods Twenty HF patients (male:female 19:1, 64±8 yrs, ejection fraction 38±6%) were allocated to 12-weeks of HIT (10*1-minute at 90% maximal workload—alternated by 2.5 minutes at 30% maximal workload) or CT (30 minutes at 60–75% of maximal workload). Before and after intervention, we examined physical fitness (incremental cycling test), cardiac function and structure (echocardiography), vascular function and structure (ultrasound) and quality of life (SF-36, Minnesota living with HF questionnaire (MLHFQ)). Results Training improved maximal workload, peak oxygen uptake (VO2peak) related to the predicted VO2peak, oxygen uptake at the anaerobic threshold, and maximal oxygen pulse (all P<0.05), whilst no differences were present between HIT and CT (N.S.). We found no major changes in resting cardiovascular function and structure. SF-36 physical function score improved after training (P<0.05), whilst SF-36 total score and MLHFQ did not change after training (N.S.). Conclusion Training induced significant improvements in parameters of physical fitness, although no evidence for superiority of HIT over CT was demonstrated. No major effect of training was found on cardiovascular structure and function or quality of life in HF patients NYHA II-III. Trial Registration Nederlands Trial Register NTR3671 PMID:26517867

  4. Fitness Trade-offs Result in the Illusion of Social Success

    PubMed Central

    Wolf, Jason B.; Howie, Jennifer A.; Parkinson, Katie; Gruenheit, Nicole; Melo, Diogo; Rozen, Daniel; Thompson, Christopher R.L.

    2015-01-01

    Summary Cooperation is ubiquitous across the tree of life, from simple microbes to the complex social systems of animals [1]. Individuals cooperate by engaging in costly behaviors that can be exploited by other individuals who benefit by avoiding these associated costs. Thus, if successful exploitation of social partners during cooperative interactions increases relative fitness, then we expect selection to lead to the emergence of a single optimal winning strategy in which individuals maximize their gain from cooperation while minimizing their associated costs [2]. Such social “cheating” appears to be widespread in nature [3], including in several microbial systems [4–11], but despite the fitness advantages favoring social cheating, populations tend to harbor significant variation in social success rather than a single optimal winning strategy. Using the social amoeba Dictyostelium discoideum, we provide a possible explanation for the coexistence of such variation. We find that genotypes typically designated as “cheaters” [12] because they produce a disproportionate number of spores in chimeric fruiting bodies do not actually gain higher fitness as a result of this apparent advantage because they produce smaller, less viable spores than putative “losers.” As a consequence of this trade-off between spore number and viability, genotypes with different spore production strategies, which give the appearance of differential social success, ultimately have similar realized fitness. These findings highlight the limitations of using single fitness proxies in evolutionary studies and suggest that interpreting social trait variation in terms of strategies like cheating or cooperating may be misleading unless these behaviors are considered in the context of the true multidimensional nature of fitness. PMID:25819562

  5. Associations of Physical Activity, Sedentary Time, and Screen Time With Cardiovascular Fitness in United States Adolescents: Results from the NHANES National Youth Fitness Survey (NNYFS).

    PubMed

    Porter, Anna K; Matthews, Krystin J; Salvo, Deborah; Kohl, Harold W

    2017-03-14

    Background Most US adolescents do not meet guidelines of at least 60 daily minutes of moderate- to vigorous-intensity physical activity. Additionally, sedentary behaviors among this age group are of increasing concern. This study examined the association of movement behaviors with cardiovascular fitness among US adolescents. Methods Data from the 2012 NHANES National Youth Fitness Survey were used to assess the association of movement behaviors (physical activity, sedentary time, screen time) with cardiovascular fitness among adolescent males and females. Multiple logistic regressions were used to test the independent and interactive effects of movement behaviors on cardiovascular fitness. Results Among females, physical activity was directly associated with cardiovascular fitness; no significant association was observed between sedentary behaviors and CVF. Among males, sedentary time moderated the relationship between physical activity and cardiovascular fitness, such that a significant, direct association was only observed among those with high sedentary time (OR: 5.01, 95% CI: 1.60, 15.70). Conclusions Results from this cross-sectional analysis suggest that among female US adolescents, physical activity, but not sedentary behavior, is associated with cardiovascular fitness. Among males, the interaction between physical activity and sedentary time seems to be important for cardiovascular fitness. Longitudinal studies are warranted to confirm these findings.

  6. Heart transplantation using allografts from older donors: Multicenter study results.

    PubMed

    Roig, Eulàlia; Almenar, Luís; Crespo-Leiro, Marisa; Segovia, Javier; Mirabet, Sònia; Delgado, Juan; Pérez-Villa, Felix; Luís Lambert, Jose; Teresa Blasco, M; Muñiz, Javier

    2015-06-01

    The lengthy waiting time for heart transplantation is associated with high mortality. To increase the number of donors, new strategies have emerged, including the use of hearts from donors ≥50 years old. However, this practice remains controversial. The aim of this study was to evaluate outcomes of patients receiving heart transplants from older donors. We retrospectively analyzed 2,102 consecutive heart transplants in 8 Spanish hospitals from 1998 to 2010. Acute and overall mortality were compared in patients with grafts from donors ≥50 years old versus grafts from younger donors. There were 1,758 (84%) transplanted grafts from donors < 50 years old (Group I) and 344 (16%) from donors ≥50 years old (Group II). Group I had more male donors than Group II (71% vs. 57%, p = 0.0001). The incidence of cardiovascular risk factors was higher in older donors. There were no differences in acute mortality or acute rejection episodes between the 2 groups. Global mortality was higher in Group II (rate ratio, 1.40; 95% confidence interval, 1.18-1.67; p = 0.001) than in Group I. After adjusting for donor cause of death, donor smoking history, recipient age, induction therapy, and cyclosporine therapy, the differences lost significance. Group II had a higher incidence of coronary allograft vasculopathy at 5 years (rate ratio, 1.67; 95% confidence interval, 1.22-2.27; p = 0.001). There were no differences in acute and overall mortality after adjusting for confounding factors. However, there was a midterm increased risk of coronary allograft vasculopathy with the use of older donors. Careful selection of recipients and close monitoring of coronary allograft vasculopathy are warranted in these patients. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  7. How do cardiorespiratory fitness improvements vary with physical training modality in heart failure patients? A quantitative guide.

    PubMed

    Smart, Neil A

    2013-01-01

    Peak oxygen consumption (VO2) is the gold standard measure of cardiorespiratory fitness and a reliable predictor of survival in chronic heart failure patients. Furthermore, any form of physical training usually improves cardiorespiratory fitness, although the magnitude of improvement in peak VO2 may vary across different training prescriptions. To quantify, and subsequently rank, the magnitude of improvement in peak VO2 for different physical training prescriptions using data from published meta-analyses and randomized controlled trials. Prospective randomized controlled parallel trials and meta-analyses of exercise training in chronic heart failure patients that provided data on change in peak VO2 for nine a priori comparative analyses were examined. All forms of physical training were beneficial, although the improvement in peak VO2 varied with modality. High-intensity interval exercise yielded the largest increase in peak VO2, followed in descending order by moderate-intensity aerobic exercise, functional electrical stimulation, inspiratory muscle training, combined aerobic and resistance training, and isolated resistance training. With regard to setting, the present study was unable to determine whether outpatient or unsupervised home exercise provided greater benefits in terms of peak VO2 improvment. Interval exercise is not suitable for all patients, especially the high-intensity variety; however, when indicated, this form of exercise should be adopted to optimize peak VO2 adaptations. Other forms of activity, such as functional electrical stimulation, may be more appropriate for patients who are not capable of high-intensity interval training, especially for severely deconditioned patients who are initially unable to exercise.

  8. Establishing percentiles for junior tennis players based on physical fitness testing results.

    PubMed

    Roetert, E P; Piorkowski, P A; Woods, R B; Brown, S W

    1995-01-01

    An important aspect of this study was the establishment of a data base. A broad data base allows for data on certain parameters to be greatly expanded and will also enhance the use and interpretation of statistical methods. A longitudinal study of these variables may also assist in monitoring the players' progress over a period of time, and can provide a useful supplement to subjective coaching appraisals. The means and standard deviation for each test were calculated according to the USTA age and gender groups, that is, 12s, 14s, and 16s for each separate gender. Additionally, the mean and standard deviations for the ages, heights, and weights of each grouping were also calculated. Once the means and standard deviations were calculated, percentile tables were developed for each of the USTA groupings (by age and gender). The percentiles for each USTA test are presented in Appendix 1. A percentile is defined as the point on the distribution below which a given percentage of the scores is found. Percentiles can provide a norm-referenced interpretation of an individual score within a distribution that often consists of scores from a comparable group of individuals. Using the USTA protocol, players and coaches now have a set of normative data by which individual player's fitness scores may be compared with participants of the USTA Area Training Centers (See appendix 1). From the test results, coaches and players can determine which fitness areas need to be improved for athletes on an individual basis. Specific training programs can then be designed based on an athlete's fitness testing results. Proper interpretation of the USTA fitness testing data base results can lead to an easy way to determine the relative position of a given fitness score in the distribution, recognizing weaker areas for the purpose of injury prevention and performance enhancement. Each player can be given a profile detailing their percentile rank relative to other area training center

  9. F-22 Pilot Heart Rate Response to +Gz and Relationship to Pilot Fitness Using U.S. Air Force Fitness Test Scores

    DTIC Science & Technology

    2015-08-19

    exercise . The purpose of this study was to look at U.S. Air Force (USAF) F-22 training sortie data to determine whether pilot fitness as characterized by...and the physiologic stress of G exposure. Individual fitness predicts resting HR and corresponding increase in HR in response to exercise . The...look for signs of fetal distress (decelerations). Resting HR is widely accepted as a function of individual aerobic fitness; the more fit an

  10. The feasibility of exercise videogames for cardiovascular risk reduction among adults: a pilot for "Wii heart fitness".

    PubMed

    Serber, Eva R; Ciccolo, Joseph; Palmer, Kathy; Cobb, Victoria; Tilkemeier, Peter L; Bock, Beth C

    2016-03-01

    More than 30% of the U.S. population is prehypertensive, and the recommended treatment of lifestyle modification includes increased physical activity. Exercise videogames (EVG) are widely marketed to Americans as a means of increasing fitness. This study aimed to examine EVG among a sample of prehypertensive adults, to determine (1) feasibility and acceptability of EVG for physical activity, and (2) assess changes in (1) estimates of cardiovascular fitness and risk indices, and psychosocial constructs. Participants with prehypertension completed a 12-week program including; 36, 1-hour sessions; supervised EVG program using Nintendo Wii platform and games. Assessments were at baseline and 13 weeks. Paired t-tests were conducted. Fourteen adults (84% female; mean age=53 years; 93% Caucasian; 87% employed) completed the study. The study retention rate was 74% and all participants reported satisfaction and enjoyment in the intervention and using the Wii for exercise. Despite the small sample size, significant improvements were seen in: physical activity minutes (P<0.01), peak heart rate (P=0.02), resting systolic blood pressure (P=0.02), and hip circumference (P=0.03). Significant improvements were also seen in the 36-item short-form survey (SF-36) as for general health (P=0.05), role limitations due to emotional problems (P=0.04), and vitality (P=0.01). Findings support that an EVG program is feasible, acceptable, and promising in promoting benefit to cardiovascular fitness and psychosocial health. These data provide pilot data for the necessary randomized clinical trials to examine efficacy and sustainability of EVG for adult engagement in physical activity for cardiovascular health promotion.

  11. Potential fitting biases resulting from grouping data into variable width bins

    NASA Astrophysics Data System (ADS)

    Towers, S.

    2014-07-01

    When reading peer-reviewed scientific literature describing any analysis of empirical data, it is natural and correct to proceed with the underlying assumption that experiments have made good faith efforts to ensure that their analyses yield unbiased results. However, particle physics experiments are expensive and time consuming to carry out, thus if an analysis has inherent bias (even if unintentional), much money and effort can be wasted trying to replicate or understand the results, particularly if the analysis is fundamental to our understanding of the universe. In this note we discuss the significant biases that can result from data binning schemes. As we will show, if data are binned such that they provide the best comparison to a particular (but incorrect) model, the resulting model parameter estimates when fitting to the binned data can be significantly biased, leading us to too often accept the model hypothesis when it is not in fact true. When using binned likelihood or least squares methods there is of course no a priori requirement that data bin sizes need to be constant, but we show that fitting to data grouped into variable width bins is particularly prone to produce biased results if the bin boundaries are chosen to optimize the comparison of the binned data to a wrong model. The degree of bias that can be achieved simply with variable binning can be surprisingly large. Fitting the data with an unbinned likelihood method, when possible to do so, is the best way for researchers to show that their analyses are not biased by binning effects. Failing that, equal bin widths should be employed as a cross-check of the fitting analysis whenever possible.

  12. Stresses and Strains in a Plate Resulting from two Closely-Spaced Interference-Fit Fasteners

    DTIC Science & Technology

    1985-05-01

    Trans-Australia Airlines, Library Qantas Airways Limited Ansett Airlines of Australia, Library Commonwealth Aircraft Corporation, Library Hawker de...fit fasteners (nominal centre distance equalling two hole diameters) in a D6ac steel plate. For comparison, a finite element analysis was performed...for the same geometry using the penalty element method. Measured strains showed broad agreementwith the results of the finite element analysis and the

  13. [The Roman coronary heart disease prevention program. Final results].

    PubMed

    1982-01-01

    The Rome Project of Coronary Heart Disease Prevention (PPCC) is a primary prevention trial of coronary heart disease; it represents the Italian section of the WHO European Multifactor Preventive Trial of CHD. The study has been carried out in 4 working groups of male subjects aged 40-59 years at entry, two groups (a total of 3,131 men) being assigned to treatment and the other two (a total of 2,896 men) to control, with a 6-year follow-up. The preventive intervention aimed at reducing or modifying: mean levels of serum cholesterol (generally through dietary prescriptions and, in a smaller number of subjects, with drug treatment), smoking habits (subjects were advised to reduce or stop smoking); overweight (by means of diet); sedentary life-style (with increased physical activity). The intervention program has also involved other factors such as high levels of serum triglycerides, blood glucose and serum uric acid. The treatment was carried out through individual sessions on about one third of subjects belonging to the upper part of an estimated coronary risk score, while mass education was administered to the remaining two thirds. No intervention at all was offered to the control groups. Changes in the levels of risk factors were measured through periodical examinations of the whole population enrolled in the trial. Monitoring of both fatal and non fatal morbid events provided data on mortality and incidence trends. Over the 6 years of follow-up, the mean reduction in the mean levels of the main coronary risk factors in treated groups, as compared to controls, was as follows: serum cholesterol: 4.8%; systolic blood pressure: 4.6%; number of cigarettes per day: 8.7%; body weight: 2.4%; estimated coronary risk: 38.9%. At the end of the 6 years of observation, mortality for all causes was lower by 6.0% to 10.7% in treated groups than in controls; mortality for coronary heart disease was also lower (by 26.8% to 30.2%), as well as the incidence of fatal plus non

  14. Comparison of Hemodynamic Performance and Clinical Results with EVAHEART Versus HeartMate II.

    PubMed

    Matsumoto, Yorihiko; Fujita, Tomoyuki; Fukushima, Satsuki; Hata, Hiroki; Shimahara, Yusuke; Kume, Yuta; Yamashita, Kizuku; Kuroda, Kensuke; Nakajima, Seiko; Sato, Takuma; Seguchi, Osamu; Yanase, Masanobu; Fukushima, Norihide; Shimizu, Hideyuki; Kobayashi, Junjiro

    This study aimed to compare the hemodynamic performance and clinical results of the EVAHEART and HeartMate II left ventricular assist devices (LVADs). From 2007 to 2016, fourteen patients received EVAHEART and 28 received HeartMate II at our center. Early survival, driveline infection, and neurologic events were evaluated. Hemodynamic performance was evaluated with transthoracic echocardiography and right heart catheterization. Mean follow-up was 35.5 ± 14.8 months for EVAHEART and 29.8 ± 6.5 months for HeartMate II. Survival rates were comparable between the two groups. After 24 months, freedom from driveline infection was 28% with EVAHEART, and 85% with HeartMate II; freedom from neurologic events was 21% with EVAHEART, and 89% with HeartMate II. Serum lactate dehydrogenase was significantly lower with EVAHEART. There was a significantly greater decrease in left ventricular size with HeartMate II. In catheter examination performed 1 month postoperatively, HeartMate II recipients had significantly lower pulmonary capillary wedge pressure and mean pulmonary pressure, despite a comparable cardiac index. Both devices provided excellent clinical results and hemodynamic performance. HeartMate II could be a better choice to avoid driveline infection and neurologic events. Our results suggest that HeartMate II reduced right ventricular afterload. However, further analysis of more cases is required.

  15. Radio Astronomers Lift "Fog" on Milky Way's Dark Heart: Black Hole Fits Inside Earth's Orbit

    NASA Astrophysics Data System (ADS)

    2004-04-01

    -emitting object would fit neatly just inside the path of the Earth's orbit around the Sun, the astronomers said. The black hole itself, they calculate, is about 14 million miles across, and would fit easily inside the orbit of Mercury. Black holes are concentrations of matter so dense that not even light can escape their powerful gravity. The new VLBA observations provided astronomers their best look yet at a black hole system. "We are much closer to seeing the effects of a black hole on its environment here than anywhere else," Bower said. The Milky Way's central black hole, like its more-massive cousins in more-active galactic nuclei, is believed to be drawing in material from its surroundings, and in the process powering the emission of the radio waves. While the new VLBA observations have not provided a final answer on the nature of this process, they have helped rule out some theories, Bower said. Based on the latest work, he explained, the top remaining theories for the nature of the radio- emitting object are jets of subatomic particles, similar to those seen in radio galaxies; and some theories involving matter being accelerated near the edge of the black hole. As the astronomers studied Sagittarius A* at higher and higher radio frequencies, the apparent size of the object became smaller. This fact, too, Bower said, helped rule out some ideas of the object's nature. The decrease in observed size with increasing frequency, or shorter wavelength, also gives the astronomers a tantalizing target. "We think we can eventually observe at short enough wavelengths that we will see a cutoff when we reach the size of the black hole itself," Bower said. In addition, he said, "in future observations, we hope to see a 'shadow' cast by a gravitational lensing effect of the very strong gravity of the black hole." In 2000, Falcke and his colleagues proposed such an observation on theoretical grounds, and it now seems feasible. "Imaging the shadow of the black hole's event horizon is now

  16. Heart failure resulting from giant left atrial synovial sarcoma metastasis.

    PubMed

    Winkler, B; Grapow, M; Seeberger, M; Matt, P; Aulitzky, W; Eckstein, F

    2012-02-01

    Synovial sarcoma metastasis affecting the heart and infiltrating the mitral valve is a very rare pathology. We report the case of a 44-year-old male treated with chemotherapy for atypical synovial sarcoma of the oral mucosa who presented to our clinic after cardiac decompensation with a presumptive diagnosis of myxoma of the left atrium. A large necrotic tumour positive for CK 22, EMA, CD 99 and BCL-2 but negative for translocation in COBRA-FISH analysis by break-apart probe could be excised and revealed a very rare subtype of synovial sarcoma metastasis arising from the endocard of the left atrium. The tumour was resected and the mitral valve reconstructed through ring annuloplasty. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  17. Physical work demands and physical fitness in low social classes--30-year ischemic heart disease and all-cause mortality in the Copenhagen Male Study.

    PubMed

    Holtermann, Andreas; Mortensen, Ole Steen; Burr, Hermann; Søgaard, Karen; Gyntelberg, Finn; Suadicani, Poul

    2011-11-01

    Investigate whether high physical work demands increase risk of ischemic heart disease (IHD) mortality among men of low social class with low physical fitness. Thirty-year follow-up in the Copenhagen Male Study of 5249 men aged 40 to 59 years without cardiovascular disease. Physical fitness was estimated using the Åstrand cycling test, and physical work demands determined by two self-reported questions. Among 2707 low social class men, multiple-adjusted Cox proportional hazard ratios showed an almost threefold increased risk of IHD mortality among men with high physical work demands and low physical fitness, but not among men with a high physical fitness, referencing men with low physical work demands. These findings among low social class men support that high physical work demands increases the risk of IHD mortality among those with low physical fitness.

  18. A 45-Second Self-Test for Cardiorespiratory Fitness: Heart Rate-Based Estimation in Healthy Individuals

    PubMed Central

    Bonato, Matteo; Papini, Gabriele; Bosio, Andrea; Mohammed, Rahil A.; Bonomi, Alberto G.; Moore, Jonathan P.; Merati, Giampiero; La Torre, Antonio; Kubis, Hans-Peter

    2016-01-01

    Cardio-respiratory fitness (CRF) is a widespread essential indicator in Sports Science as well as in Sports Medicine. This study aimed to develop and validate a prediction model for CRF based on a 45 second self-test, which can be conducted anywhere. Criterion validity, test re-test study was set up to accomplish our objectives. Data from 81 healthy volunteers (age: 29 ± 8 years, BMI: 24.0 ± 2.9), 18 of whom females, were used to validate this test against gold standard. Nineteen volunteers repeated this test twice in order to evaluate its repeatability. CRF estimation models were developed using heart rate (HR) features extracted from the resting, exercise, and the recovery phase. The most predictive HR feature was the intercept of the linear equation fitting the HR values during the recovery phase normalized for the height2 (r2 = 0.30). The Ruffier-Dickson Index (RDI), which was originally developed for this squat test, showed a negative significant correlation with CRF (r = -0.40), but explained only 15% of the variability in CRF. A multivariate model based on RDI and sex, age and height increased the explained variability up to 53% with a cross validation (CV) error of 0.532 L ∙ min-1 and substantial repeatability (ICC = 0.91). The best predictive multivariate model made use of the linear intercept of HR at the beginning of the recovery normalized for height2 and age2; this had an adjusted r2 = 0. 59, a CV error of 0.495 L·min-1 and substantial repeatability (ICC = 0.93). It also had a higher agreement in classifying CRF levels (κ = 0.42) than RDI-based model (κ = 0.29). In conclusion, this simple 45 s self-test can be used to estimate and classify CRF in healthy individuals with moderate accuracy and large repeatability when HR recovery features are included. PMID:27959935

  19. Heart rate response and fitness effects of various types of physical education for 8- to 9-year-old schoolchildren.

    PubMed

    Bendiksen, Mads; Williams, Craig A; Hornstrup, Therese; Clausen, Helle; Kloppenborg, Jesper; Shumikhin, Dmitriy; Brito, João; Horton, Joshua; Barene, Svein; Jackman, Sarah R; Krustrup, Peter

    2014-01-01

    The present study investigated the heart rate (HR) response to various types of physical education (PE) activities for 8- to 9-year-olds (five school classes, n = 93) and the fitness effects of a short-term PE training programme (three of the five classes, n = 59) with high compared to low-to-moderate aerobic intensity. HR was recorded during small-sided indoor soccer (SO), basketball (BB), unihockey (UH), circuit training (CT), walking (W) and Nintendo Wii Boxing (NWB) and Nintendo Wii Tennis (NWT). Maximal HR (HRmax) and physical fitness was determined by the Yo-Yo Intermittent Recovery Level 1 Children's test (YYIR1C) test. Following cluster randomisation, three classes were tested before and after 6 wks with 2 × 30 min/wk SO and UH lessons [high-intensity (HI), 2 classes, n = 39] or low-to-moderate intensity PE lessons (CON, 1 class, n = 20). Average HR in SO (76 ± 1% HRmax), BA (77 ± 1% HRmax) and UH (74 ± 1% HRmax) was higher (P < 0.05) than in CT (62 ± 1% HRmax), W (57 ± 1% HRmax), NWB (65 ± 2% HRmax) and NWT (57 ± 1% HRmax). Time with HR > 80% and 90% HRmax, respectively, was higher (P < 0.05) in SO (42 ± 4 and 12 ± 2%), BB (41 ± 5 and 13 ± 3%) and UH (34 ± 3 and 9 ± 2%) than in CT, W and NW (0-5%), with time >80% HRmax being higher (P < 0.05) in SO than UH. After 6 wk, YYIR1C performance was increased (P < 0.05) by 22% in HI (673 ± 57 to 821 ± 71 m), but unaltered in CON (674 ± 88 to 568 ± 81 m). HR 2 min into YYIR1C was lowered (P < 0.05) in HI after 6 wks (92.4 ± 0.8 to 89.1 ± 0.9% HRmax), but not in CON. In conclusion, ball games elicited high aerobic loading for young schoolchildren and a short-term, low-volume ball game PE-intervention improved physical fitness. Traditional PE sessions had no effects on intermittent exercise performance.

  20. 10-year results of the uncemented Allofit press-fit cup in young patients

    PubMed Central

    Streit, Marcus R; Weiss, Stefan; Andreas, Franziska; Bruckner, Thomas; Walker, Tilman; Kretzer, J Philippe; Ewerbeck, Volker; Merle, Christian

    2014-01-01

    Background and purpose Uncemented acetabular components in primary total hip arthroplasty (THA) are commonly used today, but few studies have evaluated their survival into the second decade in young and active patients. We report on a minimum 10-year follow-up of an uncemented press-fit acetabular component that is still in clinical use. Methods We examined the clinical and radiographic results of our first 121 consecutive cementless THAs using a cementless, grit-blasted, non-porous, titanium alloy press-fit cup (Allofit; Zimmer Inc., Warsaw, IN) without additional screw fixation in 116 patients. Mean age at surgery was 51 (21–60) years. Mean time of follow-up evaluation was 11 (10–12) years. Results At final follow-up, 8 patients had died (8 hips), and 1 patient (1 hip) was lost to follow-up. 3 hips in 3 patients had undergone acetabular revision, 2 for deep infection and 1 for aseptic acetabular loosening. There were no impending revisions at the most recent follow-up. We did not detect periacetabular osteolysis or loosening on plain radiographs in those hips that were evaluated radiographically (n = 90; 83% of the hips available at a minimum of 10 years). Kaplan-Meier survival analysis using revision of the acetabular component for any reason (including isolated inlay revisions) as endpoint estimated the 11-year survival rate at 98% (95% CI: 92–99). Interpretation Uncemented acetabular fixation using the Allofit press-fit cup without additional screws was excellent into early in the second decade in this young and active patient cohort. The rate of complications related to the liner and to osteolysis was low. PMID:24875058

  1. Comparison of qualitative and quantitative fit-testing results for three commonly used respirators in the healthcare sector.

    PubMed

    Hon, Chun-Yip; Danyluk, Quinn; Bryce, Elizabeth; Janssen, Bob; Neudorf, Mike; Yassi, Annalee; Shen, Hui; Astrakianakis, George

    2017-03-01

    N95 filtering facepiece respirators are used by healthcare workers when there is a risk of exposure to airborne hazards during aerosol-generating procedures. Respirator fit-testing is required prior to use to ensure that the selected respirator provides an adequate face seal. Two common fit-test methods can be employed: qualitative fit-test (QLFT) or quantitative fit-test (QNFT). Respiratory protection standards deem both fit-tests to be acceptable. However, previous studies have indicated that fit-test results may differ between QLFT and QNFT and that the outcomes may also be influenced by the type of respirator model. The aim of this study was to determine if there is a difference in fit-test outcomes with our suite of respirators, 3M - 1860S, 1860, AND 1870, and whether the model impacts the fit-test results. Subjects were recruited from residential care facilities. Each participant was assigned a respirator and underwent sequential QLFT and QNFT fit-tests and the results (either pass or fail) were recorded. To ascertain the degree of agreement between the two fit-tests, a Kappa (Κ) statistic was conducted as per the American National Standards Institute (ANSI) respiratory protection standard. The pass-fail rates were stratified by respirator model and a Kappa statistic was calculated for each to determine effect of model on fit-test outcomes. We had 619 participants and the aggregate Κ statistic for all respirators was 0.63 which is below the suggested ANSI threshold of 0.70. There was no statistically significant difference in results when stratified by respirator model. QNFT and QLFT produced different fit-test outcomes for the three respirator models examined. The disagreement in outcomes between the two fit-test methods with our suite of N95 filtering facepiece respirators was approximately 12%. Our findings may benefit other healthcare organizations that use these three respirators.

  2. Progressive Adaptive Physical Activity in Stroke Improves Balance, Gait, and Fitness: Preliminary Results

    PubMed Central

    Michael, Kathleen; Goldberg, Andrew P.; Treuth, Margarita S.; Beans, Jeffrey; Normandt, Peter; Macko, Richard F.

    2010-01-01

    Purpose We conducted a noncontrolled pilot intervention study in stroke survivors to examine the efficacy of low-intensity adaptive physical activity to increase balance, improve walking function, and increase cardiovascular fitness and to determine whether improvements were carried over into activity profiles in home and community. Method Adaptive physical activity sessions were conducted 3 times/week for 6 months. The main outcomes were Berg Balance Scale, Dynamic Gait Index, 6-Minute Walk Test, cardiovascular fitness (VO2 peak), Falls Efficacy Scale, and 5-day Step Activity Monitoring. Results Seven men and women with chronic ischemic stroke completed the 6-month intervention. The mean Berg Balance baseline score increased from 33.9 ± 8.5 to 46 ± 6.7 at 6 months (mean ± SD; p = .006). Dynamic Gait Index increased from 13.7 ± 3.0 to 19.0 ± 3.5 (p = .01). Six-minute walk distance increased from 840 ± 110 feet to 935 ± 101 feet (p = 0.02). VO2 peak increased from 15.3 ± 4.1 mL/kg/min to 17.5 ± 4.7 mL/kg/min (p = .03). There were no significant changes in falls efficacy or free-living ambulatory activity. Conclusion A structured adaptive physical activity produces improvements in balance, gait, fitness, and ambulatory performance but not in falls efficacy or free-living daily step activity. Randomized studies are needed to determine the cardiovascular health and functional benefits of structured group physical activity programs and to develop behavioral interventions that promote increased free-living physical activity patterns. PMID:19581199

  3. Comorbidity in heart failure. Results of the Spanish RICA Registry.

    PubMed

    Ruiz-Laiglesia, F-J; Sánchez-Marteles, M; Pérez-Calvo, J-I; Formiga, F; Bartolomé-Satué, J A; Armengou-Arxé, A; López-Quirós, R; Pérez-Silvestre, J; Serrado-Iglesias, A; Montero-Pérez-Barquero, M

    2014-12-01

    We sought to identify the comorbidities associated with heart failure (HF) in a non-selected cohort of patients, and its influence on mortality and rehospitalization. Data were obtained from the 'Registro de Insuficiencia Cardiaca' (RICA) of the Spanish Society of Internal Medicine. The registry includes patients prospectively admitted in Internal Medicine units for acute HF. Variables included in Charlson Index (ChI) were collected and analysed according to age, gender, left ventricular ejection fraction (LVEF) and Barthel Index. The primary end point of study was the likelihood of rehospitalization and death for any cause during the year after discharge. We included 2051 patients, mean age 78 and 53% females. LVEF was ⩾ 50% in 59.1% of the cohort. There was a high degree of dependency as measured by Barthel Index (14.8 % had an index ≤ 60). Mean ChI was 2.91 (SD ± 2.4). The most frequent comorbidities included in ChI were diabetes mellitus (44.3%), chronic renal impairment (30.8%) and chronic obstructive pulmonary disease (COPD) (27.4%). Age, myocardial infarction, peripheral artery disease, dementia, COPD, chronic renal impairment and diabetes with target-organ damage were all identified as independent prognostic factors for the combined end point of rehospitalization and death at 1 year. However, if multivariate analysis was done including ChI, only this remained as an independent prognostic factor for the combined end point (P < 0.001). HF is a comorbid condition. ChI is a simple and feasible tool for estimating the burden of comorbidities in such population. We believe that a holistic approach to HF would improve prognosis and the relief the pressure exerted on public health services. © The Author 2014. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Multi-temperature representation of electron velocity distribution functions. I. Fits to numerical results

    SciTech Connect

    Haji Abolhassani, A. A.; Matte, J.-P.

    2012-10-15

    Electron energy distribution functions are expressed as a sum of 6-12 Maxwellians or a sum of 3, but each multiplied by a finite series of generalized Laguerre polynomials. We fitted several distribution functions obtained from the finite difference Fokker-Planck code 'FPI'[Matte and Virmont, Phys. Rev. Lett. 49, 1936 (1982)] to these forms, by matching the moments, and showed that they can represent very well the coexistence of hot and cold populations, with a temperature ratio as high as 1000. This was performed for two types of problems: (1) the collisional relaxation of a minority hot component in a uniform plasma and (2) electron heat flow down steep temperature gradients, from a hot to a much colder plasma. We find that the multi-Maxwellian representation is particularly good if we accept complex temperatures and coefficients, and it is always better than the representation with generalized Laguerre polynomials for an equal number of moments. For the electron heat flow problem, the method was modified to also fit the first order anisotropy f{sub 1}(x,v,t), again with excellent results. We conclude that this multi-Maxwellian representation can provide a viable alternative to the finite difference speed or energy grid in kinetic codes.

  5. Comparison of Indian subcontinent and Middle East acute heart failure patients: Results from the Gulf Acute Heart Failure Registry

    PubMed Central

    Panduranga, Prashanth; Al-Zakwani, Ibrahim; Sulaiman, Kadhim; Al-Habib, Khalid; Alsheikh-Ali, Alawi; Al-Suwaidi, Jassim; Al-Mahmeed, Wael; Al-Faleh, Hussam; Elasfar, Abdelfatah; Ridha, Mustafa; Bulbanat, Bassam; Al-Jarallah, Mohammed; Asaad, Nidal; Bazargani, Nooshin; Al-Motarreb, Ahmed; Amin, Haitham

    2016-01-01

    Objective To compare Middle East Arabs and Indian subcontinent acute heart failure (AHF) patients. Methods AHF patients admitted from February 14, 2012 to November 14, 2012 in 47 hospitals among 7 Middle East countries. Results The Middle Eastern Arab group (4157) was older (60 vs. 54 years), with high prevalence of coronary artery disease (48% vs. 37%), valvular heart disease (14% vs. 7%), atrial fibrillation (12% vs. 7%), and khat chewing (21% vs. 1%). Indian subcontinent patients (382) were more likely to be smokers (36% vs. 21%), alcohol consumers (11% vs. 2%), diabetic (56% vs. 49%) with high prevalence of AHF with reduced ejection fraction (76% vs. 65%), and with acute coronary syndrome (46% vs. 26%). In-hospital mortality was 6.5% with no difference, but 3-month and 12-month mortalities were significantly high among Middle East Arabs, (13.7% vs. 7.6%) and (22.8% vs. 17.1%), respectively. Conclusions AHF patients from this region are a decade younger than Western patients with high prevalence of ischemic heart disease, diabetes mellitus, and AHF with reduced ejection fraction. There is an urgent need to control risk factors among both groups, as well as the need for setting up heart failure clinics for better postdischarge management. PMID:27056651

  6. Cardiorespiratory fitness estimation using wearable sensors: Laboratory and free-living analysis of context-specific submaximal heart rates.

    PubMed

    Altini, Marco; Casale, Pierluigi; Penders, Julien; Ten Velde, Gabrielle; Plasqui, Guy; Amft, Oliver

    2016-05-01

    In this work, we propose to use pattern recognition methods to determine submaximal heart rate (HR) during specific contexts, such as walking at a certain speed, using wearable sensors in free living, and using context-specific HR to estimate cardiorespiratory fitness (CRF). CRF of 51 participants was assessed by a maximal exertion test (V̇o2 max). Participants wore a combined accelerometer and HR monitor during a laboratory-based simulation of activities of daily living and for 2 wk in free living. Anthropometrics, HR while lying down, and walking at predefined speeds in laboratory settings were used to estimate CRF. Explained variance (R(2)) was 0.64 for anthropometrics, and increased up to 0.74 for context-specific HR (0.73-0.78 when including fat-free mass). Next, we developed activity recognition and walking speed estimation algorithms to determine the same contexts (i.e., lying down and walking) in free living. Context-specific HR in free living was highly correlated with laboratory measurements (Pearson's r = 0.71-0.75). R(2) for CRF estimation was 0.65 when anthropometrics were used as predictors, and increased up to 0.77 when including free-living context-specific HR (i.e., HR while walking at 5.5 km/h). R(2) varied between 0.73 and 0.80 when including fat-free mass among the predictors. Root mean-square error was reduced from 354.7 to 281.0 ml/min by the inclusion of context-specific HR parameters (21% error reduction). We conclude that pattern recognition techniques can be used to contextualize HR in free living and estimated CRF with accuracy comparable to what can be obtained with laboratory measurements of HR response to walking.

  7. Light exercise heart rate on-kinetics: a comparison of data fitted with sigmoidal and exponential functions and the impact of fitness and exercise intensity.

    PubMed

    Trounson, Karl M; Roberts, Spencer; Balloch, Aaron; Warmington, Stuart A

    2017-06-01

    This study examined the suitability of sigmoidal (SIG) and exponential (EXP) functions for modeling HR kinetics at the onset of a 5-min low-intensity cycling ergometer exercise test (5MT). The effects of training status, absolute and relative workloads, and high versus low workloads on the accuracy and reliability of these functions were also examined. Untrained participants (UTabs; n = 13) performed 5MTs at 100W. One group of trained participants (n = 10) also performed 5MTs at 100W (ETabs). Another group of trained participants (n = 9) performed 5MTs at 45% and 60% V˙O2 max (ET45 and ET60, respectively). SIG and EXP functions were fitted to HR data from 5MTs. A 30-s lead-in time was included when fitting SIG functions. Functions were compared using the standard error of the regression (SER), and test-retest reliability of curve parameters. SER for EXP functions was significantly lower than for SIG functions across all groups. When residuals from the 30-s lead-in time were omitted, EXP functions only outperformed SIG functions in ET60 (EXP, 2.7 ± 1.2 beats·min(-1); SIG, 3.1 ± 1.1 beats·min(-1): P < 0.05). Goodness of fit and test-retest reliability of curve parameters were best in ET60 and comparatively poor in UTabs Overall, goodness of fit and test-retest reliability of curve parameters favored functions fitted to 5MTs performed by trained participants at a high and relative workload, while functions fitted to data from untrained participants exercising at a low and absolute workload were less accurate and reliable. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  8. 76 FR 31936 - Non-Malleable Cast Iron Pipe Fittings From the People's Republic of China: Final Results of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-02

    ... International Trade Administration Non-Malleable Cast Iron Pipe Fittings From the People's Republic of China... China (``PRC'').\\1\\ We gave interested parties an opportunity to comment on the Preliminary Results. We... Review'' section below. \\1\\ See Non-Malleable Cast Iron Pipe Fittings From the People's Republic of China...

  9. Low Physical Fitness Levels in Older Adults with ID: Results of the HA-ID Study

    ERIC Educational Resources Information Center

    Hilgenkamp, Thessa I. M.; van Wijck, Ruud; Evenhuis, Heleen M.

    2012-01-01

    Physical fitness is as important to aging adults with ID as in the general population, but to date, the physical fitness levels of this group are unknown. Comfortable walking speed, muscle strength (grip strength), muscle endurance (30 s Chair stand) and cardiorespiratory endurance (10 m incremental shuttle walking test) were tested in a sample of…

  10. Low Physical Fitness Levels in Older Adults with ID: Results of the HA-ID Study

    ERIC Educational Resources Information Center

    Hilgenkamp, Thessa I. M.; van Wijck, Ruud; Evenhuis, Heleen M.

    2012-01-01

    Physical fitness is as important to aging adults with ID as in the general population, but to date, the physical fitness levels of this group are unknown. Comfortable walking speed, muscle strength (grip strength), muscle endurance (30 s Chair stand) and cardiorespiratory endurance (10 m incremental shuttle walking test) were tested in a sample of…

  11. Results from flight noise tests on a Viper turbojet fitted with ejector/suppressor nozzle systems

    NASA Technical Reports Server (NTRS)

    Brooks, J. R.; Mckinnon, R. A.; Johnson, E. S.

    1980-01-01

    Noise tests have been performed on a range of advanced exhaust suppressors fitted to a Viper turbojet engine with the objective of evaluating systems potentially suitable for subsonic and supersonic aircraft. A key item in the suppressor systems was an acoustically lined ejector, and tests were made with and without this ejector. Flight tests were made using an HS-125 aircraft in England and were followed by outdoor static tests at NASA Ames Research Center. In addition, acoustic and propulsion measurements were made at static, and in simulated flight conditions, with the engine installed in the Ames 40- by 80-ft wind tunnel. The paper deals mainly with the flight test results. These show that the use of a lined ejector considerably increases the attenuation obtainable using a suppressor nozzle alone and largely confirm predictions made on the basis of previous model and static tests. The maximum measured attenuation adjusted to an altitude of 500 ft was 14 EPNdB at an ideal jet velocity of 2400 ft/sec using the suppressor/ejector design intended for supersonic application. Initial propulsion performance results from the Ames wind tunnel confirm previous smaller scale propulsion results from a Douglas facility.

  12. Results of a community translation of the "Women Take PRIDE" heart disease self-management program.

    PubMed

    Gallant, Mary P; Pettinger, Tianna M; Coyle, Cassandra L; Spokane, Linda S

    2015-03-01

    This article reports the results of a community demonstration of an evidence-based heart disease self-management program for older women. Women Take PRIDE (WTP) is a group-based education and behavior modification program, based on social cognitive theory, designed to enhance heart disease self-management among older women. We implemented the program in community settings with 129 participants. Evaluation data was collected at baseline and at 4- and 12-month follow-ups. Outcomes included general health status, functional health status, and knowledge. Results showed significant improvements in self-rated health, energy, social functioning, knowledge of community resources, and number, frequency, and bother of cardiac symptoms. These results demonstrate that an evidence-based heart disease self-management program can be effective at improving health and quality of life among older women with heart disease when implemented in community settings.

  13. Rate of change in physical fitness and quality of life and depression following exercise training in patients with congestive heart failure.

    PubMed

    Smart, Neil A; Murison, Robert

    2013-01-01

    Exercise training appears to improve peak oxygen consumption (VO(2) ) and quality of life (QOL) in heart failure patients, although disease etiology, patient demographics and medication may alter the rate of adaptation. The authors sought to identify rate of change from baseline in fitness, QOL, and depression following exercise training in a cohort of patients with congestive heart failure. Thirty male systolic heart failure patients (aged 63.8±8.3 years, baseline peak VO(2) 12.2±4.8 mL/kg/min, left ventricular ejection fraction 28.2±9.4%, New York Heart Association class II/II 22/8) undertook 52 weeks of exercise training, 16 weeks as an outpatient and a further 36 weeks of home exercise. Peak VO(2) and QOL was measured using the Minnesota Living With Heart Failure (MLWHF) questionnaire and depression using the Hare-Davis scale. The authors analyzed the rate of change in peak VO(2) and MLWHF after grouping patients according to clinical, demographic, and pharmacologic characteristics. Peak VO(2) measurements varied over time, with no effect of disease pathology or β-blocker on peak VO(2) . The rate of change in physical MLWHF score was significantly greater (improved) during 0 to 16 weeks in patients with dilated pathology, but was not significantly affected by β-blocker use or age. The exercise training venue and supervision, or lack thereof, is the major determinant of adaptation to the intervention in heart failure patients, although age, β-adrenergic medication, and heart failure etiology also explain some of the variation in adaptive responses observed.

  14. Low social support level is associated with non-adherence to diet at 1 year in the Family Intervention Trial for Heart Health (FIT Heart).

    PubMed

    Aggarwal, Brooke; Liao, Ming; Allegrante, John P; Mosca, Lori

    2010-01-01

    Evaluate the relationship between low social support (SS) and adherence to diet in a cardiovascular disease (CVD) lifestyle intervention trial. Prospective substudy. Blood relatives/cohabitants of hospitalized cardiac patients in a randomized controlled trial (n=458; 66% female, 35% nonwhite, mean age 50 years). Non-adherence to diet using MEDFICTS (Meats, Eggs, Dairy, Fried foods, fat In baked goods, Convenience foods, fats added at the Table, and Snacks) tool; SS using the Enhancing Recovery in Coronary Heart Disease Patients Social Support Instrument. Logistic regression models adjusted for confounders. Significant predictors (P<.05) of non-adherence to diet recommendations at 1 year included low SS, increased body mass index and waist size, lower physical activity, depression, pre-action stages of change, control group assignment, and being male. Those with low SS at baseline 2.7 greater odds of being non-adherent to diet at 1 year vs those with higher SS (95% confidence interval=1.1-6.4); there was no interaction by group assignment. Low SS at baseline was independently associated with non-adherence to diet at 1 year, suggesting that family members with low SS may be at heightened CVD risk as a result of poor dietary adherence. Copyright © 2010 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

  15. Cardiorespiratory fitness and the risk of overweight in youth: the Healthy Hearts Longitudinal Study of Cardiometabolic Health.

    PubMed

    McGavock, Jonathan M; Torrance, Brian D; McGuire, K Ashlee; Wozny, Paul D; Lewanczuk, Richard Z

    2009-09-01

    The primary objective of this longitudinal study was to determine the association between cardiorespiratory fitness and the risk of overweight status in youth. To accomplish this aim we analyzed data from annual school-based surveys of cardiorespiratory fitness and anthropometry conducted between 2004 and 2006. The first analysis was performed on a cohort of 902 youth aged 6-15 years followed for 12 months to assess the association between cardiorespiratory fitness levels determined from a graded maximal field test and the risk of becoming overweight. The second analysis was conducted on a cohort of 222 youth followed for 2 years to assess the continuous association between annual changes fitness and weight gain. Children with low cardiorespiratory fitness were characterized by higher waist circumference and disproportionate weight gain over the 12-month follow-up period (P < 0.05). Within the entire cohort, the 12-month risk of overweight classification was 3.5-fold (95% confidence = 2.0-6.0, P < 0.001) higher in youth with low cardiorespiratory fitness, relative to fit peers. A time series mixed effects regression model revealed that reductions in cardiorespiratory fitness were significantly and independently associated with increasing BMI (r = -0.18, P < 0.05) in youth. Accordingly, low cardiorespiratory fitness and reductions in fitness over time are significantly associated with weight gain and the risk of overweight in children 6-15 years old. An assessment of cardiorespiratory fitness using a common field test may prove useful for the identification of youth at risk of overweight and serve as a potential target for obesity prevention.

  16. The relationship between physical activity, fitness, physical complaints and BMI in German adults - results of a longitudinal study.

    PubMed

    Tittlbach, Susanne A; Jekauc, Darko; Schmidt, Steffen C E; Woll, Alexander; Bös, Klaus

    2017-09-01

    This study's aims were to describe the development of physical activity, physical fitness (PF), subjective (physical complaints (PC)) and objective (Body mass index (BMI)) health measures and to examine the relationship between the development trajectories. In addition, the study also aimed to assess the influence of sociodemographic determinants (age, sex, socioeconomic status (SES)) in German adults over a period of 18 years. The longitudinal study population comprises of 721 men and women, aged 33-76 years over the study period. There was self-report of physical activity and PC and testing of physical fitness and BMI in each study year (1992, 1997, 2002 and 2010). Latent growth curve models were used to analyse the development. Physical activity slightly increased while fitness, PC and BMI worsened over the course of 18 years. Sex, age and SES play important roles concerning physical activity, fitness and health. Several integrative associations could be detected between physical activity, fitness, PC and BMI as well as their trajectories. In particular, high initial levels of physical activity and fitness protect from high PC and BMI.The slope of physical activity was not significantly associated with slopes of fitness, PC and BMI. However, increase of fitness resulted in decrease of PC. A general positive development regarding the amount of physical activity could be detected. However, if it is only an unsystematic increase of physical activity, this is not in itself enough to achieve health benefits. The strengthening of fitness should be focused when increasing physical activity, since only then a health benefit is possible.

  17. Heart rate prediction for coronary artery disease patients (CAD): Results of a clinical pilot study.

    PubMed

    Müller-von Aschwege, Frerk; Workowski, Anke; Willemsen, Detlev; Müller, Sebastian M; Hein, Andreas

    2015-01-01

    This paper describes the results of a pilot study with cardiac patients based on information that can be derived from a smartphone. The idea behind the study is to design a model for estimating the heart rate of a patient before an outdoor walking session for track planning, as well as using the model for guidance during an outdoor session. The model allows estimation of the heart rate several minutes in advance to guide the patient and avoid overstrain before its occurrence. This paper describes the first results of the clinical pilot study with cardiac patients taking β-blockers. 9 patients have been tested on a treadmill and during three outdoor sessions each. The results have been derived and three levels of improvement have been tested by cross validation. The overall result is an average Median Absolute Deviation (MAD) of 4.26 BPM between measured heart rate and smartphone sensor based model estimation.

  18. Fitting Item Response Models to the Maryland Functional Reading Test Results.

    ERIC Educational Resources Information Center

    Hambleton, Ronald K.; And Others

    The potential of item response theory (IRT) for solving a number of testing problems in the Maryland Functional Reading Program would appear to be substantial in view of the many other promising applications of the theory. But, it is well-known that the advantages derived from an IRT model cannot be achieved when the fit between an item response…

  19. Radial-velocity fitting challenge. II. First results of the analysis of the data set

    NASA Astrophysics Data System (ADS)

    Dumusque, X.; Borsa, F.; Damasso, M.; Díaz, R. F.; Gregory, P. C.; Hara, N. C.; Hatzes, A.; Rajpaul, V.; Tuomi, M.; Aigrain, S.; Anglada-Escudé, G.; Bonomo, A. S.; Boué, G.; Dauvergne, F.; Frustagli, G.; Giacobbe, P.; Haywood, R. D.; Jones, H. R. A.; Laskar, J.; Pinamonti, M.; Poretti, E.; Rainer, M.; Ségransan, D.; Sozzetti, A.; Udry, S.

    2017-02-01

    Context. Radial-velocity (RV) signals arising from stellar photospheric phenomena are the main limitation for precise RV measurements. Those signals induce RV variations an order of magnitude larger than the signal created by the orbit of Earth-twins, thus preventing their detection. Aims: Different methods have been developed to mitigate the impact of stellar RV signals. The goal of this paper is to compare the efficiency of these different methods to recover extremely low-mass planets despite stellar RV signals. However, because observed RV variations at the meter-per-second precision level or below is a combination of signals induced by unresolved orbiting planets, by the star, and by the instrument, performing such a comparison using real data is extremely challenging. Methods: To circumvent this problem, we generated simulated RV measurements including realistic stellar and planetary signals. Different teams analyzed blindly those simulated RV measurements, using their own method to recover planetary signals despite stellar RV signals. By comparing the results obtained by the different teams with the planetary and stellar parameters used to generate the simulated RVs, it is therefore possible to compare the efficiency of these different methods. Results: The most efficient methods to recover planetary signals take into account the different activity indicators, use red-noise models to account for stellar RV signals and a Bayesian framework to provide model comparison in a robust statistical approach. Using the most efficient methodology, planets can be found down to K/N= Kpl/RV_{rms×√{Nobs}=5} with a threshold of K/N = 7.5 at the level of 80-90% recovery rate found for a number of methods. These recovery rates drop dramatically for K/N smaller than this threshold. In addition, for the best teams, no false positives with K/N > 7.5 were detected, while a non-negligible fraction of them appear for smaller K/N. A limit of K/N = 7.5 seems therefore a safe

  20. Prevalence of Youth Fitness in the United States: Baseline Results from the NFL PLAY 60 FITNESSGRAM Partnership Project.

    PubMed

    Bai, Yang; Saint-Maurice, Pedro F; Welk, Gregory J; Allums-Featherston, Kelly; Candelaria, Norma; Anderson, Katelin

    2015-09-01

    To assess age- and sex-specific patterns of 6 health-related fitness components in youth, baseline data from the NFL PLAY 60 FITNESSGRAM Partnership Project were analyzed. A total of 192,848 students from 1st through 12th grade in 725 schools completed the standard FITNESSGRAM testing in 2010-2014, including assessments of aerobic capacity (AC), body mass index (BMI), upper body strength and endurance, trunk extensor strength and flexibility, abdominal strength and endurance, and flexibility. Individual data were aggregated by grade and sex. Age- and sex-specific health-related criterion-referenced standards were used to classify fitness results into the healthy fitness zone (HFZ), needs improvement zone, or needs improvement health risk. The proportion of youth meeting the HFZ for AC varied considerably by grade for both boys (62.1%-37.6%) and girls (49.1%-26.1%) among 1st-12th grade. There was less variability by age and sex for achievement of the BMI HFZ (ranged from 52.7%-65.0%). The prevalence of achievement was similar for the remaining fitness components. Significantly lower achievement was found in the middle school years for BMI HFZ in both sexes and for AC HFZ achievement in boys. Continuous age-related lower HFZ achievement was evident in girls for AC. The results provide updated health-related fitness profiles for US youth and identify the critical ages when youth fitness levels start to decline. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. The Texas Youth Fitness Study: Looking at School Policies as They Relate to Physical Fitness and Academic Variables. Program Results Report

    ERIC Educational Resources Information Center

    Feiden, Karyn

    2011-01-01

    In partnership with three universities, the Cooper Institute, Dallas, completed the Texas Youth Fitness Study from 2008 to 2009. The study explored three key questions: (1) Is physical fitness associated with academic performance?; (2) Can physical education teachers collect high-quality information on student fitness?; and (3) Are school policies…

  2. Multiple exposures to sarin vapor result in parasympathetic dysfunction in the eye but not the heart.

    PubMed

    Dabisch, Paul A; To, Filip; Kerut, Edmund K; Horsmon, Michael S; Mioduszewski, Robert J

    2007-09-01

    Several studies in conscious animals have reported parasympathetic dysfunction in the eyes following exposure to cholinesterase inhibitors. Given the similarities between the autonomic innervation in the eye and the heart, it is possible that parasympathetic dysfunction could also occur in the heart. Therefore, the present study assessed time domain indices of heart rate variability in conscious rats surgically implanted with telemetric transmitters to investigate the hypothesis that multiple exposures to the nerve agent sarin would result in muscarinic receptor desensitization and parasympathetic dysfunction in the heart. Animals exposed to sarin vapor on multiple occasions developed parasympathetic dysfunction in the eye characterized by an attenuated response to light and a diminished miotic response to sarin vapor exposure. However, the same dose of sarin vapor failed to produce any effects on either time domain indices of HRV or the magnitude of the tachycardia induced by atropine, suggesting that autonomic control in the heart was not affected. It is possible that the dose of sarin used in the present study was insufficient to inhibit cardiac acetylcholinesterase (AChE). Additional studies utilizing higher doses of sarin may be able to inhibit cardiac AChE, producing overstimulation of cardiac muscarinic receptors, ultimately resulting in desensitization and parasympathetic dysfunction.

  3. Mutations in Cytochrome b Resulting in Atovaquone Resistance Are Associated with Loss of Fitness in Plasmodium falciparum

    PubMed Central

    Peters, Jennifer M.; Chen, Nanhua; Gatton, Michelle; Korsinczky, Michael; Fowler, Elizabeth V.; Manzetti, Sergio; Saul, Allan; Cheng, Qin

    2002-01-01

    Drug resistance in malarial parasites has become a major obstacle in the control of the disease. Strategies are urgently needed to control the development of resistance and to possibly reverse existing resistance. One key element required to reverse malaria drug resistance is for the parasites to “pay” a biological “cost” or suffer a loss of fitness when acquiring resistance to antimalarial drugs. Such a situation would be a disadvantage to the resistant parasites in the absence of drug pressure. We compared here the relative fitness of atovaquone-resistant Plasmodium falciparum K1 clones with single and double base mutations in their cytochrome b genes to their parent clones during erythrocytic stages in the absence of drug pressure. We found that the double amino acid mutation (M133I and G280D) is associated with a 5 to 9% loss of fitness and that the single amino acid change of M133I did not result in any detectable loss of fitness. Molecular modeling of the interaction of P. falciparum cytochrome b with ubiquinone led to the prediction that a loss of fitness of the malaria parasites would result from the G280D mutation due to its close proximity to the putative ubiquinone-binding site. This appears to have resulted in a weakening of the cytochrome b-ubiquinone complex, thereby causing the electron transport chain to become less efficient. Our results suggest that the prevalence of resistant parasites may decrease after the drug usage is discontinued. PMID:12121915

  4. Secular trends in cardiorespiratory fitness and body mass index in Danish children: The European Youth Heart Study.

    PubMed

    Møller, N C; Wedderkopp, N; Kristensen, P L; Andersen, L B; Froberg, K

    2007-08-01

    To examine the secular trends in cardiorespiratory fitness (CF) and body fatness in Danish children. Trends were analyzed overall and across socioeconomic status (SES). Two cross-sectional studies conducted on 589 and 458 third-grade Danish children in 1997-1998 and 2003-2004, respectively. CF was determined by a maximal cycle-ergometer test. The lowest sex-specific quartile of CF in the study from 1997 to 1998 was used as a cut-point for low CF. Body mass index (BMI) cut-points were used to describe overweight, and SES was divided into two groups according to parents' occupation. This study showed a secular decline in CF in girls overall. Increased CF, BMI, and prevalence of overweight were observed in boys with high SES, in boys with low SES, and in girls with low SES, respectively. However, after additional Bonferroni's correction, none of the statistical analyses performed across socioeconomic gradients reached significant P-values. CF declined in girls overall. Although not statistically significant after additional Bonferroni's correction, results in general showed less favorable trends in low SES children. Thus, trying to describe secular trends in CF and body fatness overall without any regard to SES might disguise social-caused differences. However, further studies are needed in order to verify this hypothesis.

  5. 90/10 JP5/Synthesized ISO-Paraffin Specification and Fit-for-Purpose Test Results

    DTIC Science & Technology

    2014-06-11

    90/10 JP5/SYNTHESIZED ISO -PARAFFIN SPECIFICATION AND FIT-FOR-PURPOSE TEST RESULTS NAVAIR SYSCOM REPORT 441/14-010 11 June 2014 Prepared By...3 3.1 Synthesized Iso -Paraffins (SIP) Procurement Specification Test Results...26 Appendix A: Procurement Specification for Synthesized Iso -Paraffins (SIP) ........................... A-1

  6. Are Intensified Physical Education Sessions Able to Elicit Heart Rate at a Sufficient Level To Promote Aerobic Fitness in Adolescents?

    ERIC Educational Resources Information Center

    Baquet, Georges; Berthoin, Serge; Van Praagh, Emmanuel

    2002-01-01

    Determined the effects of intensified physical education sessions on adolescents divided into two groups: high intensity running group (HIRG) and high intensity jumping group (HIJG). Heart rate (HR) was monitored during sessions. There was no significant difference between mean HR for HIRG and HIJG. Mean HR was significantly lower for the control…

  7. Are Intensified Physical Education Sessions Able to Elicit Heart Rate at a Sufficient Level To Promote Aerobic Fitness in Adolescents?

    ERIC Educational Resources Information Center

    Baquet, Georges; Berthoin, Serge; Van Praagh, Emmanuel

    2002-01-01

    Determined the effects of intensified physical education sessions on adolescents divided into two groups: high intensity running group (HIRG) and high intensity jumping group (HIJG). Heart rate (HR) was monitored during sessions. There was no significant difference between mean HR for HIRG and HIJG. Mean HR was significantly lower for the control…

  8. Challenges in improving fitness: results of a community-based, randomized, controlled lifestyle change intervention.

    PubMed

    Yancey, Antronette K; McCarthy, William J; Harrison, Gail G; Wong, Weng Kee; Siegel, Judith M; Leslie, Joanne

    2006-05-01

    This study tested the efficacy of an 8-week culturally targeted nutrition and physical activity intervention on body composition. A randomized, attention-controlled, two-group trial was conducted in a blackowned commercial gym with a sample of 366 predominantly healthy, obese African American women. A free 1-year membership to the study site gym was provided to participants in both groups. Data were collected at baseline, 2, 6, and 12 months. Sample retention at 1 year was 71%. Between-group longitudinal analysis including only participants with complete data revealed a trend toward weight stability in the intervention group at 2 months compared with controls (+0.05 kg/m(2), p = 0.75; +0.32 kg/m(2), p = 0.08, respectively), disappearing at 12 months (+1.37 kg/m(2), p = 0.0001; +1.02 kg/m(2), p = 0.001, respectively). Within-group analysis demonstrated that intervention and control participants' fitness (1-mile run-walk) improved by 1.9 minutes (p = 0.0001) and 2.3 minutes (p = 0.0001), respectively, at 12 months. Mixed model regression analyses demonstrated a significant main effect of the intervention on fitness (p = 0.0185) and a marginally significant effect on body mass index (BMI) (p = 0.057), at 2 months, disappearing by 6 months. By 12 months, however, the controls exhibited a significant advantage in waist circumference stability compared with intervention participants (+1.1 cm, p = 0.2763; +2.1 cm, p = 0.0002, respectively). The intervention produced modest short-term improvements in body composition, but the economic incentive of a free 1-year gym membership provided to all participants was a more potent intervention than the education and social support intervention tested. However, longer-term fitness enhancement remains elusive and demands research and policy attention. These findings have policy implications in that employer-/insurer-subsidized gym memberships may require interventions targeting other levels of change (e.g., physical or social

  9. Early ketamine exposure results in cardiac enlargement and heart dysfunction in Xenopus embryos.

    PubMed

    Guo, Ran; Liu, Guangjian; Du, Min; Shi, Yu; Jiang, Pu; Liu, Xiaoli; Liu, Lan; Liu, Jianxia; Xu, Ying

    2016-04-18

    Ketamine is a commonly used clinical anesthetic and a popular recreational drug. However, with the exception of studies about the nervous system, studies about the effect of early ketamine exposure on embryos are rare. Xenopus laevis is a commonly used vertebrate model for assessing teratogenicity. Therefore, we treated Xenopus embryos with ketamine to evaluate its teratogenicity on embryos. Xenopus embryos were treated with ketamine from stages 8 to 21. Embryonic and cardiac morphology were analyzed using living embryo imaging and whole-mount RNA in situ hybridization (WMISH). Heart function was measured by heart rate and ventricular shortening fraction (VSF). The mRNA expression levels of several heart development-related genes were determined by reverse transcription quantitative polymerase chain reaction (RT-qPCR). The protein expression levels of XMLC2, phospho-histone H3 (pH3) and histone H3 were determined by western blot. Ketamine caused concentration-dependent increases in mortality and shortening of body length. At a dose of 0.5 mg/ml, ketamine exposure resulted in cardiac enlargement as the primary manifestation of several malformations: gut defects, a curved axis and shortened body length. Cardiac cells underwent increased proliferation. Moreover, the heart rate and ventricular shortening fraction were decreased, findings indicative of heart dysfunction. XMLC2 expression levels were down-regulated at stages 28, 32/33, 35/36 and 46. Ketamine exposure during early development has teratogenic effects on Xenopus embryos. The heart enlargement and decreased VSF may result from the down-regulation of XMLC2 mRNA and protein levels. These findings provide new insight into the potential fetal defects induced by ketamine exposure during early pregnancy.

  10. Racial Differences in the Prognostic Value of Cardiorespiratory Fitness (Results from the Henry Ford Exercise Testing Project).

    PubMed

    Al-Mallah, Mouaz H; Qureshi, Waqas T; Keteyian, Steven J; Brawner, Clinton A; Alam, Mohsin; Dardari, Zeina; Nasir, Khurram; Blaha, Michael J

    2016-05-01

    The aim of this analysis was to determine whether racial differences exist in the prognostic value of cardiorespiratory fitness (CRF) in black and white patients undergoing stress testing. We included 53,876 patients (mean age 53 ± 13, 49% women) from the Henry Ford Exercise Testing project free of established coronary disease or heart failure who completed a maximal exercise test from 1991 to 2009. Patients were followed for a mean duration of 11.5 years for all-cause mortality, ascertained by linkage with the Death Master File. Follow-up over mean 6.2 years was also available for incident myocardial infarction. Multivariate Cox proportional hazards regression models were used adjusting for demographic variables, risk factors, medications, and reason for stress test referral, including formal interaction testing by race (black vs white). Black patients (n = 16,725) were younger (54 ± 13 vs 52 ± 13, p <0.001) but had higher prevalence of hypertension (73% vs 57%, p <0.001) and obesity (28% vs 21%, p <0.001). On average, black patients achieved a lower CRF compared with whites (8.4 vs 9.5 metabolic equivalents, p <0.0001). A graded increase in mortality risk was noted with decreasing CRF for both black and white patients. In multivariate Cox regression, CRF was a predictor of both myocardial infarction and mortality, with no significant interaction between race, fitness, and outcomes (all interaction terms p >0.10). CRF is a strong predictor of all-cause mortality in both white and black patients, with no significant interaction observed between race, fitness, and outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. RSAP - A Code for Display of Neutron Cross Section Data and SAMMY Fit Results

    SciTech Connect

    Sayer, R.O.

    2001-02-02

    RSAP is a computer code for display of neutron cross section data and selected SAMMY output. SAMMY is a multilevel R-matrix code for fitting neutron time-of-flight cross-section data using Bayes' method. RSAP, which runs on the Digital Unix Alpha platform, reads ORELA Data Files (ODF) created by SAMMY and uses graphics routines from the PLPLOT package. In addition, RSAP can read data and/or computed values from ASCII files with a format specified by the user. Plot output may be displayed in an X window, sent to a postscript file (rsap.ps), or sent to a color postscript file (rsap.psc). Thirteen plot types are supported, allowing the user to display cross section data, transmission data, errors, theory, Bayes fits, and residuals in various combinations. In this document the designations theory and Bayes refer to the initial and final theoretical cross sections, respectively, as evaluated by SAMMY. Special plot types include Bayes/Data, Theory--Data, and Bayes--Data. Output from two SAMMY runs may be compared by plotting the ratios Theory2/Theory1 and Bayes2/Bayes1 or by plotting the differences (Theory2-Theory1) and (Bayes2-Bayes1).

  12. A study on the physical fitness index, heart rate and blood pressure in different phases of lunar month on male human subjects.

    PubMed

    Chakraborty, Ujjwal; Ghosh, Tusharkanti

    2013-09-01

    The gravitational pull of the moon on the earth is not the same in all phases of the lunar month, i.e. new moon (NM), first quarter (FQ), full moon (FM) and third quarter (TQ), and as a result the amplitude of tide differs in different phases. The gravitational pull of the moon may have effects on the fluid compartments of the human body and hence the cardiovascular system may be affected differentially in the different phases of the lunar month. In the present study resting heart rate (HR) and blood pressure (BP), physical fitness index (PFI), peak HR and BP immediately after step test, and recovery HR and BP after step test were measured during different phases of the lunar month in 76 male university students (age 23.7 ± 1.7 years). At rest, both systolic and mean arterial BP were ∼5 mmHg lower in NM and FM compared to FQ and TQ, but resting HR was not significantly different between phases. Further, peak HR and peak systolic BP after step test were lower (∼4 beat/min and ∼5 mmHg, respectively) in NM and FM compared to FQ and TQ. PFI was also higher (∼5) in NM and FM compared to FQ and TQ. Recovery of HR after step test was quicker in NM and FM compared to that of FQ and TQ. It appears from this study that gravitational pull of the moon may affect the cardiovascular functions of the human body. Moreover, the physical efficiency of humans is increased in NM and FM due to these altered cardiovascular regulations.

  13. Independent and combined association of muscle strength and cardiorespiratory fitness in youth with insulin resistance and β-cell function in young adulthood: the European Youth Heart Study.

    PubMed

    Grøntved, Anders; Ried-Larsen, Mathias; Ekelund, Ulf; Froberg, Karsten; Brage, Søren; Andersen, Lars B

    2013-09-01

    To examine the independent and combined association of isometric muscle strength of the abdomen and back and cardiorespiratory fitness (CRF) in youth with indices of glucose metabolism in young adulthood among boys and girls from the European Youth Heart Study. We used data from a population-based prospective cohort study among youth followed up for up to 12 years (n = 317). In youth, maximal voluntary contractions during isometric back extension and abdominal flexion were determined using a strain-gauge dynamometer and CRF was obtained from a maximal cycle ergometer test. Insulin resistance (homeostasis model assessment of insulin resistance [HOMA-IR]) and β-cell function (homeostasis model assessment of β-cell function [HOMA-B]) were estimated from fasting serum insulin and glucose that were obtained in youth and at follow-up in young adulthood. For each 1-SD difference in isometric muscle strength (0.16 N/kg) in youth, fasting insulin, HOMA-IR, and HOMA-B in young adulthood changed by -11.3% (95% CI -17.0 to -5.2), -12.2% (-18.2 to -5.7), and -8.9% (-14.4 to -3.0), respectively, in young adulthood after adjustment for CRF and personal lifestyle and demographic factors. Results for CRF were very similar in magnitude, and the magnitude of associations for both exposures was unchanged with additional adjustment for general or abdominal adiposity in youth. Combined associations of muscle strength and CRF with fasting insulin, HOMA-IR, and HOMA-B were additive, and adolescents in the highest sex-specific tertile for both isometric muscle strength and CRF had the lowest levels of these glucose metabolism outcomes. Increasing muscle strength and CRF should be targets in youth primordial prevention strategies of insulin resistance and β-cell dysfunction.

  14. A study on the physical fitness index, heart rate and blood pressure in different phases of lunar month on male human subjects

    NASA Astrophysics Data System (ADS)

    Chakraborty, Ujjwal; Ghosh, Tusharkanti

    2013-09-01

    The gravitational pull of the moon on the earth is not the same in all phases of the lunar month, i.e. new moon (NM), first quarter (FQ), full moon (FM) and third quarter (TQ), and as a result the amplitude of tide differs in different phases. The gravitational pull of the moon may have effects on the fluid compartments of the human body and hence the cardiovascular system may be affected differentially in the different phases of the lunar month. In the present study resting heart rate (HR) and blood pressure (BP), physical fitness index (PFI), peak HR and BP immediately after step test, and recovery HR and BP after step test were measured during different phases of the lunar month in 76 male university students (age 23.7 ± 1.7 years). At rest, both systolic and mean arterial BP were ˜5 mmHg lower in NM and FM compared to FQ and TQ, but resting HR was not significantly different between phases. Further, peak HR and peak systolic BP after step test were lower (˜4 beat/min and ˜5 mmHg, respectively) in NM and FM compared to FQ and TQ. PFI was also higher (˜5) in NM and FM compared to FQ and TQ. Recovery of HR after step test was quicker in NM and FM compared to that of FQ and TQ. It appears from this study that gravitational pull of the moon may affect the cardiovascular functions of the human body. Moreover, the physical efficiency of humans is increased in NM and FM due to these altered cardiovascular regulations.

  15. Exploring the clinical approach to the bimodal fitting of hearing aids and cochlear implants: results of an international survey.

    PubMed

    Scherf, Fanny W A C; Arnold, Laure P

    2014-11-01

    The results show that the fitting of a contralateral hearing aid (HA) in the non-implanted ear of cochlear implant (CI) recipients is now well established as standard clinical practice. However, there is a lack of experience in HA fitting within the CI centres and the use of published bimodal fitting procedures is poor. The HA is often not refitted after CI switch-on and this may contribute to rejection. Including a bimodal fitting prescription and process in the CI fitting software would make applying a balancing procedure easier and may increase its implementation in routine clinical practice. This survey was designed to investigate and understand the current approach to bimodal fitting of HAs and CIs across different countries and the recommendations made to recipients. Clinicians working with HAs and/or CIs were invited to participate in an international multicentre clinical survey, designed to obtain information on the various approaches towards bimodal hearing and CI and HA device fitting. Forty-one questions were presented to clinicians in experienced CI centres across a range of countries and answers were collected via an online survey. In all, 65 responses were obtained from 12 different countries. All clinicians said they would advise a CI user to wear a contralateral HA if indicated. However, a significant number (45%) had either never fitted HAs before or had less than 1 year of experience. In general, there were no specific criteria for selecting candidates to fit with an HA. A strategy to balance the HA with the CI was not used as a standard practice for any of the adults and was used in only 12% of the children. Only half the respondents were aware of the bimodal literature. The majority of professionals (18/30) did not refit the HA after CI switch-on. However, if users complained of sound quality or loudness issues or had poor test results, a follow-up session was provided. The main benefit reported by recipients was improvement in overall sound

  16. Does coffee drinking increase the risk of coronary heart disease? Results from a meta-analysis.

    PubMed Central

    Kawachi, I; Colditz, G A; Stone, C B

    1994-01-01

    BACKGROUND--The association between coffee drinking and risk of coronary heart disease remains controversial despite many epidemiological studies. A meta-analysis was carried out on these studies to resolve some of the uncertainties. Particular attention was paid to details of study design. METHODS--Eight case-control studies and 15 cohort studies were analysed. Weighted, fixed effects linear regression of log relative risks (or odds ratios) was used to pool the study results. The pooling procedures were performed separately by study design, sex, coronary heart disease end points, smoking habit, and period of study. RESULTS--The pooled case-control odds ratio (for the effect of drinking five cups of coffee/day v none) was 1.63 (95% confidence interval (95% CI) 1.50 to 1.78). The pooled cohort study relative risk (five cups/day v none) was 1.05 (95% CI 0.99 to 1.12). The discrepancy between the pooled case-control and cohort study results could not be attributed to differences in the end points chosen, period of study, or to confounding by smoking status or sex. CONCLUSIONS--The cohort study data suggest very little excess risk of coronary heart disease among habitual coffee drinkers. The case-control data do not rule out an increased risk of heart disease among a subgroup of people who acutely increase their coffee intake. Further epidemiological studies are needed to assess the risk of drinking boiled or decaffeinated coffee. PMID:7946780

  17. The Relation of Arm Exercise Peak Heart Rate to Stress Test Results and Outcome.

    PubMed

    Xian, Hong; Liu, Weijian; Marshall, Cynthia; Chandiramani, Pooja; Bainter, Emily; Martin, Wade H

    2016-09-01

    Arm exercise is an alternative to pharmacologic stress testing for >50% of patients unable to perform treadmill exercise, but no data exist regarding the effect of attained peak arm exercise heart rate on test sensitivity. Thus, the purpose of this investigation was to characterize the relationship of peak arm exercise heart rate responses to abnormal stress test findings, coronary revascularization, and mortality in patients unable to perform leg exercise. From 1997 until 2002, arm cycle ergometer stress tests were performed in 443 consecutive veterans age 64.1 yr (11.0 yr) (mean (SD)), of whom 253 also underwent myocardial perfusion imaging (MPI). Patients were categorized by frequency distributions of quartiles of percentage age-predicted peak heart rate (APPHR), heart rate reserve (HRR), and peak heart rate-systolic blood pressure product (PRPP). Exercise-induced ST-segment depression, abnormal MPI findings, coronary revascularization, and 12.0-yr (1.3 yr) Kaplan-Meier all-cause and cardiovascular mortality plots were then characterized by quartiles of APPHR, HRR, and PRPP. A reduced frequency of abnormal arm exercise ECG results was associated only with the lowest quartile of APPHR (≤69%) and HRR (≤43%), whereas higher frequency of abnormal MPI findings exhibited an inverse relationship trend with lower APPHR (P = 0.10) and HRR (P = 0.12). There was a strong inverse association of APPHR, HRR, and PRPP with all-cause (all P ≤ 0.01) and cardiovascular (P < 0.05) mortality. The frequency of coronary revascularization was unrelated to APPHR or HRR. Arm exercise ECG stress test sensitivity is only reduced at ≤69% APPHR or ≤43% HRR, whereas arm exercise MPI sensitivity and referral for coronary revascularization after arm exercise stress testing are not adversely affected by even a severely blunted peak heart rate. However, both all-cause mortality and cardiovascular mortality are strongly and inversely related to APPHR and HRR.

  18. Translation of First North American 50 and 70 cc Total Artificial Heart Virtual and Clinical Implantations: Utility of 3D Computed Tomography to Test Fit Devices.

    PubMed

    Ferng, Alice S; Oliva, Isabel; Jokerst, Clinton; Avery, Ryan; Connell, Alana M; Tran, Phat L; Smith, Richard G; Khalpey, Zain

    2017-08-01

    Since the creation of SynCardia's 50 cc Total Artificial Hearts (TAHs), patients with irreversible biventricular failure now have two sizing options. Herein, a case series of three patients who have undergone successful 50 and 70 cc TAH implantation with complete closure of the chest cavity utilizing preoperative "virtual implantation" of different sized devices for surgical planning are presented. Computed tomography (CT) images were used for preoperative planning prior to TAH implantation. Three-dimensional (3D) reconstructions of preoperative chest CT images were generated and both 50 and 70 cc TAHs were virtually implanted into patients' thoracic cavities. During the simulation, the TAHs were projected over the native hearts in a similar position to the actual implantation, and the relationship between the devices and the atria, ventricles, chest wall, and diaphragm were assessed. The 3D reconstructed images and virtual modeling were used to simulate and determine for each patient if the 50 or 70 cc TAH would have a higher likelihood of successful implantation without complications. Subsequently, all three patients received clinical implants of the properly sized TAH based on virtual modeling, and their chest cavities were fully closed. This virtual implantation increases our confidence that the selected TAH will better fit within the thoracic cavity allowing for improved surgical outcome. Clinical implantation of the TAHs showed that our virtual modeling was an effective method for determining the correct fit and sizing of 50 and 70 cc TAHs. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  19. Physical Fitness of University Faculty Members.

    ERIC Educational Resources Information Center

    Williford, H. N.; Barksdale, J. M.

    The purpose of this investigation was to compare physical activity, aerobic fitness, and selected coronary heart disease risk factors in 27 male and 21 female university faculty members. Results of t-tests indicate that the males had significantly greater values for physical activity index, systolic blood pressure, aerobic fitness (V02 max), and…

  20. Postoperative heart block in children with common forms of congenital heart disease: results from the KID Database.

    PubMed

    Anderson, Jeffrey B; Czosek, Richard J; Knilans, Timothy K; Meganathan, Karthikeyan; Heaton, Pamela

    2012-12-01

    Cardiac conduction system injury is a cause of postoperative cardiac morbidity following repair of congenital heart disease (CHD). The national occurrence of postoperative complete heart block (CHB) following surgical repair of CHD is unknown. We sought to describe the occurrence of and costs related to postoperative CHB following surgical repair of common forms of CHD using a large national database.  Retrospective, observational analysis performed over a 10-year period (2000-2009) using the Kids' Inpatient Database (KID). Visits for patients ≤24 months of age were identified who underwent surgical repair of ventricular septal defects (VSD), atrioventricular canal defects (AVC), and tetralogy of Fallot (TOF). Patients were identified who were diagnosed with postoperative CHB, further identifying those requiring a new pacemaker placement during the same hospitalization. Costs associated with visits were calculated. There were 16,105 surgical visits: 7,146 VSD, 3,480 AVC, and 5,480 TOF. There was a decrease in postoperative mortality (P = 0.0001) with no significant change in postoperative CHB. Hospital stay and cost were higher with CHB and placement of a permanent pacemaker. Repair of AVC (OR 1.77; [1.32-2.38]) was associated with a higher rate of postoperative CHB. Length of hospital stay and total cost were significantly increased with the development of postoperative CHB and increased further with placement of a permanent pacemaker.  There has been little change over time in the frequency of postoperative CHB in patients undergoing repair of VSD, AVC, and TOF. Postoperative CHB results in major added cost to the healthcare system. © 2012 Wiley Periodicals, Inc.

  1. Fifteen-year trends in awareness of heart disease in women: results of a 2012 American Heart Association national survey.

    PubMed

    Mosca, Lori; Hammond, Gmerice; Mochari-Greenberger, Heidi; Towfighi, Amytis; Albert, Michelle A

    2013-03-19

    The purpose of this study was to evaluate trends in awareness of cardiovascular disease (CVD) risk among women between 1997 and 2012 by racial/ethnic and age groups, as well as knowledge of CVD symptoms and preventive behaviors/barriers. A study of awareness of CVD was conducted by the American Heart Association in 2012 among US women >25 years of age identified through random-digit dialing (n=1205) and Harris Poll Online (n=1227), similar to prior American Heart Association national surveys. Standardized questions on awareness were given to all women; additional questions about preventive behaviors/barriers were given online. Data were weighted, and results were compared with triennial surveys since 1997. Between 1997 and 2012, the rate of awareness of CVD as the leading cause of death nearly doubled (56% versus 30%; P<0.001). The rate of awareness among black and Hispanic women in 2012 (36% and 34%, respectively) was similar to that of white women in 1997 (33%). In 1997, women were more likely to cite cancer than CVD as the leading killer (35% versus 30%), but in 2012, the trend reversed (24% versus 56%). Awareness of atypical symptoms of CVD has improved since 1997 but remains low. The most common reasons why women took preventive action were to improve health and to feel better, not to live longer. Awareness of CVD among women has improved in the past 15 years, but a significant racial/ethnic minority gap persists. Continued effort is needed to reach at-risk populations. These data should inform public health campaigns to focus on evidenced-based strategies to prevent CVD and to help target messages that resonate and motivate women to take action.

  2. Building capacity for heart health promotion: results of a 5-year experience in Nova Scotia, Canada.

    PubMed

    MacLean, David R; Farquharson, Jane; Heath, Stephanie; Barkhouse, Kari; Latter, Celeste; Joffres, Christine

    2003-01-01

    To present the outcomes of a capacity-building initiative for heart health promotion. Follow-up study combining quantitative and qualitative methods. The Western Health Region of Nova Scotia, Canada. Twenty organizations, including provincial and municipal agencies and community groups engaged in health, education, and recreation activities. Two strategies were used for this study: partnership development and organizational development. Partnership development included the creation of multilevel partnerships in diverse sectors. Organizational development included the provision of technical support, action research, community activation, and organizational consultation. Quantitative data included number and type of partnerships, learning opportunities, community activation initiatives, and organizational changes. Qualitative data included information on the effectiveness of partnerships, organizational consultation, and organizational changes. Results included the development of 204 intersectoral partnerships, creation of a health promotion clearinghouse, 47 workshops attended by approximately 1400 participants, diverse research products, implementation of 18 community heart health promotion initiatives, and increased organizational capacity for heart health promotion via varied organizational changes, including policy changes, fund reallocations, and enhanced knowledge and practices. Partnership and organizational development were effective mechanisms for building capacity in heart health promotion. This intervention may have implications for large-scale, community-based, chronic-disease prevention projects.

  3. Peer mentoring is associated with positive change in physical activity and aerobic fitness of grades 4, 5, and 6 students in the heart healthy kids program.

    PubMed

    Spencer, Rebecca A; Bower, Jenna; Kirk, Sara F L; Hancock Friesen, Camille

    2014-11-01

    Only 7% of Canadian children achieve activity recommendations, contributing to obesity and preventable disease. The Heart Healthy Kids (H2K) program was designed to test the relationship between peer mentoring, physical activity, and cardiovascular fitness. Participants from 10 schools (5 control, 5 intervention) were enrolled in the program. In control schools, H2K included a physical activity challenge and education sessions. Intervention schools included the addition of a peer-mentoring component. Physical activity was measured through daily pedometer recording. Cardiovascular fitness was evaluated using the PACER (Progressive Aerobic Cardiovascular Endurance Run) protocol to calculate maximal oxygen uptake (VO2 max). Participants included 808 children (average age 9.9 ± 1.0 years). Although control and intervention schools did not differ at baseline, participants with peer mentoring logged significantly more steps per school day, on average, than those in control schools (6,785 ± 3,011 vs. 5,630 ± 2,586; p < .001). Male participants logged significantly more steps per school day than female participants. A significant improvement in VO2 max was also noted in intervention schools, with an average increase of 1.72 ml/mg/min. H2K was associated with positive change in physical activity and cardiovascular fitness, suggesting that peer mentoring shows promise for application in health promotion interventions.

  4. Loss of Axin2 results in impaired heart valve maturation and subsequent myxomatous valve disease.

    PubMed

    Hulin, Alexia; Moore, Vicky; James, Jeanne M; Yutzey, Katherine E

    2017-01-01

    Myxomatous valve disease (MVD) is the most common aetiology of primary mitral regurgitation. Recent studies suggest that defects in heart valve development can lead to heart valve disease in adults. Wnt/β-catenin signalling is active during heart valve development and has been reported in human MVD. The consequences of increased Wnt/β-catenin signalling due to Axin2 deficiency in postnatal valve remodelling and pathogenesis of MVD were determined. To investigate the role of Wnt/β-catenin signalling, we analysed heart valves from mice deficient in Axin2 (KO), a negative regulator of Wnt/β-catenin signalling. Axin2 KO mice display enlarged mitral and aortic valves (AoV) after birth with increased Wnt/β-catenin signalling and cell proliferation, whereas Sox9 expression and collagen deposition are decreased. At 2 months in Axin2 KO mice, the valve extracellular matrix (ECM) is stratified but distal AoV leaflets remain thickened and develop aortic insufficiency. Progressive myxomatous degeneration is apparent at 4 months with extensive ECM remodelling and focal aggrecan-rich areas, along with increased BMP signalling. Infiltration of inflammatory cells is also observed in Axin2 KO AoV prior to ECM remodelling. Overall, these features are consistent with the progression of human MVD. Finally, Axin2 expression is decreased and Wnt/β-catenin signalling is increased in myxomatous mitral valves in a murine model of Marfan syndrome, supporting the importance of Wnt/β-catenin signalling in the development of MVD. Altogether, these data indicate that Axin2 limits Wnt/β-catenin signalling after birth and allows proper heart valve maturation. Moreover, dysregulation of Wnt/β-catenin signalling resulting from loss of Axin2 leads to progressive MVD. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For Permissions, please email: journals.permissions@oup.com.

  5. Heart Rate-Corrected QT and JT Intervals in Electrocardiograms in Physically Fit Students and Student Athletes.

    PubMed

    Misigoj-Durakovic, Marjeta; Durakovic, Zijad; Prskalo, Ivan

    2016-11-01

    In literature, data on the prevalence of prolonged and shortened corrected QT (QTc) have shown considerable variability. The aim of the study was to compare QTc and JTc intervals of competitive student athletes and noncompetitive sport participants to QTc cutoff points used in athletes. A group of 485 physically fit candidates for the study of kinesiology (139 female and 346 male candidates) aged 18-20 participated in the study. Basic anthropometry, field fitness test, cardiovascular, electrocardiograms measurements, and blood sampling for lipid profile were conducted. The prolonged QTc according to European Society of Cardiology criteria was found in 2.9% of female and 4.3% of male students. When the "Seattle criteria" were used, the proportion of prolonged QTc was 1.44% in female and 0.29% in male students. The shortened QTc according to the Seattle cutoff points was presented in 0.7% of female and 2.0% of male students. The JTc over 400 ms was found in 0.72% of female and 0.29% of male students. The JTc shorter than 320 ms was presented in 0.7% of female and 1.1% of male students. No significant differences were found between students involved in competitive sport and those involved in recreational sporting activities. Female students had lower body mass index and blood pressure values, better blood lipid profile, and lower uric acid concentrations. In conclusion, the Seattle criteria markedly decreased the proportion of prolonged QTc in student athletes, particularly in male students. It seems that the JTc interval could be a better parameter than the QTc interval for the estimation of specific repolarization time in physically fit university students.

  6. The HERS trial results: paradigms lost? Heart and Estrogen/progestin Replacement Study.

    PubMed

    Herrington, D M

    1999-09-21

    The Heart and Estrogen/progestin Replacement Study (HERS) found no overall effect of 4.1 years of therapy with estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. However, within the overall null effect, a 50% increase in cardiovascular events was seen in the first year, followed by fewer events after 2 years of treatment in the hormone therapy group than in the placebo group. Understanding the cause of this pattern of early increase and late reduction in risk is key to interpreting the HERS results and reconciling them with the large number of observational and other studies of the cardiovascular effects of estrogen. There are two possibilities. One is that the HERS regimen of estrogen plus progestin has no effect on risk for heart disease, and the pattern of changing risk over time is simply the result of chance or confounding. The other is that the pattern of early increase and late reduction in risk is due to real but opposing effects of this regimen. Several lines of evidence support each possibility. Attrition of a susceptible cohort of women uniquely at risk for a cardiovascular complication from hormone therapy coupled with a gradually progressive beneficial effect due to lipid lowering and other factors is a promising potential explanation. The HERS results remind us of the need for clinical trials to evaluate both the benefits and risks of new therapies. They also illustrate how much more we need to know about the cardiovascular effects of hormone replacement therapy.

  7. Relationship of physical fitness test results and hockey playing potential in elite-level ice hockey players.

    PubMed

    Burr, Jaime F; Jamnik, Roni K; Baker, Joseph; Macpherson, Alison; Gledhill, Norman; McGuire, E J

    2008-09-01

    The primary purpose of this study was to determine the fitness variables with the highest capability for predicting hockey playing potential at the elite level as determined by entry draft selection order. We also examined the differences associated with the predictive abilities of the test components among playing positions. The secondary purpose of this study was to update the physiological profile of contemporary hockey players including positional differences. Fitness test results conducted by our laboratory at the National Hockey League Entry Draft combine were compared with draft selection order on a total of 853 players. Regression models revealed peak anaerobic power output to be important for higher draft round selection in all positions; however, the degree of importance of this measurement varied with playing position. The body index, which is a composite score of height, lean mass, and muscular development, was similarly important in all models, with differing influence by position. Removal of the goalies' data increased predictive capacity, suggesting that talent identification using physical fitness testing of this sort may be more appropriate for skating players. Standing long jump was identified as a significant predictor variable for forwards and defense and could be a useful surrogate for assessing overall hockey potential. Significant differences exist between the physiological profiles of current players based on playing position. There are also positional differences in the relative importance of anthropometric and fitness measures of off-ice hockey tests in relation to draft order. Physical fitness measures and anthropometric data are valuable in helping predict hockey playing potential. Emphasis on anthropometry should be used when comparing elite-level forwards, whereas peak anaerobic power and fatigue rate are more useful for differentiating between defense.

  8. [The results of autogenic training in patients with ischemic heart disease after an aortocoronary bypass operation].

    PubMed

    Rakov, A L; Mandrykin, Iu V; Zamotaev, Iu N

    1997-02-01

    Were studied psychovegetative and somatic correlations in 115 patients with ischemic heart disease, having aortocoronary shunting operation and being at the sanatorium stage of the medical rehabilitation. To 70 patients was been carried out treatment with application of autogenous training (AT), to 45--without use of AT. The research has confirmed the presence in the patients psychological disadaptation, expressed essentially in asthenoneurotic and hypochondriac reactions. Is established, that estimation of expressiveness of emotional tension, investigated with the aid of Spilberger's psychometric scale, can be confirmed by parameters of peroxide oxidation of lipids and mathematical analysis of heart rythm. The use of variant of training modified by the authors has revealed improvement of clinical parameters, reflecting health state of the patients, which correlate with the data of the psychological test and the results of bicycle ergometry [correction of veloergometry].

  9. The Association of Resting Heart Rate and Incident Hypertension: The Henry Ford Hospital Exercise Testing (FIT) Project.

    PubMed

    Aladin, Amer I; Al Rifai, Mahmoud; Rasool, Shereen H; Keteyian, Steven J; Brawner, Clinton A; Michos, Erin D; Blaha, Michael J; Al-Mallah, Mouaz H; McEvoy, John W

    2016-02-01

    Given that sympathetic tone is associated with hypertension, we sought to determine whether resting heart rate (RHR), as a surrogate for cardiac autonomic function, was associated with incident hypertension. We analyzed 21,873 individuals without a history of hypertension who underwent a clinically indicated exercise stress test. Baseline RHR was assessed prior to testing and was categorized as <70, 70-85, and >85 beats-per-minute (bpm). Incident hypertension was defined by subsequent diagnosis codes for new-onset hypertension from three or more encounters. We tested for effect modification by age (<60 vs. ≥60 years), sex, race, and history of coronary heart disease (CHD). Mean (±SD) age was 49 (±12) years, 55% were men and 21% were Black. Compared to the lowest RHR (<70 bpm) category, patients in the highest category (>85 bpm) were younger, more likely to be female, heavier, diabetic, and achieve lower metabolic equivalents (METS). Over a median of 4 years follow-up, there were 8,179 cases of incident hypertension. Compared to RHR <70 bpm, persons with RHR >85 bpm had increased risk of hypertension after adjustment for CHD risk factors, baseline blood pressure (BP), and METS (hazard ratio = 1.15 (95% confidence interval 1.08-1.23)). Age was an effect modifier (interaction P = 0.02), whereas sex, race, and CHD were not. In age-stratified analyses the relationship remained significant only in those younger than 60 years. Elevated RHR is an independent risk factor for incident hypertension, particularly in younger persons. Whether lifestyle modification or other strategies to reduce RHR can prevent incident hypertension in high-risk individuals warrants further study. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Self‐Reported Cardiorespiratory Fitness: Prediction and Classification of Risk of Cardiovascular Disease Mortality and Longevity—A Prospective Investigation in the Copenhagen City Heart Study

    PubMed Central

    Holtermann, Andreas; Marott, Jacob Louis; Gyntelberg, Finn; Søgaard, Karen; Mortensen, Ole Steen; Prescott, Eva; Schnohr, Peter

    2015-01-01

    Background The predictive value and improved risk classification of self‐reported cardiorespiratory fitness (SRCF), when added to traditional risk factors on cardiovascular disease (CVD) and longevity, are unknown. Methods and Results A total of 3843 males and 5093 females from the Copenhagen City Heart Study without CVD in 1991–1994 were analyzed using multivariate Cox hazards regression to assess the predictive value and survival benefit for CVD and all‐cause mortality from SRCF. The category‐free net reclassification improvement from SRCF was calculated at 15‐year follow‐up on CVD and all‐cause mortality. Overall, 1693 individuals died from CVD. In the fully adjusted Cox model, those reporting the same (hazard ratio [HR], 1.17; 95% confidence interval [CI], 1.04 to 1.32) and lower (HR, 1.91; 95% CI, 1.62 to 2.24) SRCF than peers had an increased risk of CVD mortality, compared with individuals with higher SRCF. Compared with individuals with higher SRCF, those with the same and lower SRCF had 1.8 (95% CI, 1.0 to 2.5) and 5.1 (95% CI, 4.1 to 6.2) years lower life expectancy, respectively. Individuals with lower SRCF had a significantly increased risk of CVD mortality, compared with individuals with higher SRCF, within each strata of leisure time physical activity and self‐rated health, and SRCF significantly predicted CVD mortality independently of self‐rated health and walking pace. A net reclassification improvement of 30.5% (95% CI, 22.1% to 38.9%) for CVD mortality was found when adding SRCF to traditional risk factors. Comparable findings were found for all‐cause mortality. Conclusions SRCF has independent predictive value, is related to a considerable survival benefit, and improves risk classification when added to traditional risk factors of CVD and all‐cause mortality. SRCF might prove useful in improved risk stratification in primary prevention. PMID:25628408

  11. Results following implantation of mechanical circulatory support systems: The Montreal Heart Institute experience

    PubMed Central

    El-Hamamsy, Ismaïl; Jacques, Frédéric; Perrault, Louis P; Bouchard, Denis; Demers, Philippe; White, Michel; Pelletier, Guy B; Racine, Normand; Pellerin, Michel; Carrier, Michel

    2009-01-01

    BACKGROUND: Mechanical circulatory support systems (MCSS) have been available in Canada since 1986. Accepted indications include bridging to transplantation or recovery. The present study reviewed the results following MCSS implantation at the Montreal Heart Institute (Montreal, Quebec). METHODS: From September 1987 to September 2006, 43 MCSS were implanted (32 Thoratec [Thoratec Corporation, USA], nine Cardio West TAH [SynCardia Systems Inc, USA], two Novacor [World Heart Corporation, Canada]) in 43 patients (mean [± SD] age 44±13 years; range 19 to 64 years). Indications for implantation included cardiogenic shock due to ischemic (n=19), viral (n=10) or other types of cardiomyopathies (n=14). RESULTS: The mean ejection fraction before implantation was 17.6±6.5% (range 10% to 45%). Before MCSS implantation, most patients showed signs of end-organ failure, including mechanical ventilation (77%), central venous pressure higher than 16 mmHg (44%), oliguria (35%) and hepatic dysfunction (19%). The mean duration of MCSS support was 22.8±32.8 days (range one to 158 days). Survival to transplantation or recovery was 74%. Only one patient was successfully bridged to recovery. Complications were common during MCSS support. They included re-exploration for bleeding (47%), respiratory failure (44%), renal failure requiring temporary dialysis (40%), infection (33%) and neurological events (16%). Only one patient had device failure. In patients successfully bridged to transplantation, early actuarial survival (one month) following transplantation averaged 71±8% and was 57±9% at one year. CONCLUSION: MCSS support with a left ventricular assist device or a total artificial heart provides an effective means of bridging terminally ill patients to transplantation or recovery. Early survival after transplantation shows satisfactory results. However, these results come at the expense of frequent device-related complications, and device failure remains a constant threat. PMID

  12. Coffee and tea consumption and the prevalence of coronary heart disease in men and women: results from the Scottish Heart Health Study.

    PubMed Central

    Brown, C A; Bolton-Smith, C; Woodward, M; Tunstall-Pedoe, H

    1993-01-01

    STUDY OBJECTIVES--The aim was to determine if there was a relationship between coffee or tea consumption and the prevalence of coronary heart disease in Scotland. DESIGN--The relationship between self reported coffee and tea consumption and the prevalence of coronary heart disease (history, symptoms, or electrocardiographic evidence) was investigated using multiple logistic regression analysis in the Scottish Heart Health Study (SHHS), a cross sectional study. SETTING--Twenty two Scottish districts were surveyed for the SHHS between 1984 and 1986. SUBJECTS--A total of 10,359 men and women aged 40-59 years were studied. MEASUREMENTS AND MAIN RESULTS--Of the 9740 subjects who were assigned a category, 21.8% (2122) were classified as having indications of coronary heart disease. Men and women were combined in the odds ratio analysis because they showed almost identical patterns in the prevalence of coronary heart disease across the coffee and tea quarters (grouped according to consumption). Those who did not drink coffee had a significantly higher (p < 0.05) prevalence of coronary heart disease than the three groups for coffee drinkers. Adjustments for risk factors including cigarette smoking, total blood cholesterol, and diastolic blood pressure did not remove the significance of the odds ratios. There was a positive dose-response effect between tea consumption and coronary heart disease which was removed after adjustment for various risk factors. CONCLUSIONS--These findings do not support a positive relationship between coffee or tea consumption and coronary heart disease in this British study where most coffee consumed is instant coffee. PMID:8350026

  13. STIM1 elevation in the heart results in aberrant Ca2+ handling and cardiomyopathy

    PubMed Central

    Correll, Robert N.; Goonasekera, Sanjeewa A.; van Berlo, Jop H.; Burr, Adam R.; Accornero, Federica; Zhang, Hongyu; Makarewich, Catherine A.; York, Allen J.; Sargent, Michelle A.; Chen, Xiongwen; Houser, Steven R.; Molkentin, Jeffery D.

    2015-01-01

    Stromal interaction molecule 1 (STIM1) is a Ca2+ sensor that partners with Orai1 to elicit Ca2+ entry in response to endoplasmic reticulum (ER) Ca2+ store depletion. While store-operated Ca2+ entry (SOCE) is important for maintaining ER Ca2+ homeostasis in non-excitable cells, it is unclear what role it plays in the heart, although STIM1 is expressed in the heart and upregulated during disease. Here we analyzed transgenic mice with STIM1 overexpression in the heart to model the known increase of this protein in response to disease. As expected, STIM1 transgenic myocytes showed enhanced Ca2+ entry following store depletion and partial co-localization with the type 2 ryanodine receptor (RyR2) within the sarcoplasmic reticulum (SR), as well as enrichment around the sarcolemma. STIM1 transgenic mice exhibited sudden cardiac death as early as 6 weeks of age, while mice surviving past 12 weeks of age developed heart failure with hypertrophy, induction of the fetal gene program, histopathology and mitochondrial structural alterations, loss of ventricular functional performance and pulmonary edema. Younger, pre-symptomatic STIM1 transgenic mice exhibited enhanced pathology following pressure overload stimulation or neurohumoral agonist infusion, compared to controls. Mechanistically, cardiac myocytes isolated from STIM1 transgenic mice displayed spontaneous Ca2+ transients that were prevented by the SOCE blocker SKF-96365, increased L-type Ca2+ channel (LTCC) current, and enhanced Ca2+ spark frequency. Moreover, adult cardiac myocytes from STIM1 transgenic mice showed both increased diastolic Ca2+ and maximal transient amplitude but no increase in total SR Ca2+ load. Associated with this enhanced Ca2+ profile was an increase in cardiac nuclear factor of activated T-cells (NFAT) and Ca2+/calmodulin-dependent kinase II (CaMKII) activity. We conclude that STIM1 has an unexpected function in the heart where it alters communication between the sarcolemma and SR resulting in

  14. Effects of initiating carvedilol in patients with severe chronic heart failure: results from the COPERNICUS Study.

    PubMed

    Krum, Henry; Roecker, Ellen B; Mohacsi, Paul; Rouleau, Jean L; Tendera, Michal; Coats, Andrew J S; Katus, Hugo A; Fowler, Michael B; Packer, Milton

    2003-02-12

    Beta-blockers remain underused despite their established utility for improving outcome in heart failure. Concerns that initiation of treatment produces few immediate benefits and may have important risks may be deterring widespread use. To evaluate the early effects of the beta-blocker carvedilol in patients with severe heart failure. Randomized, double-blind, placebo-controlled trial conducted from October 28, 1997, to March 20, 2000, at 334 hospital centers in 21 countries among 2289 patients with symptoms of heart failure at rest or with minimal exertion who were clinically euvolemic and had a left ventricular ejection fraction of less than 25%. Patients were randomly assigned to receive carvedilol, with start dosage of at 3.125 mg twice daily with uptitration to a target dosage of 25 mg twice daily (n = 1156), or placebo (n = 1133), in addition to their usual medications for heart failure. Death, hospitalization, or permanent withdrawal from study drug, as well as adverse events during the first 8 weeks of treatment. The carvedilol group experienced no increase in cardiovascular risk but instead had fewer patients who died (19 vs 25; hazard ratio [HR], 0.75; 95% confidence interval [CI], 0.41-1.35); who died or were hospitalized (134 vs 153; HR, 0.85; 95% CI, 0.67-1.07); or who died, were hospitalized, or were permanently withdrawn from treatment (162 vs 188; HR, 0.83; 95% CI, 0.68-1.03). These effects were similar in direction and magnitude to those observed during the entire study, and were apparent particularly in the 624 patients with recent or recurrent decompensation or a very depressed left ventricular ejection fraction. Differences in favor of carvedilol became apparent as early as 14 to 21 days following initiation of treatment. Worsening heart failure was the only serious adverse event with a frequency greater than 2% and was reported with similar frequency in the placebo and carvedilol groups (6.4% vs 5.1%). These data suggest that, in clinically

  15. SELF-MANAGEMENT COUNSELING IN PATIENTS WITH HEART FAILURE: PRIMARY RESULTS FROM THE HEART FAILURE ADHERENCE AND RETENTION TRIAL (HART)

    PubMed Central

    Powell, Lynda H.; Calvin, James E.; Richardson, Dejuran; Janssen, Imke; Mendes de Leon, Carlos F.; Flynn, Kristin J.; Grady, Kathleen L.; Rucker-Whitaker, Cheryl S.; Eaton, Claudia; Avery, Elizabeth

    2013-01-01

    Context Activating patients with heart failure (HF) to adhere to physician advice has not translated into clinical benefit, but past trials have had methodologic limitations. Objective To determine the value of self-management counseling plus HF education, over HF education alone, on the primary endpoint of death or HF hospitalization. Design, Setting, and Patients A single center behavioral efficacy trial in 902 patients with mild to moderate systolic or diastolic dysfunction, randomized between 2001–2004. Interventions All patients were offered 18 contacts and 18 HF educational tip sheets over the course of 1 year. Patients randomized to education received tip sheets in the mail and phone calls to check comprehension. Patients randomized to self-management received tip sheets in groups and were taught self-management skills to implement the advice. Main Outcome Measure Death or HF hospitalization, blindly adjudicated by cardiologists. Intent-to-treat results were analyzed as time-to-event and accelerated failure time models were used for non-proportional hazards. Results Patients were an average of 63.6 years, 47% female, 40% minority, 52% with family income <$30,000/year, and 23% with diastolic dysfunction. The self-management arm was no different from the education arm on the primary endpoint (Wilcoxon p=0.58). Post-hoc analyses on pre-specified subgroups revealed a significant income x treatment interaction (log-logistic estimate=0.64, p=0.02). Patients with income <$30,000 in self-management had a slower time to event than those in education (p=0.05) and were no different than higher income patients in either treatment arm. Conclusions The addition of self-management counseling to HF education does not reduce death or HF hospitalizations in patients with mild to moderate HF. Future trials should evaluate tailored outpatient HF management featuring ongoing education and comprehension checks for all, augmented by group-based skill development for those more

  16. LLNL heart valve condition classification project anechoic testing results at the TRANSDEC evaluation facility

    SciTech Connect

    Candy, J V

    1999-10-31

    This report first briefly outlines the procedures and support/activation fixture developed at LLNL to perform the heart valve tests in an anechoic-like tank at the US Navy Transducer Evaluation Facility (TransDec) located in San Diego, CA. Next they discuss the basic experiments performed and the corresponding experimental plan employed to gather meaningful data systematically. The signal processing required to extract the desired information is briefly developed along with some of the data. Finally, they show the results of the individual runs for each valve, point out any of the meaningful features and summaries.

  17. Broken lung and broken heart: a case of right pneumothorax resulting in Takotsubo cardiomyopathy.

    PubMed

    Kumar, Anupam; Padala, Santosh; Morales, Donna Chelle; Swales, Heather

    2013-02-01

    Takotsubo cardiomyopathy (TC), also known as broken-heart syndrome, is usually the result of a stressful event. It is more common in postmenopausal females and can mimic an acute coronary syndrome. We report the case of an elderly female who presented with acute chest pain and ECG changes suggestive of an acute myocardial infarction, but later was found to have right-sided pneumothorax with TC. The case highlights the growing interest in stress cardiomyopathy and its variable modes of presentation. It also reminds us that the acute chest pain of a pneumothorax can closely mimic a coronary event with similar electrocardiographic changes.

  18. Cardioembolic strokes resulting from a self-inflicted needle puncture involving both sides of the heart.

    PubMed

    Tan, Mark Zheng Yi; Brunswicker, Annemarie; Abdelraheem, Shamsaldeen; Sheehan, Alison

    2017-03-14

    Foreign bodies in the heart are rare occurrences with a limited evidence base to guide recommendations on management. We report a case of multiple cardioembolic strokes as a result of a self-inflicted sewing needle puncture from the anterior chest through the right ventricle and interventricular septum with its tip in the left ventricle close to the subvalvular apparatus in a 39-year-old psychiatric patient. We discuss issues surrounding decision making and ongoing care and highlight the importance of further follow-up and reporting of cases to form a robust evidence base to guide future recommendations.

  19. Microlensing results toward the galactic bulge, theory of fitting blended light curves, and discussion of weak lensing corrections

    NASA Astrophysics Data System (ADS)

    Thomas, Christian L.

    2006-06-01

    Analysis and results (Chapters 2-5) of the full 7 year Macho Project dataset toward the Galactic bulge are presented. A total of 450 high quality, relatively large signal-to-noise ratio, events are found, including several events exhibiting exotic effects, and lensing events on possible Sagittarius dwarf galaxy stars. We examine the problem of blending in our sample and conclude that the subset of red clump giants are minimally blended. Using 42 red clump giant events near the Galactic center we calculate the optical depth toward the Galactic bulge to be t = [Special characters omitted.] × 10 -6 at ( l, b ) = ([Special characters omitted.] ) with a gradient of (1.06 ± 0.71) × 10 -6 deg -1 in latitude, and (0.29±0.43) × 10 -6 deg -1 in longitude, bringing measurements into consistency with the models for the first time. In Chapter 6 we reexamine the usefulness of fitting blended light-curve models to microlensing photometric data. We find agreement with previous workers (e.g. Wozniak & Paczynski) that this is a difficult proposition because of the degeneracy of blend fraction with other fit parameters. We show that follow-up observations at specific points along the light curve (peak region and wings) of high magnification events are the most helpful in removing degeneracies. We also show that very small errors in the baseline magnitude can result in problems in measuring the blend fraction, and study the importance of non- Gaussian errors in the fit results. The biases and skewness in the distribution of the recovered blend fraction is discussed. We also find a new approximation formula relating the blend fraction and the unblended fit parameters to the underlying event duration needed to estimate microlensing optical depth. In Chapter 7 we present work-in-progress on the possibility of correcting standard candle luminosities for the magnification due to weak lensing. We consider the importance of lenses in different mass ranges and look at the contribution

  20. The Aachen miniaturized heart-lung machine--first results in a small animal model.

    PubMed

    Schnoering, Heike; Arens, Jutta; Sachweh, Joerg S; Veerman, Melanie; Tolba, Rene; Schmitz-Rode, Thomas; Steinseifer, Ulrich; Vazquez-Jimenez, Jaime F

    2009-11-01

    Congenital heart surgery most often incorporates extracorporeal circulation. Due to foreign surface contact and the administration of foreign blood in many children, inflammatory response and hemolysis are important matters of debate. This is particularly an issue in premature and low birth-weight newborns. Taking these considerations into account, the Aachen miniaturized heart-lung machine (MiniHLM) with a total static priming volume of 102 mL (including tubing) was developed and tested in a small animal model. Fourteen female Chinchilla Bastard rabbits were operated on using two different kinds of circuits. In eight animals, a conventional HLM with Dideco Kids oxygenator and Stöckert roller pump (Sorin group, Milan, Italy) was used, and the Aachen MiniHLM was employed in six animals. Outcome parameters were hemolysis and blood gas analysis including lactate. The rabbits were anesthetized, and a standard median sternotomy was performed. The ascending aorta and the right atrium were cannulated. After initiating cardiopulmonary bypass, the aorta was cross-clamped, and cardiac arrest was induced by blood cardioplegia. Blood samples for hemolysis and blood gas analysis were drawn before, during, and after cardiopulmonary bypass. After 1 h aortic clamp time, all animals were weaned from cardiopulmonary bypass. Blood gas analysis revealed adequate oxygenation and perfusion during cardiopulmonary bypass, irrespective of the employed perfusion system. The use of the Aachen MiniHLM resulted in a statistically significant reduced decrease in fibrinogen during cardiopulmonary bypass. A trend revealing a reduced increase in free hemoglobin during bypass in the MiniHLM group could also be observed. This newly developed Aachen MiniHLM with low priming volume, reduced hemolysis, and excellent gas transfer (O(2) and CO(2)) may reduce circuit-induced complications during heart surgery in neonates.

  1. 76 FR 5333 - Non-Malleable Cast Iron Pipe Fittings from the People's Republic of China: Preliminary Results of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-31

    ... International Trade Administration Non-Malleable Cast Iron Pipe Fittings from the People's Republic of China...-2010 administrative review of the antidumping duty order on non-malleable cast iron pipe fittings... Antidumping Duty Order: Non-Malleable Cast Iron Pipe Fittings From the People's Republic of China, 68 FR 16765...

  2. 78 FR 72639 - Non-Malleable Cast Iron Pipe Fittings From the People's Republic of China: Final Results of the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-03

    ... International Trade Administration Non-Malleable Cast Iron Pipe Fittings From the People's Republic of China... sunset review of the antidumping duty order on non-malleable cast iron pipe fittings from the People's... expedited (120-day) sunset review of the antidumping duty order on non-malleable cast iron pipe fittings...

  3. Valvular heart disease associated with benfluorex therapy: results from the French multicentre registry.

    PubMed

    Le Ven, Florent; Tribouilloy, Christophe; Habib, Gilbert; Gueffet, Jean-Pierre; Maréchaux, Sylvestre; Eicher, Jean-Christophe; Blanchard-Lemoine, Bénédicte; Rousseau, Juliette; Hénon, Pierre; Jobic, Yannick; Etienne, Yves

    2011-04-01

    The aim of this paper is to report clinical characteristics, consequences, echocardiographic features, and pathological findings encountered in patients suffering from valvular disease associated with benfluorex exposure in a multicentre French registry. Forty patients suffering from unexplained restrictive valvular disease with a previous exposition to benfluorex, a fenfluramine derivative, were identified from eight French university hospitals. Patients were mostly women (87.5%) with a mean age of 57 ± 9 years and high body mass index of 30 ± 7 kg/m²; 37.5% of them presented with severe heart failure symptoms (NYHA class III and IV). Benfluorex mean daily dose was 415 ± 131 mg with total therapy duration of 72 ± 53 months. Resulting cumulative dose was 910 ± 675 g. Common echocardiographic findings were leaflets and sub-valvular apparatus thickening and retraction. Aortic and mitral valve regurgitations resulting from leaflets loss of coaptation were the most frequent findings (87.5 and 82.5%) and were severe in 29 patients (72.5%). Multiple valve involvements were present in 31 cases (77.5%). Pulmonary arterial hypertension was identified in 20 cases (50%). Histopathological examination demonstrated abundant extra cellular matrix encasing the leaflets without modification of valve architecture. Fifteen patients (37.5%) underwent valvular surgery. Benfluorex-related valvulopathy shares numerous characteristics with other drug-induced valvular disease. Clinical consequences may be serious with severe heart failure symptoms that may lead to surgical treatment.

  4. Effects of 2,000 kcal per week of walking and stair climbing on physical fitness and risk factors for coronary heart disease.

    PubMed

    Leon, A S; Casal, D; Jacobs, D

    1996-01-01

    Epidemiologic evidence suggests that 8,368 kJ or 2000 kcal per week of moderate physical activity, including walking and stair climbing, can reduce risk of coronary heart disease (CHD). The goal of this study was to assess the effects of this amount of these two activities on physical fitness and risk factors for CHD. Twenty-two healthy, slightly overweight, sedentary, normotensive, normolipemic men, age 22 to 44 years, were randomly assigned to an exercise or control group for 12 weeks followed by a 4-week washout period. The subjects then were crossed-over to the alternate group for an additional 12-week period. Exercise consisted of 5 days per week of supervised treadmill exercise plus stair climbing. Treadmill exercise consisted of walking for 45 minutes at 5.15 km per hour at 2% grade for a total of 19.3 km per week. Subjects also climbed 10 floors of stairs at a time at their own pace without prescribed target heart rates for a total of 50 floors per week. The estimated total weekly energy cost of the treadmill walking plus stair climbing was 8,368 kJ or 2,000 kcal. Mean observed heart rates were 55% and 82% of maximal heart rate during treadmill walking and stair climbing, respectively. Data from the two exercise periods and two control periods were pooled and compared by analysis of variance. Sixteen subjects completed all phases of the study. Maximal oxygen uptake (VO2max) by the Bruce treadmill exercise protocol with metabolic gas measurements was below average for age at baseline, and was not significantly affected by 12 weeks of training. No significant changes were noted between groups in body weight or percent body fat (hydrostatic weighing), although there was a trend for loss of weight and fat with exercise training. Mean systolic blood pressure (119 mm Hg) was unchanged in both groups. However, diastolic blood pressure (72 mm Hg and 78 mm Hg for the treatment and control groups, respectively) showed an unexpected 6 mm Hg increase during the

  5. Heart Failure with Recovered Ejection Fraction in African Americans: Results From the African-American Heart Failure Trial.

    PubMed

    Chang, Kay-Won; Beri, Neil; Nguyen, Nghia H; Arbit, Boris; Fox, Sutton; Mojaver, Sean; Clopton, Paul; Tam, S William; Taylor, Anne L; Cohn, Jay N; Maisel, Alan S; Anand, Inder S

    2017-09-13

    Recent studies have described the entity of heart failure with recovered ejection fraction (HFrecEF), but population specific studies remain lacking. The aim of this study was to characterize patients enrolled in the African-American Heart Failure Trial (A-HeFT) who had significant improvement in their ejection fraction (EF) during the first 6 months of follow-up. Subjects (n = 59) with HFrecEF (improvement in EF from < 35% to > 40% in 6 months) were compared to 259 with heart failure and persistently reduced EF (HFrEF), defined as EF ≤ 40% at 6 month follow-up. The effects of improvement in EFon all-cause mortality, first and all hospitalizations were analyzed. Compared to HFrEF, subjects with HFrecEF had a non-significant trend towards lower mortality (hazard ratio [HR] 0.16, 95% confidence interval [CI] 0.02 - 1.15, P = 0.068), fewer first HF hospitalizations (HR 0.22, 95% CI 0.07 - 0.71, P = 0.011), fewer recurrent HF hospitalizations (HR 0.13, 95% CI 0.05 - 0.37, P < 0.001), similar first all-cause hospitalizations (HR 0.67, 95% CI 0.39 - 1.15, P = 0.150), and fewer recurrent all-cause hospitalizations (HR 0.41, 95% CI 0.24 - 0.68, P < 0.001). These data confirm that as in other populations, a small subgroup of black patients receiving standard of care improve their EF with favorable outcomes. Further studies are required to determine whether myocardial recovery is permanent and the best management strategies in such patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Promoting physical activity in worksite settings: results of a German pilot study of the online intervention Healingo fit.

    PubMed

    Dadaczynski, Kevin; Schiemann, Stephan; Backhaus, Olaf

    2017-09-08

    Worldwide, one third of the adult population is insufficiently physically active. This fact has led to a strong demand for public health initiatives. Given the mixed evidence on the effectiveness of worksite interventions promoting physical activity (PA), a pedometer-based and gamified intervention, Healingo Fit, was developed and evaluated over a period of six weeks. The effectiveness of Healingo Fit was evaluated as part of a randomized controlled trial (RCT) with two measurement points involving employees of an automobile manufacturer. Direct health promotion outcomes were assessed using self-developed items on PA knowledge, the HAPA brief scales and the exercise self-efficacy scale. IPAQ short version was used to assess different forms of PA behavior. Intervention effects were identified using a two-way analysis of variance (ANOVA) with repeated measurements. A total of 144 participants took part in the study (intervention group = 80, control group = 64). The results of the ANOVA show significant interaction effects (group x time) for health promotion outcomes (knowledge, intention, and self-efficacy), with medium to high effect sizes. In the health behavior related outcomes, there were significant improvements, with large effect sizes for low levels of PA, but not for moderate and high PA. Walking time increased by 125 min/week in the intervention group, corresponding to a percentage increase of 30% compared to baseline. Pedometer-based interventions using gamification elements can have positive effects not only on health promotion parameters but can also lead to an increase in PA behavior. The online format of Healingo Fit is suitable for reaching large numbers of people and achieving population effects. German Clinical Trials Register (DRKS): DRKS00006105 , date of registration: 2017-03-24.

  7. The unnatural history of valvular heart disease: late results with silastic ball valve prostheses.

    PubMed

    Freimanis, I; Starr, A

    1984-01-01

    The development of prosthetic heart valves successfully arrested the dismal natural history of valvular heart disease for thousands of patients. The experiences of numerous investigators provided a setting wherein the design and implantation of the silastic ball valves led to improved survival with both aortic and mitral valve replacement. Refinement of the caged-ball design was based on clinical and laboratory findings. In the mitral position, valve related thromboembolism was reduced from 38% to 3%. With the aortic prostheses the problem of ball variance was overcome by reducing trauma to the poppet and altering its heat curing process. In 1967 a completely cloth covered valve was introduced to reduce further the thromboembolic rate. Significant improvement in the embolus-free rate was ultimately found to be dependent on the year of operation with introduction of the time-frame concept. The current mitral silastic ball valve, Model 6120, yields an actuarial survival of 72 (+/- 3%), 54 (+/- 5%), and 37 (+/- 5%) for five, ten and fifteen years respectively. For aortic valve replacement, current Model 1260, the actuarial survival is 71 (+/- 2%), 58 (+/- 3%) and 48 (+/- 4%) for five, ten and fifteen years respectively. Late results are compared to other valvular prostheses.

  8. Effects of antiresorptive therapies on glucose metabolism: results from the FIT, HORIZON-PFT, and FREEDOM trials.

    PubMed

    Schwartz, Ann V; Schafer, Anne L; Grey, Andrew; Vittinghoff, Eric; Palermo, Lisa; Lui, Li-Yung L; Wallace, Robert B; Cummings, Steven R; Black, Dennis M; Bauer, Douglas C; Reid, Ian R

    2013-06-01

    In rodent models, undercarboxylated osteocalcin (ucOC) acts as a hormone that promotes insulin sensitivity and secretion. If ucOC plays a similar role in humans, then antiresorptive therapies, which reduce ucOC levels, may increase the risk of insulin resistance and diabetes. We tested whether antiresorptive therapies result in higher fasting glucose, increased weight, or greater diabetes incidence in post hoc analyses of three randomized, placebo-controlled trials in postmenopausal women: Fracture Intervention Trial (FIT) (N = 6151) of alendronate (4 years), Health Outcomes and Reduced Incidence with Zoledronic Acid Once Yearly Pivotal Fracture Trial (HORIZON-PFT) (N = 7113) of zoledronic acid (3 years), and Fracture Reduction Evaluation of Denosumab in Osteoporosis Every 6 Months (FREEDOM) trial (N = 7076) of denosumab (3 years). Fasting glucose was measured annually in FIT and HORIZON in a subset of women, and every 6 months in FREEDOM in all participants. Weight was measured annually in all trials. Incident diabetes was identified from adverse event reports, initiation of diabetes medication, or elevated fasting glucose. Differences in fasting glucose changes from randomization to trial conclusion between treatment and placebo groups were not statistically significant: -0.47 mg/dL in FIT, 0.20 mg/dL in HORIZON-PFT, and 0.09 mg/dL in FREEDOM, all p > 0.6. Weight change differed between treatment and placebo groups in FIT (0.32 kg, p = 0.003) and FREEDOM (0.31 kg, p = 0.023) but not in HORIZON-PFT (0.15 kg, p = 0.132). In the three trials combined, diabetes occurred in 203 and 225 women assigned to treatment or placebo, respectively. Diabetes incidence was not increased in any of the treatment groups or in the pooled estimate (pooled relative risk [RR] = 0.90; 95% confidence interval [CI] 0.74-1.10). Antiresorptive therapy does not have a clinically important effect on fasting glucose, weight, or diabetes risk in

  9. Teaching Aerobic Fitness Concepts.

    ERIC Educational Resources Information Center

    Sander, Allan N.; Ratliffe, Tom

    2002-01-01

    Discusses how to teach aerobic fitness concepts to elementary students. Some of the K-2 activities include location, size, and purpose of the heart and lungs; the exercise pulse; respiration rate; and activities to measure aerobic endurance. Some of the 3-6 activities include: definition of aerobic endurance; heart disease risk factors;…

  10. Teaching Aerobic Fitness Concepts.

    ERIC Educational Resources Information Center

    Sander, Allan N.; Ratliffe, Tom

    2002-01-01

    Discusses how to teach aerobic fitness concepts to elementary students. Some of the K-2 activities include location, size, and purpose of the heart and lungs; the exercise pulse; respiration rate; and activities to measure aerobic endurance. Some of the 3-6 activities include: definition of aerobic endurance; heart disease risk factors;…

  11. Fitting of satellite and in-situ ocean surface temperatures Results for polymode during the winter of 1977-1978

    NASA Technical Reports Server (NTRS)

    Maul, G. A.; Bravo, N. J.

    1983-01-01

    For the period considered, December 1977 through February 1978, bivariate Gaussian discriminant function cloud identification revealed that more than 93 percent of the 8-km resolution GOES infrared pixels were cloud contaminated. Cloud-free in-situ calibration points were distributed in nonrandom groups; this resulted in systematic errors when using least squares techniques. Surfaces and regression lines were least squares fitted between satellite and in-situ data; use was also made of differences and ratios. The best results were achieved with a regression in the form of the infrared radiative transfer equation; but this was no better than + or - 0.9 K. Because of extensive cloudiness, the linear regressions were seldom useful, and temperature ratios with + or - 1.3 K experimental errors best represent the applicability of GEOS data to sea surface temperatures.

  12. Results From the New Jersey Statewide Critical Congenital Heart Defects Screening Program

    PubMed Central

    Garg, Lorraine F.; Van Naarden Braun, Kim; Knapp, Mary M.; Anderson, Terry M.; Koppel, Robert I.; Hirsch, Daniel; Beres, Leslie M.; Hyg, MS; Sweatlock, Joseph; Olney, Richard S.; Glidewell, Jill; Hinton, Cynthia F.; Kemper, Alex R.

    2015-01-01

    BACKGROUND AND OBJECTIVE New Jersey was the first state to implement legislatively mandated newborn pulse oximetry screening (POxS) in all licensed birthing facilities to detect critical congenital heart defects (CCHDs). The objective of this report was to evaluate implementation of New Jersey’s statewide POxS mandate. METHODS A 2-pronged approach was used to collect data on infants screened in all New Jersey birthing facilities from August 31, 2011, through May 31, 2012. Aggregate screening results were submitted by each birthing facility. Data on failed screens and clinical characteristics of those newborns were reported to the New Jersey Birth Defects Registry (NJBDR). Three indicators were used to distinguish the added value of mandated POxS from standard clinical care: prenatal congenital heart defect diagnosis, cardiology consultation or echocardiogram indicated or performed before PoxS, or clinical findings at the time of POxS warranting a pulse oximetry measurement. RESULTS Of 75 324 live births in licensed New Jersey birthing facilities, 73 320 were eligible for screening, of which 99% were screened. Forty-nine infants with failed POxS were reported to the NJBDR, 30 of whom had diagnostic evaluations solely attributable to the mandated screening. Three of the 30 infants had previously unsuspected CCHDs and 17 had other diagnoses or non-CCHD echocardiogram findings. CONCLUSIONS In the first 9 months after implementation, New Jersey achieved a high statewide screening rate and established surveillance mechanisms to evaluate the unique contribution of POxS. The screening mandate identified 3 infants with previously unsuspected CCHDs that otherwise might have resulted in significant morbidity and mortality and also identified other significant secondary targets such as sepsis and pneumonia. PMID:23858425

  13. [Heart catheterization in Mexico. Results of the 1996 census of heart catheterization services by the Mexican Society of Cardiology].

    PubMed

    Gaspar H, J; Guadalajara Boo, J F; de la Llata Romero, M

    1996-01-01

    The findings of the 1996 Cardiac Catheterization Laboratory Survey of the Sociedad Mexicana de Cardiología are presented. There are 52 cardiac catheterization laboratory departments distributed in 16 cities of which Mexico City has 20, Guadalajara 6 and Monterrey 5. Ninety-six percent are in hospitals where heart surgery can be performed and 8 (17%) have a training program in cardiac catheterization. Only two (3.8%) are exclusively dedicated to pediatric cardiac catheterization. In 1995, 19,214 diagnostic procedures and 2,429 PTCAs were done. A total of 270 physicians were reported to have privileges to perform cardiac catheterization. The geographical distribution of the cath labs, procedure volumes and number of physicians performing catheterization are discussed.

  14. Elective correction of intracardiac lesions resulting from penetrating wounds of the heart.

    PubMed Central

    Morgan, S; Maturana, G; Urzua, J; Franck, R; Dubernet, J

    1979-01-01

    Controversy exists regarding the timing and technique of total correction of traumatic intracardiac lesions. Five patients with penetrating wounds of the heart received emergency treatment aimed at securing normal haemodynamics. No attempt was made to identify intracardiac lesions at this stage. Cineangiography two months to seven years later showed aorto-right ventricular fistulae in all patients, associated in two with aortic cusp laceration and in one with an aorto-left atrial fistula. The surgical approach for aorto-right ventricular fistula was through the right ventricle or aorta. Valvar injuries were treated by plastic reconstruction. All patients showed good clinical results when seen four to 11 years later. Traumatic intracardiac lesions in patients with stable haemodynamics after initial treatment should be operated on electively. The aortic approach is preferable for aorto-right ventricular fistulae. Conservative plastic repair of valvar injuries achieves long-term competence thus avoiding prosthetic replacement. PMID:505341

  15. Clinical results of real-time ultrasonic scanning of the heart using a phased array system.

    PubMed

    Kisslo, J A; vonRamm, O T; Thurstone, F L

    1977-01-01

    This report describes the operating characteristics and initial clinical results of a new echocardiographic system that produces real-time, high resolution, cross-sectional images of the heart. This system relies upon phased-array principles to rapidly steer and focus the ultrasound beam through the cardiac structures under investigation. A hand-held, linear array of 24 transducers is manipulated on the patient's chest to direct the interrogating plane at various cardiac structures. Images of high line density are presented in selectable sector arcs to a maximum of 90 degrees. This imaging system has been used clinically in over 2,000 patients in the past two and one-half years. Its use in the detection of altered states of ventricular and valvular pathology has been described.

  16. Left Ventricular Mass, Brain Magnetic Resonance Imaging, and Cognitive Performance: Results From the Strong Heart Study.

    PubMed

    Haring, Bernhard; Omidpanah, Adam; Suchy-Dicey, Astrid M; Best, Lyle G; Verney, Steven P; Shibata, Dean K; Cole, Shelley A; Ali, Tauqeer; Howard, Barbara V; Buchwald, Dedra; Devereux, Richard B

    2017-09-11

    Left ventricular mass (LVM) has been shown to serve as a measure of target organ damage resulting from chronic exposure to several risk factors. Data on the association of midlife LVM with later cognitive performance are sparse. We studied 721 adults (mean age 56 years at baseline) enrolled in the Strong Heart Study (SHS, 1993-1995) and the ancillary CDCAI (Cerebrovascular Disease and Its Consequences in American Indians) Study (2010-2013), a study population with high prevalence of cardiovascular disease. LVM was assessed with transthoracic echocardiography at baseline in 1993 to 1995. Cranial magnetic resonance imaging and cognitive testing were undertaken between 2010 and 2013. Generalized estimating equations were used to model associations between LVM and later imaging and cognition outcomes. The mean follow-up period was 17 years. A difference of 25 g in higher LVM was associated with marginally lower hippocampal volume (0.01%; 95% confidence interval, 0.02-0.00; P=0.001) and higher white matter grade (0.10; 95% confidence interval, 0.02-0.18; P=0.014). Functionally, participants with higher LVM tended to have slightly lower scores on the modified mini-mental state examination (0.58; 95% confidence interval, 1.08-0.08; P=0.024). The main results persisted after adjusting for blood pressure levels or vascular disease. The small overall effect sizes are partly explained by survival bias because of the high prevalence of cardiovascular disease in our population. Our findings emphasize the role of cardiovascular health in midlife as a target for the prevention of deleterious cognitive and functional outcomes in later life. © 2017 American Heart Association, Inc.

  17. A Method for Bioinformatic Analysis of Transposon Insertion Sequencing (INSeq) Results for Identification of Microbial Fitness Determinants.

    PubMed

    Wang, Nengding; Ozer, Egon A

    2017-01-01

    Transposon insertion sequencing is a process whereby microbial fitness determinants can be identified on a genome-wide scale. This process uses high-throughput next generation sequencing to screen for changes in the composition of a pool of transposon mutants after exposure to selective conditions. One commonly used process for generating transposon insertion sequencing libraries is called INSeq that works with mutant pools produced using a modified Mariner transposon. Libraries produced using the INSeq process are sequenced on the Illumina platform. In this chapter, we describe our method for processing the raw Illumina sequencing reads, aligning the reads to a reference sequence to determine read counts, and using the online transposon insertion sequencing data analysis server, ESSENTIALS, to interpret the results.

  18. Inflammation Markers and Major Depressive Disorder in Patients With Chronic Heart Failure: Results From the Sertraline Against Depression and Heart Disease in Chronic Heart Failure Study.

    PubMed

    Xiong, Glen L; Prybol, Kevin; Boyle, Stephen H; Hall, Russell; Streilein, Robert D; Steffens, David C; Krishnan, Ranga; Rogers, Joseph G; O'Connor, Christopher M; Jiang, Wei

    2015-09-01

    Major depressive disorder (MDD) and chronic heart failure (CHF) have in common heightening states of inflammation, manifested by elevated inflammation markers such as C-reactive protein. This study compared inflammatory biomarker profiles in patients with CHF and MDD to those without MDD. The study recruited patients admitted to inpatient care for acute heart failure exacerbations, after psychiatric diagnostic interview. Patients with Beck Depression Inventory (BDI) scores lower than 10 and with no history of depression served as the nondepressed reference group (n = 25). MDD severity was defined as follows: mild (BDI 10-15; n = 48), moderate (BDI 16-23; n = 51), and severe (BDI ≥ 24; n = 33). A Bio-Plex assay measured 18 inflammation markers. Ordinal logistic models were used to examine the association of MDD severity and biomarker levels. Adjusting for age, sex, statin use, body mass index, left ventricular ejection fraction, tobacco use, and New York Heart Association class, the MDD overall group variable was significantly associated with elevated interleukin (IL)-2 (p = .019), IL-4 (p = .020), IL-6 (p = .026), interferon-γ (p = .010), monocyte chemoattractant protein 1 (p = .002), macrophage inflammatory protein 1β (p = .003), and tumor necrosis factor α (p = .004). MDD severity subgroups had a greater probability of elevated IL-6, IL-8, interferon-γ, monocyte chemoattractant protein 1, macrophage inflammatory protein 1β, and tumor necrosis factor α compared with nondepressed group. The nondepressed group had greater probability of elevated IL-17 (p < .001) and IL-1β (p < .01). MDD in patients with CHF was associated with altered inflammation marker levels compared with patients with CHF who had no depression. Whether effective depression treatment will normalize the altered inflammation marker levels requires further study. ClinicalTrials.gov NCT00078286.

  19. Functional status and quality of life among breast cancer survivors with heart failure: results of the Medicare Health Outcomes Survey.

    PubMed

    Harrison, Jordan M; Davis, Matthew A; Barton, Debra L; Janz, Nancy K; Pressler, Susan J; Friese, Christopher R

    2017-08-01

    The purpose of this population-based study was to examine health-related quality of life (HRQOL) and functional status among breast cancer survivors with heart failure. We examined Medicare Health Outcomes Survey data from women aged 65 and older diagnosed with breast cancer in the past 5 years. Surveys were linked to Surveillance, Epidemiology, and End Results cancer registries. Each woman identified with self-reported heart failure (n = 239) was matched to controls without heart failure (n = 685) using propensity scores. The Short Form-36/Veterans Rand-12 measured eight domains of HRQOL. Functional status impairment was measured by limitations in six activities of daily living (ADLs). Linear models estimated associations between heart failure status and HRQOL. Logistic regression models estimated odds ratios for associations between heart failure and ADL impairment. We examined associations for the total study population and subgroups stratified by cancer stage. Among all study participants, heart failure was associated with significant deficits in every HRQOL domain and impairment in all ADLs (p < 0.01, ORs ranged from 1.74 to 2.47). After stratification by cancer stage, heart failure was associated with physical HRQOL deficits across all cancer stages (physical function, vitality, general health) and mental HRQOL deficits only in women with stage I/II cancer (role-emotional, social function). Women with early stage cancer experienced the greatest HRQOL deficits associated with heart failure. Heart failure in breast cancer survivors is associated with substantial HRQOL deficits and functional status impairment, particularly in early stage cancer. Tailored interventions are needed to improve physical function and mental wellbeing in this high-risk population.

  20. Wearable defibrillator use in heart failure (WIF): results of a prospective registry

    PubMed Central

    2012-01-01

    Background Heart failure (HF) patients have a high risk of death, and implantable cardioverter defibrillators (ICDs) are effective in preventing sudden cardiac death (SCD). However, a certain percentage of patients may not be immediate candidates for ICDs, particularly those having a short duration of risk or an uncertain amount of risk. This includes the newly diagnosed patients, as well as those on the cardiac transplant list or NYHA class IV heart failure patients who do not already have an ICD. In these patients, a wearable cardioverter defibrillator (WCD) may be used until long term risk of SCD is defined. The purpose of this study was to determine the incidence of SCD in this population, and the efficacy of early defibrillation by a WCD. Methods Ten enrolling centers identified 89 eligible HF patients who were either listed for cardiac transplantation, diagnosed with dilated cardiomyopathy, or receiving inotropic medications. Data collected included medical history, device records, and outcomes (including 90 day mortality). Results Out of 89 patients, final data on 82 patients has been collected. Patients wore the device for 75±58 days. Mean age was 56.8±13.2, and 72% were male. Most patients (98.8%) were diagnosed with dilated cardiomyopathy with a low ejection fraction (<40%) and twelve were listed for cardiac transplantation. Four patients were on inotropes. There were no sudden cardiac arrests or deaths during the study. Interestingly, 41.5% of patients were much improved after WCD use, while 34.1% went on to receive an ICD. Conclusions In conclusion, the WCD monitored HF patients until further assessment of risk. The leading reasons for end of WCD use were improvement in left ventricular ejection fraction (LVEF) or ICD implantation if there was no significant improvement in LVEF. PMID:23234574

  1. Earlier surgical intervention in congenital heart disease results in better outcome and resource utilization

    PubMed Central

    2011-01-01

    Background Congenital heart disease (CHD) accounts for a major proportion of disease in the pediatric age group. The objective of the study was to estimate the cost of illness associated with CHD pre, intra and postoperatively; among patients referred to a tertiary care hospital in Karachi, Pakistan. This is the first study conducted to estimate the cost of managing CHD in Pakistan. Methods A prevalence based cost of illness study design was used to estimate the cost of cardiac surgery (corrective & palliative) for congenital heart defects in children ≤ 5 years of age from June 2006 to June 2009. A total of 120 patients were enrolled after obtaining an informed consent and the data was collected using a pre-tested questionnaire. Results The mean age at the time of surgery in group A (1-12 mo age) was 6.08 ± 2.80 months and in group B (1-5 yrs) was 37.10 ± 19.94 months. The cost of surgical admission was found to be significantly higher in the older group, p = 0.001. The total number and cost of post-operative outpatient visits was also higher in group B, p = 0.003. Pre and post operative hospital admissions were not found to be significantly different among the two groups, p = 0.166 and 0.627, respectively. The number of complications were found to be different between the two groups (p = 0.019). Majority of these were contributed by hemorrhage and post-operative seizures. Conclusion This study concluded that significant expenditure is incurred by people with CHD; with the implication that resources could be saved by earlier detection and awareness campaigns. PMID:22206493

  2. Mediterranean diet and risk of heart failure: results from the PREDIMED randomized controlled trial.

    PubMed

    Papadaki, Angeliki; Martínez-González, Miguel Ángel; Alonso-Gómez, Angel; Rekondo, Javier; Salas-Salvadó, Jordi; Corella, Dolores; Ros, Emilio; Fitó, Montse; Estruch, Ramon; Lapetra, José; García-Rodriguez, Antonio; Fiol, Miquel; Serra-Majem, Lluís; Pintó, Xavier; Ruiz-Canela, Miguel; Bulló, Monica; Serra-Mir, Mercè; Sorlí, Jose V; Arós, Fernando

    2017-09-01

    The aim of this study was to evaluate the effect of the Mediterranean diet (MedDiet) on the incidence of heart failure (HF), a pre-specified secondary outcome in the PREDIMED (PREvención con DIeta MEDiterránea) primary nutrition-intervention prevention trial. Participants at high risk of cardiovascular disease were randomly assigned to one of three diets: MedDiet supplemented with extra-virgin olive oil (EVOO), MedDiet supplemented with nuts, or a low-fat control diet. Incident HF was ascertained by a Committee for Adjudication of events blinded to group allocation. Among 7403 participants without prevalent HF followed for a median of 4.8 years, we observed 29 new HF cases in the MedDiet with EVOO group, 33 in the MedDiet with nuts group, and 32 in the control group. No significant association with HF incidence was found for the MedDiet with EVOO and MedDiet with nuts, compared with the control group [hazard ratio (HR) 0.68; 95% confidence interval (CI) 0.41-1.13, and HR 0.92; 95% CI 0.56-1.49, respectively]. In this sample of adults at high cardiovascular risk, the MedDiet did not result in lower HF incidence. However, this pre-specified secondary analysis may have been underpowered to provide valid conclusions. Further randomized controlled trials with HF as a primary outcome are needed to better assess the effect of the MedDiet on HF risk. ISRCTN35739639. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

  3. Low-sodium diet self-management intervention in heart failure: pilot study results

    PubMed Central

    Welsh, Darlene; Lennie, Terry A; Marcinek, Regina; Biddle, Martha J; Abshire, Demetrius; Bentley, Brooke; Moser, Debra K

    2013-01-01

    Background Self-care management of a low-sodium diet is a critical component of comprehensive heart failure (HF) treatment. Aims The primary purpose of this study was to examine the effectiveness of an educational intervention on reducing the dietary sodium intake of patients with HF. Secondary purposes were to examine the effects of the intervention on attitudes, subjective norm, and perceived behavioural control towards following a low-sodium diet. Methods This was a randomized clinical trial of an educational intervention based on The Theory of Planned Behavior. Patients were randomized to either a usual care (n=25) or intervention group (n=27) with data collection at baseline, 6 weeks, and 6 months. The intervention group received low-sodium diet instructions and the usual care group received no dietary instructions. Nutrition Data Systems-Research software was used to identify the sodium content of foods on food diaries. Attitudes, subjective norm, and perceived behavioural control were measured using the Dietary Sodium Restriction Questionnaire. Results Analysis of covariance (between-subjects effects) revealed that dietary sodium intake did not differ between usual care and intervention groups at 6 weeks; however, dietary sodium intake was lower in the intervention group (F=7.3, df=1,29, p=0.01) at 6 months. Attitudes subscale scores were higher in the intervention group at 6 weeks (F=7.6, df=1, 38, p<0.01). Conclusion Carefully designed educational programmes have the potential to produce desired patient outcomes such as low-sodium diet adherence in patients with heart failure. PMID:22492785

  4. 77 FR 31577 - Non-Malleable Cast Iron Pipe Fittings From the People's Republic of China: Final Results of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-29

    ... International Trade Administration Non-Malleable Cast Iron Pipe Fittings From the People's Republic of China...'') changed circumstances review with intent to revoke, in part, the AD order on non-malleable cast iron pipe... this particular connector. \\1\\ See Non-Malleable Cast Iron Pipe Fittings From the People's Republic of...

  5. 75 FR 68324 - Certain Stainless Steel Butt-Weld Pipe Fittings From Japan, South Korea and Taiwan; Final Results...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-05

    ... International Trade Administration Certain Stainless Steel Butt-Weld Pipe Fittings From Japan, South Korea and... stainless steel butt-weld pipe fittings from Japan, South Korea and Taiwan. See Initiation of Five-Year... to the scope of the order. South Korea The products subject to this order are certain...

  6. P-E Fit as Moderator of the Accountability--Employee Reactions Relationships: Convergent Results across Two Samples

    ERIC Educational Resources Information Center

    Lanivich, Stephen E.; Brees, Jeremy R.; Hochwarter, Wayne A.; Ferris, Gerald R.

    2010-01-01

    The current two-sample investigation, which incorporated Conservation of Resources (COR) and Person-Environment (P-E) fit theories, investigated the interaction effects of felt accountability x P-E fit on the work outcomes of job satisfaction, organizational commitment, depressed mood, and work intensity. Consistent with the conceptual…

  7. 76 FR 79651 - Stainless Steel Butt-Weld Pipe Fittings From Italy: Preliminary Results of Antidumping Duty...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-22

    ... pipe size), whether finished or unfinished. The product encompasses all grades of stainless steel and... specification for Wrought Austenitic Stainless Steel Piping Fittings, or its foreign equivalents (e.g., DIN or... subject merchandise and foreign like product: (1) The type of fitting; (2) the grade of steel; (3)...

  8. 77 FR 14002 - Stainless Steel Butt-Weld Pipe Fittings From Italy, Malaysia, and the Philippines: Final Results...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-08

    ... unfinished. The product encompasses all grades of stainless steel and ``commodity'' and ``specialty... Austenitic Stainless Steel Piping Fittings, or its foreign equivalents (e.g., DIN or JIS specifications... International Trade Administration Stainless Steel Butt-Weld Pipe Fittings From Italy, Malaysia, and...

  9. Smokeless tobacco (snus) and risk of heart failure: results from two Swedish cohorts.

    PubMed

    Arefalk, Gabriel; Hergens, Maria-Pia; Ingelsson, Erik; Arnlöv, Johan; Michaëlsson, Karl; Lind, Lars; Ye, Weimin; Nyrén, Olof; Lambe, Mats; Sundström, Johan

    2012-10-01

    Oral moist snuff (snus) is discussed as a safer alternative to smoking, and its use is increasing. Based on its documented effect on blood pressure, we hypothesized that use of snus increases the risk of heart failure. Two independent Swedish prospective cohorts; the Uppsala Longitudinal Study of Adult Men (ULSAM), a community-based sample of 1076 elderly men, and the Construction Workers Cohort (CWC), a sample of 118,425 never-smoking male construction workers. Cox proportional hazards models were used to investigate possible associations of snus use with risk of a first hospitalization for heart failure. In ULSAM, 95 men were hospitalized for heart failure, during a median follow up of 8.9 years. In a model adjusted for established risk factors including past and present smoking exposure, current snus use was associated with a higher risk of heart failure [hazard ratio (HR) 2.08, 95% confidence interval (CI) 1.03-4.22] relative to non-use. Snus use was particularly associated with risk of non-ischaemic heart failure (HR 2.55, 95% CI 1.12-5.82). In CWC, 545 men were hospitalized for heart failure, during a median follow up of 18 years. In multivariable-adjusted models, current snus use was moderately associated with a higher risk of heart failure (HR 1.28, 95% CI 1.00-1.64) and non-ischaemic heart failure (HR 1.28, 95% CI 0.97-1.68) relative to never tobacco use. Data from two independent cohorts suggest that use of snus may be associated with a higher risk of heart failure.

  10. Global mortality variations in patients with heart failure: results from the International Congestive Heart Failure (INTER-CHF) prospective cohort study.

    PubMed

    Dokainish, Hisham; Teo, Koon; Zhu, Jun; Roy, Ambuj; AlHabib, Khalid F; ElSayed, Ahmed; Palileo-Villaneuva, Lia; Lopez-Jaramillo, Patricio; Karaye, Kamilu; Yusoff, Khalid; Orlandini, Andres; Sliwa, Karen; Mondo, Charles; Lanas, Fernando; Prabhakaran, Dorairaj; Badr, Amr; Elmaghawry, Mohamed; Damasceno, Albertino; Tibazarwa, Kemi; Belley-Cote, Emilie; Balasubramanian, Kumar; Islam, Shofiqul; Yacoub, Magdi H; Huffman, Mark D; Harkness, Karen; Grinvalds, Alex; McKelvie, Robert; Bangdiwala, Shrikant I; Yusuf, Salim

    2017-07-01

    Most data on mortality and prognostic factors in patients with heart failure come from North America and Europe, with little information from other regions. Here, in the International Congestive Heart Failure (INTER-CHF) study, we aimed to measure mortality at 1 year in patients with heart failure in Africa, China, India, the Middle East, southeast Asia and South America; we also explored demographic, clinical, and socioeconomic variables associated with mortality. We enrolled consecutive patients with heart failure (3695 [66%] clinic outpatients, 2105 [34%] hospital in patients) from 108 centres in six geographical regions. We recorded baseline demographic and clinical characteristics and followed up patients at 6 months and 1 year from enrolment to record symptoms, medications, and outcomes. Time to death was studied with Cox proportional hazards models adjusted for demographic and clinical variables, medications, socioeconomic variables, and region. We used the explained risk statistic to calculate the relative contribution of each level of adjustment to the risk of death. We enrolled 5823 patients within 1 year (with 98% follow-up). Overall mortality was 16·5%: highest in Africa (34%) and India (23%), intermediate in southeast Asia (15%), and lowest in China (7%), South America (9%), and the Middle East (9%). Regional differences persisted after multivariable adjustment. Independent predictors of mortality included cardiac variables (New York Heart Association Functional Class III or IV, previous admission for heart failure, and valve disease) and non-cardiac variables (body-mass index, chronic kidney disease, and chronic obstructive pulmonary disease). 46% of mortality risk was explained by multivariable modelling with these variables; however, the remainder was unexplained. Marked regional differences in mortality in patients with heart failure persisted after multivariable adjustment for cardiac and non-cardiac factors. Therefore, variations in mortality

  11. Asymmetric fate of the posterior part of the second heart field results in unexpected left/right contributions to both poles of the heart.

    PubMed

    Domínguez, Jorge N; Meilhac, Sigolène M; Bland, Yvette S; Buckingham, Margaret E; Brown, Nigel A

    2012-10-26

    The second heart field (SHF) contains progenitors of all heart chambers, excluding the left ventricle. The SHF is patterned, and the anterior region is known to be destined to form the outflow tract and right ventricle. The aim of this study was to map the fate of the posterior SHF (pSHF). We examined the contribution of pSHF cells, labeled by lipophilic dye at the 4- to 6-somite stage, to regions of the heart at 20 to 25 somites, using mouse embryo culture. Cells more cranial in the pSHF contribute to the atrioventricular canal (AVC) and atria, whereas those more caudal generate the sinus venosus, but there is intermixing of fate throughout the pSHF. Caudal pSHF contributes symmetrically to the sinus venosus, but the fate of cranial pSHF is left/right asymmetrical. Left pSHF moves to dorsal left atrium and superior AVC, whereas right pSHF contributes to right atrium, ventral left atrium, and inferior AVC. Retrospective clonal analysis shows the relationships between AVC and atria to be clonal and that right and left progenitors diverge before first and second heart lineage separation. Cranial pSHF cells also contribute to the outflow tract: proximal and distal at 4 somites, and distal only at 6 somites. All outflow tract-destined cells are intermingled with those that will contribute to inflow and AVC. These observations show asymmetric fate of the pSHF, resulting in unexpected left/right contributions to both poles of the heart and can be integrated into a model of the morphogenetic movement of cells during cardiac looping.

  12. Long-term vagal stimulation for heart failure: Eighteen month results from the NEural Cardiac TherApy foR Heart Failure (NECTAR-HF) trial.

    PubMed

    De Ferrari, Gaetano M; Stolen, Craig; Tuinenburg, Anton E; Wright, D Jay; Brugada, Josep; Butter, Christian; Klein, Helmut; Neuzil, Petr; Botman, Cornelis; Castel, Maria Angeles; D'Onofrio, Antonio; de Borst, Gert J; Solomon, Scott; Stein, Kenneth M; Schubert, Bernd; Stalsberg, Kevin; Wold, Nicholas; Ruble, Stephen; Zannad, Faiez

    2017-10-01

    The NECTAR-HF study evaluated safety and feasibility of vagal nerve stimulation (VNS) for the treatment of heart failure patients. The first six-month randomized phase of the study did not show improvement in left ventricular remodelling in response to VNS. This study reports the 18-month results and provides novel findings aiming to understand the lack of efficacy of VNS, including a new technique assessing the effects of VNS. Ninety-six patients were randomized 2:1 to active or inactive VNS for 6months, thereafter VNS was activated for all patients. The primary safety endpoint was 18-month all-cause mortality. Ninety-one patients continued in the long-term evaluation with active VNS. The on-therapy survival estimate at 18months was 95% with a 95% one-sided lower confidence limit of 91%, (better than the predefined criterion). Left ventricular systolic volume decreased in the crossover group (VNS OFF→ON; 144±37 to 139±40, p<0.05) after VNS activation; LVESD (5.02±0.77 to 4.96±0.82, p>0.05) and LVEF (33.2±4.9 to 33.3±6.5, p>0.05) did not change. A new technique to detect subtle heart rate changes during Holter recordings, i.e. "heat maps", revealed that VNS evoked heart rate response in only 13/106 studies (12%) at 6 and 12months with active VNS. Although a favourable long-term safety profile was found, improvements in the efficacy endpoints were not seen with VNS. A new technique for detecting acute heart rate responses to VNS suggests that the recruitment of nerve fibres responsible for heart rate changes were substantially lower in NECTAR-HF than in pre-clinical models. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Impaired myocardial development resulting in neonatal cardiac hypoplasia alters postnatal growth and stress response in the heart.

    PubMed

    Drenckhahn, Jörg-Detlef; Strasen, Jette; Heinecke, Kirsten; Langner, Patrick; Yin, Kom Voy; Skole, Friederike; Hennig, Maria; Spallek, Bastian; Fischer, Robert; Blaschke, Florian; Heuser, Arnd; Cox, Timothy C; Black, Mary Jane; Thierfelder, Ludwig

    2015-04-01

    Foetal growth has been proposed to influence cardiovascular health in adulthood, a process referred to as foetal programming. Indeed, intrauterine growth restriction in animal models alters heart size and cardiomyocyte number in the perinatal period, yet the consequences for the adult or challenged heart are largely unknown. The aim of this study was to elucidate postnatal myocardial growth pattern, left ventricular function, and stress response in the adult heart after neonatal cardiac hypoplasia in mice. Utilizing a new mouse model of impaired cardiac development leading to fully functional but hypoplastic hearts at birth, we show that myocardial mass is normalized until early adulthood by accelerated physiological cardiomyocyte hypertrophy. Compensatory hypertrophy, however, cannot be maintained upon ageing, resulting in reduced organ size without maladaptive myocardial remodelling. Angiotensin II stress revealed aberrant cardiomyocyte growth kinetics in adult hearts after neonatal hypoplasia compared with normally developed controls, characterized by reversible overshooting hypertrophy. This exaggerated growth mainly depends on STAT3, whose inhibition during angiotensin II treatment reduces left ventricular mass in both groups but causes contractile dysfunction in developmentally impaired hearts only. Whereas JAK/STAT3 inhibition reduces cardiomyocyte cross-sectional area in the latter, it prevents fibrosis in control hearts, indicating fundamentally different mechanisms of action. Impaired prenatal development leading to neonatal cardiac hypoplasia alters postnatal cardiac growth and stress response in vivo, thereby linking foetal programming to organ size control in the heart. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  14. Fitting anxious emotion-focused intervention into the ecology of schools: results from a test anxiety program evaluation.

    PubMed

    Weems, Carl F; Scott, Brandon G; Graham, Rebecca A; Banks, Donice M; Russell, Justin D; Taylor, Leslie K; Cannon, Melinda F; Varela, R Enrique; Scheeringa, Michael A; Perry, Andre M; Marino, Reshelle C

    2015-02-01

    Emotion-focused prevention and intervention efforts in schools have been promoted as a significant developmental and public health priority. This paper reports the results of a longitudinal study testing central premises of a school-based prevention model aimed at promoting positive emotional development through targeting test anxiety. Test anxiety interventions may be a practical strategy for conducting emotion-focused prevention and intervention efforts because of a natural fit within the ecology of the school setting. At-risk youth (n = 1,048) from urban public schools were screened and 325 with elevated test anxiety were offered the intervention in one of two waves (immediate intervention vs. waitlist). The intervention was associated with decreases in test anxiety, anxiety disorder, and depression symptoms. Critically, results suggest high participant satisfaction and growth curve analysis of follow-up assessments (end of the year, the next school year, and a subsequent school year) demonstrated positive developmental trajectories consistent with predictions (e.g., initial change in test anxiety predicted change in other symptoms). Findings provide evidence for the ecological validity of targeting test anxiety in school-based, emotion-focused prevention efforts.

  15. A Large-Scale Initiative Inviting Patients to Share Personal Fitness Tracker Data with Their Providers: Initial Results

    PubMed Central

    Pevnick, Joshua M.; Fuller, Garth; Duncan, Ray; Spiegel, Brennan M. R.

    2016-01-01

    Background Personal fitness trackers (PFT) have substantial potential to improve healthcare. Objective To quantify and characterize early adopters who shared their PFT data with providers. Methods We used bivariate statistics and logistic regression to compare patients who shared any PFT data vs. patients who did not. Results A patient portal was used to invite 79,953 registered portal users to share their data. Of 66,105 users included in our analysis, 499 (0.8%) uploaded data during an initial 37-day study period. Bivariate and regression analysis showed that early adopters were more likely than non-adopters to be younger, male, white, health system employees, and to have higher BMIs. Neither comorbidities nor utilization predicted adoption. Conclusion Our results demonstrate that patients had little intrinsic desire to share PFT data with their providers, and suggest that patients most at risk for poor health outcomes are least likely to share PFT data. Marketing, incentives, and/or cultural change may be needed to induce such data-sharing. PMID:27846287

  16. Telephone counseling for patients with chronic heart failure: results of an evaluation study.

    PubMed

    Böhme, Sylvia; Geiser, Christian; Mühlenhoff, Thomas; Holtmann, Jana; Renneberg, Babette

    2012-09-01

    The effectiveness of a secondary prevention program for patients suffering from chronic heart failure (CHF) was evaluated. The program aimed at improving participants' perceived health and actual physical symptoms. Insurants of a German health insurance company participated in a telephone counseling program with four modules focusing on dietary habits, physical activity, fluid intake, and medication compliance. Multilevel analyses were conducted to analyze changes in health related outcome variables over time in N = 259 participants who completed the program in about 6 months. The results showed an improvement of perceived health status, physical symptoms, and somatic impairment. Furthermore, differential change was found when comparing "finishers" compared to "non-finishers" of specific modules indicating specific module effects. The results are auspicious and, if sustained, are expected to bring about long-term health benefits for our study's participants. The program proved to be applicable and well accepted in the sample of older, severely impaired CHF patients and effective in changing perceived health.

  17. The Pediatric Cardiomyopathy Registry and Heart Failure: Key Results from the First 15 Years

    PubMed Central

    Wilkinson, James D.; Landy, David C.; Colan, Steven D.; Towbin, Jeffrey A.; Sleeper, Lynn A.; Orav, E. John; Cox, Gerald F.; Canter, Charles E.; Hsu, Daphne T.; Webber, Steven A.; Lipshultz, Steven E.

    2010-01-01

    Synopsis Cardiomyopathy is a serious disorder of the heart muscle and, although rare, is a common cause of heart failure in children and the most common cause for heart transplantation in children older than 1 year of age. Funded by the National Heart Lung and Blood Institute since 1994, the Pediatric Cardiomyopathy Registry (PCMR) has followed more than 3500 North American children with cardiomyopathy. Early analyses determined estimates for the incidence of pediatric cardiomyopathy (1.13 cases per 100,000 children per year), risk factors for cardiomyopathy (age less than 1 year, male sex, black race, and living in New England as opposed to the Central Southwestern states), the prevalence of heart failure at diagnosis (6%–84% depending on cause), and 10-year survival (29%–94% depending on cause). More recent analyses explored cause-specific functional status, survival and transplant outcomes, and risk factors in greater detail. For many topics these analyses are based on the largest and best-documented samples of children with disease such as the muscular dystrophies, mitochondrial disorders, and Noonan’s syndrome. Data from the PCMR continue to provide valuable information that guides clinical management and the use of life-saving therapies, such as cardiac transplantation and approaches to treating heart failure, and that prepares children, their families, and their caregivers for dealing with this serious condition. PMID:20869642

  18. Lifestyle Intervention Improves Heart Rate Recovery from Exercise in Adults with Type 2 Diabetes: Results from the Look AHEAD Study

    PubMed Central

    Ribisl, Paul M.; Gaussoin, Sarah A.; Lang, Wei; Bahnson, Judy; Connelly, Stephanie A.; Horton, Edward S.; Jakicic, John M.; Killean, Tina; Kitzman, Dalane W.; Knowler, William C.; Stewart, Kerry J.; Research Group, Look AHEAD

    2012-01-01

    The primary aims of this paper were (1) to evaluate the influence of intensive lifestyle weight loss and exercise intervention (ILI) compared with diabetes support and education (DSE) upon Heart Rate Recovery (HRR) from graded exercise testing (GXT) and (2) to determine the independent and combined effects of weight loss and fitness changes upon HRR. In 4503 participants (45–76 years) who completed 1 year of intervention, HRR was measured after a submaximal GXT to compare the influence of (ILI) with (DSE) upon HRR. Participants assigned to ILI lost an average 8.6% of their initial weight versus 0.7% in DSE group (P < 0.001) while mean fitness increased in ILI by 20.9% versus 5.8% in DSE (P < 0.001). At Year 1, all exercise and HRR variables in ILI improved (P < 0.0001) versus DSE: heart rate (HR) at rest was lower (72.8 ± 11.4 versus 77.7 ± 11.7 b/min), HR range was greater (57.7 ± 12.1 versus 53.1 ± 12.4 b/min), HR at 2 minutes was lower (89.3 ± 21.8 versus 93.0 ± 12.1 b/min), and HRR was greater (41.25 ± 22.0 versus 37.8 ± 12.5 b/min). Weight loss and fitness gain produced significant separate and independent improvements in HRR. PMID:23227314

  19. Lifestyle intervention improves heart rate recovery from exercise in adults with type 2 diabetes: results from the Look AHEAD study.

    PubMed

    Ribisl, Paul M; Gaussoin, Sarah A; Lang, Wei; Bahnson, Judy; Connelly, Stephanie A; Horton, Edward S; Jakicic, John M; Killean, Tina; Kitzman, Dalane W; Knowler, William C; Stewart, Kerry J

    2012-01-01

    The primary aims of this paper were (1) to evaluate the influence of intensive lifestyle weight loss and exercise intervention (ILI) compared with diabetes support and education (DSE) upon Heart Rate Recovery (HRR) from graded exercise testing (GXT) and (2) to determine the independent and combined effects of weight loss and fitness changes upon HRR. In 4503 participants (45-76 years) who completed 1 year of intervention, HRR was measured after a submaximal GXT to compare the influence of (ILI) with (DSE) upon HRR. Participants assigned to ILI lost an average 8.6% of their initial weight versus 0.7% in DSE group (P < 0.001) while mean fitness increased in ILI by 20.9% versus 5.8% in DSE (P < 0.001). At Year 1, all exercise and HRR variables in ILI improved (P < 0.0001) versus DSE: heart rate (HR) at rest was lower (72.8 ± 11.4 versus 77.7 ± 11.7 b/min), HR range was greater (57.7 ± 12.1 versus 53.1 ± 12.4 b/min), HR at 2 minutes was lower (89.3 ± 21.8 versus 93.0 ± 12.1 b/min), and HRR was greater (41.25 ± 22.0 versus 37.8 ± 12.5 b/min). Weight loss and fitness gain produced significant separate and independent improvements in HRR.

  20. Association between health behaviors and cardiorespiratory fitness in adolescents: results from the cross-sectional MoMo-study.

    PubMed

    Peterhans, Eliane; Worth, Annette; Woll, Alexander

    2013-08-01

    The aim of this study was to analyze the association between adolescent and familial health behavioral factors and cardiorespiratory fitness in German adolescent boys and girls. This study is based on a large nationwide cross-sectional study and its substudy on physical activity and fitness of children and adolescents ("Motorik-Modul"). For 1,328 adolescents between 11 and 17 years of age, data on cardiorespiratory fitness (Physical working capacity 170, PWC(170)) and familial and adolescent health behavioral factors were collected. Health behavior was assessed using psychometric questionnaires (socioeconomic status, pubertal stage, daily physical activity, sports-club time, parental physical activity habits, etc.). A hierarchical multiple regression model was used to quantify the association between relative PWC(170) values and health behavior. The relationship between adolescents' health behavioral factors and cardiorespiratory fitness was stronger than the relationship between age, social status, familial health behavior and cardiorespiratory fitness. Familial health behavioral factors explained 4.1% and 2.1% of variance in cardiorespiratory fitness in girls and boys, respectively. Adolescents' health behavioral factors explained 15.2% of variance in girls and 25.7% of variance in boys. For both girls (β = .273) and boys (β = .400), being normal weight had the greatest effect on relative PWC(170) values. The difference in explained variance in cardiorespiratory fitness by familial and adolescents' health behavioral factors between girls and boys indicates that different predictors for cardiorespiratory fitness are important for girls and boys. Hence, sex specific research and interventions aimed at improving familial and adolescent health behavior may be important. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  1. Subgroups associated with lower physical fitness in older adults with ID: results of the HA-ID study.

    PubMed

    Hilgenkamp, Thessa I M; van Wijck, Ruud; Evenhuis, Heleen M

    2014-02-01

    Although physical fitness is generally very low in older adults with intellectual disabilities (ID), levels may differ across subgroups. It is important to identify which subgroups need to be targeted specifically in physical activity and fitness interventions and reference values. Physical fitness was measured with box-and-block-test, response-time-test, Berg-balance-scale, walking speed, grip strength, 30s-chair-stand, 10 m incremental-shuttle-walking test and the extended modified-back-saver-sit-and-reach-test in a large sample of older adults with ID (n=1050), and subgroups associated with lower physical fitness levels were identified applying multivariate linear regression analyses. Both fixed personal characteristics such as being older, being female, having more severe ID and having Down syndrome and modifiable or preventable factors such as physical activity levels, mobility impairments and a need of more intensive care, are independently associated with lower levels of multiple physical fitness components. This first study identifies subgroups of older adults with ID which require adapted reference values, and subgroups that need to be specifically targeted in fitness promotion programs.

  2. [Hearing aid fitting: Effect of doubling the standard rate on compliance, quality of results, and excess payments].

    PubMed

    Braun, B; Dietrich, A; Akcicek, B; Wollenberg, B; Schönweiler, R; Löhler, J

    2015-12-01

    This study investigates the effect that doubling the standard rate for hearing aid fitting which is covered by statutory insurance has had on the size of excess payments and compliance, as well as on benefits for patients and their satisfaction. In April 2014, 859 members of a statutory insurance scheme (hkk) who received hearing aids in the 6 months prior to the reform were questioned on the timing and financial details of their hearing aid fitting, as well as on treatment compliance and quality of the results using a standardized questionnaire. In October 2014, the same questionnaire was used to collect these data from a further 622 insurance holders who had received hearing aids in the 8 months following introduction of the new regulation. Most of the questions concerning hearing quality corresponded to those of the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire. The project revealed a statistically significant decrease of 6 percent points in the proportion of hearing aid users who had to pay any excess whatsoever; from 80.6% to 74.1%. However, 40% of the insured persons continued to pay an excess of 1000 euros and more. The subjective hearing quality remained practically unimproved by the reform and was statistically, almost without exception, independent of whether hearing aid users wore expensive devices associated with a large excess, or devices available at the standard rate. Finally, the study confirmed a previously recognized usage pattern characterized by noncompliance. For example, approximately 40% of hearing aid users did not wear their device in the everyday environment. This observation was independent of the size of the excess and the timing of the most recent visit to the hearing aid acoustician. Despite doubling of the standard rate, three quarters of patients pay an excess--sometimes a substantial one. The subjective hearing quality was not improved by doubling the standard rate; the majority of patients continue to complain of

  3. Forehead reflectance photoplethysmography to monitor heart rate: preliminary results from neonatal patients.

    PubMed

    Grubb, M R; Carpenter, J; Crowe, J A; Teoh, J; Marlow, N; Ward, C; Mann, C; Sharkey, D; Hayes-Gill, B R

    2014-05-01

    Around 5%-10% of newborn babies require some form of resuscitation at birth and heart rate (HR) is the best guide of efficacy. We report the development and first trial of a device that continuously monitors neonatal HR, with a view to deployment in the delivery room to guide newborn resuscitation. The device uses forehead reflectance photoplethysmography (PPG) with modulated light and lock-in detection. Forehead fixation has numerous advantages including ease of sensor placement, whilst perfusion at the forehead is better maintained in comparison to the extremities. Green light (525 nm) was used, in preference to the more usual red or infrared wavelengths, to optimize the amplitude of the pulsatile signal. Experimental results are presented showing simultaneous PPG and electrocardiogram (ECG) HRs from babies (n = 77), gestational age 26-42 weeks, on a neonatal intensive care unit. In babies ⩾32 weeks gestation, the median reliability was 97.7% at ±10 bpm and the limits of agreement (LOA) between PPG and ECG were +8.39 bpm and -8.39 bpm. In babies <32 weeks gestation, the median reliability was 94.8% at ±10 bpm and the LOA were +11.53 bpm and -12.01 bpm. Clinical evaluation during newborn deliveries is now underway.

  4. ENDOMYOCARDIAL BIOPSY AND SELECTIVE CORONARY ANGIOGRAPHY ARE LOW RISK PROCEDURES IN PEDIATRIC HEART TRANSPLANT RECIPIENTS: RESULTS OF A MULTICENTER EXPERIENCE

    PubMed Central

    Daly, Kevin P.; Marshall, Audrey C.; Vincent, Julie A.; Zuckerman, Warren A.; Hoffman, Timothy M.; Canter, Charles E.; Blume, Elizabeth D.; Bergersen, Lisa

    2011-01-01

    Background No prior reports documenting the safety and diagnostic yield of cardiac catheterization and endomyocardial biopsy (EMB) in heart transplant recipients include multicenter data. Methods Data on the safety and diagnostic yield of EMB procedures performed in heart transplant recipients were recorded in the Congenital Cardiac Catheterization Outcomes Project database at 8 pediatric centers over a 3 year period. Adverse events (AE) were classified according to a 5 level severity scale. Generalized estimating equation models identified risk factors for high severity adverse events (HSAE) (Levels 3-5) and non-diagnostic biopsy samples. Results A total of 2665 EMB cases were performed in 744 pediatric heart transplant recipients (median age 12 years [IQR: 4.8,16.7] and 54% male). AE occurred in 88 cases (3.3%), of which 28 (1.1%) were HSAE. AE attributable to EMB included tricuspid valve injury, transient complete heart block, and RBBB. Amongst 822 cases involving coronary angiography, 10 (1.2%) resulted in a coronary related AE. There were no myocardial perforations or deaths. Multivariable risk factors for HSAE included fewer prior catheterizations (p=0.006) and longer case length (p=<0.001). EMB yielded sufficient tissue for diagnosis in 99% of cases. Longer time since heart transplant was the most significant predictor of a non-diagnostic biopsy sample (p<0.001). Conclusions In the current era, cardiac catheterizations involving EMB can be performed in pediatric heart transplant recipients with a low AE rate and high diagnostic yield. Risk of HSAE is increased in early post-transplant biopsies and with longer case length. Longer time since heart transplant is associated with non-diagnostic EMB sample. PMID:22209354

  5. The effect of physical activity on psychological distress, cortisol and obesity: results of the Farming Fit intervention program.

    PubMed

    Brumby, Susan; Chandrasekara, Ananda; Kremer, Peter; Torres, Susan; McCoombe, Scott; Lewandowski, Paul

    2013-10-28

    Rural and regional Australians have a higher likelihood of mental illness throughout their lifetime than people living in major cities, although the underlying reasons are not yet well defined. Additionally, rural populations experience more lifestyle associated co-morbidities including obesity, diabetes and cardiovascular disease. Research conducted by the National Centre for Farmer Health between 2004 and 2009 revealed a positive correlation between obesity and psychological distress among the farming community. Chronic stress is known to overstimulate the regulation of the hypothalamic-pituitary-adrenal (HPA) axis and cortisol secretion which are associated with abdominal adiposity. Increasing physical activity may normalise cortisol secretion and thereby positively impact both physical and mental health. This paper assesses the effects of increasing physical activity on obesity, health behaviors and mental health in Victorian farming men and women. Farming Fit was a six month quasi-experimental (convenience sample) longitudinal design control-intervention study. Overweight or obese (BMI ≥25 kg/m2) farm men (n = 43) and women (n = 29) were recruited with demographic, health behaviors, anthropometric, blood pressure and biochemistry data collected at baseline and at a six months. Salivary cortisol and depression anxiety stress scale results were collected at baseline, three and six months. The intervention group (n = 37) received a personalized exercise program and regular phone coaching to promote physical activity. The intervention group showed significant reductions in body weight and waist circumference. Results indicated that following the six month exercise program, the intervention group were 2.64 ± 0.65 kg lighter (p < 0.001), had reduced waist circumference by 2.01 ± 0.86 cm (p = 0.02) and BMI by 0.97 ± 0.22 kg/m2 (p < 0.001) relative to the control group. Increasing physical activity altered measures of obesity in farm men and women but did

  6. [Results of the treatment of open heart injuries at a central regional hospital].

    PubMed

    Segida, V F; Efremov, N I; Chernov, A I

    1994-09-01

    In a period of 10 years seven patients with open injury to the heart were treated. Their ages ranged from 17 to 39 years. One patient had a gunshot injury, in six the injury was inflicted with a knife. In three patients the injuries were combined (concurrent injury to the lung in 2 and to the diaphragm in one) and in four isolated. Perforating injury of both ventricles and damage of the interventricular septum were found in one case. All patients underwent emergency closure of the heart wounds with an atraumatic synthetic thread and drainage of the pleural cavity. Complications developed in the postoperative period in six patients: suppuration of the operative wound in one and pericarditis in five. One patient died. Analysis of the obtained data testifies to the expediency of two-stage treatment with rehabilitation in cardiological departments. This shortens the period of rehabilitation of patients with open injuries to the heart treated in a central regional hospital.

  7. Novel insect-tree associations resulting from accidental and intentional biological 'invasions': a meta-analysis of effects on insect fitness.

    PubMed

    Bertheau, Coralie; Brockerhoff, Eckehard G; Roux-Morabito, Géraldine; Lieutier, François; Jactel, Hervé

    2010-04-01

    The translocation of species beyond their native range is a major threat to biodiversity. Invasions by tree-feeding insects attacking native trees and the colonization of introduced trees by native insects result in new insect-tree relationships. To date there is uncertainty about the key factors that influence the outcome of these novel interactions. We report the results of a meta-analysis of 346 pairwise comparisons of forest insect fitness on novel and ancient host tree species from 31 publications. Host specificity of insects and phylogenetic relatedness between ancient and novel host trees emerged as key factors influencing insect fitness. Overall, fitness was significantly lower on novel host species than on ancient hosts. However, in some cases, fitness increased on novel hosts, mainly in polyphagous insects or when close relatives of ancient host trees were colonized. Our synthesis enables greatly improved impact prediction and risk assessment of biological invasions.

  8. The influence of aerobic fitness on cerebral white matter integrity and cognitive function in older adults: Results of a one-year exercise intervention

    PubMed Central

    Voss, Michelle W.; Heo, Susie; Prakash, Ruchika S.; Erickson, Kirk I.; Alves, Heloisa; Chaddock, Laura; Szabo, Amanda N.; Mailey, Emily L.; Wójcicki, Thomas R.; White, Siobhan M.; Gothe, Neha; McAuley, Edward; Sutton, Bradley P.; Kramer, Arthur F.

    2014-01-01

    Cerebral white matter degeneration occurs with increasing age and is associated with declining cognitive function. Research has shown that cardiorespiratory fitness and exercise are effective as protective, even restorative, agents against cognitive and neurobiological impairments in older adults. In this study, we investigated whether the beneficial impact of aerobic fitness would extend to white matter integrity in the context of a one-year exercise intervention. Further, we examined the pattern of diffusivity changes to better understand the underlying biological mechanisms. Finally, we assessed whether training-induced changes in white matter integrity would be associated with improvements in cognitive performance independent of aerobic fitness gains. Results showed that aerobic fitness training did not affect group-level change in white matter integrity, executive function, or short-term memory, but that greater aerobic fitness derived from the walking program was associated with greater change in white matter integrity in the frontal and temporal lobes, and greater improvement in short-term memory. Increases in white matter integrity, however, were not associated with short-term memory improvement, independent of fitness improvements. Therefore, while not all findings are consistent with previous research, we provide novel evidence for correlated change in training-induced aerobic fitness, white matter integrity, and cognition among healthy older adults. PMID:22674729

  9. The influence of aerobic fitness on cerebral white matter integrity and cognitive function in older adults: results of a one-year exercise intervention.

    PubMed

    Voss, Michelle W; Heo, Susie; Prakash, Ruchika S; Erickson, Kirk I; Alves, Heloisa; Chaddock, Laura; Szabo, Amanda N; Mailey, Emily L; Wójcicki, Thomas R; White, Siobhan M; Gothe, Neha; McAuley, Edward; Sutton, Bradley P; Kramer, Arthur F

    2013-11-01

    Cerebral white matter (WM) degeneration occurs with increasing age and is associated with declining cognitive function. Research has shown that cardiorespiratory fitness and exercise are effective as protective, even restorative, agents against cognitive and neurobiological impairments in older adults. In this study, we investigated whether the beneficial impact of aerobic fitness would extend to WM integrity in the context of a one-year exercise intervention. Further, we examined the pattern of diffusivity changes to better understand the underlying biological mechanisms. Finally, we assessed whether training-induced changes in WM integrity would be associated with improvements in cognitive performance independent of aerobic fitness gains. Results showed that aerobic fitness training did not affect group-level change in WM integrity, executive function, or short-term memory, but that greater aerobic fitness derived from the walking program was associated with greater change in WM integrity in the frontal and temporal lobes, and greater improvement in short-term memory. Increases in WM integrity, however, were not associated with short-term memory improvement, independent of fitness improvements. Therefore, while not all findings are consistent with previous research, we provide novel evidence for correlated change in training-induced aerobic fitness, WM integrity, and cognition among healthy older adults.

  10. Severe pneumonia after heart transplantation as a result of human parvovirus B19.

    PubMed

    Janner, D; Bork, J; Baum, M; Chinnock, R

    1994-01-01

    The diverse manifestations of human parvovirus B19 infection have been well established. Erythema infectiosum, fetal hydrops, adult arthropathy, and aplastic anemia in patients with hemoglobinopathies or underlying immunocompromise have been described. Recently we successfully treated a patient who, after heart transplantation, had fever, rash, and pneumonia with respiratory failure caused by human parovirus B19. Human parovirus B19 has not been reported previously as a pathogen causing pulmonary disease after pediatric heart transplantation, and we wish to report it at this time.

  11. [Unique mechanism in heart-shaped balloon burst resulting in blunt ocular injury].

    PubMed

    Brosh, Koby; Bekenstein, Yehonadav; Strassman, Israel

    2014-05-01

    We have previously shown that heart-shaped balloons have a different explosion mechanism than spherical balloons in which the former splits into two rubber parts still attached to the balloon base with a backward whiplash motion. This backward whiplash motion may cause significant blunt ocular trauma if the balloon is inflated by mouth. In this article, the energy of the blunt ocular trauma is estimated by the high speed camera photos analysis of the balloon burst. Furthermore, we describe the followup of eight patients with ocular trauma following inflation of heart-shaped balloons.

  12. ICPES analyses using full image spectra and astronomical data fitting algorithms to provide diagnostic and result information

    SciTech Connect

    Spencer, W.A.; Goode, S.R.

    1997-10-01

    ICP emission analyses are prone to errors due to changes in power level, nebulization rate, plasma temperature, and sample matrix. As a result, accurate analyses of complex samples often require frequent bracketing with matrix matched standards. Information needed to track and correct the matrix errors is contained in the emission spectrum. But most commercial software packages use only the analyte line emission to determine concentrations. Changes in plasma temperature and the nebulization rate are reflected by changes in the hydrogen line widths, the oxygen emission, and neutral ion line ratios. Argon and off-line emissions provide a measure to correct the power level and the background scattering occurring in the polychromator. The authors` studies indicated that changes in the intensity of the Ar 404.4 nm line readily flag most matrix and plasma condition modifications. Carbon lines can be used to monitor the impact of organics on the analyses and calcium and argon lines can be used to correct for spectral drift and alignment. Spectra of contaminated groundwater and simulated defense waste glasses were obtained using a Thermo Jarrell Ash ICP that has an echelle CID detector system covering the 190-850 nm range. The echelle images were translated to the FITS data format, which astronomers recommend for data storage. Data reduction packages such as those in the ESO-MIDAS/ECHELLE and DAOPHOT programs were tried with limited success. The radial point spread function was evaluated as a possible improved peak intensity measurement instead of the common pixel averaging approach used in the commercial ICP software. Several algorithms were evaluated to align and automatically scale the background and reference spectra. A new data reduction approach that utilizes standard reference images, successive subtractions, and residual analyses has been evaluated to correct for matrix effects.

  13. Magnetic Resonance Imaging of Coronary Arteries and Heart Valves in a Living Mouse: Techniques and Preliminary Results

    NASA Astrophysics Data System (ADS)

    Ruff, Jan; Wiesmann, Frank; Lanz, Titus; Haase, Axel

    2000-10-01

    New investigations in MRI of a mouse heart showed high-contrast cardiac images and thereby the possibility of doing functional cardiac studies of in vivo mice. But is MRI, in addition, capable of visualizing microstructures such as the coronary arteries and the heart valves of a living mouse? To answer this question, 2D and 3D gradient echo sequences with and without flow compensation were used to image the coronary arteries. To increase signal-to-noise ratio, a birdcage resonator was optimized for mouse heart imaging. Contrast between blood and myocardium was achieved through the inflow effect. A segmented three-dimensional FLASH sequence acquired with a multiple overlap thin slab technique showed the best results. With this technique an isotropic resolution of 100 μm was achieved. The left coronary artery could be visualized up to the apex of the heart. This is demonstrated with short axis views and 3D surface reconstructions of the mouse heart. The four cardiac valves were also visible with the 3D method.

  14. Magnetic resonance imaging of coronary arteries and heart valves in a living mouse: techniques and preliminary results.

    PubMed

    Ruff, J; Wiesmann, F; Lanz, T; Haase, A

    2000-10-01

    New investigations in MRI of a mouse heart showed high-contrast cardiac images and thereby the possibility of doing functional cardiac studies of in vivo mice. But is MRI, in addition, capable of visualizing microstructures such as the coronary arteries and the heart valves of a living mouse? To answer this question, 2D and 3D gradient echo sequences with and without flow compensation were used to image the coronary arteries. To increase signal-to-noise ratio, a birdcage resonator was optimized for mouse heart imaging. Contrast between blood and myocardium was achieved through the inflow effect. A segmented three-dimensional FLASH sequence acquired with a multiple overlap thin slab technique showed the best results. With this technique an isotropic resolution of 100 microm was achieved. The left coronary artery could be visualized up to the apex of the heart. This is demonstrated with short axis views and 3D surface reconstructions of the mouse heart. The four cardiac valves were also visible with the 3D method.

  15. A Couples' Based Self-Management Program for Heart Failure: Results of a Feasibility Study.

    PubMed

    Trivedi, Ranak; Slightam, Cindie; Fan, Vincent S; Rosland, Ann-Marie; Nelson, Karin; Timko, Christine; Asch, Steven M; Zeliadt, Steven B; Heidenreich, Paul; Hebert, Paul L; Piette, John D

    2016-01-01

    Heart failure (HF) is associated with frequent exacerbations and shortened lifespan. Informal caregivers such as significant others often support self-management in patients with HF. However, existing programs that aim to enhance self-management seldom engage informal caregivers or provide tools that can help alleviate caregiver burden or improve collaboration between patients and their informal caregivers. To develop and pilot test a program targeting the needs of self-management support among HF patients as well as their significant others. We developed the Dyadic Health Behavior Change model and conducted semi-structured interviews to determine barriers to self-management from various perspectives. Participants' feedback was used to develop a family-centered self-management program called "SUCCEED: Self-management Using Couples' Coping EnhancEment in Diseases." The goals of this program are to improve HF self-management, quality of life, communication within couples, relationship quality, and stress and caregiver burden. We conducted a pilot study with 17 Veterans with HF and their significant others to determine acceptability of the program. We piloted psychosocial surveys at baseline and after participants' program completion to evaluate change in depressive symptoms, caregiver burden, self-management of HF, communication, quality of relationship, relationship mutuality, and quality of life. Of the 17 couples, 14 completed at least 1 SUCCEED session. Results showed high acceptability for each of SUCCEED's sessions. At baseline, patients reported poor quality of life, clinically significant depressive symptoms, and inadequate self-management of HF. After participating in SUCCEED, patients showed improvements in self-management of HF, communication, and relationship quality, while caregivers reported improvements in depressive symptoms and caregiver burden. Quality of life of both patients and significant others declined over time. In this small pilot study, we

  16. Early results of neurodevelopment following hybrid stage I for hypoplastic left heart syndrome.

    PubMed

    Cheatham, Sharon L; Carey, Helen; Chisolm, Joanne L; Heathcock, Jill C; Steward, Deborah

    2015-03-01

    Motor skills and neurodevelopment in infants with hypoplastic left heart syndrome (HLHS) who have undergone Hybrid Stage I palliation is unknown. The purpose of this study is to assess early neurodevelopment in infants with HLHS after Hybrid Stage I palliation. Developmental assessment was performed in HLHS infants who underwent Hybrid Stage I palliation at 2 and 4 months of age using the Test of Infant Motor Performance, and at 6 months of age, prior to undergoing the second staged surgery, using the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III). Results were compared to healthy control subjects and norm-referenced data. The HLHS group scored between -1 and -2 standard deviations (SD) below the mean at 2 months of age (p = 0.002), and within -1 SD of the mean, at 4 months of age (p = 0.0019), on the TIMP. Compared to the control group, composite motor skills were significantly lower at 6 months of age on the Bayley-III in the HLHS group (p = 0.0489), however, not significant for cognitive (p = 0.29) or language (p = 0.68). Percentile rank motor scores were 17 ± 20 % in the HLHS group compared to 85 ± 12 % for the healthy age-matched control group. Infants with HLHS who undergo Hybrid Stage I palliation score lower on standardized motor skill tests compared to healthy age-matched controls and the norm-referenced population. This suggests that infants with HLHS have poorer motor skill performance than typically developing infants at 6 months of age.

  17. Altered renal sodium handling and risk of incident hypertension: Results of the Olivetti Heart Study

    PubMed Central

    D’Elia, Lanfranco; Cappuccio, Francesco P.; Iacone, Roberto; Russo, Ornella; Galletti, Ferruccio; Strazzullo, Pasquale

    2017-01-01

    Renal tubular sodium (Na) handling plays a key role in blood pressure (BP) regulation. Several cross-sectional studies reported a positive association between higher proximal tubule fractional reabsorption of Na and BP, but no prospective investigation has been reported of this possible association. Hence, the purpose of this study was to estimate the predictive role of renal Na handling on the risk of incident hypertension and the changes in BP occurring in the 8-year follow-up observation of a sample of initially normotensive men (The Olivetti Heart Study). The study included 294 untreated normotensive non-diabetic men with normal renal function examined twice (1994–95 and 2002–04). Renal tubular Na handling was estimated by exogenous lithium clearance. Fractional reabsorption of Na in proximal and distal tubules was calculated and included in the analysis. At baseline, there was no association between BP and either proximal or distal fractional reabsorption of Na. At the end of the 8-year follow-up, direct associations were observed between baseline proximal (but not distal) Na fractional reabsorption and the changes occurred in systolic and diastolic BP over time (+2.79 and +1.53 mmHg, respectively, per 1SD difference in proximal Na-FR; p<0.01). Also multivariable analysis showed a direct association between baseline proximal Na fractional reabsorption and risk of incident hypertension, independently of potential confounders (OR: 1.34, 95%CI:1.06–1.70). The results of this prospective investigation strongly suggest a causal relationship between an enhanced rate of Na reabsorption in the proximal tubule and the risk of incident hypertension in initially normotensive men. PMID:28196131

  18. Bootstrapping Results of Exercise Therapy and Education for Patients with Congestive Heart Failure

    ERIC Educational Resources Information Center

    Witta, E. Lea; Brubaker, Craig

    2003-01-01

    When studies are conducted over a period of time, the sample size typically decreases. In a study of the effects of exercise therapy and education with recovering congestive heart failure (CHF) patients (Brubaker, Witta, & Angelopoulus, 2003), the sample size decreased from over 40 to 9 participants after an 18-month time span. Although the…

  19. HeartCode BLS with voice assisted manikin for teaching nursing students: preliminary results.

    PubMed

    Oermann, Marilyn H; Kardong-Edgren, Suzan; Odom-Maryon, Tamara; Ha, Yeongmi; McColgan, Jacqueline Keegan; Hurd, Debbie; Rogers, Nancy; Resurreccion, Leandro A; Snelson, Catherine; Kuerschner, Dawn R; Haus, Carol; Smart, Denise A; Lamar, Jerrilee; Hallmark, Beth F; Tennant, Monica Nelson; Dowdy, Sharon Wilson

    2010-01-01

    The purpose of this study was to evaluate the effectiveness of HeartCode BLS, a self-directed, computer-based course for obtaining basic life support (BLS) certification. For part 2 of the course, students learned and practiced their cardiopulmonary resuscitation (CPR) psychomotor skills on a voice assisted manikin (VAM). Students from 10 schools of nursing were randomly assigned to two types of CPR training: HeartCode BLS with VAM or the standard, instructor-led (IL) course with manikins that were not voice assisted; 264 students trained using HeartCode BLS and 339 had an IL course. When students passed their respective courses and were certified in BLS, their CPR skills were tested using the Laerdal PC SkillReporting System. Students who trained using HeartCode BLS and practiced their CPR skills on VAMs were significantly more accurate in their ventilations, compressions, and single-rescuer CPR than students who had the standard, IL course with regular manikins.

  20. Small dense low density lipoprotein cholesterol and coronary heart disease: results from the Framingham Offspring Study

    USDA-ARS?s Scientific Manuscript database

    We sought to establish reference values for a new direct assay for small dense LDL cholesterol (sdLDL-C) and to measure sdLDL-C concentrations in patients with established coronary heart disease (CHD) vs controls. Direct LDL-C and sdLDL-C were measured in samples from 3188 male and female participan...

  1. Atrial support pacing in heart failure: results from the multicenter PEGASUS CRT trial.

    PubMed

    Martin, David O; Day, John D; Lai, Peter Y; Murphy, Allan L; Nayak, Hemal M; Villareal, Rollo P; Weiner, Stanislav; Kraus, Stacia M; Stolen, Kira Q; Gold, Michael R

    2012-12-01

    Cardiac resynchronization therapy (CRT) efficacy trials to date used atrial-synchronous biventricular pacing wherein there is no or minimal atrial pacing. However, bradycardia and chronotropic incompetence are common in this patient population. This trial was designed to evaluate the effect of atrial support pacing among heart failure patients receiving a CRT defibrillator. PEGASUS CRT was a multicenter, 3-arm, randomized study. At 6 weeks, patients were randomized to DDD mode at a lower rate of 40 bpm (DDD-40; control arm), or one of the following 2 treatment arms: DDD-70, or DDDR-40. The primary endpoint was a clinical composite endpoint that included all-cause mortality, heart failure events, NYHA functional class, and patient global self-assessment. Subjects were classified as improved, unchanged, or worsened at 12 months. There were 1,433 patients randomized, of whom 66% were male, mean age was 67 ± 11 years, and mean left ventricular ejection fraction was 23 ± 7%. The average follow-up time was 10.5 ± 3.5 months and 1,309 patients contributed to the primary endpoint. No significant differences were observed in the composite endpoint between either of the 2 treatment arms compared to the control arm (P>0.05 for both comparisons). Additionally, there were no differences among the groups in mortality or heart failure events. In advanced heart failure patients treated with CRT, atrial support pacing did not improve clinical outcomes compared to atrial tracking. However, atrial pacing did not adversely affect mortality or heart failure events. © 2012 Wiley Periodicals, Inc.

  2. Endurance training in early life results in long-term programming of heart mass in rats.

    PubMed

    Wadley, Glenn D; Laker, Rhianna C; McConell, Glenn K; Wlodek, Mary E

    2016-02-01

    Being born small for gestational age increases the risk of developing adult cardiovascular and metabolic diseases. This study aimed to examine if early-life exercise could increase heart mass in the adult hearts from growth restricted rats. Bilateral uterine vessel ligation to induce uteroplacental insufficiency and fetal growth restriction in the offspring (Restricted) or sham surgery (Control) was performed on day 18 of gestation in WKY rats. A separate group of sham litters had litter size reduced to five pups at birth (Reduced litter), which restricted postnatal growth. Male offspring remained sedentary or underwent treadmill running from 5 to 9 weeks (early exercise) or 20 to 24 weeks of age (later exercise). Remarkably, in Control, Restricted, and Reduced litter groups, early exercise increased (P < 0.05) absolute and relative (to body mass) heart mass in adulthood. This was despite the animals being sedentary for ~4 months after exercise. Later exercise also increased adult absolute and relative heart mass (P < 0.05). Blood pressure was not significantly altered between groups or by early or later exercise. Phosphorylation of Akt Ser(473) in adulthood was increased in the early exercise groups but not the later exercise groups. Microarray gene analysis and validation by real-time PCR did not reveal any long-term effects of early exercise on the expression of any individual genes. In summary, early exercise programs the heart for increased mass into adulthood, perhaps by an upregulation of protein synthesis based on greater phosphorylation of Akt Ser(473).

  3. 50/50 F-76/DSH-76 Specification and Fit-for-Purpose Level I Test Results

    DTIC Science & Technology

    2013-09-27

    molecule fuel produced from direct fermentation of renewable sugars. This test report summarizes chemical, physical and fit for purpose (FFP) test...direct fermentation of sugar into olefinic hydrocarbons. The olefinic hydrocarbons are hydroprocessed to produce an iso-paraffinic hydrocarbon. To...minor components side products of farnesane, a 15 carbon number iso-paraffinic alcohol , and a cyclic isomer of farnesane were also present at less

  4. Effect of a Lifestyle Intervention on Change in Cardiorespiratory Fitness in Adults with Type 2 Diabetes: Results from the Look AHEAD Study

    PubMed Central

    Jakicic, John M.; Jaramillo, Sarah A.; Balasubramanyam, Ashok; Bancroft, Barbara; Curtis, Jeffery M.; Mathews, Anne; Pereira, Mark; Regensteiner, Judith G.; Ribisl, Paul M.

    2008-01-01

    Objective To examine the effect of an intensive lifestyle weight loss intervention (ILI) compared to diabetes support and education (DSE) on changes in fitness and physical activity in the Look AHEAD trial. Design Randomized clinical trial to compare a lifestyle intervention for weight loss with a diabetes support and education condition in individuals with type 2 diabetes. Subjects Data from 4,376 overweight or obese adults with type 2 diabetes (age = 58.7±6.8 years, BMI = 35.8±5.8 kg/m2) who completed one-year of the Look AHEAD trial and had available fitness data were analyzed. Intervention Subjects were randomly assigned to DSE or ILI. DSE received standard-care plus 3 education sessions over the one-year period. ILI included individual and group contact throughout the year, restriction in energy intake, and 175 min/wk of prescribed physical activity. Measurements Fitness was assessed using a submaximal graded exercise test. Physical activity was assessed via questionnaire in a subset of 2,221 subjects. Results Change in fitness was statistically greater in ILI vs. DSE after adjustment for baseline fitness (20.9% vs. 5.7%) (p<0.0001). Multivariate analysis showed that change in fitness was greater in overweight vs. obese Class II and III (p<0.05). Physical activity increased by 892±1694 kcal/wk in ILI vs. 108±1254 kcal/wk in DSE (p<0.01). Changes in fitness (r=0.41) and physical activity (r=0.42) were significantly correlated with weight loss (p<0.0001). Conclusions The ILI was effective in increasing physical activity and improving cardiorespiratory fitness in overweight and obese individuals with type 2 diabetes. This effect may add to weight loss in improving metabolic control in patients in lifestyle intervention programs. PMID:19153582

  5. Description of 214 cases of autoimmune congenital heart block: Results of the French neonatal lupus syndrome.

    PubMed

    Levesque, Kateri; Morel, Nathalie; Maltret, Alice; Baron, Gabriel; Masseau, Agathe; Orquevaux, Pauline; Piette, Jean-Charles; Barriere, Francois; Le Bidois, Jérome; Fermont, Laurent; Fain, Olivier; Theulin, Arnaud; Sassolas, Francois; Pezard, Philippe; Amoura, Zahir; Guettrot-Imbert, Gaëlle; Le Mercier, Delphine; Georgin-Lavialle, Sophie; Deligny, Christophe; Hachulla, Eric; Mouthon, Luc; Ravaud, Philippe; Villain, Elisabeth; Bonnet, Damien; Costedoat-Chalumeau, Nathalie

    2015-12-01

    Cardiac neonatal lupus syndrome is due to anti-SSA or SSB antibodies and mainly includes congenital heart block (CHB) and dilated cardiomyopathy (DCM). Its optimal management is still debated. We report a large series of autoimmune high degree CHB. Inclusion criteria in this retrospective study were fetuses or neonates with high-degree CHB associated with maternal anti-SSA/SSB antibodies. 214 CHB were included: 202 detected in utero at a median term of 23 weeks' gestation (WG) [range 16 to 39 WG] and 12 neonatal cases diagnosed at a median age of 0 days [range birth to 8 days]. The 214 cases of CHB included 202 (94.4%) third-degree CHB, 8 (3.7%) second-degree CHB, and 4 (1.9%) intermittent CHB. In multivariate analysis, the factors associated with feto-neonatal deaths (15.7%) were hydrops (p<0.001; hazard ratio [HR] 12.4 [95% confidence interval (95%CI) 4.7-32.7]) and prematurity (p=0.002; HR 17.1 [95%CI 2.8-103.1]). During a median follow-up of 7 years [birth to 36 years], 148 of 187 children born alive (79.1%) had a pacemaker, 35 (18.8%, one missing data) had DCM, and 22 (11.8%) died. In multivariate analysis, factors associated with child death were in utero DCM (p=0.0157; HR 6.37 [95%CI: 1.25-32.44]), postnatal DCM (p<0.0001; HR 227.58[95%CI: 24.33-2128.46]) and pacemaker implantation (p=0.0035; HR 0.11[95%CI: 0.02-0.51]). The use of fluorinated steroids was neither associated with survival nor with regression of 2nd degree CHB. In this second largest series of CHB, we confirm some of the previous results. We were unable to find data supporting the routine use of in utero fluorinated steroids. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Results of Open-Heart Surgery in High-Risk Patients

    PubMed Central

    Chafizadeh, G.N.

    1982-01-01

    Of 732 patients undergoing open heart surgery in Pars Hospital Tehran, 127 were classified in a high risk surgical category. Of these, there were 19 mortalities. Three main groups of patients were studied; Group I consisted of those with congenital disorders, such as Ebstein's anomaly and the medical-necrosis type of ascending aneurysms; Group II consisted of reoperaton cases; and Group III was composed of patients with cardiomegaly who required double or triple-valve surgery. PMID:15226817

  7. [Comparative results of Fontan surgery in patients with and without hypoplastic left heart syndrome].

    PubMed

    Becker Rencoret, Pedro; Besa Bandeira, Santiago; Riveros González, Sergio; Frangini Sanhueza, Patricia; Springmüller Pinto, Daniel; González Foretic, Rodrigo; Urcelay Montecinos, Gonzalo

    During the last few years, numerous patients with univentricular heart disease have been treated surgically with total cavopulmonary anastomosis according to a staged surgery protocol in our institution. To evaluate the perioperative outcomes and survival of patients with hypoplastic left heart syndrome (HLHS) after the Fontan procedure and compare them with other types of univentricular heart disease. A total of 102 patients underwent a Fontan procedure between April 1996 and March 2014, 25 with HLHS (group I), and 77 patients with other types of univentricular heart disease (group II). Groups survival, demographics, hemodinamic studies, morbimortality, mechanical ventilation, surgical drains, post-operative stay, isotopes score, pacemaker use, and requiriment of Fontan takedown were analyzed. Intraoperative mortality was 4% (n=1) for group I, and 7.8% (n=6) for group II (P=.451). A difference was only found in hospital length of stay (LOS), being 17 days (6-47) for group I and 12 days (5-103) for group II (P=.017). Mean follow-up was 4.24±2.08 years for group I, and 8.7±4.67 for group II. Survival rate at 8 years for both groups was 88%, and 81% at 10 years for group II. The Fontan procedure had similar mortality, but longer LOS, in patients with HLHS compared to those with another types of single ventricle anatomy. Long term survival was comparable between both groups. Copyright © 2016 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. A panel study of air pollution in subjects with heart failure: negative results in treated patients.

    PubMed

    Barclay, J L; Miller, B G; Dick, S; Dennekamp, M; Ford, I; Hillis, G S; Ayres, J G; Seaton, A

    2009-05-01

    To investigate preclinical adverse effects of ambient particulate air pollution and nitrogen oxides in patients with heart failure. A cohort of 132 non-smoking patients living in Aberdeen, Scotland, with stable chronic heart failure were enrolled in a repeated-measures panel study. Patients with atrial fibrillation or pacemakers were excluded. Participants were studied for 3 days every 2 months for up to 1 year with monitoring of pollutant exposure and concurrent measurements of pathophysiological responses. Measurements included daily area concentration of particulate matter with a median aerodynamic diameter of <10 micrometres (PM(10)), particle number concentration (PNC) and nitrogen oxides; daily estimated personal concentration of particulate matter with a median aerodynamic diameter of <2.5 micrometres (PM(2.5)) and PNC exposures; and 3-day cumulative personal nitrogen dioxide (NO(2)). Concurrent meteorological data were recorded. Blood was taken at the end of each 3-day block for assays of markers of endothelial activation, inflammation and coagulation. Cardiac rhythm was monitored by ambulatory Holter monitor during the final 24 h of each block. The average 24 h background ambient PM(10) ranged from 7.4 to 68 microg.m(-3) and PNC from 454 to 11 283 particles.cm(-3). No associations were demonstrated between the incidence of arrhythmias, heart rate variability or haematological/biochemical measures and any variations in pollutant exposures at any lags. Assuming that low-level pollution affects the parameters measured, these findings may suggest a beneficial effect of modern cardioprotective therapy, which may modify responses to external risk factors. Widespread use of such drugs in susceptible populations may in future reduce the adverse effects of air pollution on the heart.

  9. Long-term results of CMV hyperimmune globulin prophylaxis in 377 heart transplant recipients.

    PubMed

    Kocher, Alfred A; Bonaros, Nikolaos; Dunkler, Daniela; Ehrlich, Marek; Schlechta, Bernhard; Zweytick, Barbara; Grimm, Michael; Zuckermann, Andreas; Wolner, Ernst; Laufer, Guenther

    2003-03-01

    Cytomegalovirus (CMV) has emerged as the most important pathogen to affect the post-operative course after heart transplantation. We performed a retrospective analysis to evaluate the efficiency of CMV hyperimmune globulin (CMVIG) prophylaxis in preventing CMV disease in aggressively immunosuppressed patients after heart transplantation. We studied 377 heart transplant recipients who received quadruple-immunosuppressive therapy and CMVIG as sole CMV prophylaxis. The study population was categorized into 4 groups according to donor and recipient CMV serology at the time of transplantation (D+/R+, D+/R-, D-/R+, D-/R-) and was monitored for CMV immediate early antigen in peripheral blood cells, in urine sediments, and in throat washings; for the presence of serum CMV immunoglobulin M and CMV immunoglobulin G; and for clinical evidence of CMV-related symptoms. In addition, we compared the incidence of cardiac allograft vasculopathy and infection among the groups. During the first 5 years after transplantation, CMV disease developed in 79 patients (20.96%). Comparison among the groups showed significantly increased risk for CMV disease in allograft recipients of organs from seropositive donors (D+, 27.31%; D-, 11.33%; p = 0.0003). We observed 6 CMV-associated deaths, all in CMV-antibody-negative recipients. Additionally CMV-positive recipients had a greater incidence of cardiac allograft vasculopathy (p = 0.048), and a greater overall infection rate (p = 0.0034). Cytomegalovirus hyperimmune globulin administration prevents CMV disease and infection in aggressively immunosuppressed heart transplant recipients. Because fatal CMV disease in CMV-negative recipients of organs from seropositive donors could not be prevented with CMVIG alone, we recommend the additional use of prophylactic ganciclovir in this CMV-mismatched population.

  10. Correlation between the results of three physical fitness tests (endurance, strength, speed) and the output measured during a bicycle ergometer test in a cohort of military servicemen.

    PubMed

    Sammito, Stefan; Gundlach, Nils; Böckelmann, Irina

    2016-01-01

    Physical fitness tests are widely used to assess endurance, sprint ability, coordination and/or strength. The objective of the present study was to analyze the degree to which the results of the Bundeswehr Basis Fitness Test (BFT)--a physical fitness test comprising a sprint test (11 × 10-m shuttle test), a flexed-arm hang test and a 1000-m run--are consistent with the output measured during a bicycle ergometer test. The number of false-positive and false-negative results with regard to the assessment of physical fitness were also examined. As part of a retrospective study, health assessments from 323 reenlistment examinations were evaluated regarding the output measured during a bicycle ergometer test and compared with the BFT results of the candidates. Overall, a good correlation was shown between the bicycle ergometer test results and the results achieved in the BFT disciplines. All three disciplines of the BFT showed a highly significant correlation with the relative output achieved during the bicycle ergometer test (P < 0.001), and also, the overall BFT score was highly significantly correlated (P < 0.001). The overall rate of false-positive and false-negative results was 4.0 %. The BFT results measured in the three physical fitness test items were highly correlated with the output measured during the bicycle ergometer tests. The rate of false-positive and false-negative results was low. The test items thus represent an appropriate measurement instrument because the test items require few equipment and less time. Additionally, a large number of subjects can be assessed. We suggest that it would be more useful to assess the physical fitness of this special group exclusively on the basis of the BFT instead of using the bicycle ergometer test.

  11. The Congenital Heart Disease Genetic Network Study: rationale, design, and early results.

    PubMed

    Gelb, Bruce; Brueckner, Martina; Chung, Wendy; Goldmuntz, Elizabeth; Kaltman, Jonathan; Kaski, Juan Pablo; Kim, Richard; Kline, Jennie; Mercer-Rosa, Laura; Porter, George; Roberts, Amy; Rosenberg, Ellen; Seiden, Howard; Seidman, Christine; Sleeper, Lynn; Tennstedt, Sharon; Kaltman, Jonathan; Schramm, Charlene; Burns, Kristin; Pearson, Gail; Rosenberg, Ellen

    2013-02-15

    Congenital heart defects (CHD) are the leading cause of infant mortality among birth defects, and later morbidities and premature mortality remain problematic. Although genetic factors contribute significantly to cause CHD, specific genetic lesions are unknown for most patients. The National Heart, Lung, and Blood Institute-funded Pediatric Cardiac Genomics Consortium established the Congenital Heart Disease Genetic Network Study to investigate relationships between genetic factors, clinical features, and outcomes in CHD. The Pediatric Cardiac Genomics Consortium comprises 6 main and 4 satellite sites at which subjects are recruited, and medical data and biospecimens (blood, saliva, cardiovascular tissue) are collected. Core infrastructure includes an administrative/data-coordinating center, biorepository, data hub, and core laboratories (genotyping, whole-exome sequencing, candidate gene evaluation, and variant confirmation). Eligibility includes all forms of CHD. Annual follow-up is obtained for probands <1-year-old. Parents are enrolled whenever available. Enrollment from December 2010 to June 2012 comprised 3772 probands. One or both parents were enrolled for 72% of probands. Proband median age is 5.5 years. The one third enrolled at age <1 year are contacted annually for follow-up information. The distribution of CHD favors more complex lesions. Approximately, 11% of probands have a genetic diagnosis. Adequate DNA is available from 97% and 91% of blood and saliva samples, respectively. Genomic analyses of probands with heterotaxy, atrial septal defects, conotruncal, and left ventricular outflow tract obstructive lesions are underway. The scientific community's use of Pediatric Cardiac Genomics Consortium resources is welcome.

  12. Mortality and morbidity during and after Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial: results by sex.

    PubMed

    Oparil, Suzanne; Davis, Barry R; Cushman, William C; Ford, Charles E; Furberg, Curt D; Habib, Gabriel B; Haywood, L Julian; Margolis, Karen; Probstfield, Jeffrey L; Whelton, Paul K; Wright, Jackson T

    2013-05-01

    To determine whether an angiotensin-converting enzyme inhibitor (lisinopril) or calcium channel blocker (amlodipine) is superior to a diuretic (chlorthalidone) in reducing cardiovascular disease incidence in sex subgroups, we carried out a prespecified subgroup analysis of 15 638 women and 17 719 men in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Total follow-up (active treatment + passive surveillance using national administrative databases to ascertain deaths and hospitalizations) was 8 to 13 years. The primary outcome was fatal coronary heart disease or nonfatal myocardial infarction. Secondary outcomes included all-cause mortality, stroke, combined cardiovascular disease (coronary heart disease death, nonfatal myocardial infarction, stroke, angina, coronary revascularization, heart failure [HF], or peripheral vascular disease), and end-stage renal disease. In-trial rates of HF, stroke, and combined cardiovascular disease were significantly higher for lisinopril compared with chlorthalidone, and rates of HF were significantly higher for amlodipine compared with chlorthalidone in both men and women. There were no significant treatment sex interactions. These findings did not persist through the extension period with the exception of the HF result for amlodipine versus chlorthalidone, which did not differ significantly by sex. For both women and men, rates were not lower in the amlodipine or lisinopril groups than in the chlorthalidone group for either the primary coronary heart disease outcome or any other cardiovascular disease outcome, and chlorthalidone-based treatment resulted in the lowest risk of HF. Neither lisinopril nor amlodipine is superior to chlorthalidone for initial treatment of hypertension in either women or men. Clinical Trial Registration- clinicaltrials.gov; Identifier: NCT00000542.

  13. Cognitive fitness.

    PubMed

    Gilkey, Roderick; Kilts, Clint

    2007-11-01

    Recent neuroscientific research shows that the health of your brain isn't, as experts once thought, just the product of childhood experiences and genetics; it reflects your adult choices and experiences as well. Professors Gilkey and Kilts of Emory University's medical and business schools explain how you can strengthen your brain's anatomy, neural networks, and cognitive abilities, and prevent functions such as memory from deteriorating as you age. The brain's alertness is the result of what the authors call cognitive fitness -a state of optimized ability to reason, remember, learn, plan, and adapt. Certain attitudes, lifestyle choices, and exercises enhance cognitive fitness. Mental workouts are the key. Brain-imaging studies indicate that acquiring expertise in areas as diverse as playing a cello, juggling, speaking a foreign language, and driving a taxicab expands your neural systems and makes them more communicative. In other words, you can alter the physical makeup of your brain by learning new skills. The more cognitively fit you are, the better equipped you are to make decisions, solve problems, and deal with stress and change. Cognitive fitness will help you be more open to new ideas and alternative perspectives. It will give you the capacity to change your behavior and realize your goals. You can delay senescence for years and even enjoy a second career. Drawing from the rapidly expanding body of neuroscience research as well as from well-established research in psychology and other mental health fields, the authors have identified four steps you can take to become cognitively fit: understand how experience makes the brain grow, work hard at play, search for patterns, and seek novelty and innovation. Together these steps capture some of the key opportunities for maintaining an engaged, creative brain.

  14. Distinguishing between those dying suddenly or not suddenly from coronary heart disease: long-term prospective results from the Northwick Park Heart Study

    PubMed Central

    Meade, Tom; Clayton, Tim; Chamberlain, Douglas

    2016-01-01

    Aim To establish whether ECG findings are associated with subsequent risk of sudden death from coronary heart disease (CHD). Methods and results Potential risk factors for CHD were measured at entry to the first Northwick Park Heart Study of 2167 men. ECG findings were coded as high or low risk for CHD according to definitions in the Minnesota code. Sudden or non-sudden deaths were defined as occurring in less than or more than 24 hours, respectively. The only factor independently associated with sudden death among the 262 men dying of CHD was high-risk ECG. Of 184 sudden CHD deaths, 34 men (18.5%) had had high-risk ECGs at entry to the study compared with 5 (6.4%) of 78 men who experienced non-sudden deaths (adjusted OR 3.94 (95% CI 1.33 to 11.67)) (p=0.006). Findings were also compared among all 2167 men, where high-risk ECGs were again associated with sudden death. T-wave changes were the main abnormalities associated with a high risk of sudden death. Conclusions In a group of men who had not previously experienced major episodes of CHD but who subsequently died from it, there was strong evidence that high-risk ECG changes, mainly T-wave abnormalities, differentiated between those who later died sudden deaths and those who survived for >24 hours. PMID:28008355

  15. Baseline anemia is not a predictor of all-cause mortality in outpatients with advanced heart failure or severe renal dysfunction. Results from the Norwegian Heart Failure Registry.

    PubMed

    Waldum, Bård; Westheim, Arne S; Sandvik, Leiv; Flønæs, Berit; Grundtvig, Morten; Gullestad, Lars; Hole, Torstein; Os, Ingrid

    2012-01-24

    The aim of this study was to evaluate the prognostic impact of anemia in outpatients with chronic heart failure attending specialized heart failure clinics and specifically to investigate its prognostic utility in patients with severe renal dysfunction or advanced heart failure. Anemia is an independent prognostic marker in patients with heart failure. The effect of anemia on mortality decreases with increasing creatinine levels. Multivariate Cox regression analyses were used to investigate the prognostic effect of anemia in 4,144 patients with heart failure from 21 outpatient heart failure clinics in Norway. Severe renal failure was defined as estimated glomerular filtration rate ≤45 ml/min/1.73 m(2) and advanced heart failure as New York Heart Association functional classes IIIb and IV. Baseline anemia was present in 24% and was a strong predictor of all-cause mortality (adjusted hazard ratio [HR]: 1.30, 95% CI: 1.09 to 1.56, p = 0.004). Baseline anemia did not predict mortality in the 752 patients with severe renal dysfunction (adjusted HR: 1.08, 95 % CI: 0.77 to 1.51, p = 0.662) and the 528 patients with advanced heart failure (adjusted HR: 0.87, 95% CI: 0.56 to 1.34, p = 0.542). In the 1,743 patients who attended subsequent visits, sustained anemia independently predicted worse prognosis (adjusted HR: 1.47, 95% CI: 1.10 to 1.94, p = 0.008), whereas transient and new-onset anemia did not. According to our study, baseline anemia was not an independent predictor of all-cause mortality in outpatients with heart failure and accompanied severe renal dysfunction or advanced heart disease. Sustained anemia after optimizing heart failure treatment might imply worse prognosis independently of renal function and New York Heart Association functional class. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  16. Stroke and bleeding risk evaluation in atrial fibrillation: results of the European heart rhythm association survey.

    PubMed

    Larsen, Torben Bjerregaard; Potpara, Tatjana; Dagres, Nikolaos; Pison, Laurent; Estner, Heidi; Blomström-Lundqvist, Carina

    2014-05-01

    The aim of this European Heart Rhythm Association (EHRA) survey was to assess clinical practice in relation to stroke and bleeding risk evaluation in atrial fibrillation, particularly regarding the use of risk evaluation schemes, among members of the EHRA electrophysiology (EP) research network. In this EP Wire survey, we have provided some insights into current practice in Europe for the use of these risk assessment schemes. There were some obvious practice differences. However, reassuring information on current practice in Europe was evident, but more focus on renal function is warranted, especially facing the fact that novel oral anticoagulants are used for antithrombotic therapy.

  17. Fetal heart rate and motor activity associations with maternal organochlorine levels: Results of an exploratory study

    PubMed Central

    DiPietro, Janet A.; Davis, Meghan F.; Costigan, Kathleen A; Barr, Dana Boyd

    2015-01-01

    Contemporaneous associations between circulating maternal organochlorines and measures of fetal heart rate and motor activity were evaluated. A panel of 47 organochlorines (OCs), including pesticides and polychlorinated biphenyls (PCBs), was analyzed from serum of 50 pregnant women at 36 weeks gestation. Data were empirically reduced into four factors and six individual compounds. All participants had detectable concentrations of at least one-quarter of the assayed OCs and, in general, higher socioeconomic level was associated with higher OC concentrations. Fetal heart rate measures were not consistently associated with maternal OCs. In contrast, one or more indicators of greater fetal motor activity were significantly associated with higher levels of the DDT and low chlorinated OC factors and five of the six individual compounds (heptachlor epoxide, trans nonachlor, oxychlordane, and PCBs 18 and 52). This preliminary demonstration of associations between fetal motor activity and maternal concentrations of persistent and pervasive environmental contaminants suggests that fetal assessment may be useful in ascertaining the potential early effects of these compounds on development. PMID:23591698

  18. Fetal heart rate and motor activity associations with maternal organochlorine levels: results of an exploratory study.

    PubMed

    DiPietro, Janet A; Davis, Meghan F; Costigan, Kathleen A; Barr, Dana Boyd

    2014-01-01

    Contemporaneous associations between circulating maternal organochlorines (OCs) and measures of fetal heart rate and motor activity were evaluated. A panel of 47 OCs, including pesticides and polychlorinated biphenyls (PCBs), was analyzed from serum of 50 pregnant women at 36 weeks gestation. Data were empirically reduced into four factors and six individual compounds. All participants had detectable concentrations of at least one-quarter of the assayed OCs and, in general, higher socioeconomic level was associated with higher OC concentrations. Fetal heart rate measures were not consistently associated with maternal OCs. In contrast, one or more indicators of greater fetal motor activity were significantly associated with higher levels of the DDT and low chlorinated OC factors and five of the six individual compounds (heptachlor epoxide, trans nonachlor, oxychlordane, and PCBs 18 and 52). This preliminary demonstration of associations between fetal motor activity and maternal concentrations of persistent and pervasive environmental contaminants suggests that fetal assessment may be useful in ascertaining the potential early effects of these compounds on development.

  19. The experimental evolution of herbicide resistance in Chlamydomonas reinhardtii results in a positive correlation between fitness in the presence and absence of herbicides.

    PubMed

    Vogwill, T; Lagator, M; Colegrave, N; Neve, P

    2012-10-01

    Pleiotropic fitness trade-offs will be key determinants of the evolutionary dynamics of selection for pesticide resistance. However, for herbicide resistance, empirical support for a fitness cost of resistance is mixed, and it is therefore also questionable what further ecological trade-offs can be assumed to apply to herbicide resistance. Here, we test the existence of trade-offs by experimentally evolving herbicide resistance in Chlamydomonas reinhardtii. Although fitness costs are detected for all herbicides, we find that, counterintuitively, the most resistant populations also have the lowest fitness costs as measured by growth rate in the ancestral environment. Furthermore, after controlling for differences in the evolutionary dynamics of resistance to different herbicides, we also detect significant positive correlations between resistance, fitness in the ancestral environment and cross-resistance to other herbicides. We attribute this to the highest levels of nontarget-site resistance being achieved by fixing mutations that more broadly affect cellular physiology, which results in both more cross-resistance and less overall antagonistic pleiotropy on maximum growth rate. Consequently, the lack of classical ecological trade-offs could present a major challenge for herbicide resistance management. © 2012 The Authors. Journal of Evolutionary Biology © 2012 European Society For Evolutionary Biology.

  20. Fitting Formulas For Determining The Existence Of S-Type And P-Type Habitable Zones In Binary Systems: First Results

    NASA Astrophysics Data System (ADS)

    Wang, Zhaopeng; Cuntz, Manfred

    2016-09-01

    We present initial work about attaining fitting formulas for the quick determination of the existence of S-type and P-type habitable zones in binary systems. Following previous work, we calculate the limits of the climatological habitable zone in binary systems (which sensitively depend on the system parameters) based on a joint constraint encompassing planetary orbital stability and a habitable region for a possible system planet. We also consider updated results on planetary climate models previously obtained by Kopparapu and collaborators. Fitting equations based on our work are presented for selected cases.

  1. Updated Users' Guide for RSAP -- A Code for Display and Manipulation of Neutron Cross Section Data and SAMMY Fit Results

    SciTech Connect

    Sayer, R.O.

    2003-07-29

    RSAP [1] is a computer code for display and manipulation of neutron cross section data and selected SAMMY output. SAMMY [2] is a multilevel R-matrix code for fitting neutron time-of-flight cross-section data using Bayes' method. This users' guide provides documentation for the recently updated RSAP code (version 6). The code has been ported to the Linux platform, and several new features have been added, including the capability to read cross section data from ASCII pointwise ENDF files as well as double-precision PLT output from SAMMY. A number of bugs have been found and corrected, and the input formats have been improved. Input items are parsed so that items may be separated by spaces or commas.

  2. Features of the metabolic syndrome are associated with objectively measured physical activity and fitness in Danish children: the European Youth Heart Study (EYHS).

    PubMed

    Brage, Søren; Wedderkopp, Niels; Ekelund, Ulf; Franks, Paul W; Wareham, Nicholas J; Andersen, Lars Bo; Froberg, Karsten

    2004-09-01

    Features of the metabolic syndrome are becoming increasingly evident in children. Decreased physical activity is likely to be an important etiological factor, as shown previously for subjective measures of physical activity in selected groups. The purpose of this study was to examine the relationship between the metabolic syndrome and objectively measured physical activity and whether fitness modified this relationship. A total of 589 Danish children (310 girls, 279 boys, mean [+/-SD] age 9.6 +/- 0.44 years, mean weight 33.6 +/- 6.4 kg, mean height 1.39 +/- 0.06 m) were randomly selected. Physical activity was measured with the uni-axial Computer Science & Applications accelerometer (MTI actigraph) worn at the hip for at least 3 days (>/=10 h/day) and fitness with a maximal bike test. As outcomes, we measured sitting systolic and diastolic blood pressure, degree of adiposity (sum of four skinfolds), and, finally, insulin, glucose, triglicerides, and HDL cholesterol in fasting blood samples. The outcome variables were statistically normalized and expressed as the number of SDs from the mean. (i.e., Z scores). A metabolic syndrome risk score was computed as the mean of these Z scores. Multiple linear regression was used to test the association between physical activity and metabolic risk, adjusted primarily for age, sex, sexual maturation, ethnicity, parental smoking, socioeconomic factors, and the Computer Science & Applications unit, as well as for fitness. Robust SEs were computed by clustering on school. All children were in the nondiabetic range of fasting glucose. Metabolic risk was inversely related to physical activity (P = 0.008). The relationship was weakened after adjustment for fitness, but there was a significantly positive interaction between physical activity and fitness. Physical activity is inversely associated with metabolic risk, independently of potential confounders. The interaction between physical activity and fitness suggests that the

  3. Fruit and vegetable intake and mortality from ischaemic heart disease: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study

    PubMed Central

    Crowe, Francesca L.; Roddam, Andrew W.; Key, Timothy J.; Appleby, Paul N.; Overvad, Kim; Jakobsen, Marianne U.; Tjønneland, Anne; Hansen, Louise; Boeing, Heiner; Weikert, Cornelia; Linseisen, Jakob; Kaaks, Rudolf; Trichopoulou, Antonia; Misirli, Gesthimani; Lagiou, Pagona; Sacerdote, Carlotta; Pala, Valeria; Palli, Domenico; Tumino, Rosario; Panico, Salvatore; Bueno-de-Mesquita, H. Bas; Boer, Jolanda; van Gils, Carla H.; Beulens, Joline W.J.; Barricarte, Aurelio; Rodríguez, Laudina; Larrañaga, Nerea; Sánchez, Maria-José; Tormo, María-José; Buckland, Genevieve; Lund, Eiliv; Hedblad, Bo; Melander, Olle; Jansson, Jan-Håkan; Wennberg, Patrik; Wareham, Nicholas J.; Slimani, Nadia; Romieu, Isabelle; Jenab, Mazda; Danesh, John; Gallo, Valentina; Norat, Teresa; Riboli, Elio

    2011-01-01

    Aims A higher intake of fruits and vegetables has been associated with a lower risk of ischaemic heart disease (IHD), but there is some uncertainty about the interpretation of this association. The objective was to assess the relation between fruit and vegetable intake and risk of mortality from IHD in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heart study. Methods and results After an average of 8.4 years of follow-up, there were 1636 deaths from IHD among 313 074 men and women without previous myocardial infarction or stroke from eight European countries. Participants consuming at least eight portions (80 g each) of fruits and vegetables a day had a 22% lower risk of fatal IHD [relative risk (RR) = 0.78, 95% confidence interval (CI): 0.65–0.95] compared with those consuming fewer than three portions a day. After calibration of fruit and vegetable intake to account for differences in dietary assessment between the participating centres, a one portion (80 g) increment in fruit and vegetable intake was associated with a 4% lower risk of fatal IHD (RR = 0.96, 95% CI: 0.92–1.00, P for trend = 0.033). Conclusion Results from this large observational study suggest that a higher intake of fruits and vegetables is associated with a reduced risk of IHD mortality. Whether this association is causal and, if so, the biological mechanism(s) by which fruits and vegetables operate to lower IHD risks remains unclear. PMID:21245490

  4. Routine Checkup Should Assess Fitness, Too

    MedlinePlus

    ... news/fullstory_162856.html Routine Checkup Should Assess Fitness, Too Cardiorespiratory test would help gauge patients' heart ... checked regularly, but an exercise expert says cardiorespiratory fitness should also be part of a routine medical ...

  5. In female rat heart mitochondria, oophorectomy results in loss of oxidative phosphorylation.

    PubMed

    Pavón, Natalia; Cabrera-Orefice, Alfredo; Gallardo-Pérez, Juan Carlos; Uribe-Alvarez, Cristina; Rivero-Segura, Nadia A; Vazquez-Martínez, Edgar Ricardo; Cerbón, Marco; Martínez-Abundis, Eduardo; Torres-Narvaez, Juan Carlos; Martínez-Memije, Raúl; Roldán-Gómez, Francisco-Javier; Uribe-Carvajal, Salvador

    2017-02-01

    Oophorectomy in adult rats affected cardiac mitochondrial function. Progression of mitochondrial alterations was assessed at one, two and three months after surgery: at one month, very slight changes were observed, which increased at two and three months. Gradual effects included decrease in the rates of oxygen consumption and in respiratory uncoupling in the presence of complex I substrates, as well as compromised Ca(2+) buffering ability. Malondialdehyde concentration increased, whereas the ROS-detoxifying enzyme Mn(2+) superoxide dismutase (MnSOD) and aconitase lost activity. In the mitochondrial respiratory chain, the concentration and activity of complex I and complex IV decreased. Among other mitochondrial enzymes and transporters, adenine nucleotide carrier and glutaminase decreased. 2-Oxoglutarate dehydrogenase and pyruvate dehydrogenase also decreased. Data strongly suggest that in the female rat heart, estrogen depletion leads to progressive, severe mitochondrial dysfunction. © 2017 Society for Endocrinology.

  6. Results with an anticoagulation protocol in 99 SynCardia total artificial heart recipients.

    PubMed

    Copeland, Jack; Copeland, Hannah; Nolan, Paul; Gustafson, Monica; Slepian, Marvin; Smith, Richard

    2013-01-01

    For 15 years, we employed a consistent anticoagulation protocol in 99 consecutive SynCardia Systems total artificial heart (TAH) recipients. Thromboelastography and platelet aggregation studies were used for evaluating and modulating therapy with dipyridamole, pentoxiphylline, aspirin, and heparin. Partial thromboplastin times, international normalized ratios, and platelet counts were also followed. After the second post-implant day in patients who were free of endo-device infection (97 patients), the embolic stroke incidence was 0.08 per patient year. This included 23.6 patient years of device support. There were no spontaneous hemorrhagic strokes. Two patients had endo-device infections and both had strokes. Postimplantation bleeding was seen in 20% of patients. All but two of these were within the first postoperative week. In all, 4% of patients had gastrointestinal bleeding. We did not observe heparin-induced thrombocytopenia in any patient. We conclude that stroke rates on TAH support have been low, and recommend this protocol.

  7. An editorial view on the reporting of results in heart valve bioprostheses.

    PubMed

    Del Campo, C

    1986-01-01

    Heart valve bioprostheses are most commonly analyzed as a group rather than individualized. Mechanical valves are usually referred to by specific name and manufacturer, while bioprostheses are pooled together as "tissue valves". Each specific bioprosthesis has its own structural characteristics and therefore a different level of performance and durability. Most large centers have an adequate number of these implants and a follow-up long enough to warrant separate analysis of each valve type. This review analyzes the differences among the most commonly used bioprostheses and reaffirms the reasons for their separate analysis. Authors, reviewers and editors must standardize their criteria to prevent this problem from recurring or escalating. New bioprostheses are now being released and unless we simplify their evaluation our questions will remain unanswered.

  8. Preliminary results from BCG and ECG measurements in the heart failure clinic.

    PubMed

    Giovangrandi, Laurent; Inan, Omer T; Banerjee, Dipanjan; Kovacs, Gregory T A

    2012-01-01

    We report on the preliminary deployment of a bathroom scale-based ballistocardiogram (BCG) system for the in-hospital monitoring of patients with heart failure. These early trials provided valuable insights into the challenges and opportunities for such monitoring. In particular, the need for robust algorithms and adapted BCG metric is suggested. The system was designed to be robust and user-friendly, with dual ballistocardiogram (BCG) and electrocardiogram (ECG) capabilities. The BCG was measured from a modified bathroom scale, while the ECG (used as timing reference) was measured using dry handlebar electrodes. The signal conditioning and digitization circuits were USB-powered, and data acquisition performed using a netbook. Four patients with a NYHA class III at admission were measured daily for the duration of their treatment at Stanford hospital. A measure of BCG quality, in essence a quantitative implementation of the BCG classes originally defined in the 1950s, is proposed as a practical parameter.

  9. [Case of ischemic heart disease resulting from persistent diuresis after giant ovarian tumor resection].

    PubMed

    Sata, Naho; Satoh, Masaaki; Seo, Norimasa

    2010-02-01

    A patient with a giant ovarian tumor weighing about 7 kg was successfully removed by operation. However, her ECG demonstrated ischemic changes after the operation. We report a case of ischemic heart disease due to persistent diuresis after giant ovarian tumor resection. A 75-year-old, 56.5 kg, 143.5 cm woman was admitted to our hospital for ovarian tumor resection. The preoperative ECG showed normal sinus rhythm and no ischemic changes. Both general anesthesia and epidural anesthesia were planed. An epidural catheter was inserted at T12-L1. Anesthesia was induced with propofol 100 mg, fentanyl 100 microg and vecuronium 8 mg under 100% oxygen inhalation. General anesthesia was maintained with sevoflurane while epidural anesthesia was achieved using 0.375% ropivacaine 6 ml. During the operation, blood pressure was 90-110/70-80 mmHg, with SaO2, 100% and heart rate, 70-80 beats x min(-1). The content of tumor was suctioned for 30 minutes. Surgery was successfully finished without any other incidence. After extubation, her ECG changed to atrial fibrillation from normal sinus rhythm and showed ST-T depression. And then her systolic blood pressure became 80 mmHg or below, but we found continued diuresis at about 10 ml x kg(-1) x hr(-1) for over 2 hr. The total of 7 unit vasopressin was intermittently given for vasoconstriction and antidiuresis. Her hemodynamic was immediately restored, and ECG turned to normal ST-T. The patient had uneventful postoperative recovery.

  10. Wearable defibrillator use in heart failure (WIF): results of a prospective registry.

    PubMed

    Kao, Andrew C; Krause, Steven W; Handa, Rajiv; Karia, Darshak; Reyes, Guillermo; Bianco, Nicole R; Szymkiewicz, Steven J

    2012-12-12

    Heart failure (HF) patients have a high risk of death, and implantable cardioverter defibrillators (ICDs) are effective in preventing sudden cardiac death (SCD). However, a certain percentage of patients may not be immediate candidates for ICDs, particularly those having a short duration of risk or an uncertain amount of risk. This includes the newly diagnosed patients, as well as those on the cardiac transplant list or NYHA class IV heart failure patients who do not already have an ICD. In these patients, a wearable cardioverter defibrillator (WCD) may be used until long term risk of SCD is defined. The purpose of this study was to determine the incidence of SCD in this population, and the efficacy of early defibrillation by a WCD. Ten enrolling centers identified 89 eligible HF patients who were either listed for cardiac transplantation, diagnosed with dilated cardiomyopathy, or receiving inotropic medications. Data collected included medical history, device records, and outcomes (including 90 day mortality). Out of 89 patients, final data on 82 patients has been collected. Patients wore the device for 75±58 days. Mean age was 56.8±13.2, and 72% were male. Most patients (98.8%) were diagnosed with dilated cardiomyopathy with a low ejection fraction (<40%) and twelve were listed for cardiac transplantation. Four patients were on inotropes. There were no sudden cardiac arrests or deaths during the study. Interestingly, 41.5% of patients were much improved after WCD use, while 34.1% went on to receive an ICD. In conclusion, the WCD monitored HF patients until further assessment of risk. The leading reasons for end of WCD use were improvement in left ventricular ejection fraction (LVEF) or ICD implantation if there was no significant improvement in LVEF.

  11. Inverse association between cancer and Alzheimer's disease: results from the Framingham Heart Study.

    PubMed

    Driver, Jane A; Beiser, Alexa; Au, Rhoda; Kreger, Bernard E; Splansky, Greta Lee; Kurth, Tobias; Kiel, Douglas P; Lu, Kun Ping; Seshadri, Sudha; Wolf, Phillip A

    2012-03-12

    To relate cancer since entry into the Framingham Heart Study with the risk of incident Alzheimer's disease and to estimate the risk of incident cancer among participants with and without Alzheimer's disease. Community based prospective cohort study; nested age and sex matched case-control study. Framingham Heart Study, USA. 1278 participants with and without a history of cancer who were aged 65 or more and free of dementia at baseline (1986-90). Hazard ratios and 95% confidence intervals for the risks of Alzheimer's disease and cancer. Over a mean follow-up of 10 years, 221 cases of probable Alzheimer's disease were diagnosed. Cancer survivors had a lower risk of probable Alzheimer's disease (hazard ratio 0.67, 95% confidence interval 0.47 to 0.97), adjusted for age, sex, and smoking. The risk was lower among survivors of smoking related cancers (0.26, 0.08 to 0.82) than among survivors of non-smoking related cancers (0.82, 0.57 to 1.19). In contrast with their decreased risk of Alzheimer's disease, survivors of smoking related cancer had a substantially increased risk of stroke (2.18, 1.29 to 3.68). In the nested case-control analysis, participants with probable Alzheimer's disease had a lower risk of subsequent cancer (0.39, 0.26 to 0.58) than reference participants, as did participants with any Alzheimer's disease (0.38) and any dementia (0.44). Cancer survivors had a lower risk of Alzheimer's disease than those without cancer, and patients with Alzheimer's disease had a lower risk of incident cancer. The risk of Alzheimer's disease was lowest in survivors of smoking related cancers, and was not primarily explained by survival bias. This pattern for cancer is similar to that seen in Parkinson's disease and suggests an inverse association between cancer and neurodegeneration.

  12. Low-sodium diet self-management intervention in heart failure: pilot study results.

    PubMed

    Welsh, Darlene; Lennie, Terry A; Marcinek, Regina; Biddle, Martha J; Abshire, Demetrius; Bentley, Brooke; Moser, Debra K

    2013-02-01

    Self-care management of a low-sodium diet is a critical component of comprehensive heart failure (HF) treatment. The primary purpose of this study was to examine the effectiveness of an educational intervention on reducing the dietary sodium intake of patients with HF. Secondary purposes were to examine the effects of the intervention on attitudes, subjective norm, and perceived behavioural control towards following a low-sodium diet. This was a randomized clinical trial of an educational intervention based on The Theory of Planned Behavior. Patients were randomized to either a usual care (n=25) or intervention group (n=27) with data collection at baseline, 6 weeks, and 6 months. The intervention group received low-sodium diet instructions and the usual care group received no dietary instructions. Nutrition Data Systems-Research software was used to identify the sodium content of foods on food diaries. Attitudes, subjective norm, and perceived behavioural control were measured using the Dietary Sodium Restriction Questionnaire. Analysis of covariance (between-subjects effects) revealed that dietary sodium intake did not differ between usual care and intervention groups at 6 weeks; however, dietary sodium intake was lower in the intervention group (F=7.3, df=1,29, p=0.01) at 6 months. Attitudes subscale scores were higher in the intervention group at 6 weeks (F=7.6, df=1, 38, p<0.01). Carefully designed educational programmes have the potential to produce desired patient outcomes such as low-sodium diet adherence in patients with heart failure.

  13. Five-year results of patients supported by HeartMate II: outcomes and adverse events.

    PubMed

    Hanke, Jasmin S; Rojas, Sebastian V; Mahr, Claudius; Schmidt, Anja-Franziska; Zoch, Amelie; Dogan, Günes; Feldmann, Christina; Deniz, Ezin; Molitoris, Ullrich; Bara, Christoph; Strüber, Martin; Haverich, Axel; Schmitto, Jan D

    2017-09-02

    Improved outcomes over the past decade have increased confidence of physicians and patients in extended duration of left ventricular assist device (LVAD) support. This single-centre cohort study reports 5-year outcomes with the HeartMate II (HMII) LVAD. We describe a cohort of 89 patients who received a HMII LVAD between February 2004 and December 2010. The causes of death and adverse events were assessed by examination of medical records. A total of 202.74 patient-years were analysed. After 5 years, of the 89 patients, 15 patients remained on device therapy, 39 patients died, 28 patients underwent heart transplantation and 7 patients underwent explantation of the HMII for recovery. One year after the HMII implantation, there was a survival of 71% in the study cohort. In the following years, the survival rate was 65% in the 2nd year, 63% in the 3rd year, 56% in the 4th year and 54% after 5 years of LVAD support. Ten LVAD exchanges were performed in 8 (11%) patients. Currently (March 2017), 12 patients still remain on their original device. The longest ongoing patient on the HMII has been supported for over 11 years (4097 days). The most common adverse events were bleeding (68%; 1.5837 events per patient-year) and LVAD infection [49%; 1.0666 events per patient-year]. Seven cases of pump thrombosis were described (8%; 0.1131 events per patient-year). This is the first single-cohort study to describe a 5-year survival of HMII patients on extended duration of support. A 5-year survival of 54% was observed in this single-centre cohort.

  14. [Cardiac failure in Chilean hospitals: results of the National Registry of Heart Failure, ICARO].

    PubMed

    Castro, Pablo; Vukasovic, José Luis; Garcés, Eduardo; Sepúlveda, Luis; Ferrada, Marcela; Alvarado, Sergio

    2004-06-01

    Heart failure (HF) is a major public health problem. In Chile hospitalized patients due to HF have not been characterized. To evaluate clinical profile and outcome of patients hospitalized for heart failure in Chilean hospitals. Prospective registry of 14 centers. Patients hospitalized for HF in functional class III and IV were included. Epidemiological and clinical data, functional class, type of presentation, decompensation cause, electrocardiogram, echocardiogram, treatment and evolution were registered. Three hundred seventy two patients aged 69 +/- 13 years old, 59% men, were assessed. The main etiologies of HF were ischemic in 31.6%, hypertensive in 35.2%, valvular in 14.9% and idiopathic in 7.4%. There was a history of hypertension 69%, diabetes in 35%, myocardial infarction in 22%, atrial fibrillation (AF) in 28%. The presentation form of HF was chronic decompensated in 86%, acute in 12%, refractory in 2%. The causes of decompensation were non compliance with diet or medical prescriptions in 28%, infections in 22% and AF 17%. ECG showed AF in 36% and left bundle branch block in 16%. Echocardiography was performed in 52% of the patients, 69% had left ventricular ejection fraction <40%. On admission, 39% received angiotensin converting enzyme (ACE) inhibitors, 15% beta-blocker, 25% digoxin, 16% spironolactone and 53% furosemide. The mean hospital stay was 111 +/- 10 days and mortality was 4.5%. The elderly is the age group most commonly admitted to hospital due to HF. The main etiologies were ischemic and hypertensive. The main causes for decompensations were noncompliance with diet or medical prescriptions and infections. A significant proportion had a relatively well preserved ventricular systolic function.

  15. Effects of structured heart failure disease management on mortality and morbidity depend on patients' mood: results from the Interdisciplinary Network for Heart Failure Study.

    PubMed

    Gelbrich, Götz; Störk, Stefan; Kreißl-Kemmer, Sonja; Faller, Hermann; Prettin, Christiane; Heuschmann, Peter U; Ertl, Georg; Angermann, Christiane E

    2014-10-01

    Depression is common in heart failure (HF) and associated with adverse outcomes. Randomized comparisons of the effectiveness of HF care strategies by patients' mood are scarce. We therefore investigated in a randomized trial a structured collaborative disease management programme (HeartNetCare-HF™; HNC) recording mortality, morbidity, and symptoms in patients enrolled after hospitalization for decompensated systolic HF according to their responses to the 9-item Patient Health Questionnaire (PHQ-9) during an observation period of 180 days. Subjects scoring <12/≥12 were categorized as non-depressed/depressed, and those ignoring the questionnaire as PHQ-deniers. Amongst 715 participants (69 ± 12 years, 29% female), 141 (20%) were depressed, 466 (65%) non-depressed, and 108 (15%) PHQ-deniers. The composite endpoint of mortality and re-hospitalization was neutral overall and in all subgroups. However, HNC reduced mortality risk in both depressed and non-depressed patients [adjusted hazard ratios (HRs) 0.12, 95% confidence interval (CI) 0.03-0.56, P = 0.006, and 0.49, 95% CI 0.25-0.93, P = 0.03, respectively], but not in PHQ-deniers (HR 1.74, 95% CI 0.77-3.96, P = 0.19; P = 0.006 for homogeneity of HRs). Average frequencies of patient contacts in the HNC arm were 12.8 ± 7.9 in non-depressed patients, 12.4 ± 7.1 in depressed patients, and 5.5 ± 7.2 in PHQ-deniers (P < 0.001). Early after decompensation, HNC reduced mortality risk in non-depressed and even more in depressed subjects, but not in PHQ-deniers. This suggests that differential acceptability and chance of success of care strategies such as HNC might be predicted by appropriate assessment of patients' baseline characteristics including psychological disposition. These post-hoc results should be reassessed by prospective evaluation of HNC in larger HF populations. © 2014 The Authors. European Journal of Heart Failure © 2014 European Society of Cardiology.

  16. Multicenter Analysis of Immune Biomarkers and Heart Transplant Outcomes: Results of the Clinical Trials in Organ Transplantation-05 Study.

    PubMed

    Starling, R C; Stehlik, J; Baran, D A; Armstrong, B; Stone, J R; Ikle, D; Morrison, Y; Bridges, N D; Putheti, P; Strom, T B; Bhasin, M; Guleria, I; Chandraker, A; Sayegh, M; Daly, K P; Briscoe, D M; Heeger, P S

    2016-01-01

    Identification of biomarkers that assess posttransplant risk is needed to improve long-term outcomes following heart transplantation. The Clinical Trials in Organ Transplantation (CTOT)-05 protocol was an observational, multicenter, cohort study of 200 heart transplant recipients followed for the first posttransplant year. The primary endpoint was a composite of death, graft loss/retransplantation, biopsy-proven acute rejection (BPAR), and cardiac allograft vasculopathy (CAV) as defined by intravascular ultrasound (IVUS). We serially measured anti-HLA- and auto-antibodies, angiogenic proteins, peripheral blood allo-reactivity, and peripheral blood gene expression patterns. We correlated assay results and clinical characteristics with the composite endpoint and its components. The composite endpoint was associated with older donor allografts (p < 0.03) and with recipient anti-HLA antibody (p < 0.04). Recipient CMV-negativity (regardless of donor status) was associated with BPAR (p < 0.001), and increases in plasma vascular endothelial growth factor-C (OR 20; 95%CI:1.9-218) combined with decreases in endothelin-1 (OR 0.14; 95%CI:0.02-0.97) associated with CAV. The remaining biomarkers showed no relationships with the study endpoints. While suboptimal endpoint definitions and lower than anticipated event rates were identified as potential study limitations, the results of this multicenter study do not yet support routine use of the selected assays as noninvasive approaches to detect BPAR and/or CAV following heart transplantation.

  17. Soil-transmitted helminth infections and physical fitness in school-aged Bulang children in southwest China: results from a cross-sectional survey

    PubMed Central

    2012-01-01

    Background Chronic soil-transmitted helminth (STH) infections have been associated with reduced physical fitness, but available evidence is limited. The aim of this cross-sectional survey was to assess the feasibility of measuring children's physical fitness and to relate it to STH infections. Our study was carried out among school-aged children of the Bulang ethnic group in rural southwest People's Republic of China (P.R. China). Standardized, quality-controlled methods were employed to determine STH infections (Kato-Katz technique), haemoglobin levels, anthropometry (body weight and height) and physical fitness (20-m shuttle run test). Results A compliance of 87% suggested good acceptance of the methods used. Among 69 children with complete data records, infection prevalence of Trichuris trichiura, Ascaris lumbricoides and hookworm were 81%, 44% and 6%, respectively. The maximum volume of oxygen that can be utilized within 1 min during exhaustive exercise (VO2 max estimate) of T. trichiura-infected children was 1.94 ml kg-1 min-1 lower than that of their non-infected counterparts (P = 0.005). Until exhaustion, T. trichiura-infected children had completed 6.14 20-m laps less (P = 0.004). Additionally, the mean VO2 max estimate of stunted children was lowered by 1.63 ml kg-1 min-1 (P = 0.002) and they completed 5.32 20-m laps less (P = 0.001) compared to children of normal stature. No significant association between stunting and infection with any STH species could be established. Conclusions Implementation of physical fitness tests in rural, resource-constraint settings is feasible. The physical fitness of children who are stunted or infected with STHs, particularly T. trichiura, is significantly impaired. We have launched a larger study and will determine the dynamics of school-aged children's physical fitness over a 7-month period after administration of anthelminthic drugs. PMID:22424138

  18. Is heart rate a risk marker in patients with chronic heart failure and concomitant atrial fibrillation? Results from the MAGGIC meta-analysis.

    PubMed

    Simpson, Joanne; Castagno, Davide; Doughty, Rob N; Poppe, Katrina K; Earle, Nikki; Squire, Iain; Richards, Mark; Andersson, Bert; Ezekowitz, Justin A; Komajda, Michel; Petrie, Mark C; McAlister, Finlay A; Gamble, Greg D; Whalley, Gillian A; McMurray, John J V

    2015-11-01

    To investigate the relationship between heart rate and survival in patients with heart failure (HF) and coexisting atrial fibrillation (AF). Patients with AF included in the Meta-analysis Global Group in Chronic Heart Failure (MAGGIC) meta-analysis were the main focus of this analysis (3259 patients from 17 studies). The outcome was all-cause mortality at 3 years. Heart rate was analysed as a categorical (tertiles; T1 ≤77 b.p.m., T2 78-98 b.p.m., T3 ≥98 b.p.m.) and continuous variable. Cox proportional hazard models were used to compare the risk of all-cause death between tertiles of baseline heart rate. Patients in the highest tertile were more often female, less likely to have an ischaemic aetiology or diabetes, had a lower ejection fraction but higher blood pressure and New York Heart Association (NYHA) class. Higher heart rate was associated with higher mortality in patients with sinus rhythm (SR) but not in those in AF. In patients with heart failure and reduced ejection fraction (HF-REF) and AF, death rates per 100 patient years were lowest in the highest heart rate tertile (T1 18.9 vs. T3 15.9) but this difference was not statistically significant (P = 0.10). In patients with heart failure and preserved ejection fraction (HF-PEF), death rates per 100 patient years were highest in the highest heart rate tertile (T1 14.6 vs. T3 16.0, P = 0.014). However, after adjustment for other important prognostic variables, higher heart rate was no longer associated with higher mortality in HF-PEF (or HF-REF). In this meta-analysis of patients with HF, heart rate does not have the same prognostic significance in patients in AF as it does in those in SR, irrespective of ejection fraction or treatment with beta-blocker. © 2015 The Authors European Journal of Heart Failure © 2015 European Society of Cardiology.

  19. Yoga Is as Good as Stretching-Strengthening Exercises in Improving Functional Fitness Outcomes: Results From a Randomized Controlled Trial.

    PubMed

    Gothe, Neha P; McAuley, Edward

    2016-03-01

    Despite yoga's popularity, few clinical trials have employed rigorous methodology to systematically explore its functional benefits compared with more established forms of exercise. The objective of this study was to compare the functional benefits of yoga with the conventional stretching-strengthening exercises recommended for adults. Sedentary healthy adults (N = 118; M age = 62.0) participated in an 8-week (three times a week for 1 hour) randomized controlled trial, which consisted of a Hatha yoga group (n = 61) and a stretching-strengthening exercise group (n = 57). Standardized functional fitness tests assessing balance, strength, flexibility, and mobility were administered at baseline and postintervention. A repeated measures multivariate analysis of variance showed a significant time effect for measures of balance [F(3,18) = 4.88, p < .01, partial η(2) = .45], strength [F(2,19) = 15.37, p < .001, partial η(2) = .62], flexibility [F(4,17) = 8.86, p < .001, partial η(2) = .68], and mobility [F(2,19) = 8.54, p < .002, partial η(2) = .47]. Both groups showed significant improvements on measures of balance (left-right leg and four square step); strength (chair stands and arm curls); flexibility (back scratch and sit-and-reach); and mobility (gait speed and 8-feet up and go), with partial η(2) ranging from .05 to .47. These data suggest that regular yoga practice is just as effective as stretching-strengthening exercises in improving functional fitness. To our knowledge, this is the first study to examine functional benefits of yoga in comparison with stretching-strengthening exercises in sedentary, healthy, community-dwelling older adults. These findings have clinical implications as yoga is a more amenable form of exercise than strengthening exercises as it requires minimal equipment and can be adapted for individuals with lower levels of functioning or disabilities. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological

  20. Mixed evidence for reduced local adaptation in wild salmon resulting from interbreeding with escaped farmed salmon: complexities in hybrid fitness

    PubMed Central

    Fraser, Dylan J; Cook, Adam M; Eddington, James D; Bentzen, Paul; Hutchings, Jeffrey A

    2008-01-01

    Interbreeding between artificially-selected and wild organisms can have negative fitness consequences for the latter. In the Northwest Atlantic, farmed Atlantic salmon recurrently escape into the wild and enter rivers where small, declining populations of wild salmon breed. Most farmed salmon in the region derive from an ancestral source population that occupies a nonacidified river (pH 6.0–6.5). Yet many wild populations with which escaped farmed salmon might interbreed inhabit acidified rivers (pH 4.6–5.2). Using common garden experimentation, and examining two early-life history stages across two generations of interbreeding, we showed that wild salmon populations inhabiting acidified rivers had higher survival at acidified pH than farmed salmon or F1 farmed-wild hybrids. In contrast, however, there was limited evidence for reduced performance in backcrosses, and F2 farmed-wild hybrids performed better or equally well to wild salmon. Wild salmon also survived or grew better at nonacidified than acidified pH, and wild and farmed salmon survived equally well at nonacidified pH. Thus, for acid tolerance and the stages examined, we found some evidence both for and against the theory that repeated farmed-wild interbreeding may reduce adaptive genetic variation in the wild and thereby negatively affect the persistence of depleted wild populations. PMID:25567731

  1. Tidal wind, temperature, and density fields from 80-400 km: Results from a physics-based empirical fit model to TIMED observations

    NASA Astrophysics Data System (ADS)

    Oberheide, Jens; Forbes, Jeffrey M.; Zhang, Xiaoli; Bruinsma, Sean; Ward, William E.

    A physics-based empirical fit model (HME, Hough Mode Extensions) is constrained with tidal temperature and wind observations in the MLT region made by the SABER and TIDI instru-ments on the TIMED satellite. The resulting amplitudes and phases represent self-consistent solutions of the tidal equations for upward propagating tides in horizontal wind, vertical wind, temperature and density, from pole-to-pole and up to 400 km altitude. Monthly mean aver-ages for 2002-2008 are presented for the most important migrating and nonmigrating diurnal and semidiurnal tides. Results are validated with ground-based observations (MLT region) and in-situ tidal diagnostics from the CHAMP satellite (400 km). Although designed as a TIMED based tidal climatology, the fit approach might be usable to further improve empirical upper atmosphere models, particularly in terms of nonmigrating tides: Each tide (wavenum-ber/frequency pair) is described by 2-4 latitude and height independent fit parameters per month and 2-4 corresponding time independent two-dimensional basis functions (HMEs). The fit parameters are the same for winds, temperature, and density.

  2. What is the economic value of digoxin therapy in congestive heart failure patients? Results from the DIG trial.

    PubMed

    Eisenstein, Eric L; Yusuf, Salim; Bindal, Vishal; Bourassa, Martial G; Horney, Anne; Collins, Joseph F; Mark, Daniel B

    2006-06-01

    The Digitalis Investigation Group (DIG) clinical train randomized 6800 congestive heart failure patients (ejection fraction > or =45%) to a daily regimen of either digoxin or placebo. At 37 months average follow-up, patients in both groups had similar mortality. We determined the incremental costs associated with the use of digoxin in this high-risk population. Hospitalizations and medical costs were compared by using a societal perspective. Hospitalizations were assigned Medicare DRG codes by using descriptive information from the clinical trial. Digoxin use was assigned a cost by using the 1998 average wholesale price as reported by Red Book. On average, there were fewer hospitalizations in digoxin-treated patients. These patients had lower heart failure yet higher non-heart failure hospitalization costs than placebo patients. Digoxin therapy was cost saving versus placebo in only 27% of 1000 bootstrap samples using Medicare costs (mean costs 12,648 dollars vs. 12,362 dollars) and in 44% of samples using commercial carrier costs (mean costs 17,400 dollars vs. 17,306 dollars). How ever, digoxin was cost saving in >50% of samples for several higher-risk patient subgroups. The use of digoxin therapy versus placebo was associated with reduced hospitalizations. Moreover, the resulting cost-savings could cover the costs of this inexpensive therapy in selected subgroups of higher-risk patients. In the remainder, there is a modest cost associated with this therapy.

  3. Resistance of Dynamin-related Protein 1 Oligomers to Disassembly Impairs Mitophagy, Resulting in Myocardial Inflammation and Heart Failure.

    PubMed

    Cahill, Thomas J; Leo, Vincenzo; Kelly, Matthew; Stockenhuber, Alexander; Kennedy, Nolan W; Bao, Leyuan; Cereghetti, Grazia; Harper, Andrew R; Czibik, Gabor; Lao, Chunyan; Bellahcene, Mohamed; Steeples, Violetta; Ghaffari, Safar; Yavari, Arash; Mayer, Alice; Poulton, Joanna; Ferguson, David J P; Scorrano, Luca; Hettiarachchi, Nishani T; Peers, Chris; Boyle, John; Hill, R Blake; Simmons, Alison; Watkins, Hugh; Dear, T Neil; Ashrafian, Houman

    2015-10-23

    We have reported previously that a missense mutation in the mitochondrial fission gene Dynamin-related protein 1 (Drp1) underlies the Python mouse model of monogenic dilated cardiomyopathy. The aim of this study was to investigate the consequences of the C452F mutation on Drp1 protein function and to define the cellular sequelae leading to heart failure in the Python monogenic dilated cardiomyopathy model. We found that the C452F mutation increased Drp1 GTPase activity. The mutation also conferred resistance to oligomer disassembly by guanine nucleotides and high ionic strength solutions. In a mouse embryonic fibroblast model, Drp1 C452F cells exhibited abnormal mitochondrial morphology and defective mitophagy. Mitochondria in C452F mouse embryonic fibroblasts were depolarized and had reduced calcium uptake with impaired ATP production by oxidative phosphorylation. In the Python heart, we found a corresponding progressive decline in oxidative phosphorylation with age and activation of sterile inflammation. As a corollary, enhancing autophagy by exposure to a prolonged low-protein diet improved cardiac function in Python mice. In conclusion, failure of Drp1 disassembly impairs mitophagy, leading to a downstream cascade of mitochondrial depolarization, aberrant calcium handling, impaired ATP synthesis, and activation of sterile myocardial inflammation, resulting in heart failure.

  4. Residential Proximity to Major Roadways Is Not Associated with Cardiac Function in African Americans: Results from the Jackson Heart Study

    PubMed Central

    Weaver, Anne M.; Wellenius, Gregory A.; Wu, Wen-Chih; Hickson, DeMarc A.; Kamalesh, Masoor; Wang, Yi

    2016-01-01

    Cardiovascular disease (CVD), including heart failure, is a major cause of morbidity and mortality, particularly among African Americans. Exposure to ambient air pollution, such as that produced by vehicular traffic, is believed to be associated with heart failure, possibly by impairing cardiac function. We evaluated the cross-sectional association between residential proximity to major roads, a marker of long-term exposure to traffic-related pollution, and echocardiographic indicators of left and pulmonary vascular function in African Americans enrolled in the Jackson Heart Study (JHS): left ventricular ejection fraction, E-wave velocity, isovolumic relaxation time, left atrial diameter index, and pulmonary artery systolic pressure. We examined these associations using multivariable linear or logistic regression, adjusting for potential confounders. Of 4866 participants at study enrollment, 106 lived <150 m, 159 lived 150–299 m, 1161 lived 300–999 m, and 3440 lived ≥1000 m from a major roadway. We did not observe any associations between residential distance to major roads and these markers of cardiac function. Results were similar with additional adjustment for diabetes and hypertension, when considering varying definitions of major roadways, or when limiting analyses to those free from cardiovascular disease at baseline. Overall, we observed little evidence that residential proximity to major roads was associated with cardiac function among African Americans. PMID:27304962

  5. Micro-economic impact of congenital heart surgery: results of a prospective study from a limited-resource setting.

    PubMed

    Raj, Manu; Paul, Mary; Sudhakar, Abish; Varghese, Anu Alphonse; Haridas, Aareesh Chittulliparamb; Kabali, Conrad; Kumar, Raman Krishna

    2015-01-01

    The microeconomic impact of surgery for congenital heart disease is unexplored, particularly in resource limited environments. We sought to understand the direct and indirect costs related to congenital heart surgery and its impact on Indian households from a family perspective. Baseline and first follow-up data of 644 consecutive children admitted for surgery for congenital heart disease (March 2013 - July 2014) in a tertiary referral hospital in Central Kerala, South India was collected prospectivelyfrom parents through questionnaires using a semi-structured interview schedule. The median age was 8.2 months (IQR: 3.0- 36.0 months). Most families belonged to upper middle (43.0%) and lower middle (35.7%) socioeconomic class. Only 3.9% of families had some form of health insurance. The median expense for the admission and surgery was INR 201898 (IQR: 163287-266139) [I$ 11989 (IQR: 9696-15804)], which was 0.93 (IQR: 0.52-1.49) times the annual family income of affected patients. Median loss of man-days was 35 (IQR: 24-50) and job-days was 15 (IQR: 11-24). Surgical risk category and hospital stay duration significantly predicted higher costs. One in two families reported overwhelming to high financial stress during admission period for surgery. Approximately half of the families borrowed money during the follow up period after surgery. Surgery for congenital heart disease results in significant financial burden for majority of families studied. Efforts should be directed at further reductions in treatment costs without compromising the quality of care together with generating financial support for affected families.

  6. The use of Yo-Yo intermittent recovery level 1 and Andersen testing for fitness and maximal heart rate assessments of 6- to 10-year-old school children.

    PubMed

    Bendiksen, Mads; Ahler, Thomas; Clausen, Helle; Wedderkopp, Niels; Krustrup, Peter

    2013-06-01

    We evaluated a submaximal and maximal version of the Yo-Yo intermittent recovery level 1 children's (YYIR1C) test and the Andersen test for fitness and maximal heart rate assessments of children aged 6-10 years. Two repetitions of the YYIR1C and Andersen tests were carried out within 1 week by 6- to 7-year-olds and 8- to 9-year-olds (grade 0, n = 17; grade 2, n = 16) and 6 weeks apart by 9- to 10-year-olds (grade 3, n = 49). Grade 0-2 pupils also performed an incremental treadmill test (ITT). Grade 2 pupils had a better (p < 0.05) YYIR1C (84%; 994 ± 399 m (±SD) vs. 536 ± 218 m) and Andersen test performance (10%; 1,050 ± 71 m vs. 955 ± 56 m) than grade 0 pupils. For grade 0-2 pupils, YYIR1C, Andersen, and ITT peak heart rates were 205 ± 11, 207 ± 9, and 203 ± 7 b·min(-1), respectively (Andersen > ITT, p < 0.05), and for grade 3 pupils, YYIR1C and Andersen peak heart rates were 208 ± 9 and 204 ± 9 b·min(-1), respectively (YYIR1C > Andersen, p < 0.05). Submaximal YYIR1C heart rate (HR) was inversely correlated (p < 0.05) with YYIR1C test performance (r = -0.54 to -0.67) and VO2peak (r = -0.42). The 6-week change in submaximal HR correlated with the change in YYIR1C test performance (r = -0.42 to -0.53, p < 0.05). In conclusion, YYIR1C and Andersen tests are simple and inexpensive intermittent field tests that can detect differences in fitness levels and determine maximal HR of 6- to 10-year-old children. Additionally, submaximal YYIR1C testing can be used for frequent nonexhaustive fitness assessments.

  7. Conveying a probabilistic genetic test result to families with an inherited heart disease.

    PubMed

    Ingles, Jodie; Semsarian, Christopher

    2014-06-01

    The evolution of genetic testing in the past few years has been astounding. In a matter of only a few years, we now have comprehensive gene tests comprising vast panels of "cardiac" genes, whole exome sequencing (the entire coding region) and even whole genome sequencing (the entire genome). Making the call as to whether a DNA variant is causative or benign is difficult and the focus of intense research efforts. In most cases, the final answer will not be a simple yes/no outcome but rather a graded continuum of pathogenicity. This allows classification of variants in a more probabilistic way. How we convey this to a patient is the challenge, and certainly shines a spotlight on the important skills of the cardiac genetic counselor. This is an exciting step forward, but the overwhelming complexity of the information generated from these tests means our current practices of conveying genetic information to the family must be carefully considered. Despite the challenges, a genetic diagnosis in a family has great benefit both in reassuring unaffected family members and removing the need for lifetime clinical surveillance. The multidisciplinary specialized clinic model, incorporating genetic counselors, cardiologists and geneticists, provides the ideal framework for ensuring the best possible care for genetic heart disease families.

  8. Relation between serum creatinine and postoperative results of open-heart surgery.

    PubMed

    Ezeldin, Tamer H

    2013-10-01

    To determine the impact of preoperative serum creatinine level in non-dialyzable patients on postoperative morbidity and mortality. This is a prospective study, where serum creatinine was used to give primary assessment on renal function status preoperatively. This study includes 1,033 patients, who underwent coronary artery bypass grafting, or valve(s) operations. The study took place at Al-Hada Military Hospital, Taif, Kingdom of Saudi between May 2008 and January 2012. Data were statistically analyzed using Chi square (x2) test and multivariable logistic regression, to evaluate the postoperative morbidity and mortality risks associated with low serum creatinine levels. Postoperative mortality increased with high serum creatinine level >1.8 mg/dL (pheart surgery. High serum creatinine in non-dialyzable patients can predict the increased morbidity and mortality after cardiac operations.

  9. Experimental Periodontitis Results in Prediabetes and Metabolic Alterations in Brain, Liver and Heart: Global Untargeted Metabolomic Analyses

    PubMed Central

    Ilievski, Vladimir; Kinchen, Jason M; Prabhu, Ramya; Rim, Fadi; Leoni, Lara; Unterman, Terry G.; Watanabe, Keiko

    2016-01-01

    Results from epidemiological studies suggest that there is an association between periodontitis and prediabetes, however, causality is not known. The results from our previous studies suggest that induction of periodontitis leads to hyperinsulinemia glucose intolerance and insulin resistance, all hallmarks of prediabetes. However, global effects of periodontitis on critical organs in terms of metabolic alterations are unknown. We determined the metabolic effects of periodontitis on brain, liver, heart and plasma resulting from Porphyromonas gingivalis induced periodontitis in mice. Periodontitis was induced by oral application of the periodontal pathogen, Porphyromonas gingivalis for 22 weeks. Global untargeted biochemical profiles in samples from these organs/plasma were determined by liquid and gas chromatography/mass spectrometry and compared between controls and animals with periodontitis. Oral application of Porphyromonas gingivalis induced chronic periodontitis and hallmarks of prediabetes. The results of sample analyses indicated a number of changes in metabolic readouts, including changes in metabolites related to glucose and arginine metabolism, inflammation and redox homeostasis. Changes in biochemicals suggested subtle systemic effects related to periodontal disease, with increases in markers of inflammation and oxidative stress most prominent in the liver. Signs of changes in redox homeostasis were also seen in the brain and heart. Elevated bile acids in liver were suggestive of increased biosynthesis, which may reflect changes in liver function. Interestingly, signs of decreasing glucose availability were seen in the brain. In all three organs and plasma, there was a significant increase in the microbiome-derived bioactive metabolite 4-ethylphenylsulfate sulfate in animals with periodontitis. The results of metabolic profiling suggest that periodontitis/bacterial products alter metabolomic signatures of brain, heart, liver, and plasma in the

  10. Health Fitness Standards. Aerobic Endurance.

    ERIC Educational Resources Information Center

    Dotson, Chuck

    1988-01-01

    An exploration of the current thinking about levels of fitness necessary to meet health fitness standards, with particular focus on aerobic capacity, discusses major health problems, the prevalence of heart disease, how health standards are set, and how health habits change as people age. (CB)

  11. MUNI-FITS-Utils

    NASA Astrophysics Data System (ADS)

    Chrastina, M.; Zejda, M.; Mikulášek, Z.

    2010-12-01

    The FITS standard allows arbitrary use of name-space for keywords, except some reserved keywords. Result of this freedom is that several keywords have the same meaning. Similar problem is that values of keywords have different physical units. These facts complicate automated data processing and also creation of FITS file archives with simple structure. MUNI-FITS-Utils is a package of Python scripts which have been developed in PyFITS, a Python FITS Module. Scripts are user-friendly and allow manipulating FITS headers to get uniform shape. Further functions will be added soon.

  12. A mobile phone intervention increases physical activity in people with cardiovascular disease: Results from the HEART randomized controlled trial.

    PubMed

    Maddison, Ralph; Pfaeffli, Leila; Whittaker, Robyn; Stewart, Ralph; Kerr, Andrew; Jiang, Yannan; Kira, Geoffrey; Leung, William; Dalleck, Lance; Carter, Karen; Rawstorn, Jonathan

    2015-06-01

    To determine the effectiveness and cost-effectiveness of a mobile phone intervention to improve exercise capacity and physical activity behaviour in people with ischaemic heart disease (IHD). In this single-blind, parallel, two-arm, randomized controlled trial adults (n = 171) with IHD were randomized to receive a mobile phone delivered intervention (HEART; n = 85) plus usual care, or usual care alone (n = 86). Adult participants aged 18 years or more, with a diagnosis of IHD, were clinically stable as outpatients, able to perform exercise, able to understand and write English, and had access to the Internet. The HEART (Heart Exercise And Remote Technologies) intervention involved a personalized, automated package of text messages and a secure website with video messages aimed at increasing exercise behaviour, delivered over 24 weeks. All participants were able to access usual community-based cardiac rehabilitation, which involves encouragement of physical activity and an offer to join a local cardiac support club. All outcomes were assessed at baseline and 24 weeks and included peak oxygen uptake (PVO2; primary outcome), self-reported physical activity, health-related quality of life, self-efficacy and motivation (secondary outcomes). Results showed no differences in PVO2 between the two groups (difference -0.21 ml kg(-1)min(-1), 95% CI: -1.1, 0.7; p = 0.65) at 24 weeks. However significant treatment effects were observed for selected secondary outcomes, including leisure time physical activity (difference 110.2 min/week, 95% CI: -0.8, 221.3; p = 0.05) and walking (difference 151.4 min/week, 95% CI: 27.6, 275.2; p = 0.02). There were also significant improvements in self-efficacy to be active (difference 6.2%, 95% CI: 0.2, 12.2; p = 0.04) and the general health domain of the SF36 (difference 2.1, 95% CI: 0.1, 4.1; p = 0.03) at 24 weeks. The HEART programme was considered likely to be cost-effective for leisure time activity and walking. A mobile phone intervention

  13. Palliative needs for heart failure or chronic obstructive pulmonary disease: Results of a multicenter observational registry.

    PubMed

    Gavazzi, Antonello; De Maria, Renata; Manzoli, Lamberto; Bocconcelli, Paolo; Di Leonardo, Antonio; Frigerio, Maria; Gasparini, Stefano; Humar, Franco; Perna, Gianpiero; Pozzi, Roberto; Svanoni, Fausto; Ugolini, Marcello; Deales, Alberto

    2015-04-01

    Heart failure (HF) and chronic obstructive pulmonary disease (COPD) share a common organ failure trajectory marked by prognostic uncertainty, which is a barrier to appropriate provision of palliative care. We describe in a prospective cohort from specialist hospital services the epidemiology and late clinical course of these chronic diseases to trace criteria for transition to palliative care in the community. Seven centers enrolled 267 patients with advanced HF (n=174) or COPD (n=93) using common (multiple hospitalizations or severely impaired functional status or cachexia) and disease-specific (HF: systolic dysfunction, NYHA classes III-IV, end-organ hypoperfusion; COPD: very severe airflow obstruction, hypoxemia, hypercapnia, or long-term oxygen therapy) entry criteria. These patients represented 7.2% and 13% respectively of the overall HF and COPD population hospitalized during one year. They showed similar symptom burden, functional and quality of life impairment, recurrent hospitalizations, and 6-month mortality (39% and 37%, respectively). Organ failure progression was the cause of death in >75%. In-hospital overall stay during the previous year was the main mortality predictor in both. Disease-specific predictors included anemia, hyponatremia, no beta-blockers in HF; older age, hypercapnia in COPD. Patients with advanced HF/COPD represent almost 10% of subjects hospitalized yearly with a primary diagnosis of HF or COPD, have similarly impaired functional status, disabling symptoms and reduced survival. Overall days spent in-hospital during the previous year, a "red flag" in the late clinical course of both diseases, might be used as a simple, reliable screening tool for appropriate transition to palliative care in the community. Copyright © 2015. Published by Elsevier Ireland Ltd.

  14. Ideal cardiovascular health and peripheral artery disease in African Americans: Results from the Jackson Heart Study.

    PubMed

    Collins, Tracie C; Slovut, David P; Newton, Robert; Johnson, William D; Larrivee, Sandra; Patterson, Jeremy; Johnston, Judy A; Correa, Adolfo

    2017-09-01

    We sought to determine the association of Life's Simple Seven (LSS) with peripheral artery disease (PAD) in African Americans. We performed a cross-sectional analysis of baseline data (2000-2004) from subjects participating in the Jackson Heart Study. African American men and women (N = 4403) age 35-84 years participated in the study. PAD was defined by an ankle-brachial index (ABI) of < 0.9. We assessed frequency of LSS (body mass index [BMI], blood pressure, total cholesterol, glucose, dietary habits, physical activity, and smoking) among participants with and without PAD. LSS variables were categorized as ideal, intermediate, or poor to indicate a participant's health status. Data were analyzed using logistic regression to assess the association of PAD with LSS. PAD was diagnosed in 113 participants (2.6%). The percentage of the cohort meeting criteria for ideal health for each of the seven LSS factors was: 14.2% for BMI, 17.1% for blood pressure, 38.0% for total cholesterol, 72.9% for glucose, 1.0% for dietary habits, 19.2% for physical activity, and 84.6% for smoking. Having ≥ 3 LSS variables within the category of poor health was associated with elevated odds for PAD (odds ratio (OR) 1.34, 95% CI 1.11-1.63) after adjusting for age. Among African American adults, LSS variables are associated with PAD. Further studies are needed to determine the association of LSS with PAD among other racial/ethnic groups.

  15. [Healthy heart: Results of a community education program on cardiovascular health].

    PubMed

    Madridejos Mora, Rosa; Majem Fabres, Lourdes; Puig Acebal, Helena; Sanz Latorre, Inma; Llobet Traveset, Eva; Arce Casas, Mar; Ruiz Morilla, Dolors; Mercadal Dalmau, Angel; Pañart Sánchez, Dani

    2014-11-01

    To improve the knowledge of the population about heart-healthy habits through a training program supplemented by a web site and community activities. A controlled clinical trial with intervention done through participation in the Cardiovascular Health Training Classroom (CHTC) LOCATION: A town of 80,000 inhabitants. both sexes, aged 55 to 70 years, with at least one cardiovascular risk factor (CVRF). The intervention group (IG) consisted of patients who participated in the CHTC. Intervention was carried out through a 20-hour presential group course in which a support web site was offered and complementary activities were organized. Classes were taught by three Primary Care nurses. The primary endpoint was knowledge of CVRF. The secondary variables were age, sex, CVRF, lifestyle, visits to health centers, pharmaceutical use adherence, and satisfaction with the program. Data from patients in the first 10 courses (n=150) were evaluated. A statistically significant improvement was observed in overall knowledge of CVRF in the IG (87.3% to 100%) compared with control group (GC) (84.5% to 92.7%), p<.001, as well as an improvement in physical activity is (IG: 71.2% to 83.1% versus CG: 72.6% to 78.2%), p=.05. The total number of Primary Care visits (medical and nursing) decreased in the IG more than in the CG. The satisfaction rate of the course was very high. This experience is effective in improving cardiovascular health knowledge and promoting some healthy habits. Copyright © 2012 Elsevier España, S.L.U. All rights reserved.

  16. [Chronic obstructive pulmonary disease on inpatients with heart failure. GESAIC study results].

    PubMed

    Recio-Iglesias, Jesús; Grau-Amorós, Jordi; Formiga, Francesc; Camafort-Babkowski, Miquel; Trullàs-Vila, Joan Carles; Rodríguez, Avelino

    2010-04-10

    The clinical relevance of Heart failure (HF) and chronic obstructive pulmonary disease (COPD) in the same patient is not well established. We decided to study the prevalence of COPD in patients admitted due to HF, to define their clinical profile and the relationship with adrenergic beta-blockers (BB) treatment. Prospective cohort of inpatients with HF admitted in 15 Internal Medicine Services from October 2005 to March 2006. Diagnosis of COPD was established according to clinical criteria or spirometry. Data about neurohormonal treatment (before, during the admission, and at discharge) were collected. Statistical analyses were performed using Ji square test and T Student test. A logistic regression model was designed with data. P<0.05 being considered statistically significant. About 391 patients were included . CPOD was present in 25.1% of patients. In two thirds of patients, the COPD diagnosis was established by clinical criteria. Regarding GOLD, 23.5% of patients had moderate or severe COPD severity. Bivariate analysis showed that male (<0.05), poor Charlson's Index and overweight (p=0.04 both) had all relationship with COPD. The regression model indicated that only left ventricular ejection fraction (LVEF) and BB treatment before admission had statistical significance (p=0.03 and p<0.001 respectively). At discharge, 27,6% of patients received BB. COPD in HF patients is common and most frequent patients are aged men high comorbidity and overweight. BB treatment is conditioned by LVEF, without relationship with COPD severity. Copyright 2009 Elsevier España, S.L. All rights reserved.

  17. Plasma Leptin Levels and Risk of Incident Cancer: Results from the Dallas Heart Study.

    PubMed

    Gupta, Arjun; Herman, Yehuda; Ayers, Colby; Beg, Muhammad S; Lakoski, Susan G; Abdullah, Shuaib M; Johnson, David H; Neeland, Ian J

    2016-01-01

    Leptin dysregulation has been postulated to affect cancer risk through its effects on obesity and inflammation. Epidemiological data evaluating this relationship are conflicting and studies in non-white cohorts is lacking. Therefore, we examined the association of leptin with the risk of incident cancer in the multiethnic Dallas Heart Study (DHS). Participants enrolled in the DHS without prevalent cancer and with baseline leptin measurements were included. Incident cancer cases were identified through a systematic linkage of the DHS and the Texas Cancer Registry. Leptin was evaluated both as a continuous variable and in sex-specific quartiles. Multivariable Cox proportional hazards modeling was performed to examine the association between leptin levels with incident cancer after adjusting for age, sex, race, smoking status, alcohol use, family history of malignancy, body mass index (BMI), diabetes mellitus and C-reactive protein. Among 2,919 participants (median age 44 years; 54% women; 70% nonwhite; median BMI 29.4 kg/m2), 190 (6.5%) developed cancer after median follow- up of 12 years. Median leptin levels were 12.9 (interquartile range [IQR] 5.8-29.5) ng/ml in the incident cancer group vs. 12.3 (IQR 5.4-26.4) ng/ml those without an incident cancer (p = 0.34). Leptin was not associated with cancer incidence in multivariable analysis (unit standard deviation increase in log-transformed leptin, hazard ratio 0.95; 95% confidence interval, 0.77-1.16; p = 0.60). No association was observed in analyses stratified by sex, race/ethnicity, diabetes, or obesity status. In this study of a predominantly minority population, no association between premorbid leptin levels and cancer incidence was demonstrated. Despite preclinical rationale and positive findings in other studies, this association may not replicate across all racial/ethnic populations.

  18. Fringe Fitting

    NASA Astrophysics Data System (ADS)

    Cotton, W. D.

    Fringe Fitting Theory; Correlator Model Delay Errors; Fringe Fitting Techniques; Baseline; Baseline with Closure Constraints; Global; Solution Interval; Calibration Sources; Source Structure; Phase Referencing; Multi-band Data; Phase-Cals; Multi- vs. Single-band Delay; Sidebands; Filtering; Establishing a Common Reference Antenna; Smoothing and Interpolating Solutions; Bandwidth Synthesis; Weights; Polarization; Fringe Fitting Practice; Phase Slopes in Time and Frequency; Phase-Cals; Sidebands; Delay and Rate Fits; Signal-to-Noise Ratios; Delay and Rate Windows; Details of Global Fringe Fitting; Multi- and Single-band Delays; Phase-Cal Errors; Calibrator Sources; Solution Interval; Weights; Source Model; Suggested Procedure; Bandwidth Synthesis

  19. [A new technique for transcrestal sinus floor elevation with press-fit bone cylinders (dowel lift): short communication of the first in vitro results].

    PubMed

    Draenert, G F; Ehrenfeld, M; Eisenmenger, W

    2007-01-01

    The minimally invasive sinus floor elevation as first described by Summers is limited in augmentation volume, whereas a more invasive approach is required for the technique of Tatum for larger bone defects. We developed a new technique for the transcrestal elevation of the sinus floor with bone dowels using a press-fit technique (dowel lift). We present the technique with first in vitro results in a fresh, unpreserved, human cadaver.

  20. Novel oral anticoagulants for stroke prevention in atrial fibrillation: results of the European Heart Rhythm Association survey.

    PubMed

    Lip, Gregory Y H; Bongiorni, Maria Grazia; Dobreanu, Dan; Lewalter, Thorsten; Hastrup Svendsen, Jesper; Blomström-Lundqvist, Carina

    2013-10-01

    The purpose of this European Heart Rhythm Association (EHRA) survey was to assess clinical practice in relation to stroke prevention in atrial fibrillation (AF), particularly into the use of novel oral anticoagulants (NOACs) for stroke prevention, among members of the EHRA electrophysiology (EP) research network. In this EP Wire survey, we have provided some insights into current practice in Europe for the use of NOACs for stroke prevention in AF. There were clear practice differences evident, and also the need for greater adherence to the guidelines, especially since guideline adherent management results in better outcomes in AF.

  1. Rheumatic Heart Disease and Myxomatous Degeneration: Differences and Similarities of Valve Damage Resulting from Autoimmune Reactions and Matrix Disorganization

    PubMed Central

    Martins, Carlo de Oliveira; Demarchi, Lea; Ferreira, Frederico Moraes; Pomerantzeff, Pablo Maria Alberto; Brandao, Carlos; Sampaio, Roney Orismar; Spina, Guilherme Sobreira; Kalil, Jorge; Cunha-Neto, Edecio

    2017-01-01

    Autoimmune inflammatory reactions leading to rheumatic fever (RF) and rheumatic heart disease (RHD) result from untreated Streptococcus pyogenes throat infections in individuals who exhibit genetic susceptibility. Immune effector mechanisms have been described that lead to heart tissue damage culminating in mitral and aortic valve dysfunctions. In myxomatous valve degeneration (MXD), the mitral valve is also damaged due to non-inflammatory mechanisms. Both diseases are characterized by structural valve disarray and a previous proteomic analysis of them has disclosed a distinct profile of matrix/structural proteins differentially expressed. Given their relevance in organizing valve tissue, we quantitatively evaluated the expression of vimentin, collagen VI, lumican, and vitronectin as well as performed immunohistochemical analysis of their distribution in valve tissue lesions of patients in both diseases. We identified abundant expression of two isoforms of vimentin (45 kDa, 42 kDa) with reduced expression of the full-size protein (54 kDa) in RHD valves. We also found increased vitronectin expression, reduced collagen VI expression and similar lumican expression between RHD and MXD valves. Immunohistochemical analysis indicated disrupted patterns of these proteins in myxomatous degeneration valves and disorganized distribution in rheumatic heart disease valves that correlated with clinical manifestations such as valve regurgitation or stenosis. Confocal microscopy analysis revealed a diverse pattern of distribution of collagen VI and lumican into RHD and MXD valves. Altogether, these results demonstrated distinct patterns of altered valve expression and tissue distribution/organization of structural/matrix proteins that play important pathophysiological roles in both valve diseases. PMID:28121998

  2. Rheumatic Heart Disease and Myxomatous Degeneration: Differences and Similarities of Valve Damage Resulting from Autoimmune Reactions and Matrix Disorganization.

    PubMed

    Martins, Carlo de Oliveira; Demarchi, Lea; Ferreira, Frederico Moraes; Pomerantzeff, Pablo Maria Alberto; Brandao, Carlos; Sampaio, Roney Orismar; Spina, Guilherme Sobreira; Kalil, Jorge; Cunha-Neto, Edecio; Guilherme, Luiza

    2017-01-01

    Autoimmune inflammatory reactions leading to rheumatic fever (RF) and rheumatic heart disease (RHD) result from untreated Streptococcus pyogenes throat infections in individuals who exhibit genetic susceptibility. Immune effector mechanisms have been described that lead to heart tissue damage culminating in mitral and aortic valve dysfunctions. In myxomatous valve degeneration (MXD), the mitral valve is also damaged due to non-inflammatory mechanisms. Both diseases are characterized by structural valve disarray and a previous proteomic analysis of them has disclosed a distinct profile of matrix/structural proteins differentially expressed. Given their relevance in organizing valve tissue, we quantitatively evaluated the expression of vimentin, collagen VI, lumican, and vitronectin as well as performed immunohistochemical analysis of their distribution in valve tissue lesions of patients in both diseases. We identified abundant expression of two isoforms of vimentin (45 kDa, 42 kDa) with reduced expression of the full-size protein (54 kDa) in RHD valves. We also found increased vitronectin expression, reduced collagen VI expression and similar lumican expression between RHD and MXD valves. Immunohistochemical analysis indicated disrupted patterns of these proteins in myxomatous degeneration valves and disorganized distribution in rheumatic heart disease valves that correlated with clinical manifestations such as valve regurgitation or stenosis. Confocal microscopy analysis revealed a diverse pattern of distribution of collagen VI and lumican into RHD and MXD valves. Altogether, these results demonstrated distinct patterns of altered valve expression and tissue distribution/organization of structural/matrix proteins that play important pathophysiological roles in both valve diseases.

  3. Stroke prevention strategies in patients with atrial fibrillation and heart valve abnormalities: perceptions of 'valvular' atrial fibrillation: results of the European Heart Rhythm Association Survey.

    PubMed

    Potpara, Tatjana S; Lip, Gregory Y H; Larsen, Torben B; Madrid, Antonio; Dobreanu, Dan; Jędrzejczyk-Patej, Ewa; Dagres, Nikolaos

    2016-10-01

    The purpose of this European Heart Rhythm Association (EHRA) Survey was to assess the perceptions of 'valvular' atrial fibrillation (AF) and management of AF patients with various heart valve abnormalities in daily clinical practice in European electrophysiology (EP) centres. Questionnaire survey was sent via the Internet to the EHRA-EP Research Network Centres. Of the 52 responding centres, 42 (80.8%) were university hospitals. Choosing the most comprehensive definition of valvular AF, a total of 49 centres (94.2%) encountered a mechanical prosthetic heart valve and significant rheumatic mitral stenosis, 35 centres (67.3%) also considered bioprosthetic valves, and 25 centres (48.1%) included any significant valvular heart disease, requiring surgical repair in the definition of valvular AF. Only three centres (5.8%) would define valvular AF as the presence of any (even mild) valvular abnormality. None of the centres would use non-vitamin K antagonist oral anticoagulants (NOACs) in AF patients with mechanical prosthetic valves, only 5 centres (9.8%) would use NOACs in patients with significant mitral stenosis, 17 centres (32.7%) would consider the use of NOACs in patients with bioprosthetic valves, and 21 centres (41.2%) would use NOACs in patients with a non-recent transcatheter valve replacement/implantation, while 13 centres (25.5%) would never consider the use of NOACs in AF patients with even mild native heart valve abnormality. Our survey showed marked heterogeneity in the definition of valvular AF and thromboprophylactic treatments, with the use of variable NOACs in patients with valvular heart disease other than prosthetic heart valves or significant mitral stenosis, indicating that this term may be misleading and should not be used.

  4. Maternal Exposure to Criteria Air Pollutants and Congenital Heart Defects in Offspring: Results from the National Birth Defects Prevention Study

    PubMed Central

    Luben, Thomas J.; Daniels, Julie L.; Fuentes, Montserrat; Richardson, David B.; Aylsworth, Arthur S.; Herring, Amy H.; Anderka, Marlene; Botto, Lorenzo; Correa, Adolfo; Gilboa, Suzanne M.; Langlois, Peter H.; Mosley, Bridget; Shaw, Gary M.; Siffel, Csaba; Olshan, Andrew F.

    2014-01-01

    Background: Epidemiologic literature suggests that exposure to air pollutants is associated with fetal development. Objectives: We investigated maternal exposures to air pollutants during weeks 2–8 of pregnancy and their associations with congenital heart defects. Methods: Mothers from the National Birth Defects Prevention Study, a nine-state case–control study, were assigned 1-week and 7-week averages of daily maximum concentrations of carbon monoxide, nitrogen dioxide, ozone, and sulfur dioxide and 24-hr measurements of fine and coarse particulate matter using the closest air monitor within 50 km to their residence during early pregnancy. Depending on the pollutant, a maximum of 4,632 live-birth controls and 3,328 live-birth, fetal-death, or electively terminated cases had exposure data. Hierarchical regression models, adjusted for maternal demographics and tobacco and alcohol use, were constructed. Principal component analysis was used to assess these relationships in a multipollutant context. Results: Positive associations were observed between exposure to nitrogen dioxide and coarctation of the aorta and pulmonary valve stenosis. Exposure to fine particulate matter was positively associated with hypoplastic left heart syndrome but inversely associated with atrial septal defects. Examining individual exposure-weeks suggested associations between pollutants and defects that were not observed using the 7-week average. Associations between left ventricular outflow tract obstructions and nitrogen dioxide and between hypoplastic left heart syndrome and particulate matter were supported by findings from the multipollutant analyses, although estimates were attenuated at the highest exposure levels. Conclusions: Using daily maximum pollutant levels and exploring individual exposure-weeks revealed some positive associations between certain pollutants and defects and suggested potential windows of susceptibility during pregnancy. Citation: Stingone JA, Luben TJ

  5. Low-Dose Gamma Irradiation of Decellularized Heart Valves Results in Tissue Injury in Vitro and in Vivo

    PubMed Central

    Helder, Meghana R. K.; Hennessy, Ryan S.; Spoon, Daniel B.; Tefft, Brandon J.; Witt, Tyra A.; Marler, Ronald J.; Pislaru, Sorin V.; Simari, Robert D.; Stulak, John M.; Lerman, Amir

    2017-01-01

    Background Decellularized heart valves are emerging as a potential alternative to current bioprostheses for valve replacement. While techniques of decellularization have been thoroughly examined, terminal sterilization techniques have not received the same scrutiny. Methods This study evaluated low dose gamma irradiation as a sterilization method for decellularized heart valves. Incubation of valves and transmission electron microscopy evaluation after different doses of gamma irradiation were used to determine the optimal dose of gamma irradiation. Quantitative evaluation of mechanical properties was done by tensile mechanical testing of isolated cusps. Sterilize decellularized heart valves were tested in a sheep model (n=3, 1 1,500 Gy and 2 3,000 Gy) of pulmonary valve replacement. Results Valves sterilized with gamma radiation between 1,000 Gy and 3,000 Gy were found to be optimal with in-vitro testing. However, with in-vivo showed deteriorating valve function within 2 months. On explant the valve with 1,500 Gy gamma irradiation showed signs of endocarditis with neutrophils on hematoxylin and eosin staining, positive gram stain resembling streptococcus infection. The 3,000 Gy valves had no evidence of infection, but the hematoxylin and eosin staining showed evidence of wound remodeling with macrophages and fibroblasts. Tensile strength testing showed decreased strength (0 Gy-2.53±0.98 MPa, 1,500 Gy-2.03±1.23 MPa, 3,000 Gy-1.26±0.90 MPa) with increasing levels of irradiation. Conclusions Low dose gamma irradiation does not maintain the mechanical integrity of valves and the balance between sterilization and damage may not be able to be achieved with gamma irradiation. Other methods of terminal sterilization must be pursued and evaluated. PMID:26453425

  6. Radiation–Induced Signaling Results in Mitochondrial Impairment in Mouse Heart at 4 Weeks after Exposure to X-Rays

    PubMed Central

    Barjaktarovic, Zarko; Schmaltz, Dominik; Shyla, Alena; Azimzadeh, Omid; Schulz, Sabine; Haagen, Julia; Dörr, Wolfgang; Sarioglu, Hakan; Schäfer, Alexander; Atkinson, Michael J.; Zischka, Hans; Tapio, Soile

    2011-01-01

    Backround Radiation therapy treatment of breast cancer, Hodgkin's disease or childhood cancers expose the heart to high local radiation doses, causing an increased risk of cardiovascular disease in the survivors decades after the treatment. The mechanisms that underlie the radiation damage remain poorly understood so far. Previous data show that impairment of mitochondrial oxidative metabolism is directly linked to the development of cardiovascular disease. Methodology/Principal findings In this study, the radiation-induced in vivo effects on cardiac mitochondrial proteome and function were investigated. C57BL/6N mice were exposed to local irradiation of the heart with doses of 0.2 Gy or 2 Gy (X-ray, 200 kV) at the age of eight weeks, the control mice were sham-irradiated. After four weeks the cardiac mitochondria were isolated and tested for proteomic and functional alterations. Two complementary proteomics approaches using both peptide and protein quantification strategies showed radiation-induced deregulation of 25 proteins in total. Three main biological categories were affected: the oxidative phophorylation, the pyruvate metabolism, and the cytoskeletal structure. The mitochondria exposed to high-dose irradiation showed functional impairment reflected as partial deactivation of Complex I (32%) and Complex III (11%), decreased succinate-driven respiratory capacity (13%), increased level of reactive oxygen species and enhanced oxidation of mitochondrial proteins. The changes in the pyruvate metabolism and structural proteins were seen with both low and high radiation doses. Conclusion/Significance This is the first study showing the biological alterations in the murine heart mitochondria several weeks after the exposure to low- and high-dose of ionizing radiation. Our results show that doses, equivalent to a single dose in radiotherapy, cause long-lasting changes in mitochondrial oxidative metabolism and mitochondria-associated cytoskeleton. This prompts us to

  7. Heart disease mortality following widowhood: some results from the OPCS Longitudinal Study. Office of Population Censuses and Surveys.

    PubMed

    Jones, D R

    1987-01-01

    Many studies have suggested that following the experience of 'stressful' life events the risks of myocardial infarction, accidents and perhaps other diseases are elevated. In the OPCS Longitudinal Study routinely collected data on deaths, and deaths of a spouse occurring in a 1% sample of the population of England and Wales in the period 1971-1981 are linked together, and with 1971 census records of sample members. The timing and patterns of death following the potentially very stressful event of conjugal bereavement may thus be analysed. Overall the mortality (from ischaemic heart disease) was less than 10% in excess of that in all members of the LS sample. As in many earlier studies, some increases in death rates shortly after widowhood are observed. Unusually, for deaths from all causes these increases are more marked in widows than in widowers with, for example, a two-fold increase in mortality from all causes in the first month after widowhood. However, no peak of post-bereavement mortality from ischaemic heart disease is clearly established in either sex. Although the study is large, with a well-chosen control group, only a limited characterisation of study members from data collected in the census is possible. In particular, no measures of personality, behaviour or diet are available. Investigation of potential effects of social or familial support, as measured by household structure and numbers of children, led to equivocal results. Several possible explanations for the increased mortality rates are examined. Hypotheses based on common marital environment, homogamy or simultaneous accidental death are seen to be of very limited value. The observed patterns, although consistent with an early effect of a stressful life event, do not suggest that stress following bereavement leads to an excess of ischaemic heart disease mortality.

  8. Radiation-induced signaling results in mitochondrial impairment in mouse heart at 4 weeks after exposure to X-rays.

    PubMed

    Barjaktarovic, Zarko; Schmaltz, Dominik; Shyla, Alena; Azimzadeh, Omid; Schulz, Sabine; Haagen, Julia; Dörr, Wolfgang; Sarioglu, Hakan; Schäfer, Alexander; Atkinson, Michael J; Zischka, Hans; Tapio, Soile

    2011-01-01

    Radiation therapy treatment of breast cancer, Hodgkin's disease or childhood cancers expose the heart to high local radiation doses, causing an increased risk of cardiovascular disease in the survivors decades after the treatment. The mechanisms that underlie the radiation damage remain poorly understood so far. Previous data show that impairment of mitochondrial oxidative metabolism is directly linked to the development of cardiovascular disease. In this study, the radiation-induced in vivo effects on cardiac mitochondrial proteome and function were investigated. C57BL/6N mice were exposed to local irradiation of the heart with doses of 0.2 Gy or 2 Gy (X-ray, 200 kV) at the age of eight weeks, the control mice were sham-irradiated. After four weeks the cardiac mitochondria were isolated and tested for proteomic and functional alterations. Two complementary proteomics approaches using both peptide and protein quantification strategies showed radiation-induced deregulation of 25 proteins in total. Three main biological categories were affected: the oxidative phophorylation, the pyruvate metabolism, and the cytoskeletal structure. The mitochondria exposed to high-dose irradiation showed functional impairment reflected as partial deactivation of Complex I (32%) and Complex III (11%), decreased succinate-driven respiratory capacity (13%), increased level of reactive oxygen species and enhanced oxidation of mitochondrial proteins. The changes in the pyruvate metabolism and structural proteins were seen with both low and high radiation doses. This is the first study showing the biological alterations in the murine heart mitochondria several weeks after the exposure to low- and high-dose of ionizing radiation. Our results show that doses, equivalent to a single dose in radiotherapy, cause long-lasting changes in mitochondrial oxidative metabolism and mitochondria-associated cytoskeleton. This prompts us to propose that these first pathological changes lead to an increased

  9. Screening for heart transplantation and left ventricular assist system: results from the ScrEEning for advanced Heart Failure treatment (SEE-HF) study.

    PubMed

    Lund, Lars H; Trochu, Jean-Noel; Meyns, Bart; Caliskan, Kadir; Shaw, Steven; Schmitto, Jan D; Schibilsky, David; Damme, Laura; Heatley, Jerry; Gustafsson, Finn

    2017-09-27

    Heart transplantation (HTx) and implantable left ventricular assist systems (LVAS) improve outcomes in advanced heart failure but may be underutilized. We hypothesized that screening can identify appropriate candidates. The ScrEEning for advanced Heart Failure treatment (SEE-HF) study was a multicentre prospective study screening patients with existing cardiac resynchronization therapy (CRT) and/or implantable cardioverter-defibrillator (ICD) for ejection fraction ≤40% and New York Heart Association (NYHA) class III-IV, and subsequently for guideline-based HTx and LVAS indication. Of 1722 (mean age 64 ± 14 years, 26% women) patients screened at eight centres in seven European countries, 121 (7.0%) were eligible and 99 (5.7%; mean age 61 ± 10 years, 19% women) patients were enrolled for detailed assessment. Twenty-six of the 99 enrolled patients (26%) were eligible for either HTx or LVAD (18 eligible for HTx; 7 eligible for LVAD; and 1 eligible for both). Eleven patients were listed for HTx and three received an LVAS. Eligible patients were 61 ± 8 years and 19% women, whereas those actually receiving intervention were 56 ± 8 years and 8% women. Among patients with CRT and/or ICD, a minority have NYHA class III-IV heart failure and ejection fraction ≤40%. Among these, however, more than one-quarter have an unrecognized need for HTx or LVAS. When patients are offered intervention based on screening, many decline. Discrepancies exist between clinical and patient equipoise. Clinical Trial Registration ClinicalTrials.gov Unique Identifier: NCT00894387. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

  10. Availability of, referral to and participation in exercise-based cardiac rehabilitation after heart valve surgery: Results from the national CopenHeart survey.

    PubMed

    Hansen, Tina B; Berg, Selina K; Sibilitz, Kirstine L; Søgaard, Rikke; Thygesen, Lau C; Yazbeck, Anne-Marie; Zwisler, Ann D

    2015-06-01

    As with ischaemic heart disease, cardiac rehabilitation (CR) is recommended for patients undergoing heart valve surgery; recommendations are based on limited evidence. The organization of CR programmes and factors associated with uptake among patients undergoing heart valve surgery have not been studied. This study investigated CR programmes for these patients and factors associated with referral and participation. We distributed two nationwide surveys: one to 37 hospitals and 98 municipalities and one to 742 consecutive patients undergoing heart valve surgery. Data were linked to nationwide registries. We analysed the provision and content of programmes using descriptive statistics, and factors associated with referral and participation using logistic regression analysis. Coverage of CR programmes for these patients was high, with national programme variation. The overall uptake rate was 52%. Simultaneous CABG was associated with a higher probability of referral to CR (OR 2.02 (95%CI 1.12-3.65)); being unmarried (0.44 (0.27-0.72)) and having TAVI with a lower probability (0.26; 0.13-0.52). The referral pattern varied across administrative regions, with patients in the capital region less likely to be referred (0.22 (0.08-0.57)). Patients with TAVI were less likely to participate (0.29 (0.12-0.70)). Despite high national programme coverage, only half the patients post heart valve surgery received CR. Both factors identified at provider- and patient-level influenced uptake and included significant regional variation in referral pattern. Further research into the effect and organization of CR post heart valve surgery is needed. © The European Society of Cardiology 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  11. Asymptotic results for fitting marginal hazards models from stratified case-cohort studies with multiple disease outcomes

    PubMed Central

    Kang, Sangwook; Cai, Jianwen

    2010-01-01

    In stratified case-cohort designs, samplings of case-cohort samples are conducted via a stratified random sampling based on covariate information available on the entire cohort members. In this paper, we extended the work of Kang & Cai (2009) to a generalized stratified case-cohort study design for failure time data with multiple disease outcomes. Under this study design, we developed weighted estimating procedures for model parameters in marginal multiplicative intensity models and for the cumulative baseline hazard function. The asymptotic properties of the estimators are studied using martingales, modern empirical process theory, and results for finite population sampling. PMID:22442642

  12. Comprehensive analysis of cardiopulmonary exercise testing and mortality in patients with systolic heart failure: the Henry Ford Hospital cardiopulmonary exercise testing (FIT-CPX) project.

    PubMed

    Brawner, Clinton A; Shafiq, Ali; Aldred, Heather A; Ehrman, Jonathan K; Leifer, Eric S; Selektor, Yelena; Tita, Cristina; Velez, Mauricio; Williams, Celeste T; Schairer, John R; Lanfear, David E; Keteyian, Steven J

    2015-09-01

    Many studies have shown a strong association between numerous variables from a cardiopulmonary exercise (CPX) test and prognosis in patients with heart failure with reduced ejection fraction (HFrEF). However, few studies have compared the prognostic value of a majority of these variables simultaneously, so controversy remains regarding optimal interpretation. This was a retrospective analysis of patients with HFrEF (n = 1,201; age = 55 ± 13 y; 33% female) and a CPX test from 1997 to 2010. Thirty variables from a CPX test were considered in separate adjusted Cox regression analyses to describe the strength of the relation of each to a composite end point of all-cause mortality, left ventricular assist device implantation, or heart transplantation. During a median follow-up of 3.8 years, there were 577 (48.0%) events. The majority of variables were highly significant (P < .001). Among these, percentage of predicted maximum V˙O2 (ppMV˙O2; Wald = 203; P < .001; C-index = 0.73) was similar to VE-VCO2 slope (Wald = 201; P < .001; C = 0.72) and peak V˙O2 (Wald = 161; P < .001; C = 0.72). In addition, there was no significant interaction observed for peak respiratory exchange ratio <1 vs ≥1. Consistent with prior studies, many CPX test variables were strongly associated with prognosis in patients with HFrEF. The choice of which variable to use is up to the clinician. Renewed attention should be given to ppMV˙O2, which appears to be highly predictive of survival in these patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Does manual T-wave window adjustment affect microvolt T-wave alternans results in patients with structural heart disease?

    PubMed

    Ramanan, Tharmathai; Balakumaran, Kathir; Ravichandran, Sairekha; Ganocy, Stephen J; Oshodi, Ganiyu; Costantini, Otto; Dettmer, Mary; Leo, Peter J; Kaufman, Elizabeth S

    Microvolt T-wave alternans (MTWA) analysis can identify patients at low risk of sudden cardiac death who might not benefit from an implantable cardioverter-defibrillator (ICD). Current spectral methodology for performing MTWA analysis may "miss" part of the T-wave in patients with QT prolongation. The value of T-wave window adjustment in patients with structural heart disease has not been studied. We assembled MTWA data from 5 prior prospective studies including 170 patients with reduced left ventricular ejection fraction, adjusted the T-wave window to include the entire T-wave, and reanalyzed MTWA. Of 170 patients, 43% required T-wave window adjustment. Only 3 of 170 patients (1.8%) had a clinically significant change in MTWA results. In 98.2% of patients, T-wave window adjustment did not improve the accuracy of MTWA analysis. Spectral MTWA as currently implemented remains effective for identifying patients with structural heart disease unlikely to benefit from ICD therapy. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Long-term monitoring of sleep apnea at home in heart failure patients: preliminary results from the HHH study.

    PubMed

    Pinna, G D; Maestri, R; Gobbi, E; Capomolla, S; Campana, C; Emdin, M; Di Lenarda, A; La Rovere, M T; Andrews, D; Johnson, P; Mortara, A; Sleight, P

    2004-01-01

    Sleep apnea is very common in patients with chronic heart failure (CHF) and has important implications in terms of morbidity, mortality and clinical management. Home respiratory telemonitoring might constitute a potential low-cost, widely-applicable alternative to traditional polysomnography in the evaluation and long-term monitoring of breathing disorders in these patients. In this paper we briefly describe the technological infrastructure and present preliminary results of the European Community multicountry trial HHH (Home or Hospital in Heart Failure), which is currently testing a novel system for home telemonitoring of cardiorespiratory signals in CHF patients. The recording and transmitting devices are suitable to be self-managed by the patient. We give a detailed report on the prevalence of nocturnal respiratory disorders at the beginning of the one-year follow-up and on their persistency over the following recordings (one per month). These preliminary findings clearly indicate that intermittent home telemonitoring of respiratory signals based on patient's self-management is feasible in CHF patients and the compliance is high. Reported statistics unambiguously confirm the high prevalence of nocturnal breathing disorders in these patients and clearly show that this phenomenon tends to persist over time.

  15. Femoral press-fit fixation in ACL reconstruction using bone-patellar tendon-bone autograft: results at 15 years follow-up

    PubMed Central

    2012-01-01

    Background If anterior cruciate ligament (ACL) reconstruction is to be performed, decision regarding graft choice and its fixation remains one of the most controversial. Multiple techniques for ACL reconstruction are available. To avoid disadvantages related to fixation devices, a hardware-free, press-fit ACL reconstruction technique was developed. The aim of this study was to evaluate clinical outcome and osteoarthritis progression in long term after ACL reconstruction with central third patellar-tendon autograft fixed to femur by press-fit technique. Methods Fifty two patients met inclusion/excusion criteria for this study. The patients were assessed preoperatively and at 15 years after surgery with International Knee Documentation Committee Knee Ligament Evaluation Form, Lysholm knee score, Tegner activity scale and radiographs. Results Good overall clinical outcomes and self-reported assessments were documented, and remained good at 15 years. The mean Lysholm and Tegner scores improved from 59.7 ± 18.5 and 4.2 ± 1.0 preoperatively to 86.4 ± 5.6 (p = 0.004) and 6.9 ± 1.4 (p = 0.005) respectively at follow-up. The IKDC subjective score improved from 60.1 ± 9.2 to 80.2 ± 8.1 (p = 0.003). According to IKDC objective score, 75% of patients had normal or nearly normal knee joints at follow-up. Grade 0 or 1 results were seen in 85% of patients on laxity testing. Degenerative changes were found in 67% of patients. There was no correlation between arthritic changes and stability of knee and subjective evaluation (p > 0.05). Conclusions ACL reconstruction with patellar tendon autograft fixed to femur with press-fit technique allows to achieve good self-reported assessments and clinical ligament evaluation up to 15 years. Advantages of the bone-patellar-tendon-bone (BPTB) press-fit fixation include unlimited bone-to-bone healing, cost effectiveness, avoidance of disadvantages associated with hardware, and ease for

  16. Impact of Plasma Kynurenine Level on Functional Capacity and Outcome in Heart Failure - Results From Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF).

    PubMed

    Konishi, Masaaki; Ebner, Nicole; Springer, Jochen; Schefold, Joerg C; Doehner, Wolfram; Dschietzig, Thomas Bernd; Anker, Stefan D; von Haehling, Stephan

    2016-12-22

    Kynurenine is a circulating metabolite from the essential amino acid tryptophan. Accelerated degradation of kynurenine in skeletal muscle has been reported to provide an anti-inflammatory effect. The aim of this study was to investigate the association between blood kynurenine and muscle mass/function in patients with heart failure (HF), in whom diseased muscle mass/function plays a pathophysiological role.Methods and Results:Plasma kynurenine was assessed in 249 patients with HF (67±11 years, 21% women) and in 45 controls from the SICA-HF study. Kynurenine was higher in 173 HF patients with reduced ejection fraction (EF) and in 76 patients with preserved EF than controls (3.5±1.5, 3.4±1.3, and 2.4±1.1 μmol/L, P<0.001). In HF patients, kynurenine had an inverse association with handgrip strength (r=-0.26, P<0.01), peak oxygen consumption (r=-0.29, P<0.01), 6-min walk distance (r=-0.23, P<0.01), and had a positive association with kidney and liver function parameters. No correlation was observed between kynurenine and lean mass. On multivariable linear regression analysis, a significant association was noted between kynurenine and peak oxygen consumption even after adjustment for age, gender, BMI, and hemoglobin (β=-0.23, P<0.001). Patients with higher kynurenine were at higher risk of death (adjusted HR, 1.46 per 1 μmol/L, P<0.01). In stable HF patients, plasma kynurenine was inversely correlated with muscle strength and functional capacity as well as with liver and kidney function.

  17. Preoperative heart rate and myocardial injury after non-cardiac surgery: results of a predefined secondary analysis of the VISION study

    PubMed Central

    Abbott, T. E. F.; Ackland, G. L.; Archbold, R. A.; Wragg, A.; Kam, E.; Ahmad, T.; Khan, A. W.; Niebrzegowska, E.; Rodseth, R. N.; Devereaux, P. J.; Pearse, R. M.

    2016-01-01

    Background Increased baseline heart rate is associated with cardiovascular risk and all-cause mortality in the general population. We hypothesized that elevated preoperative heart rate increases the risk of myocardial injury after non-cardiac surgery (MINS). Methods We performed a secondary analysis of a prospective international cohort study of patients aged ≥45 yr undergoing non-cardiac surgery. Preoperative heart rate was defined as the last measurement before induction of anaesthesia. The sample was divided into deciles by heart rate. Multivariable logistic regression models were used to determine relationships between preoperative heart rate and MINS (determined by serum troponin concentration), myocardial infarction (MI), and death within 30 days of surgery. Separate models were used to test the relationship between these outcomes and predefined binary heart rate thresholds. Results Patients with missing outcomes or heart rate data were excluded from respective analyses. Of 15 087 patients, 1197 (7.9%) sustained MINS, 454 of 16 007 patients (2.8%) sustained MI, and 315 of 16 037 patients (2.0%) died. The highest heart rate decile (>96 beats min−1) was independently associated with MINS {odds ratio (OR) 1.48 [1.23–1.77]; P<0.01}, MI (OR 1.71 [1.34–2.18]; P<0.01), and mortality (OR 3.16 [2.45–4.07]; P<0.01). The lowest decile (<60 beats min−1) was independently associated with reduced mortality (OR 0.50 [0.29–0.88]; P=0.02), but not MINS or MI. The predefined binary thresholds were also associated with MINS, but more weakly than the highest heart rate decile. Conclusions Preoperative heart rate >96 beats min−1 is associated with MINS, MI, and mortality after non-cardiac surgery. This association persists after accounting for potential confounding factors. Clinical trial registration NCT00512109. PMID:27440628

  18. Evaluation of the geomorphometric results and residual values of a robust plane fitting method applied to different DTMs of various scales and accuracy

    NASA Astrophysics Data System (ADS)

    Koma, Zsófia; Székely, Balázs; Dorninger, Peter; Kovács, Gábor

    2013-04-01

    Due to the need for quantitative analysis of various geomorphological landforms, the importance of fast and effective automatic processing of the different kind of digital terrain models (DTMs) is increasing. The robust plane fitting (segmentation) method, developed at the Institute of Photogrammetry and Remote Sensing at Vienna University of Technology, allows the processing of large 3D point clouds (containing millions of points), performs automatic detection of the planar elements of the surface via parameter estimation, and provides a considerable data reduction for the modeled area. Its geoscientific application allows the modeling of different landforms with the fitted planes as planar facets. In our study we aim to analyze the accuracy of the resulting set of fitted planes in terms of accuracy, model reliability and dependence on the input parameters. To this end we used DTMs of different scales and accuracy: (1) artificially generated 3D point cloud model with different magnitudes of error; (2) LiDAR data with 0.1 m error; (3) SRTM (Shuttle Radar Topography Mission) DTM database with 5 m accuracy; (4) DTM data from HRSC (High Resolution Stereo Camera) of the planet Mars with 10 m error. The analysis of the simulated 3D point cloud with normally distributed errors comprised different kinds of statistical tests (for example Chi-square and Kolmogorov-Smirnov tests) applied on the residual values and evaluation of dependence of the residual values on the input parameters. These tests have been repeated on the real data supplemented with the categorization of the segmentation result depending on the input parameters, model reliability and the geomorphological meaning of the fitted planes. The simulation results show that for the artificially generated data with normally distributed errors the null hypothesis can be accepted based on the residual value distribution being also normal, but in case of the test on the real data the residual value distribution is

  19. Femoral press-fit fixation in ACL reconstruction using bone-patellar tendon-bone autograft: results at 15 years follow-up.

    PubMed

    Widuchowski, Wojciech; Widuchowska, Malgorzata; Koczy, Bogdan; Dragan, Szymon; Czamara, Andrzej; Tomaszewski, Wieslaw; Widuchowski, Jerzy

    2012-06-27

    If anterior cruciate ligament (ACL) reconstruction is to be performed, decision regarding graft choice and its fixation remains one of the most controversial. Multiple techniques for ACL reconstruction are available. To avoid disadvantages related to fixation devices, a hardware-free, press-fit ACL reconstruction technique was developed. The aim of this study was to evaluate clinical outcome and osteoarthritis progression in long term after ACL reconstruction with central third patellar-tendon autograft fixed to femur by press-fit technique. Fifty two patients met inclusion/excusion criteria for this study. The patients were assessed preoperatively and at 15 years after surgery with International Knee Documentation Committee Knee Ligament Evaluation Form, Lysholm knee score, Tegner activity scale and radiographs. Good overall clinical outcomes and self-reported assessments were documented, and remained good at 15 years. The mean Lysholm and Tegner scores improved from 59.7 ± 18.5 and 4.2 ± 1.0 preoperatively to 86.4 ± 5.6 (p = 0.004) and 6.9 ± 1.4 (p = 0.005) respectively at follow-up. The IKDC subjective score improved from 60.1 ± 9.2 to 80.2 ± 8.1 (p = 0.003). According to IKDC objective score, 75% of patients had normal or nearly normal knee joints at follow-up. Grade 0 or 1 results were seen in 85% of patients on laxity testing. Degenerative changes were found in 67% of patients. There was no correlation between arthritic changes and stability of knee and subjective evaluation (p > 0.05). ACL reconstruction with patellar tendon autograft fixed to femur with press-fit technique allows to achieve good self-reported assessments and clinical ligament evaluation up to 15 years. Advantages of the bone-patellar-tendon-bone (BPTB) press-fit fixation include unlimited bone-to-bone healing, cost effectiveness, avoidance of disadvantages associated with hardware, and ease for revision surgery. BPTB femoral press-fit fixation technique can be safely applied in

  20. Conservative treatment of idiopathic scoliosis according to FITS concept: presentation of the method and preliminary, short term radiological and clinical results based on SOSORT and SRS criteria

    PubMed Central

    2011-01-01

    Background Conservative scoliosis therapy according to the FITS Concept is applied as a unique treatment or in combination with corrective bracing. The aim of the study was to present author's method of diagnosis and therapy for idiopathic scoliosis FITS-Functional Individual Therapy of Scoliosis and to analyze the early results of FITS therapy in a series of consecutive patients. Methods The analysis comprised separately: (1) single structural thoracic, thoracolumbar or lumbar curves and (2) double structural scoliosis-thoracic and thoracolumbar or lumbar curves. The Cobb angle and Risser sign were analyzed at the initial stage and at the 2.8-year follow-up. The percentage of patients improved (defined as decrease of Cobb angle of more than 5 degrees), stable (+/- 5 degrees), and progressed (increase of Cobb angle of more than 5 degrees) was calculated. The clinical assessment comprised: the Angle of Trunk Rotation (ATR) initial and follow-up value, the plumb line imbalance, the scapulae level and the distance from the apical spinous process of the primary curve to the plumb line. Results In the Group A: (1) in single structural scoliosis 50,0% of patients improved, 46,2% were stable and 3,8% progressed, while (2) in double scoliosis 50,0% of patients improved, 30,8% were stable and 19,2% progressed. In the Group B: (1) in single scoliosis 20,0% of patients improved, 80,0% were stable, no patient progressed, while (2) in double scoliosis 28,1% of patients improved, 46,9% were stable and 25,0% progressed. Conclusion Best results were obtained in 10-25 degrees scoliosis which is a good indication to start therapy before more structural changes within the spine establish. PMID:22122964

  1. Inflammation markers and Major Depressive Disorder in Patients with Chronic Heart Failure: Results from the Sertraline Against Depression and Heart Disease in Chronic Heart Failure (SADHART-CHF) study

    PubMed Central

    Xiong, Glen L.; Prybol, Kevin; Boyle, Stephen H.; Hall, Russell; Streilein, Robert D; Steffens, David C.; Krishnan, Ranga; Rogers, Joseph G.; O’Connor, Christopher M.; Jiang, Wei

    2015-01-01

    Background Major Depressive Disorder (MDD) and Chronic Heart Failure (CHF) have in common heightening states of inflammation, manifested by elevated inflammation markers such as C-reactive protein (CRP). This study compared inflammatory biomarker profiles in CHF patients with MDD to those without MDD. Methods The study recruited patients admitted to inpatient care for acute heart failure exacerbations, after psychiatric diagnostic interview. Patients with Beck Depression Inventory (BDI) scores < 10 and with no prior history of depression served as the non-depressed reference group (n = 25). MDD severity was defined as: Mild (BDI 10–15; n = 48); Moderate (BDI 16–23; n = 51); and Severe (BDI ≥ 24; n = 33). A Bio-Plex assay measured 18 inflammation markers. Ordinal logistic models were used to examine the association of MDD severity and biomarker levels. Results Adjusting for age, sex, statin use, BMI, LVEF, tobacco use, and NHYA class the MDD overall group variable was significantly associated with elevated interleukin (IL) −2 (p = .019), IL-4 (p = .020), IL-6 (p = .026),, interferon (INF)-γ (p = .010), monocyte chemoattractant protein (MCP-1) (p = .002), macrophage inflammatory protein (MIP-1β) (p = .003) and tumor necrosis factor (TNF)-α (p = .004). MDD severity subgroups had a greater probability of elevated IL-6, IL-8, IFN-γ, MCP-1, MIP-1β, and TNF-α compared to none-depressed group. The non-depressed group had greater probability of elevated IL-17 (p < 0.001) and IL-1β (p < 0.01). Conclusions MDD in CHF patients was associated with altered inflammation marker levels compared to CHF patients who had no depression. Whether effective depression treatment will normalize the altered inflammation marker levels requires further study. PMID:26186432

  2. Making sense of health care delivery Where does the close to community health care worker fit in? - The case for congestive heart failure.

    PubMed

    Iyngkaran, P; Biddargardi, N; Bastiampillai, T; Beneby, G

    2015-01-01

    Close to community health care workers (CTC-HCW) is an increasingly used term to describe the emergence of a new partner in health services delivery. In strengthening arguments for this part of the health workforce the authorities, health staffers, supporters, sceptics and perhaps clients will look to the academicians and the evidence base to determine the fate of this group. There is no doubt, CTC-HCW are a vital resource, whose importance is tied to socio-demo-geographic variables. Regardless of what the common perceptions of its importance are, the evolving evidence base could suggest either way. In this short commentary we would like to highlight the importance of a balanced and common sense approach in these arguments. An important example is heart failure where the majority have an associated comorbidity and one in four would also suffer with cognitive or mood disturbances. It is unclear how the CTC-HCW would fare for this devastating syndrome. In moving forward it is important we understand there are: strengths and limitations in the evidence gathering processes; indecision as to the questions; uncertainty of the starting points to gather evidence; and sociodemogeographic biases, which have to be factored before determining the fate of this much needed health care resource.

  3. Making sense of health care delivery Where does the close to community health care worker fit in? – The case for congestive heart failure

    PubMed Central

    Iyngkaran, P.; Biddargardi, N.; Bastiampillai, T.; Beneby, G.

    2015-01-01

    Close to community health care workers (CTC-HCW) is an increasingly used term to describe the emergence of a new partner in health services delivery. In strengthening arguments for this part of the health workforce the authorities, health staffers, supporters, sceptics and perhaps clients will look to the academicians and the evidence base to determine the fate of this group. There is no doubt, CTC-HCW are a vital resource, whose importance is tied to socio-demo-geographic variables. Regardless of what the common perceptions of its importance are, the evolving evidence base could suggest either way. In this short commentary we would like to highlight the importance of a balanced and common sense approach in these arguments. An important example is heart failure where the majority have an associated comorbidity and one in four would also suffer with cognitive or mood disturbances. It is unclear how the CTC-HCW would fare for this devastating syndrome. In moving forward it is important we understand there are: strengths and limitations in the evidence gathering processes; indecision as to the questions; uncertainty of the starting points to gather evidence; and sociodemogeographic biases, which have to be factored before determining the fate of this much needed health care resource. PMID:26138183

  4. Design Concepts and Preclinical Results of a Miniaturized HeartWare Platform

    PubMed Central

    Cheung, Anson; Chorpenning, Katherine; Tamez, Daniel; Shambaugh, Charles; Dierlam, Anne E.; Taskin, M. Ertan; Ashenuga, Michael; Reyes, Carlos; LaRose, Jeffrey A.

    2015-01-01

    Objective Ventricular assist device (VAD) miniaturization is one design trend that may result in less-invasive implantation techniques and more versatility with patient selection. The MVAD System is a miniature, continuous-flow device implanted in the ventricle. The pump is capable of delivering between 0 and 7 L/min of flow at a mean arterial pressure of 75 mm Hg. The impeller was optimized from its original design to improve hydraulic performance, minimize shear regions, and enhance the impeller’s radial stiffness. These studies evaluated the MVAD System with modified impeller in the preclinical setting. Methods This modified pump design was tested through chronic studies (n = 6) in a healthy ovine model where 4 animals were implanted for a duration of 30 ± 5 days and 2 animals were implanted for a duration of 90 ± 5 days. The pump was placed in the left ventricular apex with the outflow graft anastomosed to the descending aorta. Postoperatively, no anticoagulant or antiplatelet therapies were administered throughout the study duration. Results All 6 animals reached their elective date of kill, demonstrating no evidence of organ compromise or device-related complications. Average pump parameters did not deviate significantly, and average rotational speed, pump flow, and power consumption were 14095 ± 139 RPM, 4.1 ± 0.4 L/min, and 4.3 ± 0.1 W, respectively. Examination of pump components postexplant demonstrated no mechanical wear or thrombus formation. Conclusions Hemocompatibility and biocompatibility of the modified MVAD System were demonstrated through pump parameters, blood chemistry panels, and histopathology analysis. PMID:26098174

  5. Clinical Results of Real-Time Ultrasonic Scanning of the Heart Using a Phased Array System 12

    PubMed Central

    Kisslo, Joseph A.; Vonramm, Olaf T.; Thurstone, Frederick L.

    1977-01-01

    This report describes the operating characteristics and initial clinical results of a new echocardiographic system that produces real-time, high resolution, cross-sectional images of the heart. This system relies upon phased-array principles to rapidly steer and focus the ultrasound beam through the cardiac structures under investigation. A hand-held, linear array of 24 transducers is manipulated on the patient's chest to direct the interrogating plane at various cardiac structures. Images of high line density are presented in selectable sector arcs to a maximum of 90 degrees. This imaging system has been used clinically in over 2,000 patients in the past two and one-half years. Its use in the detection of altered states of ventricular and valvular pathology has been described. ImagesFIG. 5FIG. 6FIG. 7FIG. 8FIG. 9FIG. 10FIG. 11 PMID:906555

  6. Fitness reduction and potential extinction of wild populations of Atlantic salmon, Salmo salar, as a result of interactions with escaped farm salmon.

    PubMed Central

    McGinnity, Philip; Prodöhl, Paulo; Ferguson, Andy; Hynes, Rosaleen; Maoiléidigh, Niall O; Baker, Natalie; Cotter, Deirdre; O'Hea, Brendan; Cooke, Declan; Rogan, Ger; Taggart, John; Cross, Tom

    2003-01-01

    The high level of escapes from Atlantic salmon farms, up to two million fishes per year in the North Atlantic, has raised concern about the potential impact on wild populations. We report on a two-generation experiment examining the estimated lifetime successes, relative to wild natives, of farm, F(1) and F(2) hybrids and BC(1) backcrosses to wild and farm salmon. Offspring of farm and "hybrids" (i.e. all F(1), F(2) and BC(1) groups) showed reduced survival compared with wild salmon but grew faster as juveniles and displaced wild parr, which as a group were significantly smaller. Where suitable habitat for these emigrant parr is absent, this competition would result in reduced wild smolt production. In the experimental conditions, where emigrants survived downstream, the relative estimated lifetime success ranged from 2% (farm) to 89% (BC(1) wild) of that of wild salmon, indicating additive genetic variation for survival. Wild salmon primarily returned to fresh water after one sea winter (1SW) but farm and 'hybrids' produced proportionately more 2SW salmon. However, lower overall survival means that this would result in reduced recruitment despite increased 2SW fecundity. We thus demonstrate that interaction of farm with wild salmon results in lowered fitness, with repeated escapes causing cumulative fitness depression and potentially an extinction vortex in vulnerable populations. PMID:14667333

  7. Hemoglobin test result variability and cost analysis of eight different analyzers during open heart surgery.

    PubMed

    Patel, Kirti P; Hay, Gary W; Cheteri, Mahesh Keitheri; Holt, David W

    2007-03-01

    The purpose of this study was to compare the variation in hemoglobin (Hgb) values among various point-of-care (POC) analyzers available on the market. Eight analyzers (Gem 3000, ABL 720, ABL 77, Rapidpoint 405, IL 682, GemOPL, Hb 201+, and manual/centrifugation) were compared with the Hgb values from the Beckman Coulter LH750. A total of 72 patient samples were analyzed on each test instrument. The samples were obtained after intubation, after heparinization, during cardiopulmonary bypass, and after protamine administration. Four of the samples were excluded from the study because of delayed sample analysis. The calculated mean differences of reference test method Hgb (mean +/- SD) for all samples (n = 68) were Gem 3000 = 1.431 +/- 0.396 g/dL; ABL 720 = -0.224 +/- 0.240 g/dL; ABL 77 = 0.341 +/- 0.578 g/dL; Rapidpoint 405 = 0.001 +/- 0.205 g/dL; IL 682 = -0.137 +/- 0.232 g/dL; GemOPL = 0.774 +/- 0.427 g/dL; Hb 201+ = 0.110 +/- 0.524 g/dL; and manual/ centrifugation = 0.547 +/- 0.499 g/dL. Cumulative results indicated that the bias in Hgb values from the Gem 3000, ABL720, ABL 77, IL 682, GemOPL, and the manual method were statistically significant (p < .05), compared with the Coulter LH750. Additionally, only the Rapidpoint 405 and Hb 201+ most closely matched the values from the Coulter LH750 (p > .05). Some of the methodologies have previously been shown to be affected during hemodilution, hypoproteinemia, and/or after blood transfusion. There is variability among methodologies, which can give rise to statistically different Hgb values, and one should consider the "ideal" instrument based on this and many other factors. Based on our results, the rank order of closest approximation to the Coulter LH750 measurement was Rapidpoint 405, Hb 201+, IL 682, ABL 720, ABL 77, manual/centrifugation, GemOPL, and Gem 3000.

  8. Healthy Dietary Interventions and Lipoprotein (a) Plasma Levels: Results from the Omni Heart Trial

    PubMed Central

    Haring, Bernhard; Wyler von Ballmoos, Moritz C.; Appel, Lawrence J.; Sacks, Frank M.

    2014-01-01

    Background Increased lipoprotein(a) [Lp(a)] levels are associated with atherosclerotic cardiovascular disease. Studies of dietary interventions on changes in Lp(a) are sparse. We aimed to compare the effects of three healthy dietary interventions differing in macronutrient content on Lp(a) concentration. Methods Secondary analysis of a randomized, 3-period crossover feeding study including 155 (89 blacks; 66 whites) individuals. Participants were given DASH-type healthy diets rich in carbohydrates [Carb], in protein [Prot] or in unsaturated fat [Unsat Fat] for 6 weeks each. Plasma Lp(a) concentration was assessed at baseline and after each diet. Results Compared to baseline, all interventional diets increased mean Lp(a) by 2 to 5 mg/dl. Unsat Fat increased Lp(a) less than Prot with a difference of 1.0 mg/dl (95% CI, −0.5, 2.5; p = 0.196) in whites and 3.7 mg/dl (95% CI, 2.4, 5.0; p<0.001) in blacks (p-value between races = 0.008); Unsat Fat increased Lp(a) less than Carb with a difference of −0.6 mg/dl, 95% CI, −2.1, 0.9; p = 0.441) in whites and −1.5 mg/dl (95% CI, −0.2, −2.8; p = 0.021) in blacks (p-value between races = 0.354). Prot increased Lp(a) more than Carb with a difference of 0.4 mg/dl (95% CI, −1.1, 1.9; p = 0.597) in whites and 2.2 mg/dl (95%CI, 0.9, 3.5; p = 0.001) in blacks (p-value between races = 0.082). Conclusion Diets high in unsaturated fat increased Lp(a) levels less than diets rich in carbohydrate or protein with greater changes in blacks than whites. Our results suggest that substitutions with dietary mono- and polyunsaturated fatty acids in healthy diets may be preferable over protein or carbohydrates with regards to Lp(a). Trial Registration Clinicaltrials.gov NCT00051350 PMID:25506933

  9. PTSD and Obesity in Younger and Older Veterans: Results from the Mind Your Heart Study

    PubMed Central

    Smith, Brian N.; Tyzik, Anna L.; Neylan, Thomas C.; Cohen, Beth E.

    2015-01-01

    Posttraumatic stress disorder (PTSD) is increasingly recognized as a relatively common condition that is associated with poor health, including obesity. With a sizable proportion of the population approaching older adulthood, it is important to understand PTSD health associations in the context of age. Participants were recruited from two Veterans Administration medical centers and included 380 patients age 60 and over and 365 under age 60. PTSD diagnosis was determined by the Clinician Administered PTSD Scale. BMI was trichotomized into normal/under (≤.24.9), overweight (25.0–29.9), and obese (≥30.0). Models were run in the total sample, as well as stratified by age group, and adjusted for demographics, depression, antipsychotic medication use, and physical activity. Current PTSD was associated with greater likelihood of overweight and obesity in the total sample, and lifetime PTSD was associated with significantly increased odds of obesity. In the stratified models, current and lifetime PTSD were associated with increased likelihood of overweight and obesity in the older group only. Results suggest that PTSD is associated with risk for overweight and obesity, an effect that may be particularly strong in older adults. These findings support the importance of examining PTSD and potential health correlates across the life course. PMID:26210650

  10. Decline in ventricular function as a result of general anesthesia in pediatric heart transplant recipients.

    PubMed

    Elhoff, Justin J; Chowdhury, Shahryar M; Taylor, Carolyn L; Hassid, Marc; Savage, Andrew J; Atz, Andrew M; Butts, Ryan J

    2016-12-01

    Echocardiography is frequently performed under anesthesia during procedures such as cardiac catheterization with EMB in pediatric HTx recipients. Anesthetic agents may depress ventricular function, resulting in concern for rejection. The aim of this study was to compare ventricular function as measured by echocardiography before and during GA in 17 pediatric HTx recipients. Nearly all markers of ventricular systolic function were significantly decreased under GA, including EF (-4.2% ±1.2, P < .01) and RV FAC (-0.05 ± 0.02, P = .04). Subjects in the first post-transplant year (n = 9) trended toward a more significant decrease in EF vs those beyond the first post-transplant year (n = 8; -6.0% ±1.2 vs -2.1 ± 2.0, P = .1). This information quantifies a decline in biventricular function that should be expected in pediatric HTx recipients while under GA and can assist the transplant clinician in avoiding unnecessary treatment of transient GA-induced ventricular dysfunction. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. PTSD and obesity in younger and older veterans: Results from the mind your heart study.

    PubMed

    Smith, Brian N; Tyzik, Anna L; Neylan, Thomas C; Cohen, Beth E

    2015-10-30

    Posttraumatic stress disorder (PTSD) is increasingly recognized as a relatively common condition that is associated with poor health, including obesity. With a sizable proportion of the population approaching older adulthood, it is important to understand PTSD-health associations in the context of age. Participants were recruited from two Veterans Administration medical centers and included 380 patients age 60 and over and 365 under age 60. PTSD diagnosis was determined by the Clinician Administered PTSD Scale. BMI was trichotomized into normal/under (≤24.9), overweight (25.0-29.9), and obese (≥30.0). Models were run in the total sample, as well as stratified by age group, and adjusted for demographics, depression, antipsychotic medication use, and physical activity. Current PTSD was associated with greater likelihood of overweight and obesity in the total sample, and lifetime PTSD was associated with significantly increased odds of obesity. In the stratified models, current and lifetime PTSD were associated with increased likelihood of overweight and obesity in the older group only. Results suggest that PTSD is associated with risk for overweight and obesity, an effect that may be particularly strong in older adults. These findings support the importance of examining PTSD and potential health correlates across the life course. Published by Elsevier Ireland Ltd.

  12. Is There a Relationship between Body Mass Index, Fitness, and Academic Performance? Mixed Results from Students in a Southeastern United States Elementary School

    ERIC Educational Resources Information Center

    Wingfield, Robert Joshua; Graziano, Paulo A.; McNamara, Joseph P. H., Janicke, David M.

    2011-01-01

    The purpose of this study was to investigate relationships between body mass index (BMI), physical fitness, and academic performance in elementary school students. Specifically, BMI and scores on the President's Challenge Physical Activity and Fitness Awards Program, a physical fitness test, were compared to reading and mathematics scores on the…

  13. Is There a Relationship between Body Mass Index, Fitness, and Academic Performance? Mixed Results from Students in a Southeastern United States Elementary School

    ERIC Educational Resources Information Center

    Wingfield, Robert Joshua; Graziano, Paulo A.; McNamara, Joseph P. H., Janicke, David M.

    2011-01-01

    The purpose of this study was to investigate relationships between body mass index (BMI), physical fitness, and academic performance in elementary school students. Specifically, BMI and scores on the President's Challenge Physical Activity and Fitness Awards Program, a physical fitness test, were compared to reading and mathematics scores on the…

  14. The Army's High Priority Physical Fitness Program.

    ERIC Educational Resources Information Center

    Drews, Fred R.

    1984-01-01

    This article explores the importance of physical fitness in the United States Army. The development of expanded fitness assessment and programs is related to health and the prevention of coronary heart disease. Improved physical training programs, improved nutrition, and fundamental research are necessary for maintaining a highly fit and healthy…

  15. The Army's High Priority Physical Fitness Program.

    ERIC Educational Resources Information Center

    Drews, Fred R.

    1984-01-01

    This article explores the importance of physical fitness in the United States Army. The development of expanded fitness assessment and programs is related to health and the prevention of coronary heart disease. Improved physical training programs, improved nutrition, and fundamental research are necessary for maintaining a highly fit and healthy…

  16. Suppression of T cells results in long-term survival of mouse heart xenografts in C6-deficient rats.

    PubMed

    Wu, G; Korsgren, O; van Rooijen, N; Tibell, A

    2001-11-01

    The present study aimed to investigate the role of cellular immune response in the absence of membrane attack complex (MAC) formation in the concordant mouse-to-rat heart xenografting. Hearts from BALB/c mice were transplanted into the neck vessels of C6-competent (C6(+)) and C6-deficient (C6(-)) PVG rats. Liposome-encapsulated dichloro-methylene diphosphonate (Lip-Cl2MDP) was administered at a dose of 10 ml/kg 2 days before transplantation and every 5 days thereafter. Cyclosporine (CsA) was administered intramuscularly (i.m.) at a dose of 15 mg/kg per day. The heart xenografts were harvested for immuno-histological analysis at the time of rejection and the functioning grafts were removed at 70 days after transplantation. In untreated C6(+) rats, xeno-grafts survived for 2.3 +/- 0.5 days. Treatment with CsA or Lip-Cl(2)MDP in C6(+) rats did not significantly affect graft survival (2.5 +/- 0.6 and 2.3 +/- 0.4 days, respectively). In untreated C6(-) rats, xenografts survived for 5.0 +/- 0.6 days. However, Lip-Cl(2)MDP in C6(-) rats resulted in a prolongation of graft survival to 11 +/- 2.3 days (P < 0.05 vs. untreated C6(-) rats), while treatment with CsA alone in these rats led to more than 70 days' survival in four out of six grafts (61 +/- 16 days). In untreated C6(+) rats, immunohistology showed a severe myocardial necrosis and thrombosis with a scarce cellular infiltrate in the rejected xenografts. By contrast, in untreated C6(-) rats, xenografts were heavily infiltrated by macrophages and T cells. The number of macrophages, but not T cells, was markedly reduced in Lip-Cl(2)MDP-treated rats. In CsA-treated C6(-) rats, the grafts harvested at 70 days after transplantation had a normal morphology, with a minimal cellular infiltrate. Our data indicate that MAC-mediated injury plays an essential role in concordant xenograft rejection. Once this mechanism has been prevented, suppression of T cells allows for long-term xenograft survival.

  17. Prognostic value of cardiopulmonary exercise testing in heart failure with preserved ejection fraction. The Henry Ford HospITal CardioPulmonary EXercise Testing (FIT-CPX) project.

    PubMed

    Shafiq, Ali; Brawner, Clinton A; Aldred, Heather A; Lewis, Barry; Williams, Celeste T; Tita, Christina; Schairer, John R; Ehrman, Jonathan K; Velez, Mauricio; Selektor, Yelena; Lanfear, David E; Keteyian, Steven J

    2016-04-01

    Although cardiopulmonary exercise (CPX) testing in patients with heart failure and reduced ejection fraction is well established, there are limited data on the value of CPX variables in patients with HF and preserved ejection fraction (HFpEF). We sought to determine the prognostic value of select CPX measures in patients with HFpEF. This was a retrospective analysis of patients with HFpEF (ejection fraction ≥ 50%) who performed a CPX test between 1997 and 2010. Selected CPX variables included peak oxygen uptake (VO2), percent predicted maximum oxygen uptake (ppMVO2), minute ventilation to carbon dioxide production slope (VE/VCO2 slope) and exercise oscillatory ventilation (EOV). Separate Cox regression analyses were performed to assess the relationship between each CPX variable and a composite outcome of all-cause mortality or cardiac transplant. We identified 173 HFpEF patients (45% women, 58% non-white, age 54 ± 14 years) with complete CPX data. During a median follow-up of 5.2 years, there were 42 deaths and 5 cardiac transplants. The 1-, 3-, and 5-year cumulative event-free survival was 96%, 90%, and 82%, respectively. Based on the Wald statistic from the Cox regression analyses adjusted for age, sex, and β-blockade therapy, ppMVO2 was the strongest predictor of the end point (Wald χ(2) = 15.0, hazard ratio per 10%, P < .001), followed by peak VO2 (Wald χ(2) = 11.8, P = .001). VE/VCO2 slope (Wald χ(2)= 0.4, P = .54) and EOV (Wald χ(2) = 0.15, P = .70) had no significant association to the composite outcome. These data support the prognostic utility of peak VO2 and ppMVO2 in patients with HFpEF. Additional studies are needed to define optimal cut points to identify low- and high-risk patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Sports Fitness

    MedlinePlus

    ... pole vaulting as for swimming. You might, however, cross train. Cross training simply means that you include a variety ... fitness activities in your program. Research shows that cross training builds stronger bones. Remember to listen to ...

  19. Effects of selective heart rate reduction with ivabradine on left ventricular remodelling and function: results from the SHIFT echocardiography substudy

    PubMed Central

    Tardif, Jean-Claude; O'Meara, Eileen; Komajda, Michel; Böhm, Michael; Borer, Jeffrey S.; Ford, Ian; Tavazzi, Luigi; Swedberg, Karl

    2011-01-01

    Aims The SHIFT echocardiographic substudy evaluated the effects of ivabradine on left ventricular (LV) remodelling in heart failure (HF). Methods and results Eligible patients had chronic HF and systolic dysfunction [LV ejection fraction (LVEF) ≤35%], were in sinus rhythm, and had resting heart rate ≥70 bpm. Patients were randomly allocated to ivabradine or placebo, superimposed on background therapy for HF. Complete echocardiographic data at baseline and 8 months were available for 411 patients (ivabradine 208, placebo 203). Treatment with ivabradine reduced LVESVI (primary substudy endpoint) vs. placebo [−7.0 ± 16.3 vs. −0.9 ± 17.1 mL/m2; difference (SE), −5.8 (1.6), 95% CI −8.8 to −2.7, P< 0.001]. The reduction in LVESVI was independent of beta-blocker use, HF aetiology, and baseline LVEF. Ivabradine also improved LV end-diastolic volume index (−7.9 ± 18.9 vs. −1.8 ± 19.0 mL/m2, P= 0.002) and LVEF (+2.4 ± 7.7 vs. −0.1 ± 8.0%, P< 0.001). The incidence of the SHIFT primary composite outcome (cardiovascular mortality or hospitalization for worsening HF) was higher in patients with LVESVI above the median (59 mL/m2) at baseline (HR 1.62, 95% CI 1.03–2.56, P= 0.04). Patients with the largest relative reductions in LVESVI had the lowest event rates. Conclusion Ivabradine reverses cardiac remodelling in patients with HF and LV systolic dysfunction. PMID:21875858

  20. Maternal Antihypertensive Medication Use and Congenital Heart Defects: Updated Results From the National Birth Defects Prevention Study.

    PubMed

    Fisher, Sarah C; Van Zutphen, Alissa R; Werler, Martha M; Lin, Angela E; Romitti, Paul A; Druschel, Charlotte M; Browne, Marilyn L

    2017-05-01

    Previous NBDPS (National Birth Defects Prevention Study) findings from 1997 to 2003 suggested that maternal antihypertensive use was associated with congenital heart defects (CHDs). We re-examined associations between specific antihypertensive medication classes and specific CHDs with additional NBDPS data from 2004 to 2011. After excluding mothers missing hypertension information or who reported pregestational diabetes mellitus, a multiple birth, or antihypertensive use but no hypertension, we compared self-reported maternal exposure data on 10 625 CHD cases and 11 137 nonmalformed controls. We calculated adjusted odds ratios [95% confidence intervals] to estimate the risk of specific CHDs associated with antihypertensive use during the month before conception through the third month of pregnancy, controlling for maternal age, race/ethnicity, body mass index, first trimester cigarette smoking, and NBDPS site. Overall, 164 (1.5%) case mothers and 102 (0.9%) control mothers reported early pregnancy antihypertensive use for their hypertension. We observed increased risk of 4 CHD phenotypes, regardless of antihypertensive medication class reported: coarctation of the aorta (2.50 [1.52-4.11]), pulmonary valve stenosis (2.19 [1.44-3.34]), perimembranous ventricular septal defect (1.90 [1.09-3.31]), and secundum atrial septal defect (1.94 [1.36-2.79]). The associations for these phenotypes were statistically significant for mothers who reported β-blocker use or renin-angiotensin system blocker use; estimates for other antihypertensive medication classes were generally based on fewer exposed cases and were less stable but remained elevated. Our results support and expand on earlier NBDPS findings that antihypertensive medication use may be associated with increased risk of specific CHDs, although we cannot completely rule out confounding by underlying disease characteristics. © 2017 American Heart Association, Inc.

  1. Loss of Rearranged L-Myc Fusion (RLF) results in defects in heart development in the mouse.

    PubMed

    Bourke, L M; Del Monte-Nieto, G; Outhwaite, J E; Bharti, V; Pollock, P M; Simmons, D G; Adam, A; Hur, S S J; Maghzal, G J; Whitelaw, E; Stocker, R; Suter, C M; Harvey, R P; Harten, S K

    Recently we reported that Rearranged L-Myc Fusion, RLF, acts as an epigenetic modifier maintaining low levels of DNA methylation at CpG island shores and enhancers across the genome. Here we focus on the phenotype of Rlf null mutant mice generated via an ENU mutagenesis screen, to identify genes required for epigenetic regulation. RLF is expressed in a range of fetal mouse tissues, including the fetal heart. Comprehensive timed-mating studies are consistent with our previously reported findings that Rlf homozygous mutant mice rarely survive to adulthood, with the majority dying shortly after birth. Histological analysis of two independent Rlf ENU mutant lines at E11.5-E14.5 showed heart defects resembling those present in humans with Left Ventricular Non-Compaction (LVNC). In situ hybridisation analysis localized expression of Rlf to the endocardium and epicardium of embryonic and postnatal hearts, and transiently to cardiomyocytes during heart looping and early chamber formation stages. RNA-seq analysis of Rlf mutant hearts highlighted defective NOTCH pathway signalling, recently describe as one cause of LVNC. This study provides the first evidence that RLF is required for normal heart development in the mouse. The heart morphological defects present at high penetrance in Rlf mutants are consistent with features of LVNC in humans, and molecular analysis identified attenuated JAGGED 1 expression and NOTCH signalling as likely contributors to these defects. Our study highlights the importance of RLF-dependent epigenetic modifications to DNA for maintaining correct gene regulatory network and intercellular signalling interactions during heart chamber and septal development. Further investigations are needed to define the biochemical role of RLF in the developing heart, and whether RLF mutations are a cause of heart defects in humans. Copyright © 2016 International Society of Differentiation. Published by Elsevier B.V. All rights reserved.

  2. Occupational physical activity and 20-year incidence of acute myocardial infarction: results from the Kuopio Ischemic Heart Disease Risk Factor Study.

    PubMed

    Krause, Niklas; Brand, Richard J; Arah, Onyebuchi A; Kauhanen, Jussi

    2015-03-01

    This study aimed to assess the effects of physically demanding work - measured as energy expenditure (EE) during occupational physical activities (OPA) - on risk of acute myocardial infarction (AMI) among men with and without preexisting ischemic heart disease (IHD). The 20-year prospective study examined 1891 middle-aged working men using absolute (kcal/day) and relative (relative aerobic strain and percent oxygen uptake reserve) measures of EE. Linear and quadratic hazard models were explored in Cox regression analyses adjusting for 19 potential confounders and considering interactions with baseline IHD. Relative EE measures were positively associated with 20-year incidence of AMI in linear and quadratic hazard models and interacted with IHD. Each 10% increase of relative aerobic strain increased AMI risk by 18% among men without IHD [hazard ratio (HR) 1.18, 95% confidence interval (95% CI) 1.08-1.28, P=0.001] and by 8% among men with IHD (HR 1.08, 95% CI 0.98-1.20, P=0.129) in fully adjusted linear models. Results for quadratic models and percent oxygen uptake reserve were similar. Absolute EE did not predict AMI. Age, baseline IHD, systolic blood pressure, anti-hypertensive medication, body mass index, blood glucose, low-density lipoprotein cholesterol, cholesterol-lowering medication, mental stress, and smoking were independently associated with AMI, but not income, social support, alcohol, or conditioning leisure-time physical activity. In contrast to absolute EE, relative workload measures that take individual fitness into account were positively associated with AMI incidence among men without IHD. For men with IHD, associations were also positive but weaker possibly due to healthy worker selection effects. These findings provide evidence for a positive association between OPA and AMI among men.

  3. Heart Health - Brave Heart

    MedlinePlus

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Brave Heart Past Issues / Winter 2009 Table of Contents For ... you can have a good life after a heart attack." Lifestyle Changes Surviving—and thriving—after such ...

  4. Cardiac looping may be driven by compressive loads resulting from unequal growth of the heart and pericardial cavity. Observations on a physical simulation model

    PubMed Central

    Bayraktar, Meriç; Männer, Jörg

    2014-01-01

    The transformation of the straight embryonic heart tube into a helically wound loop is named cardiac looping. Such looping is regarded as an essential process in cardiac morphogenesis since it brings the building blocks of the developing heart into an approximation of their definitive topographical relationships. During the past two decades, a large number of genes have been identified which play important roles in cardiac looping. However, how genetic information is physically translated into the dynamic form changes of the looping heart is still poorly understood. The oldest hypothesis of cardiac looping mechanics attributes the form changes of the heart loop (ventral bending → simple helical coiling → complex helical coiling) to compressive loads resulting from growth differences between the heart and the pericardial cavity. In the present study, we have tested the physical plausibility of this hypothesis, which we call the growth-induced buckling hypothesis, for the first time. Using a physical simulation model, we show that growth-induced buckling of a straight elastic rod within the confined space of a hemispherical cavity can generate the same sequence of form changes as observed in the looping embryonic heart. Our simulation experiments have furthermore shown that, under bilaterally symmetric conditions, growth-induced buckling generates left- and right-handed helices (D-/L-loops) in a 1:1 ratio, while even subtle left- or rightward displacements of the caudal end of the elastic rod at the pre-buckling state are sufficient to direct the buckling process toward the generation of only D- or L-loops, respectively. Our data are discussed with respect to observations made in biological “models.” We conclude that compressive loads resulting from unequal growth of the heart and pericardial cavity play important roles in cardiac looping. Asymmetric positioning of the venous heart pole may direct these forces toward a biased generation of D- or L-loops. PMID

  5. Reduction in driveline infection rates: Results from the HeartMate II Multicenter Driveline Silicone Skin Interface (SSI) Registry.

    PubMed

    Dean, David; Kallel, Faouzi; Ewald, Gregory A; Tatooles, Antony; Sheridan, Brett C; Brewer, Robert J; Caldeira, Christian; Farrar, David J; Akhter, Shahab A

    2015-06-01

    During left ventricular assist device implantation, a surgical tunneling technique to keep the entire driveline (DL) velour portion in the subcutaneous tunnel, resulting in a silicone-skin interface (SSI) at the exit site, has been adopted by many centers. To assess long-term freedom from DL infection associated with this technique, a multicenter SSI registry was initiated. It was hypothesized that the modified tunneling technique is associated with at least 50% reduction in DL infection at 1 year post-implant compared with the velour-to-skin method used in the HeartMate II (HMII) Destination Therapy (DT) trial. SSI is a retrospective and prospective registry of patients who have received the HMII device. Results are reported from the retrospective cohort, which consists of 200 patients who were implanted during the period 2009-2012 with the SSI tunneling method and on HMII support for at least 10 months at the time of enrollment. The prevalence and incidence of DL infection after left ventricular assist device implantation in the SSI retrospective cohort were determined and compared with a control group of 201 patients also on HMII support for at least 10 months from the HMII DT clinical trial who were implanted during the period 2007-2009 using the traditional method in which a small section of the velour portion of the DL was externalized. The 1-year and 2-year prevalence rates of DL infection were 9% and 19% in the SSI patient group compared with 23% and 35% in the control group (hazard ratio 0.49, 95% confidence interval 0.33-0.73, p < 0.001). The event-per-patient year was 0.11 and 0.22 for the SSI and control groups, respectively (p < 0.001). Based on a multivariate analysis, age and DL exit side were the only independent variables associated with DL infection. Effects of management changes over the eras were not studied and could have contributed to the findings. These results suggest that leaving the entire DL velour portion below the skin is associated

  6. Is diabetes mellitus a heart disease equivalent in women? Results from an international study of postmenopausal women in the Raloxifene Use for the Heart (RUTH) Trial.

    PubMed

    Daniels, Lori B; Grady, Deborah; Mosca, Lori; Collins, Peter; Mitlak, Bruce H; Amewou-Atisso, Messan G; Wenger, Nanette K; Barrett-Connor, Elizabeth

    2013-03-01

    Several studies have concluded that diabetes mellitus and heart disease carry similar risk for future cardiovascular disease (CVD). Most of these studies were too small to quantify independent risks specific to women. The purpose of this study was to determine whether diabetes mellitus is a coronary heart disease (CHD) risk equivalent for prediction of future CHD and CVD events in women. The Raloxifene Use for the Heart (RUTH) trial was an international, multicenter, double-blind, randomized, placebo-controlled trial of raloxifene and CVD outcomes in 10 101 postmenopausal women selected for high CHD risk. Of these, 3672 had a history of diabetes mellitus without known CHD, and 3265 had a history of CHD without known diabetes mellitus. Cox proportional hazard models were used to compare cardiovascular outcomes in these 2 groups. Mean age at baseline was 67.5 years; median follow-up was 5.6 years. There were 725 deaths, including 450 cardiovascular deaths. In age-adjusted analyses, diabetic women had an increased risk of all-cause mortality compared with women with CHD. Although the overall risk of CHD and CVD was lower in diabetic women compared with women with CHD, the risk of fatal CHD, fatal CVD, and all-cause mortality was similar (hazard ratio [95% confidence interval]: 0.85 [0.65-1.12], 0.99 [0.78-1.25], and 1.18 [0.98-1.42], respectively, after adjusting for age, lifestyle factors, CHD risk factors, statin use, and treatment assignment). In the RUTH trial, diabetes mellitus was a CHD risk equivalent in women for fatal, but not nonfatal, CHD and CVD.

  7. Change in intrathoracic impedance measures during acute decompensated heart failure admission: results from the Diagnostic Data for Discharge in Heart Failure Patients (3D-HF) Pilot Study.

    PubMed

    Whellan, David J; Droogan, Christopher J; Fitzpatrick, James; Adams, Suzanne; McCarey, Melissa M; Andrel, Jocelyn; Mather, Paul; Rubin, Sharon; Bonita, Raphael; Keith, Scott

    2012-02-01

    Despite the high number of admissions for acute decompensated heart failure (ADHF), there are no specific criteria for discharge readiness. A number of patients have implantable devices that might provide data to assist in determining readiness for discharge. The 3D-HF (Diagnostic Data for Discharge in Heart Failure Patients) study was a prospective observational pilot study enrolling HF patients with Optivol-capable cardiac devices within 48 hours of a hospital admission characterized by worsening HF symptoms. The primary end point was the difference in times from admission to 50% improvement in impedance and to when patient was medically ready for discharge. The nonparametric sign test was used to determine if the difference was significant. A total of 20 subjects were enrolled over a 24-month period. The median ADHF length of stay was 7 days. Of the 20 subjects, 18 achieved the intrathoracic impedance improvement threshold before discharge. The time to reach the threshold for improvement was 2.5 days (interquartile range 2.0-6.0). The difference between days to 50% impedance and days to provider's discharge decision was 3.0 (P = .0072). Intrathoracic impedance changes were evident over a short duration in the majority of patients admitted for ADHF and may be a potential criterion for discharge readiness. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. Associations of Fat Mass and Fat-Free Mass with Physical Fitness in 4-Year-Old Children: Results from the MINISTOP Trial.

    PubMed

    Henriksson, Pontus; Cadenas-Sanchez, Cristina; Leppänen, Marja H; Delisle Nyström, Christine; Ortega, Francisco B; Pomeroy, Jeremy; Ruiz, Jonatan R; Löf, Marie

    2016-07-30

    Physical fitness is a powerful marker of health in youth. Studies in adolescents and adults suggest that higher fat mass is related to worse physical fitness. However, there is limited knowledge whether fat mass and fat-free mass are associated with physical fitness already in preschoolers. Baseline data from the MINISTOP (Mobile-based INtervention Intended to STop Obesity in Preschoolers) trial was utilized for this cross-sectional analysis. Body composition was assessed using air-displacement plethysmography. Fat mass index [fat mass (kg)/height² (m)] and fat-free mass index [fat-free mass (kg)/height² (m)] were used to provide height-adjusted measures of body composition. Physical fitness was measured using the PREFIT (FITness testing in PREschool children) battery, which assesses cardiorespiratory fitness, upper-body and lower-body muscular strength as well as motor fitness. In total, this study included 303 children (168 boys and 135 girls), who were on average 4.48 ± 0.15 years old. Higher fat mass index was associated with worse cardiorespiratory fitness (standardized β = -0.17, p = 0.002), lower-body muscular strength (β = -0.17, p = 0.003) and motor fitness (β = -0.21, p < 0.001) in regression analyses adjusted for age, sex and mutually adjusted for fat-mass index and fat-free mass index. Conversely, higher fat-free mass index was associated with better cardiorespiratory fitness (β = 0.18, p = 0.002), upper-body muscular strength (β = 0.39, p < 0.001), lower-body muscular strength (β = 0.22, p < 0.001) and motor fitness (β = 0.17, p = 0.004). Thus, fat mass and fat-free mass in preschoolers appear to have joint but opposite associations with physical fitness, an important marker for current and future health.

  9. Associations of Fat Mass and Fat-Free Mass with Physical Fitness in 4-Year-Old Children: Results from the MINISTOP Trial

    PubMed Central

    Henriksson, Pontus; Cadenas-Sanchez, Cristina; Leppänen, Marja H.; Delisle Nyström, Christine; Ortega, Francisco B.; Pomeroy, Jeremy; Ruiz, Jonatan R.; Löf, Marie

    2016-01-01

    Physical fitness is a powerful marker of health in youth. Studies in adolescents and adults suggest that higher fat mass is related to worse physical fitness. However, there is limited knowledge whether fat mass and fat-free mass are associated with physical fitness already in preschoolers. Baseline data from the MINISTOP (Mobile-based INtervention Intended to STop Obesity in Preschoolers) trial was utilized for this cross-sectional analysis. Body composition was assessed using air-displacement plethysmography. Fat mass index [fat mass (kg)/height2 (m)] and fat-free mass index [fat-free mass (kg)/height2 (m)] were used to provide height-adjusted measures of body composition. Physical fitness was measured using the PREFIT (FITness testing in PREschool children) battery, which assesses cardiorespiratory fitness, upper-body and lower-body muscular strength as well as motor fitness. In total, this study included 303 children (168 boys and 135 girls), who were on average 4.48 ± 0.15 years old. Higher fat mass index was associated with worse cardiorespiratory fitness (standardized β = −0.17, p = 0.002), lower-body muscular strength (β = −0.17, p = 0.003) and motor fitness (β = −0.21, p < 0.001) in regression analyses adjusted for age, sex and mutually adjusted for fat-mass index and fat-free mass index. Conversely, higher fat-free mass index was associated with better cardiorespiratory fitness (β = 0.18, p = 0.002), upper-body muscular strength (β = 0.39, p < 0.001), lower-body muscular strength (β = 0.22, p < 0.001) and motor fitness (β = 0.17, p = 0.004). Thus, fat mass and fat-free mass in preschoolers appear to have joint but opposite associations with physical fitness, an important marker for current and future health. PMID:27483320

  10. Heart Failure

    MedlinePlus

    ... version of this page please turn Javascript on. Heart Failure What is Heart Failure? In heart failure, the heart cannot pump enough ... failure often experience tiredness and shortness of breath. Heart Failure is Serious Heart failure is a serious and ...

  11. In-hospital and 1-year mortality associated with diabetes in patients with acute heart failure: results from the ESC-HFA Heart Failure Long-Term Registry.

    PubMed

    Targher, Giovanni; Dauriz, Marco; Laroche, Cécile; Temporelli, Pier Luigi; Hassanein, Mahmoud; Seferovic, Petar M; Drozdz, Jaroslaw; Ferrari, Roberto; Anker, Stephan; Coats, Andrew; Filippatos, Gerasimos; Crespo-Leiro, Maria G; Mebazaa, Alexandre; Piepoli, Massimo F; Maggioni, Aldo Pietro; Tavazzi, Luigi

    2017-01-01

    The aim of this study was to evaluate the in-hospital and 1-year prognostic impact of diabetes and elevated blood glucose levels at hospital admission in patients with acute heart failure (HF). We studied a multinational cohort of 6926 hospitalized patients with acute HF enrolled in the European Society of Cardiology (ESC) and Heart Failure Association (HFA) Long-Term Registry, of whom 49.4% (n = 3422) had known or previously undiagnosed diabetes (defined as self-reported history, or medication use, or fasting glucose levels ≥7.0 mmol/L or haemoglobin A1c ≥6.5%). Compared with those without diabetes, patients with known or previously undiagnosed diabetes had higher cumulative rates of in-hospital mortality, 1-year mortality, and 1-year HF re-hospitalization that occurred independently of multiple clinical risk factors: in-hospital mortality [6.8 vs. 4.4%; adjusted hazard ratio (HR) 1.774; 95% confidence interval (CI) 1.282-2.456, P < 0.001], 1-year all-cause mortality (27.5 vs. 24%; adjusted HR 1.162; 95% CI 1.020-1.325, P = 0.024), and 1-year hospital re-admissions for HF (23.2 vs. 18.5%; adjusted HR 1.320; 95% CI 1.139-1.530, P < 0.001). Moreover, elevated admission blood glucose concentrations were powerfully prognostic for in-hospital mortality, but not for 1-year mortality or re-hospitalizations, in both patients with and without diabetes. Among patients hospitalized for acute HF, the presence of diabetes is independently associated with an increased risk of in-hospital mortality, 1-year all-cause mortality, and 1-year re-hospitalizations for HF, underscoring the need for more effective and personalized treatments of diabetes in this particularly high-risk patient population. © 2016 The Authors. European Journal of Heart Failure © 2016 European Society of Cardiology.

  12. Sudden Cardiac Death in Patients With Ischemic Heart Failure Undergoing Coronary Artery Bypass Grafting: Results From the STICH Randomized Clinical Trial (Surgical Treatment for Ischemic Heart Failure).

    PubMed

    Rao, Meena P; Al-Khatib, Sana M; Pokorney, Sean D; She, Lilin; Romanov, Alexander; Nicolau, Jose C; Lee, Kerry L; Carson, Peter; Selzman, Craig H; Stepinska, Janina; Cleland, John G F; Tungsubutra, Wiwun; Desvigne-Nickens, Patrice M; Sueta, Carla A; Siepe, Matthias; Lang, Irene; Feldman, Arthur M; Yii, Michael; Rouleau, Jean L; Velazquez, Eric J

    2017-03-21

    The risk of sudden cardiac death (SCD) in patients with heart failure after coronary artery bypass graft surgery (CABG) has not been examined in a contemporary clinical trial of surgical revascularization. This analysis describes the incidence, timing, and clinical predictors of SCD after CABG. Patients enrolled in the STICH trial (Surgical Treatment of Ischemic Heart Failure) who underwent CABG with or without surgical ventricular reconstruction were included. We excluded patients with prior implantable cardioverter-defibrillator and those randomized only to medical therapy. The primary outcome was SCD as adjudicated by a blinded committee. A Cox model was used to examine and identify predictors of SCD. The Fine and Gray method was used to estimate the incidence of SCD accounting for the competing risk of other deaths. Over a median follow-up of 46 months, 113 of 1411 patients who received CABG without (n = 934) or with (n = 477) surgical ventricular reconstruction had SCD; 311 died of other causes. The mean left ventricular ejection fraction at enrollment was 28±9%. The 5-year cumulative incidence of SCD was 8.5%. Patients who had SCD and those who did not die were younger and had fewer comorbid conditions than did those who died of causes other than SCD. In the first 30 days after CABG, SCD (n=5) accounted for 7% of all deaths. The numerically greatest monthly rate of SCD was in the 31- to 90-day time period. In a multivariable analysis including baseline demographics, risk factors, coronary anatomy, and left ventricular function, end-systolic volume index and B-type natriuretic peptide were most strongly associated with SCD. The monthly risk of SCD shortly after CABG among patients with a low left ventricular ejection fraction is highest between the first and third months, suggesting that risk stratification for SCD should occur early in the postoperative period, particularly in patients with increased preoperative end-systolic volume index or B

  13. Heart failure in patients with coronary heart disease: Prevalence, characteristics and guideline implementation - Results from the German EuroAspire IV cohort.

    PubMed

    Morbach, Caroline; Wagner, Martin; Güntner, Stefan; Malsch, Carolin; Oezkur, Mehmet; Wood, David; Kotseva, Kornelia; Leyh, Rainer; Ertl, Georg; Karmann, Wolfgang; Heuschmann, Peter U; Störk, Stefan

    2017-05-05

    Adherence to pharmacotherapeutic treatment guidelines in patients with heart failure (HF) is of major prognostic importance, but thorough implementation of guidelines in routine care remains insufficient. Our aim was to investigate prevalence and characteristics of HF in patients with coronary heart disease (CHD), and to assess the adherence to current HF guidelines in patients with HF stage C, thus identifying potential targets for the optimization of guideline implementation. Patients from the German sample of the European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EuroAspire) IV survey with a hospitalization for CHD within the previous six to 36 months providing valid data on echocardiography as well as on signs and symptoms of HF were categorized into stages of HF: A, prevalence of risk factors for developing HF; B, asymptomatic but with structural heart disease; C, symptomatic HF. A Guideline Adherence Indicator (GAI-3) was calculated for patients with reduced (≤40%) left ventricular ejection fraction (HFrEF) as number of drugs taken per number of drugs indicated; beta-blockers, angiotensin converting enzyme inhibitors/angiotensin receptor blockers, and mineralocorticoid receptor antagonists (MRA) were considered. 509/536 patients entered analysis. HF stage A was prevalent in n = 20 (3.9%), stage B in n = 264 (51.9%), and stage C in n = 225 (44.2%) patients; 94/225 patients were diagnosed with HFrEF (42%). Stage C patients were older, had a longer duration of CHD, and a higher prevalence of arterial hypertension. Awareness of pre-diagnosed HF was low (19%). Overall GAI-3 of HFrEF patients was 96.4% with a trend towards lower GAI-3 in patients with lower LVEF due to less thorough MRA prescription. In our sample of CHD patients, prevalence of HF stage C was high and a sizable subgroup suffered from HFrEF. Overall, pharmacotherapy was fairly well implemented in HFrEF patients, although somewhat worse in patients with

  14. Clinical and cost-effectiveness of home-based cardiac rehabilitation compared to conventional, centre-based cardiac rehabilitation: Results of the FIT@Home study.

    PubMed

    Kraal, Jos J; Van den Akker-Van Marle, M Elske; Abu-Hanna, Ameen; Stut, Wim; Peek, Niels; Kemps, Hareld Mc

    2017-08-01

    Aim Although cardiac rehabilitation improves physical fitness after a cardiac event, many eligible patients do not participate in cardiac rehabilitation and the beneficial effects of cardiac rehabilitation are often not maintained over time. Home-based training with telemonitoring guidance could improve participation rates and enhance long-term effectiveness. Methods and results We randomised 90 low-to-moderate cardiac risk patients entering cardiac rehabilitation to three months of either home-based training with telemonitoring guidance or centre-based training. Although training adherence was similar between groups, satisfaction was higher in the home-based group ( p = 0.02). Physical fitness improved at discharge ( p < 0.01) and at one-year follow-up ( p < 0.01) in both groups, without differences between groups (home-based p = 0.31 and centre-based p = 0.87). Physical activity levels did not change during the one-year study period (centre-based p = 0.38, home-based p = 0.80). Healthcare costs were statistically non-significantly lower in the home-based group (€437 per patient, 95% confidence interval -562 to 1436, p = 0.39). From a societal perspective, a statistically non-significant difference of €3160 per patient in favour of the home-based group was found (95% confidence interval -460 to 6780, p = 0.09) and the probability that it was more cost-effective varied between 97% and 75% (willingness-to-pay of €0 and €100,000 per quality-adjusted life-years, respectively). Conclusion We found no differences between home-based training with telemonitoring guidance and centre-based training on physical fitness, physical activity level or health-related quality of life. However, home-based training was associated with a higher patient satisfaction and appears to be more cost-effective than centre-based training. We conclude that home-based training with telemonitoring guidance can be used as an alternative to centre

  15. Impact of concomitant medication use on myocardial 123I-mIBG imaging results in patients with heart failure.

    PubMed

    Jacobson, Arnold F; White, Susan; Travin, Mark I; Tseng, Carol

    2017-02-01

    Medications that interfere with sympathetic neuronal norepinephrine uptake and storage, such as neuropsychiatrics (NP) and sympathomimetic amines, are most likely to affect cardiac uptake of iodine-123 metaiodobenzylguanidine (I-mIBG). The present study examined these and other medications reported to affect I-mIBG uptake using measurements of cardiac I-mIBG uptake on the heart failure (HF) patients in the ADMIRE-HF extension (X) study. Baseline concomitant medications taken by the 961 HF patients were categorized into five groups: calcium channel blockers, NP medications, β agonists and sympathomimetics, α antagonists, and other antihypertensives. NP medications were further subcategorized into those expected to have high and low impact on norepinephrine transporter (NET) function. Myocardial I-mIBG heart/mediastinum (H/M) uptake ratios on 4 h planar images were compared among the groups. Impact of medication group on the prognostic value of the H/M ratio for all-cause (AC) and cardiac death during a median 2-year follow-up was also examined. A total of 283 (29%) patients were using at least one calcium channel blocker, NP medication, or β agonist or sympathomimetic. These patients had a lower mean H/M ratio than the other study patients (1.42±0.20 vs. 1.45±0.20; P=0.022). However, the 2-year AC mortality rates in the two groups were the same [11.3% (95% confidence interval: 7.5-15.2%) vs. 11.8% (95% confidence interval: 9.2-14.4%)]. In terms of medication categories, there were no significant differences in the mean H/M ratios between patients who did and did not use NP medications, β agonists, calcium channel blockers, and α antagonists. Across all categories, patients with H/M ratio greater than or equal to 1.60 had lower AC and cardiac mortality. Patients using higher potency (for NET inhibition) NP medications had significantly lower H/M ratio values, but the prognostic significance of H/M ratio greater than or equal to 1.60 was unchanged. Only a

  16. Post-cardiotomy ECMO in pediatric and congenital heart surgery: impact of team training and equipment in the results

    PubMed Central

    Miana, Leonardo Augusto; Canêo, Luiz Fernando; Tanamati, Carla; Penha, Juliano Gomes; Guimarães, Vanessa Alves; Miura, Nana; Galas, Filomena Regina Barbosa Gomes; Jatene, Marcelo Biscegli

    2015-01-01

    Introduction Post-cardiotomy myocardial dysfunction requiring mechanical circulatory support occurs in about 0.5% of cases. In our environment, the use of extracorporeal membrane oxygenation has been increasing in recent years. Objective To evaluate the impact of investment in professional training and improvement of equipment in the rate of weaning from extracorporeal membrane oxygenation and survival. Methods A retrospective study. Fifty-six pediatric and/or congenital heart patients underwent post-cardiotomy extracorporeal membrane oxygenation at our institution between November 1999 and July 2014. We divided this period into two phases: phase I, 36 cases (before the structuring of the extracorporeal membrane oxygenation program) and phase II, 20 cases (after the extracorporeal membrane oxygenation program implementation) with investment in training and equipment). Were considered as primary outcomes: extracorporeal membrane oxygenation weaning and survival to hospital discharge. The results in both phases were compared using Chi-square test. To identify the impact of the different variables we used binary logistic regression analysis. Results Groups were comparable. In phase I, 9 patients (25%) were weaned from extracorporeal membrane oxygenation, but only 2 (5.5%) were discharged. In phase II, extracorporeal membrane oxygenation was used in 20 patients, weaning was possible in 17 (85%), with 9 (45%) hospital discharges (P<0.01). When the impact of several variables on discharge and weaning of extracorporeal membrane oxygenation was analyzed, we observe that phase II was an independent predictor of better results (P<0.001) and need for left cavities drainage was associated with worse survival (P=0.045). Conclusion The investment in professional training and improvement of equipment significantly increased extracorporeal membrane oxygenation results. PMID:27163414

  17. Relation Between Dose of Loop Diuretics and Outcomes in a Heart Failure Population: Results of the ESCAPE Trial

    PubMed Central

    Hasselblad, Vic; Stough, Wendy Gattis; Shah, Monica R.; Lokhnygina, Yuliya; O’Connor, Christopher M.; Califf, Robert M.; Adams, Kirkwood F.

    2007-01-01

    Background We examined the relation of maximal in-hospital diuretic dose to weight loss, changes in renal function, and mortality in hospitalised heart failure (HF) patients. Methods In ESCAPE, 395 patients received diuretics in-hospital. Weight was measured at baseline, discharge, and every other day before discharge. Weight loss was defined as the difference between baseline and last in-hospital weight. Mortality was assessed using a log-logistic model with non-zero background. Results Median weight loss: 2.8 kg (0.7, 6.1); mean: 3.7 kg (22% of values <0). Weight loss and maximum in-hospital dose were correlated (p = 0.0007). Baseline weight, length of stay, and baseline brain natriuretic peptide were significant predictors of weight loss. After adjusting for these, dose was not a significant predictor of weight loss. A strong relation between dose and mortality was seen (p = 0.003), especially at >300 mg/day. Dose remained a significant predictor of mortality after adjusting for baseline variables that significantly predicted mortality. Correlation between maximal dose and creatinine level change was not significant (r = 0.043; p = 0.412) Conclusions High diuretic doses during HF hospitalisation are associated with increased mortality and poor 6-month outcome. PMID:17719273

  18. Use of the exercise maximal ST segment/heart rate slope in assessing the results of coronary angioplasty.

    PubMed Central

    Silverton, N P; Elamin, M S; Smith, D R; Ionescu, M I; Kardash, M; Whitaker, W; Mary, D A; Linden, R J

    1984-01-01

    A new exercise test was used to assess the effects of coronary angioplasty in 22 patients. Twenty five angioplasty procedures were performed and the exercise maximal ST segment/heart rate slope was measured before and after operation on 23 occasions; in two patients treated for unstable angina the slope was measured only after the two procedures. Successful angioplasty (23 of the 25 procedures) resulted in a significant reduction of the maximal ST/HR slope, usually falling by the equivalent of single vessel disease according to previously published criteria. When angioplasty produced little angiographic change (two of the 25 procedures) the maximal ST/HR slope was not significantly altered. A second, and successful, angioplasty for these two patients led to a significant reduction of the maximal ST/HR slope. Twelve patients were restudied by coronary angiography and exercise testing approximately six months after angioplasty. Of these, six had experienced recurrent chest pain, and the exercise test successfully identified the three who had restenoses and the three who did not. Thus the maximal ST/HR slope was useful as a non-invasive and accurate method for following the progress of individual patients after coronary angioplasty. PMID:6231041

  19. Prevalence and risk factors of prolonged QTc interval in HIV-infected patients: results of the HIV-HEART study.

    PubMed

    Reinsch, Nico; Buhr, Christiane; Krings, Peter; Kaelsch, Hagen; Neuhaus, Kathrin; Wieneke, Heiner; Erbel, Raimund; Neumann, Till

    2009-01-01

    Corrected QT (QTc) prolongation is predictive of cardiovascular mortality in both the general and human immunodeficiency virus (HIV) populations. As part of the HIV-HEART study, we assessed the prevalence and risk factors of a prolonged QTc interval in patients with HIV infection. In this cross-sectional cohort study, 802 unselected HIV-infected patients were included. Data were analyzed by the use of gender-specific QTc categories (men abnormal at > 440 ms and women abnormal at >460 ms). Multiple variables related to infection and treatment were collected. Results were analyzed with a multivariable model. The QTc interval was found to be prolonged in 154 patients (19.8%; 95% CI 17-23). The mean (+/-SD) QTc in men (n = 142) presenting with a prolonged QTc interval was 456 +/- 16.3 ms (range 441-548 ms). The mean (+/-SD) QTc in women (n = 12) presenting with a prolonged QTc interval was 479 +/- 9 ms (range 465-498 ms). In the multivariable model, female gender, diabetes mellitus, and arterial hypertension were associated with prolonged QTc. There were no parameters related to HIV independently associated with QT interval prolongation. In particular, no anti-HIV drug was associated with QTc prolongation. Our study demonstrated that in an HIV-infected population, QTc prolongation had a high prevalence of nearly 20% compared to the general population and was possibly influenced by common factors like gender, diabetes, and arterial hypertension.

  20. Current implantable cardioverter-defibrillator programming in Europe: the results of the European Heart Rhythm Association survey.

    PubMed

    Proclemer, Alessandro; Grazia Bongiorni, Maria; Etsner, Heidi; Todd, Derick; Sciaraffia, Elena; Blomström-Lundqvist, Carina

    2014-06-01

    The purpose of this European Heart Rhythm Association (EHRA) survey was to examine the current practice on the choice of implantable cardioverter-defibrillator (ICD) type, use of defibrillation testing, and ICD programming for detection and therapy of ventricular arrhythmias. In accordance with recent guidelines and the results of observational studies, the majority of EHRA research network centres reported a high utilization rate of dual-chamber ICDs in the presence of symptomatic and asymptomatic sinus node dysfunction, biventricular ICD in high-degree atrioventricular block and QRS duration <120 ms, and a limited use of defibrillation testing either in primary and secondary prevention settings. Activation of the long ventricular tachycardia (VT) detection window, slow VT zone, antitachycardia pacing before shock for slow and fast VT, and atrial tachyarrhythmia discrimination were considered useful in ICD programming for the majority of patients. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  1. Preferred tools and techniques for implantation of cardiac electronic devices in Europe: results of the European Heart Rhythm Association survey.

    PubMed

    Bongiorni, Maria Grazia; Proclemer, Alessandro; Dobreanu, Dan; Marinskis, Germanas; Pison, Laurent; Blomstrom-Lundqvist, Carina

    2013-11-01

    The aim of this European Heart Rhythm Association (EHRA) survey was to assess clinical practice in relation to the tools and techniques used for cardiac implantable electronic devices procedures in the European countries. Responses to the questionnaire were received from 62 members of the EHRA research network. The survey involved high-, medium-, and low-volume implanting centres, performing, respectively, more than 200, 100-199 and under 100 implants per year. The following topics were explored: the side approach for implantation, surgical techniques for pocket incision, first venous access for lead implantation, preference of lead fixation, preferred coil number for implantable cardioverter-defibrillator (ICD) leads, right ventricular pacing site, generator placement site, subcutaneous ICD implantation, specific tools and techniques for cardiac resynchronization therapy (CRT), lead implantation sequence in CRT, coronary sinus cannulation technique, target site for left ventricular lead placement, strategy in left ventricular lead implant failure, mean CRT implantation time, optimization of the atrioventricular (AV) and ventriculo-ventricular intervals, CRT implants in patients with permanent atrial fibrillation, AV node ablation in patients with permanent AF. This panoramic view allows us to find out the operator preferences regarding the techniques and tools for device implantation in Europe. The results showed different practices in all the fields we investigated, nevertheless the survey also outlines a good adherence to the common standards and recommendations.

  2. Hemodynamic-guided heart-failure management using a wireless implantable sensor: Infrastructure, methods, and results in a community heart failure disease-management program.

    PubMed

    Jermyn, Rita; Alam, Amit; Kvasic, Jessica; Saeed, Omar; Jorde, Ulrich

    2017-03-01

    The real-world impact of remote pulmonary artery pressure (PAP) monitoring on New York Heart Association (NYHA) class improvement and heart failure (HF) hospitalization rate is presented here from a single center. METHODS: Seventy-seven previously hospitalized outpatients with NYHA class III HF were offered PAP monitoring via device implantation in a multidisciplinary HF-management program. Prospective effectiveness analyses compared outcomes in 34 hemodynamically monitored patients to a group of similar patients (n = 32) who did not undergo device implantation but received usual care. NYHA class and 6-minute walk testing were assessed at baseline and 90 days. All hospitalizations were collected after 6 months of the implantation date (average follow-up, 15 months) and compared with the number of hospitalizations experienced prior to hemodynamic monitoring. Patients in both groups had similar distributions of age, sex, and ejection fraction. After 90 days, 61.8% of the monitored patients had NYHA class improvement of ≥1, compared with 12.5% in the controls (P < 0.001). Distance walked in 6 minutes increased by 54.5 meters in the monitored group (253.0 ± 25.6 meters to 307.4 ± 26.3 meters; P < 0.005), whereas no change was seen in the usual-care group. After implantation, 19.4% of the monitored group had ≥1 HF hospitalization, compared with 100% who had been hospitalized in the year prior to implantation. The monitored group had a significantly lower HF hospitalization rate (0.16; 95% confidence interval: 0.06-0.35 hospitalizations/patient-year) compared with the year prior (1.0 hospitalizations/patient-year; P < 0.001). Hemodynamic-guided HF management leads to significant improvements in NYHA class and HF hospitalization rate in a real-world setting compared with usual care delivered in a comprehensive disease-management program. © 2016 Wiley Periodicals, Inc.

  3. Fitness and Americans.

    ERIC Educational Resources Information Center

    Nordholm, Catherine R.

    This document makes a number of observations about physical fitness in America. Among them are: (1) the symptoms of aging (fat accumulation, lowered basal metabolic rate, loss of muscular strength, reduction in motor fitness, reduction in work capacity, etc.) are not the result of disease but disuse; (2) society conditions the individual to…

  4. Physical fitness is predictive for a decline in daily functioning in older adults with intellectual disabilities: results of the HA-ID study.

    PubMed

    Oppewal, Alyt; Hilgenkamp, Thessa I M; van Wijck, Ruud; Schoufour, Josje D; Evenhuis, Heleen M

    2014-10-01

    A high incidence of limitations in daily functioning is seen in older adults with intellectual disabilities (ID), along with poor physical fitness levels. The aim of this study was to assess the predictive value of physical fitness for daily functioning after 3 years, in 602 older adults with borderline to profound ID (≥ 50 years). At baseline, physical fitness levels and daily functioning (operationalized as basic activities of daily living [ADL] and mobility) were assessed. After 3 years, the measurements of daily functioning were repeated. At follow-up, 12.6% of the participants were completely independent in ADL and 48.5% had no mobility limitations. More than half of the participants (54.8%) declined in their ability to perform ADL and 37.5% declined in their mobility. Manual dexterity, visual reaction time, balance, comfortable and fast gait speed, muscular endurance, and cardiorespiratory fitness were significant predictors for a decline in ADL. For a decline in mobility, manual dexterity, balance, comfortable and fast walking speed, grip strength, muscular endurance, and cardiorespiratory fitness were all significant predictors. This proves the predictive validity of these physical fitness tests for daily functioning and stresses the importance of using physical fitness tests and implementing physical fitness enhancing programs in the care for older adults with ID. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Feasibility of Eight Physical Fitness Tests in 1,050 Older Adults with Intellectual Disability: Results of the Healthy Ageing with Intellectual Disabilities Study

    ERIC Educational Resources Information Center

    Hilgenkamp, Thessa I. M.; van Wijck, Ruud; Evenhuis, Heleen M.

    2013-01-01

    Although physical fitness is relevant for well-being and health, knowledge on the feasibility of instruments to measure physical fitness in older adults with intellectual disability (ID) is lacking. As part of the study Healthy Ageing with Intellectual Disabilities with 1,050 older clients with ID in three Dutch care services, the feasibility of 8…

  6. Feasibility of Eight Physical Fitness Tests in 1,050 Older Adults with Intellectual Disability: Results of the Healthy Ageing with Intellectual Disabilities Study

    ERIC Educational Resources Information Center

    Hilgenkamp, Thessa I. M.; van Wijck, Ruud; Evenhuis, Heleen M.

    2013-01-01

    Although physical fitness is relevant for well-being and health, knowledge on the feasibility of instruments to measure physical fitness in older adults with intellectual disability (ID) is lacking. As part of the study Healthy Ageing with Intellectual Disabilities with 1,050 older clients with ID in three Dutch care services, the feasibility of 8…

  7. Heart MRI

    MedlinePlus

    Magnetic resonance imaging - cardiac; Magnetic resonance imaging - heart; Nuclear magnetic resonance - cardiac; NMR - cardiac; MRI of the heart; Cardiomyopathy - MRI; Heart failure - MRI; Congenital heart disease - MRI

  8. High-Intensity Interval Training and Isocaloric Moderate-Intensity Continuous Training Result in Similar Improvements in Body Composition and Fitness in Obese Individuals.

    PubMed

    Martins, Catia; Kazakova, Irina; Ludviksen, Marit; Mehus, Ingar; Wisloff, Ulrik; Kulseng, Bard; Morgan, Linda; King, Neil

    2016-06-01

    This study aimed to determine the effects of 12 weeks of isocaloric programs of high-intensity intermittent training (HIIT) or moderate-intensity continuous training (MICT) or a short-duration HIIT (1/2HIIT) inducing only half the energy deficit on a cycle ergometer, on body weight and composition, cardiovascular fitness, resting metabolism rate (RMR), respiratory exchange ratio (RER), nonexercise physical activity (PA) levels and fasting and postprandial insulin response in sedentary obese individuals. Forty-six sedentary obese individuals (30 women), with a mean BMI of 33.3 ± 2.9 kg/m2 and a mean age of 34.4 ± 8.8 years were randomly assigned to one of the three training groups: HIIT (n = 16), MICT (n = 14) or 1/2HIIT (n = 16) and exercise was performed 3 times/week for 12 weeks. Overall, there was a significant reduction in body weight, waist (p < .001) and hip (p < .01) circumference,, trunk and leg fat mass (FM; p < .01) and an increase in trunk and leg fat free mass (FFM; p < .01) and cardiovascular fitness (VO2max in ml/kg/min; p < .001) with exercise. However, no significant differences were observed between groups. There was no significant change in RMR, RER, nonexercise PA levels, fasting insulin or insulin sensitivity with exercise or between groups. There was a tendency for a reduction in AUC insulin with exercise (p = .069), but no differences between groups. These results indicate that isocaloric training protocols of HIIT or MICT (or 1/2HIIT inducing only half the energy deficit) exert similar metabolic and cardiovascular improvements in sedentary obese individuals.

  9. Development of the Canadian Home Fitness Test

    PubMed Central

    Shephard, Roy J.; Bailey, Donald A.; Mirwald, Robert L.

    1976-01-01

    The Canadian Home Fitness Test is a self-administered procedure in which the participant steps at an age- and sex-specific rhythm controlled by recorded music, then palpates the pulse immediately following activity. Validation of the test has shown a correlation of 0.72 with the results of a standard submaximum bicycle ergometer test, while the directly measured maximum oxygen intake is correlated even more closely (r = 0.88) with the attained stepping rate, body weight and recovery heart rate. Given modest training, subjects could measure their immediate postexercise heart rate (correlation with electro-cardiographic data, r = 0.94), although 10-second counts underestimated the true rate by an average of 7 beats/min. The safety of the test will be established ultimately by experience in its use in a large population; nevertheless, both theoretical considerations and results of trials in over 14 000 adults suggest the procedure can be self-administered without serious consequences. It is also well accepted by the general public and arouses considerable interest in most homes. The test can thus be recommended as providing an approximate measure of an individual's physical fitness in order to stimulate an increase in personal physical activity. It also has potential as a simple screening procedure that would allow paramedical personnel to record fitness levels and standardized exercise electrocardiograms in large segments of the population. PMID:56979

  10. Sarcopenia and Endothelial Function in Patients With Chronic Heart Failure: Results From the Studies Investigating Comorbidities Aggravating Heart Failure (SICA-HF).

    PubMed

    Dos Santos, Marcelo R; Saitoh, Masakazu; Ebner, Nicole; Valentova, Miroslava; Konishi, Masaaki; Ishida, Junichi; Emami, Amir; Springer, Jochen; Sandek, Anja; Doehner, Wolfram; Anker, Stefan D; von Haehling, Stephan

    2017-03-01

    Skeletal muscle wasting, also known as sarcopenia, has recently been identified as a serious comorbidity in patients with heart failure (HF). We aimed to assess the impact of sarcopenia on endothelial dysfunction in patients with HF with reduced ejection fraction (HFrEF) and with preserved ejection fraction (HFpEF). Cross-sectional study. Ambulatory patients with HF were recruited at Charité Medical School, Campus Virchow-Klinikum, Berlin, Germany. We assessed peripheral blood flow (arm and leg) in 228 patients with HF and 32 controls who participated in the Studies Investigating Comorbidities Aggravating HF (SICA-HF). The appendicular skeletal muscle mass of the arms and the legs combined was assessed by dual energy x-ray absorptiometry (DEXA). Sarcopenia was defined as the appendicular muscle mass two standard deviations below the mean of a healthy reference group of adults aged 18 to 40 years, as suggested for the diagnosis of muscle wasting in healthy aging. All patients underwent a 6-minute walk test and spiroergometry testing. Forearm and leg blood flow were measured by venous occlusion plethysmography. Peak blood flow was assessed after a period of ischemia in the limbs to test endothelial function. Sarcopenia was identified in 37 patients (19.5%). Patients with sarcopenia presented with lower baseline forearm blood flow (2.30 ± 1.21 vs. 3.06 ± 1.49 vs. 4.00 ± 1.66 mL min(-1) 100 mL(-1); P = .02) than those without sarcopenia or controls. The group of patients with sarcopenia showed similar baseline leg blood flow (2.06 ± 1.62 vs. 2.39 ± 1.39 mL min(-1) 100 mL(-1); P = .11) to those without but lower values when compared to controls (2.06 ± 1.62 vs. 2.99 ± 1.28 mL min(-1) 100 mL(-1); P = .03). In addition, patients with and without sarcopenia presented with lower peak flow in the forearm when compared to controls (18.37 ± 7.07 vs. 22.19 ± 8.64 vs. 33.63 ± 8.57 mL min(-1) 100 mL(-1); P < .001). A similar result was

  11. Phylogeny, ecology, and heart position in snakes.

    PubMed

    Gartner, Gabriel E A; Hicks, James W; Manzani, Paulo R; Andrade, Denis V; Abe, Augusto S; Wang, Tobias; Secor, Stephen M; Garland, Theodore

    2010-01-01

    The cardiovascular system of all animals is affected by gravitational pressure gradients, the intensity of which varies according to organismic features, behavior, and habitat occupied. A previous nonphylogenetic analysis of heart position in snakes-which often assume vertical postures-found the heart located 15%-25% of total body length from the head in terrestrial and arboreal species but 25%-45% in aquatic species. It was hypothesized that a more anterior heart in arboreal species served to reduce the hydrostatic blood pressure when these animals adopt vertical postures during climbing, whereas an anterior heart position would not be needed in aquatic habitats, where the effects of gravity are less pronounced. We analyzed a new data set of 155 species from five major families of Alethinophidia (one of the two major branches of snakes, the other being blind snakes, Scolecophidia) using both conventional and phylogenetically based statistical methods. General linear models regressing log(10) snout-heart position on log(10) snout-vent length (SVL), as well as dummy variables coding for habitat and/or clade, were compared using likelihood ratio tests and the Akaike Information Criterion. Heart distance to the tip of the snout scaled isometrically with SVL. In all instances, phylogenetic models that incorporated transformation of the branch lengths under an Ornstein-Uhlenbeck model of evolution (to mimic stabilizing selection) better fit the data as compared with their nonphylogenetic counterparts. The best-fit model predicting snake heart position included aspects of both habitat and clade and indicated that arboreal snakes in our study tend to have hearts placed more posteriorly, opposite the trend identified in previous studies. Phylogenetic signal in relative heart position was apparent both within and among clades. Our results suggest that overcoming gravitational pressure gradients in snakes most likely involves the combined action of several cardiovascular and

  12. Does rating of perceived exertion result in target exercise intensity during interval training in cardiac rehabilitation? A study of the Borg scale versus a heart rate monitor.

    PubMed

    Aamot, Inger-Lise; Forbord, Siv Hege; Karlsen, Trine; Støylen, Asbjørn

    2014-09-01

    To assess whether rating of perceived exertion using the Borg 6-20 scale is a valid method for achieving target exercise intensity during high-intensity interval training in cardiac rehabilitation. A single-group cross-over design. Ten participants (56 (6.5) years) who were enrolled in a high-intensity interval training cardiac rehabilitation program were recruited. A target exercise intensity of Borg 17 (very hard) was used for exercise intensity guidance in the initial four exercise sessions that took place before a cardiopulmonary exercise test, as in usual care rehabilitation. The heart rate was recorded and blinded to the participants. After performing the test, the participants were then instructed using heart rate monitors openly for exercise guidance in four subsequent exercise sessions, at an intensity corresponding to 85-95% of peak heart rate. The mean exercise intensity during high-intensity bouts was 82% (6%) of peak heart rate for the rating of perceived exertion and 85% (6%) using heart rate monitors (p=0.005). Bland-Altman limits of agreement analysis with a mean bias showed a bias of 2.97 (-2.08, 8.02) percentage points for the two methods. Exercise intensity was highly repeatable with intra-class correlations of 0.95 (95% CI 0.86-0.99, p<0.001) and 0.96 (95% CI 0.88-0.99, p<0.001) in the exercise sessions using rating of perceived exertion and percentage of peak heart rate for intensity control, respectively. Rating of perceived exertion results in an exercise intensity below target during high-intensity interval training bouts in cardiac rehabilitation. Heart rate monitoring should be used for accurate intensity guidance. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  13. Effect of carvedilol on the morbidity of patients with severe chronic heart failure: results of the carvedilol prospective randomized cumulative survival (COPERNICUS) study.

    PubMed

    Packer, Milton; Fowler, Michael B; Roecker, Ellen B; Coats, Andrew J S; Katus, Hugo A; Krum, Henry; Mohacsi, Paul; Rouleau, Jean L; Tendera, Michal; Staiger, Christoph; Holcslaw, Terry L; Amann-Zalan, Ildiko; DeMets, David L

    2002-10-22

    Beta-blocking agents improve functional status and reduce morbidity in mild-to-moderate heart failure, but it is not known whether they produce such benefits in severe heart failure. We randomly assigned 2289 patients with symptoms of heart failure at rest or on minimal exertion and with an ejection fraction <25% (but not volume-overloaded) to double-blind treatment with either placebo (n=1133) or carvedilol (n=1156) for an average of 10.4 months. Carvedilol reduced the combined risk of death or hospitalization for a cardiovascular reason by 27% (P=0.00002) and the combined risk of death or hospitalization for heart failure by 31% (P=0.000004). Patients in the carvedilol group also spent 27% fewer days in the hospital for any reason (P=0.0005) and 40% fewer days in the hospital for heart failure (P<0.0001). These differences were as a result of both a decrease in the number of hospitalizations and a shorter duration of each admission. More patients felt improved and fewer patients felt worse in the carvedilol group than in the placebo group after 6 months of maintenance therapy (P=0.0009). Carvedilol-treated patients were also less likely than placebo-treated patients to experience a serious adverse event (P=0.002), especially worsening heart failure, sudden death, cardiogenic shock, or ventricular tachycardia. In euvolemic patients with symptoms at rest or on minimal exertion, the addition of carvedilol to conventional therapy ameliorates the severity of heart failure and reduces the risk of clinical deterioration, hospitalization, and other serious adverse clinical events.

  14. Munc18-1 haploinsufficiency results in enhanced anxiety-like behavior as determined by heart rate responses in mice.

    PubMed

    Hager, Torben; Maroteaux, Grégoire; Pont, Paula du; Julsing, Joris; van Vliet, Rick; Stiedl, Oliver

    2014-03-01

    Heterozygous (HZ) missense mutations in the gene encoding syntaxin binding protein 1 (Stxbp1 or Munc18-1), a presynaptic protein essential for neurotransmitter release, causes early infantile epileptic encephalopathy, abnormal brain structure and mental retardation in humans. Here we investigated whether the mouse model mimics symptoms of the human phenotype. The effects of the deletion of munc18-1 were studied in HZ and wild-type (WT) mice based on heart rate (HR) and its variability (HRV) as independent measures to expand previous behavioral results of enhanced anxiety and impaired emotional learning suggesting mild cognitive impairments. HR responses were assessed during novelty exposure, during the expression and extinction of conditioned tone-dependent fear and during the diurnal phase. Novelty exposure yielded no differences in activity patterns between the two genotypes, while maximum HR differed significantly (WT: 770 bpm; HZ: 790 bpm). Retention tests after both auditory delay and trace fear conditioning showed a delayed extinction of the conditioned HR response in HZ mice compared to WT mice. Since the HR versus HRV correlation and HR dynamics assessed by nonlinear methods revealed similar function in HZ and WT mice, the higher HR responses of munc18-1 HZ mice to different emotional challenges cannot be attributed to differences in autonomic nervous system function. Thus, in contrast to the adverse consequences of deletion of a single allele of munc18-1 in humans, C57BL/6J mice show enhanced anxiety responses based on HR adjustments that extend previous results on the behavioral level without support of cognitive impairment, epileptic seizures and autonomic dysregulation. Copyright © 2013 Elsevier B.V. All rights reserved.

  15. Normative health-related fitness values for children: analysis of 85347 test results on 9-17-year-old Australians since 1985.

    PubMed

    Catley, Mark J; Tomkinson, Grant R

    2013-01-01

    To provide sex- and age-specific normative values for health-related fitness of 9-17-year-old Australians. A systematic literature search was undertaken to identify peer-reviewed studies reporting health-related fitness data on Australian children since 1985-the year of the last national fitness survey. Only data on reasonably representative s amples of apparently healthy (free from known disease or injury) 9-17-year-old Australians, who were tested using field tests of health-related fitness, were included. Both raw and pseudo data (generated using Monte Carlo simulation) were combined with sex- and age-specific normative centile values generated using the Lambda Mu and Sigma (LMS) method. Sex- and age-related differences were expressed as standardised effect sizes. Normative values were displayed as tabulated percentiles and as smoothed centile curves for nine health-related fitness tests based on a dataset comprising 85347 test performances. Boys typically scored higher than girls on cardiovascular endurance, muscular strength, muscular endurance, speed and power tests, but lower on the flexibility test. The magnitude of the age-related changes was generally larger for boys than for girls, especially during the teenage years. This study provides the most up-to-date sex- and age-specific normative centile values for the health-related fitness of Australian children that can be used as benchmark values for health and fitness screening and surveillance systems.

  16. Can Tongue Acupuncture Enhance Body Acupuncture? First Results from Heart Rate Variability and Clinical Scores in Patients with Depression

    PubMed Central

    Shi, Xian; Wang, Huan; Zhao, Zengkai; Tao, Jingqiao; Sheng, Zemin

    2014-01-01

    Tongue acupuncture (TA) is a method which is not used in western medicine and even in China it is applied very rarely in clinical practice. This study aimed at investigating whether additional TA can improve the efficacy of body acupuncture (BA) in patients with depression. Twenty patients with a mean age of ± SD of 42.9 ± 11.2 years were randomly divided into two groups (n = 10 patients each), one group receiving BA (Zusanli, Sanyinjiao, Neiguan, Shenting, Yintang, and Baihui) and the other receiving BA and TA (Liver, Heart, and Brain). The quantitative and qualitative outcome measures were heart rate (HR), heart rate variability (HRV), and different clinical scores. We found that in both groups all scores and HR improved significantly, whereas HRV increased partly significantly. It seems that TA can enhance acute and treatment effects of BA in patients with depression. The investigation of de qi sensation in TA needs further attention. PMID:24782907

  17. Soluble ST2 and Risk of Arrhythmias, Heart Failure, or Death in Patients with Mildly Symptomatic Heart Failure: Results from MADIT-CRT.

    PubMed

    Skali, Hicham; Gerwien, Robert; Meyer, Timothy E; Snider, James V; Solomon, Scott D; Stolen, Craig M

    2016-12-01

    Soluble ST2 is an established biomarker of heart failure (HF) progression. Data about its prognostic implications in patients with mildly symptomatic HF eligible to receive cardiac resynchronization therapy defibrillators (CRT-D) are limited. In a cohort of 684 patients enrolled in Multicenter Automated Defibrillator Implantation Trial (MADIT)-CRT, levels of soluble ST2 (sST2) were serially assessed at baseline and 1 year (n = 410). In multivariable-adjusted models, elevated baseline sST2 was associated with an increased risk of death, death or HF, and death or ventricular arrhythmia (VA) even when adjusting for baseline brain natriuretic protein (BNP) levels. In addition, patients with lower baseline sST2 levels had greater risk reduction with CRT-D (p = 0.006). Serial assessment revealed increased risk of VA and death or VA (HR per 10 % increase in sST2 1.11 (1.04-1.20), p = 0.004). Among patients with mildly symptomatic HF and eligibility for CRT-D, baseline and serial assessments sST2 may provide important information for risk stratification.

  18. A novel biodegradable stent applicable for use in congenital heart disease: bench testing and feasibility results in a rabbit model.

    PubMed

    Veeram Reddy, Surendranath R; Welch, Tre R; Wang, Jian; Bernstein, Frederic; Richardson, James A; Forbess, Joseph M; Nugent, Alan W

    2014-02-15

    A novel double opposed helical (DH) biodegradable stent was designed and fabricated for CHD applications. The primary objective was to evaluate the feasibility of DH stent delivery and deployment in rabbit external iliac arteries (EIA). Secondary objectives were to assess stent patency, thrombosis and inflammation at 1-week and 1-month follow-up. Biodegradable stents have largely been designed for adult cardiovascular indications, to avoid long term complications of permanent implants. A growing child with congenital heart disease (CHD) would especially derive substantial benefit from this technology. DH stents were manufactured to 3, 4, 5, and 6-mm diameter with poly-l-lactic acid (PLLA) fibers. Bench test analysis was performed. Six DH stents were implanted in rabbit EIA. Vessel patency was assessed at 1-week and 1-month follow-up with repeat angiography, intravascular ultrasound (IVUS). Histopathological evaluation was performed. The elastic recoil and collapse pressure of DH stents were comparable to conventional metal stents. All DH stents were successfully delivered and implanted with good apposition to the vessel wall and no collapse of the proximal, mid or distal ends. All stented vessels remained patent. No acute or early stent thrombosis was noted. Histopathology showed minimal inflammatory response and mild neointimal proliferation at 1 month follow-up. In vitro results of DH PLLA biodegradable stents are comparable to conventional metal stents. The pilot animal study confirms the delivery and deployment of the DH stents to the desired location. The DH design can be used to fabricate larger diameter stents needed for CHD. Copyright © 2013 Wiley Periodicals, Inc.

  19. Design and initial results of a programme for routine standardised longitudinal follow-up after congenital heart surgery.

    PubMed

    Pasquali, Sara K; Ravishankar, Chitra; Romano, Jennifer C; Kane, Kristin; Viers, Suzanne; Kennedy, Andrea; Burnham, Nancy; Lowery, Ray; Uzark, Karen; Retzloff, Lauren; Rome, Jonathon J; Rossano, Joseph W; Charpie, John R; Spray, Thomas L; Gaies, Michael G; Ohye, Richard G; Gaynor, J William

    2016-12-01

    With improvements in early survival following congenital heart surgery, it has become increasingly important to understand longer-term outcomes; however, routine collection of these data is challenging and remains very limited. We describe the development and initial results of a collaborative programme incorporating standardised longitudinal follow-up into usual care at the Children's Hospital of Philadelphia (CHOP) and University of Michigan (UM). We included children undergoing benchmark operations of the Society of Thoracic Surgeons. Considerations regarding personnel, patient/parent engagement, funding, regulatory issues, and annual data collection are described, and initial follow-up rates are reported. The present analysis included 1737 eligible patients undergoing surgery at CHOP from January 2007 to December 2014 and 887 UM patients from January 2010 to December 2014. Overall, follow-up data, of any type, were obtained from 90.8% of patients at CHOP (median follow-up 4.3 years, 92.2% survival) and 98.3% at UM (median follow-up 2.8 years, 92.7% survival), with similar rates across operations and institutions. Most patients lost to follow-up at CHOP had undergone surgery before 2010. Standardised questionnaires assessing burden of disease/quality of life were completed by 80.2% (CHOP) and 78.4% (UM) via phone follow-up. In subsequent pilot testing of an automated e-mail system, 53.4% of eligible patients completed the follow-up questionnaire through this system. Standardised follow-up data can be obtained on the majority of children undergoing benchmark operations. Ongoing efforts to support automated electronic systems and integration with registry data may reduce resource needs, facilitate expansion across centres, and support multi-centre efforts to understand and improve long-term outcomes in this population.

  20. [Relation of baseline examination results to death from ischemic heart disease, cerebro-vascular disease and sudden death].

    PubMed

    Matsumoto, K; Ohta, T; Iwatsuka, T; Hashimoto, S; Fukutomi, K

    1991-06-01

    The relation of variables obtained from a baseline examination to death from ischemic heart disease (IHD), cerebro-vascular disease (CVD) and sudden death (SUD) was analyzed in a case-control study. From questionnaire survey of approximately 180,000 subjects who underwent baseline health examinations in 1971-1986 at Aichi prefectural center of health care, 148 deaths were selected for this study. The number of cases on IHD, CVD and SUD was 36, 60, and 52, respectively. Mean age of cases was 54.8 years old and the mean follow up interval between baseline examination and death was 3.7 years. Four controls matched according to year of baseline examination, age and sex were chosen arbitrarily for each case, and odds ratios for the three diseases were estimated. In some of the matched sets, odds ratios at a follow up examination were compared with that at the first examination. The results were as follows: 1) Variables showing positive relationships to death from each of the three diseases were hypertension, high fasting blood sugar, abnormality of cardio-thoracic ratio, ST-T abnormality in ECG, left ventricular hypertrophy in ECG. The odds ratio for ST-T abnormality in ECG was significant for all three causes of death. 2) High total cholesterol showed a significant positive relation only to death from IHD. As to death from CVD and SUD, albuminuria and sclerotic changes in fundus oculi were positively and significantly related. Risk factors differed for deaths from the three diseases. 3) In death from IHD and CVD, odds ratio at the second examination was apt to be higher than that at baseline examination. In death from SUD, however, odds ratios at the first and the second examination showed no significant difference.

  1. Major life events increase the risk of stroke but not of myocardial infarction: results from the Copenhagen City Heart Study

    PubMed Central

    Kornerup, Henriette; Osler, Merete; Boysen, Gudrun; Barefoot, John; Schnohr, Peter; Prescott, Eva

    2013-01-01

    Background More attention has been paid to psychosocial conditions as possible risk factors for cardiovascular disease (CVD) and the impact of accumulated major life events (MLE) on the development of CVD has received little attention. Design The aim of this study was to explore the influences of MLE on CVD risk in a large cohort study. Methods The study population consisted of 9542 randomly selected adults free of CVD examined in the Copenhagen City Heart Study in 1991–1994 and followed up for CVD defined as myocardial infarction or ischaemic stroke until 2001. MLE were analysed using an 11-item questionnaire and hazard ratios (HR) were calculated using the Cox proportional hazards model. Results During follow-up there were 443 myocardial infarctions (MI) and 350 ischaemic strokes. Financial problems in both childhood and adulthood were associated with risk of stroke with an HR of 1.71 (95% CI: 1.29–2.26) and 1.60 (1.12–2.30), respectively. Accumulation of MLE was also associated with risk of stroke with HR reaching a maximum of 1.41 (95% CI: 1.06–1.90) for more than one event in childhood and 1.49 (95% CI: 1.09–2.04) for more than one event in adulthood. MLE accumulated over a life course showed a dose–response relationship with stroke. Associations were somewhat attenuated by adjustment for vital exhaustion suggesting a mediating role, but not by adjustment for behavioural risk factors. There were no associations between MLE and MI. Conclusion In this population-based cohort study, we found that MLE conveyed a moderately increased risk of stroke partly mediated through vital exhaustion. We found no association between MLE and the risk of MI. PMID:20038841

  2. Effect of a High-Protein Diet on Kidney Function in Healthy Adults: Results From the OmniHeart Trial

    PubMed Central

    Juraschek, Stephen P.; Appel, Lawrence J.; Anderson, Cheryl A.M.; Miller, Edgar R.

    2013-01-01

    Background Consumption of a diet high in protein can cause glomerular hyperfiltration, a potentially maladaptive response, which may accelerate the progression of kidney disease. Study Design An ancillary study of the OmniHeart trial, a randomized 3-period crossover feeding trial testing the effects of partial replacement of carbohydrate with protein on kidney function. Setting & Participants Healthy adults (N=164) with prehypertension or stage 1 hypertension at a community-based research clinic with a metabolic kitchen. Intervention Participants were fed each of 3 diets for 6 weeks. Feeding periods were separated by a 2- to 4-week washout period. Weight was held constant on each diet. The 3 diets emphasized carbohydrate, protein, or unsaturated fat; dietary protein was either 15% (carbohydrate and unsaturated fat diets) or 25% (protein diet) of energy intake. Outcomes Fasting serum creatinine, cystatin C, and β2-microglobulin levels, estimated glomerular filtration rate (eGFR). Measurements Serum creatinine, cystatin C, and β2-microglobulin collected at the end of each feeding period. Results Baseline cystatin C-based eGFR was 92.0±16.3 (SD) mL/min/1.73 m2. Compared with the carbohydrate and unsaturated fat diets, the protein diet increased cystatin C-based eGFR by ~4 mL/min/1.73 m2 (P < 0.001). The effects of the protein diet on kidney function were independent of changes in blood pressure. There was no significant difference between the carbohydrate and unsaturated fat diets. Limitations Participants did not have kidney disease at baseline. Conclusions A healthy diet rich in protein increased eGFR. Whether long-term consumption of a high-protein diet leads to kidney disease is uncertain. PMID:23219108

  3. Mortality Among Patients Hospitalized with Heart Failure and Diabetes Mellitus: Results from the National Inpatient Sample 2000 – 2010

    PubMed Central

    Win, Theingi Tiffany; Davis, Herbert T.; Laskey, Warren K.

    2016-01-01

    Background Case-fatality and hospitalization rates for U.S. heart failure (HF) patients have steadily decreased over the past several decades. Diabetes mellitus (DM), a risk factor for, and frequent co-existing condition with, HF continues to increase in the general population. Methods and Results We used the National Inpatient Sample to estimate overall as well as age-, sex-, and race/ethnicity-specific trends in HF hospitalizations, DM prevalence and in-hospital mortality among 2.5 million discharge records from 2000–2010 with HF as primary discharge diagnosis. Multivariable logistic and Poisson regression were used to assess the impact of the above demographic characteristics on in-hospital mortality. Age-standardized hospitalizations decreased significantly in HF overall and in HF with DM . Age-standardized in-hospital mortality with HF declined from 2000 to 2010 (4.57% to 3.09%, ptrend <0.0001), while DM prevalence in HF increased (38.9% to 41.9%, ptrend < 0.0001) as did comorbidity burden. Age-standardized in-hospital mortality in HF with DM also decreased significantly (3.53% to 2.27%, ptrend <0.0001). After adjusting for year, age and comorbid burden, males remained at 17% increased risk versus females, non-Hispanics remained at 12% increased risk versus Hispanics and whites had a 30% higher mortality versus non-white minorities. Absolute mortality rates were lower in younger versus older patients although the rate of decline was attenuated in younger patients. Conclusions In-hospital mortality in HF patients with DM significantly decreased over the past decade despite increases in DM prevalence and co-morbid conditions. Mortality rate decreases among younger patients were significantly attenuated and mortality disparities remain among important demographic sub-groups. PMID:27146551

  4. Feasibility of eight physical fitness tests in 1,050 older adults with intellectual disability: results of the healthy ageing with intellectual disabilities study.

    PubMed

    Hilgenkamp, Thessa I M; van Wijck, Ruud; Evenhuis, Heleen M

    2013-02-01

    Although physical fitness is relevant for well-being and health, knowledge on the feasibility of instruments to measure physical fitness in older adults with intellectual disability (ID) is lacking. As part of the study Healthy Ageing with Intellectual Disabilities with 1,050 older clients with ID in three Dutch care services, the feasibility of 8 physical fitness tests was expressed in completion rates: box and block test, response time test, Berg balance scale, walking speed, grip strength, 30-s chair stand, 10-m incremental shuttle walking test, and the extended modified back saver sit and reach test. All tests had moderate to good feasibility in all subgroups, except for the participants with profound ID (all tests), severe ID (response time test and Berg balance scale), and wheelchair users (all tests that involve the legs). We conclude that the 8 tests are feasible to measure physical fitness in most older adults with ID.

  5. NiTinol-based cutting edges for endovascular heart valve resection: first in-vitro cutting results.

    PubMed

    Wendt, Daniel; Stühle, Sebastian; Kawa, Emilia; Thielmann, Matthias; Kipfmüller, Brigitte; Wendt, Hermann; Hauck, Florian; Vogel, Bernd; Fischer, Harald; Jakob, Heinz

    2009-01-01

    Machining of shape memory alloys based on Nitinol (NiTi) creates difficulties due to its ductility and severe strain hardening. In this experiment, different cutting edges and grinding parameters were tested to optimize cutting results on NiTi-based blades intended for endovascular heart valve resection. The cutting procedure was performed using two counter-rotating circular NiTi blades of different diameter. A rotating/punching process should be performed. Different shapes (glazed, waved, and saw tooth), different grinding techniques (manual, manual grinder, and precise milling cutter) and additionally various velocities (50 and 200 rpm) were tested on specific test specimens. Cutting forces were measured and cutting quality was examined using digital microscopy. Preliminary tests with rotating blades showed superior results using cutting edges for the punching process (150 N vs. 200 N; n=7). In a second step special test specimens were tested. Maximum cutting-force was 265 N+/-20 N (mean+/-SD; n=7). Subsequently different shapes were tested at 50 and 200 rpm using the rotating/punching method regarding alternate grinding techniques. Cutting forces were 27 N+/-7.7 N for glazed blades (n=7) at 50 rpm and 18 N+/-4.7 N at 200 rpm, waved blades (n=7) required a maximum force of 18 N+/-5 N at 50 rpm and 11 N+/-3.3 N at 200 rpm, whereas saw tooth blades (n=7) needed 17 N+/-12.7 N at 50 rpm and 9 N+/-1.2 N at 200 rpm. Precise cutting quality was only seen when using glazed blades sharpened under accurate conditions with a high-speed milling cutter. Although shape memory alloys based on Nitinol are difficult to process, and well-defined grinding parameters do not exist, acceptable results can be reached using high-speed milling cutters. Best cutting quality can be observed by using glazed blades, performing a rotating/punching process at high velocities. Lower cutting forces can be observed by using other shape-types, however this leads to lower cutting quality. Therefore

  6. Lifestyle intervention improves heart rate recovery from exercise in adults with Type 2 diabetes: Results from the Look AHEAD Study

    USDA-ARS?s Scientific Manuscript database

    The primary aims of this paper were (1) to evaluate the influence of intensive lifestyle weight loss and exercise intervention (ILI) compared with diabetes support and education (DSE) upon Heart Rate Recovery (HRR) from graded exercise testing (GXT) and (2) to determine the independent and combined ...

  7. Genetic variation at the PCSK9 locus, low density lipoproteins, response to pravastatin and coronary heart disease: results from PROSPER

    USDA-ARS?s Scientific Manuscript database

    Caucasian carriers of the T allele at R46L in the proprotein convertase subtilisin/kexin type 9 (PCSK9) locus have been reported to have 15% lower low-density lipoprotein (LDL) cholesterol (C) levels and 47% lower coronary heart disease (CHD) risk. Our objective was to examine two PCSK9 single nucle...

  8. Lifestyle intervention improves heart rate recovery from exercise in adults with type 2 diabetes: Results from the Look AHEAD study

    USDA-ARS?s Scientific Manuscript database

    The primary aims of this paper were (1) to evaluate the influence of intensive lifestyle weight loss and exercise intervention (ILI) compared with diabetes support and education (DSE) upon Heart Rate Recovery (HRR) from graded exercise testing (GXT), and (2) to determine the independent and combined...

  9. The importance of consistent, high-quality acute myocardial infarction and heart failure care results from the American Heart Association's Get with the Guidelines Program.

    PubMed

    Wang, Tracy Y; Dai, David; Hernandez, Adrian F; Bhatt, Deepak L; Heidenreich, Paul A; Fonarow, Gregg C; Peterson, Eric D

    2011-08-02

    This study examined the degree to which hospital performance for acute myocardial infarction (AMI) and heart failure (HF) care processes are correlated. Although AMI and HF care processes may be amenable to similar quality improvement interventions, whether these are indeed correlated and whether hospitals with consistently superior performance for both care metrics have the best outcomes remains unknown. We compared hospital performance of the Centers for Medicare & Medicaid Services AMI and HF core measures in 283 hospitals submitting 10 or more patients to the Get With The Guidelines AMI and HF programs between January 2005 and April 2009. Median hospital adherence to AMI and HF composite measures were 93% (interquartile range: 87% to 97%) and 92% (interquartile range: 85% to 96%), respectively, with only a modest correlation between hospital performance on these 2 composite metrics (r = 0.50; 95% confidence interval: 0.41 to 0.58). Hospitals with superior performance to both AMI and HF processes had significantly longer duration of Get With The Guidelines participation and lower adjusted in-hospital mortality (odds ratio: 0.79; 95% confidence interval: 0.63 to 0.99) for AMI and HF patients, whereas hospitals with superior adherence to either alone had similar mortality rates as hospitals with superior adherence to neither measure. Hospitals that had consistent, superior performance for both AMI and HF care had significantly lower risk-adjusted mortality than those with superior performance either alone or for neither measure. Whether a single scoring system to assess global, rather than condition-specific, quality of cardiovascular care would facilitate care quality improvement more consistently and would optimize patient outcomes merits further investigation. Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  10. Association of Digoxin With Interstage Mortality: Results From the Pediatric Heart Network Single Ventricle Reconstruction Trial Public Use Dataset.

    PubMed

    Oster, Matthew E; Kelleman, Michael; McCracken, Courtney; Ohye, Richard G; Mahle, William T

    2016-01-13

    Mortality for infants with single ventricle congenital heart disease remains as high as 8% to 12% during the interstage period, the time between discharge after the Norwood procedure and before the stage II palliation. The objective of our study was to determine the association between digoxin use and interstage mortality in these infants. We conducted a retrospective cohort study using the Pediatric Heart Network Single Ventricle Reconstruction Trial public use dataset, which includes data on infants with single right ventricle congenital heart disease randomized to receive either a Blalock-Taussig shunt or right ventricle-to-pulmonary artery shunt during the Norwood procedure at 15 institutions in North America from 2005 to 2008. Parametric survival models were used to compare the risk of interstage mortality between those discharged to home on digoxin versus those discharged to home not on digoxin, adjusting for center volume, ascending aorta diameter, shunt type, and socioeconomic status. Of the 330 infants eligible for this study, 102 (31%) were discharged home on digoxin. Interstage mortality for those not on digoxin was 12.3%, compared to 2.9% among those on digoxin, with an adjusted hazard ratio of 3.5 (95% CI, 1.1-11.7; P=0.04). The number needed to treat to prevent 1 death was 11 patients. There were no differences in complications between the 2 groups during the interstage period. Digoxin use in infants with single ventricle congenital heart disease is associated with significantly reduced interstage mortality. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  11. Effect of Visit-to-Visit Variation of Heart Rate and Systolic Blood Pressure on Outcomes in Chronic Systolic Heart Failure: Results From the Systolic Heart Failure Treatment With the If Inhibitor Ivabradine Trial (SHIFT) Trial.

    PubMed

    Böhm, Michael; Robertson, Michele; Borer, Jeffrey; Ford, Ian; Komajda, Michel; Mahfoud, Felix; Ewen, Sebastian; Swedberg, Karl; Tavazzi, Luigi

    2016-02-12

    Elevated resting heart rate (HR) and low systolic blood pressure (SBP) are related to poor outcomes in heart failure (HF). The association between visit-to-visit variation in SBP and HR and risk in HF is unknown. In Systolic Heart Failure Treatment with the If inhibitor ivabradine Trial (SHIFT) patients, we evaluated relationships between mean HR, mean SBP, and visit-to-visit variations (coefficient of variation [CV]=SD/mean×100%) in SBP and HR (SBP-CV and HR-CV, respectively) and primary composite endpoint (cardiovascular mortality or HF hospitalization), its components, all-cause mortality, and all-cause hospitalization. High HR and low SBP were closely associated with risk for primary endpoint, all-cause mortality, and HF hospitalization. The highest number of primary endpoint events occurred in the highest HR tertile (38.8% vs 16.4% lowest tertile; P<0.001). For HR-CV, patients at highest risk were those in the lowest tertile. Patients in the lowest thirds of mean SBP and SBP-CV had the highest risk. The combination of high HR and low HR-CV had an additive deleterious effect on risk, as did that of low SBP and low SBP-CV. Ivabradine reduced mean HR and increased HR-CV, and increased SBP and SBP-CV slightly. Beyond high HR and low SBP, low HR-CV and low SBP-CV are predictors of cardiovascular outcomes with additive effects on risk in HF, but with an unknown effect size. Beyond HR reduction, ivabradine increases HR-CV. Low visit-to-visit variation of HR and SBP might signal risk of cardiovascular outcomes in systolic HF. URL: http://www.isrctn.com/. Unique identifier: ISRCTN70429960. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  12. Correlation of results obtained by in-vivo optical spectroscopy with measured blood oxygen saturation using a positive linear regression fit

    NASA Astrophysics Data System (ADS)

    McCormick, Patrick W.; Lewis, Gary D.; Dujovny, Manuel; Ausman, James I.; Stewart, Mick; Widman, Ronald A.

    1992-05-01

    Near infrared light generated by specialized instrumentation was passed through artificially oxygenated human blood during simultaneous sampling by a co-oximeter. Characteristic absorption spectra were analyzed to calculate the ratio of oxygenated to reduced hemoglobin. A positive linear regression fit between diffuse transmission oximetry and measured blood oxygenation over the range 23% to 99% (r2 equals .98, p < .001) was noted. The same technology was used to pass two channels of light through the scalp of brain-injured patients with prolonged, decreased level of consciousness in a tertiary care neuroscience ICU. Transmission data were collected with gross superficial-to-deep spatial resolution. Saturation calculation based on the deep signal was observed in the patient over time. The procedure was able to be performed clinically without difficulty; rSO2 values recorded continuously demonstrate the usefulness of the technique. Using the same instrumentation, arterial input and cerebral response functions, generated by IV tracer bolus, were deconvoluted to measure mean cerebral transit time. Date collected over time provided a sensitive index of changes in cerebral blood flow as a result of therapeutic maneuvers.

  13. Heart murmurs

    MedlinePlus

    Chest sounds - murmurs; Heart sounds - abnormal; Murmur - innocent; Innocent murmur; Systolic heart murmur; Diastolic heart murmur ... The heart has 4 chambers: Two upper chambers (atria) Two lower chambers (ventricles) The heart has valves that close ...

  14. Ghrelin and hormonal markers under exercise training in patients with heart failure with preserved ejection fraction: results from the Ex‐DHF pilot study

    PubMed Central

    Trippel, Tobias Daniel; Holzendorf, Volker; Halle, Martin; Gelbrich, Götz; Nolte, Kathleen; Duvinage, Andre; Schwarz, Silja; Rutscher, Tinka; Wiora, Julian; Wachter, Rolf; Herrmann‐Lingen, Christoph; Duengen, Hans‐Dirk; Hasenfuß, Gerd; Pieske, Burkert

    2016-01-01

    Abstract Background Over 50% of patients with symptomatic heart failure (HF) experience HF with preserved ejection fraction (HFpEF). Exercise training (ET) is effective in improving cardiorespiratory fitness and dimensions of quality of life in patients with HFpEF. A systemic pro‐inflammatory state induced by comorbidities as the cause of myocardial structural and functional alterations has been proposed in HFpEF. ET modifies myocardial structure and has been related to inflammatory state. We investigated Ghrelin, related adipokines, markers of inflammation, and neuro‐hormonal activation in patients undergoing a structured ET vs. usual care are with HFpEF. Methods and results Ex‐DHF‐P was a prospective, controlled, randomized multi‐centre trial on structured and supervised ET in patients with HFpEF. We performed a post hoc analysis in 62 patients from Ex‐DHF‐P. Ghrelin, adiponectin, leptin, IL‐1ß, IL‐6, IL‐10, tumour necrosis factor‐alpha, MR‐proANP, MR‐proADM, CT‐proET1, and CT‐proAVP were assessed to seize the impact of ET on these markers in patients with HFpEF. Thirty‐six (58%) patients were female, mean age was 64 years, and median ghrelin was 928 pg/mL (interquartile range 755–1156). When stratified for high versus low ghrelin, groups significantly differed at baseline in presence obesity, waist circumference, and adiponectin levels (P < 0.05, respectively). Overall, ghrelin levels rose significantly to 1013 pg/mL (interquartile range 813–1182) (P < 0.001). Analysis of covariance modelling for change in ghrelin identified ET (P = 0.013) and higher baseline adiponectin levels (P = 0.035) as influencing factors. Conclusions Exercise training tended to increase ghrelin levels in Ex‐DHF‐P. This increase was especially pronounced in patients with higher baseline adiponectin levels. Future trials are needed to investigate the effect of ET on endogenous ghrelin levels in regard to interactions with

  15. Late Results of Cox Maze III Procedure in Patients with Atrial Fibrillation Associated with Structural Heart Disease.

    PubMed

    Gomes, Gustavo Gir; Gali, Wagner Luis; Sarabanda, Alvaro Valentim Lima; Cunha, Claudio Ribeiro da; Kessler, Iruena Moraes; Atik, Fernando Antibas

    2017-07-01

    Cox-Maze III procedure is one of the surgical techniques used in the surgical treatment of atrial fibrillation (AF). To determine late results of Cox-Maze III in terms of maintenance of sinus rhythm, and mortality and stroke rates. Between January 2006 and January 2013, 93 patients were submitted to the cut-and-sew Cox-Maze III procedure in combination with structural heart disease repair. Heart rhythm was determined by 24-hour Holter monitoring. Procedural success rates were determined by longitudinal methods and recurrence predictors by multivariate Cox regression models. Thirteen patients that obtained hospital discharge alive were excluded due to lost follow-up. The remaining 80 patients were aged 49.9 ± 12 years and 47 (58.7%) of them were female. Involvement of mitral valve and rheumatic heart disease were found in 67 (83.7%) and 63 (78.7%) patients, respectively. Seventy patients (87.5%) had persistent or long-standing persistent AF. Mean follow-up with Holter monitoring was 27.5 months. There were no hospital deaths. Sinus rhythm maintenance rates were 88%, 85.1% and 80.6% at 6 months, 24 months and 36 months, respectively. Predictors of late recurrence of AF were female gender (HR 3.52; 95% CI 1.21-10.25; p = 0.02), coronary artery disease (HR 4.73 95% CI 1.37-16.36; p = 0.01) and greater left atrium diameter (HR 1.05; 95% CI 1.01-1.09; p = 0.02). Actuarial survival was 98.5% at 12, 24 and 48 months and actuarial freedom from stroke was 100%, 100% and 97.5% in the same time frames. The Cox-Maze III procedure, in our experience, is efficacious for sinus rhythm maintenance, with very low late mortality and stroke rates. A operação de Cox-Maze III é uma das variantes técnicas no tratamento cirúrgico da fibrilação atrial (FA). Estudar os resultados tardios da operação de Cox-Maze III, quanto à eficácia na manutenção de ritmo sinusal e taxas de mortalidade e acidente vascular cerebral (AVC). Entre janeiro de 2006 a janeiro de 2013, 93 pacientes

  16. Impact of dopamine infusion on renal function in hospitalized heart failure patients: results of the Dopamine in Acute Decompensated Heart Failure (DAD-HF) Trial.

    PubMed

    Giamouzis, Gregory; Butler, Javed; Starling, Randall C; Karayannis, George; Nastas, John; Parisis, Charalambos; Rovithis, Dimitrios; Economou, Dimitrios; Savvatis, Konstantinos; Kirlidis, Themistoklis; Tsaknakis, Themistoklis; Skoularigis, John; Westermann, Dirk; Tschöpe, Carsten; Triposkiadis, Filippos

    2010-12-01

    Worsening renal function (WRF) and hypokalemia related to diuretic use for acute decompensated heart failure (ADHF) are common and associated with poor prognosis. Low-dose dopamine infusion improves renal perfusion; its effect on diuresis or renal function specifically in ADHF is not known. Sixty consecutive ADHF patients (age 75.7 ± 11.2 years; 51.7% female; left ventricular ejection fraction 35.3 ± 12.1%) were randomized, after receiving a 40 mg intravenous furosemide bolus, to either high-dose furosemide (HDF, 20 mg/h continuous infusion for 8 hours) or low-dose furosemide combined with low-dose dopamine (LDFD, furosemide 5 mg/h plus dopamine 5 μg kg(-1) min(-1) continuous infusion for 8 hours). Both strategies were compared for total diuresis, WRF (defined as a rise in serum creatinine of >0.3 mg/dL from baseline to 24 hours), electrolyte balance, and 60-day postdischarge outcomes. Mean hourly excreted urine volume (272 ± 149 mL in HDF vs 278 ± 186 mL in LDFD group; P = .965) and changes in dyspnea score (Borg index: -4.4 ± 2.1 in HDF group vs -4.7 ± 2.0 in LDFD group; P = .575) during the 8 hours of protocol treatment were similar in the two groups. WRF was more frequent in the HDF (n = 9; 30%) than in the LDFD group (n = 2; 6.7%; P = .042). Serum potassium changed from 4.3 ± 0.5 to 3.9 ± 0.4 mEq/L at 24 hours (P = .003) in the HDF group and from 4.4 ± 0.5 to 4.2 ± 0.5 mEq/L at 24 hours (P = .07) in the LDFD group. Length of stay and 60-day mortality or rehospitalization rates (all-cause, cardiovascular, and worsening HF) were similar in the two groups. In ADHF patients, the combination of low-dose furosemide and low-dose dopamine is equally effective as high-dose furosemide but associated with improved renal function profile and potassium homeostasis. Copyright © 2010 Elsevier Inc. All rights reserved.

  17. Results of animal experiments using an undulation pump total artificial heart: analysis of 10 day and 19 day survival.

    PubMed

    Mochizuki, S; Abe, Y; Chinzei, T; Isoyama, T; Ono, T; Saito, I; Guba, P; Karita, T; Sun, Y P; Kouno, A; Suzuki, T; Baba, K; Mabuchi, K; Imachi, K

    2000-01-01

    An undulation pump is a special rotary blood pump in which rotation of a brushless DC motor is transformed to an undulating motion by a disc in the pump housing attached by means of a special link mechanism. In the blood pump, a closed line between the disc and housing moves from the inlet to the outlet by this undulating disc motion, which sucks and pushes the blood from the inlet to the outlet. Because the same phenomena occurs at both sides of the disc, a continuous flow is obtained when the motor rotational speed is constant. The pump flow pattern can be easily changed from continuous flow to pulsatile flow by controlling the motor drive current pattern. A seal membrane made of segmented polyurethane protects the blood from invading the link mechanism as well as the motor. UPTAH is fabricated with two undulation pumps and two brushless DC motors. Its size is 75 mm in diameter and 80 mm long, and it has one of the great advantage of no compliance chamber required in the system. UPTAHs were implanted under cardiopulmonary bypass (CPB) into the chest cavities of 16 goats, each weighing between 41 and 72 kg. No anticoagulant and antiplatelet agent was used after the surgery. The left atrial pressure was automatically controlled to prevent its elevation and sucking of the atrial wall into the atrial cuff. The following results were obtained: (1) UPTAHs fit well into all the goats; (2) the longest survival was 19.8 days, the cause of death was bleeding from the aortic anastomosis; (3) No thrombus was observed in the blood pump despite no anticoagulant use. Hemolysis depended upon the length of CPB during surgery. When CPB time was within 2 hours, hemolysis level returned to baseline within a few days of the surgery. UPTAH is a promising implantable TAH, because of its small size and easy controllability.

  18. Cancer and heart attack survivors' expectations of employment status: results from the English Longitudinal Study of Ageing.

    PubMed

    Duijts, Saskia F A; van der Beek, Allard J; Bleiker, Eveline M A; Smith, Lee; Wardle, Jane

    2017-08-07

    Sociodemographic, health- and work-related factors have been found to influence return to work in cancer survivors. It is feasible though that behavioural factors, such as expectation of being at work, could also affect work-related outcomes. Therefore, the effect of earlier identified factors and expectation of being at work on future employment status in cancer survivors was explored. To assess the degree to which these factors specifically concern cancer survivors, a comparison with heart attack survivors was made. Data from the English Longitudinal Study of Ageing were used. Cancer and heart attack survivors of working age in the UK were included and followed up for 2 years. Baseline characteristics of both cancer and heart attack survivors were compared regarding employment status. Univariate and multivariate regression analyses were performed in survivors at work, and the interaction between independent variables and diagnose group was assessed. In cancer survivors at work (N = 159), alcohol consumption, participating in moderate or vigorous sport activities, general health and participation were univariate associated with employment status at two-year follow-up. Only fair general health (compared to very good general health) remained statistically significant in the multivariate model (OR 0.31; 95% CI 0.13-0.76; p = 0.010). In heart attack survivors at work (N = 78), gender, general health and expectation of being at work were univariate associated with employment status at follow-up. Female gender (OR 0.03; 95% CI 0.00-0.57; p = 0.018) and high expectation of being at work (OR 10.68; 95% CI 1.23-93.92; p = 0.033) remained significant in the multivariate model. The influence of gender (p = 0.066) and general health (p = 0.020) regarding employment status was found to differ significantly between cancer and heart attack survivors. When predicting future employment status in cancer survivors in the UK, general health is the most relevant factor

  19. Soft robotic sleeve supports heart function.

    PubMed

    Roche, Ellen T; Horvath, Markus A; Wamala, Isaac; Alazmani, Ali; Song, Sang-Eun; Whyte, William; Machaidze, Zurab; Payne, Christopher J; Weaver, James C; Fishbein, Gregory; Kuebler, Joseph; Vasilyev, Nikolay V; Mooney, David J; Pigula, Frank A; Walsh, Conor J

    2017-01-18

    There is much interest in form-fitting, low-modulus, implantable devices or soft robots that can mimic or assist in complex biological functions such as the contraction of heart muscle. We present a soft robotic sleeve that is implanted around the heart and actively compresses and twists to act as a cardiac ventricular assist device. The sleeve does not contact blood, obviating the need for anticoagulation therapy or blood thinners, and reduces complications with current ventricular assist devices, such as clotting and infection. Our approach used a biologically inspired design to orient individual contracting elements or actuators in a layered helical and circumferential fashion, mimicking the orientation of the outer two muscle layers of the mammalian heart. The resulting implantable soft robot mimicked the form and function of the native heart, with a stiffness value of the same order of magnitude as that of the heart tissue. We demonstrated feasibility of this soft sleeve device for supporting heart function in a porcine model of acute heart failure. The soft robotic sleeve can be customized to patient-specific needs and may have the potential to act as a bridge to transplant for patients with heart failure. Copyright © 2017, American Association for the Advancement of Science.

  20. Darwinian fitness.

    PubMed

    Demetrius, Lloyd; Ziehe, Martin

    2007-11-01

    The term Darwinian fitness refers to the capacity of a variant type to invade and displace the resident population in competition for available resources. Classical models of this dynamical process claim that competitive outcome is a deterministic event which is regulated by the population growth rate, called the Malthusian parameter. Recent analytic studies of the dynamics of competition in terms of diffusion processes show that growth rate predicts invasion success only in populations of infinite size. In populations of finite size, competitive outcome is a stochastic process--contingent on resource constraints--which is determined by the rate at which a population returns to its steady state condition after a random perturbation in the individual birth and death rates. This return rate, a measure of robustness or population stability, is analytically characterized by the demographic parameter, evolutionary entropy, a measure of the uncertainty in the age of the mother of a randomly chosen newborn. This article appeals to computational and numerical methods to contrast the predictive power of the Malthusian and the entropic principles. The computational analysis rejects the Malthusian model and is consistent with of the entropic principle. These studies thus provide support for the general claim that entropy is the appropriate measure of Darwinian fitness and constitutes an evolutionary parameter with broad predictive and explanatory powers.

  1. Character displacement as the "best of a bad situation": fitness trade-offs resulting from selection to minimize resource and mate competition.

    PubMed

    Pfennig, Karin S; Pfennig, David W

    2005-10-01

    Character displacement has long been considered a major cause of adaptive diversification. When species compete for resources or mates, character displacement minimizes competition by promoting divergence in phenotypes associated with resource use (ecological character displacement) or mate attraction (reproductive character displacement). In this study, we investigated whether character displacement can also have pleiotropic effects that lead to fitness trade-offs between the benefits of avoiding competition and costs accrued in other fitness components. We show that both reproductive and ecological character displacement have caused spadefoot toads to evolve smaller body size in the presence of a heterospecific competitor. Although this shift in size likely arose as a by-product of character displacement acting to promote divergence between species in mating behavior and larval development, it concomitantly reduces offspring survival, female fecundity, and sexual selection on males. Thus, character displacement may represent the "best of a bad situation" in that it lessens competition, but at a cost. Individuals in sympatry with the displaced phenotype will have higher fitness than those without the displaced trait because they experience reduced competition, but they may have reduced fitness relative to individuals in allopatry. Such a fitness trade-off can limit the conditions under which character displacement evolves and may even increase the risk of "Darwinian extinction" in sympatric populations. Consequently, character displacement may not always promote diversification in the manner that is often expected.

  2. Increased Heart Rate Is Associated With Higher Mortality in Patients With Atrial Fibrillation (AF): Results From the Outcomes Registry for Better Informed Treatment of AF (ORBIT-AF)

    PubMed Central

    Steinberg, Benjamin A; Kim, Sunghee; Thomas, Laine; Fonarow, Gregg C; Gersh, Bernard J; Holmqvist, Fredrik; Hylek, Elaine; Kowey, Peter R; Mahaffey, Kenneth W; Naccarelli, Gerald; Reiffel, James A; Chang, Paul; Peterson, Eric D; Piccini, Jonathan P

    2015-01-01

    Background Most patients with atrial fibrillation (AF) require rate control; however, the optimal target heart rate remains under debate. We aimed to assess rate control and subsequent outcomes among patients with permanent AF. Methods and Results We studied 2812 US outpatients with permanent AF in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation. Resting heart rate was measured longitudinally and used as a time-dependent covariate in multivariable Cox models of all-cause and cause-specific mortality during a median follow-up of 24 months. At baseline, 7.4% (n=207) had resting heart rate <60 beats per minute (bpm), 62% (n=1755) 60 to 79 bpm, 29% (n=817) 80 to 109 bpm, and 1.2% (n=33) ≥110 bpm. Groups did not differ by age, previous cerebrovascular disease, heart failure status, CHA2DS2-VASc scores, renal function, or left ventricular function. There were significant differences in race (P=0.001), sinus node dysfunction (P=0.004), and treatment with calcium-channel blockers (P=0.006) and anticoagulation (P=0.009). In analyses of continuous heart rates, lower heart rate ≤65 bpm was associated with higher all-cause mortality (adjusted hazard ratio [HR], 1.15 per 5-bpm decrease; 95% CI, 1.01 to 1.32; P=0.04). Similarly, increasing heart rate >65 bpm was associated with higher all-cause mortality (adjusted HR, 1.10 per 5-bpm increase; 95% CI, 1.05 to 1.15; P<0.0001). This relationship was consistent across endpoints and in a broader sensitivity analysis of permanent and nonpermanent AF patients. Conclusions Among patients with permanent AF, there is a J-shaped relationship between heart rate and mortality. These data support current guideline recommendations, and clinical trials are warranted to determine optimal rate control. Clinical Trial Registration URL: http://clinicaltrials.gov/. Unique identifier: NCT01165710. PMID:26370445

  3. Initial application in the EACTS and STS Congenital Heart Surgery Databases of an empirically derived methodology of complexity adjustment to evaluate surgical case mix and results.

    PubMed

    Jacobs, Jeffrey Phillip; Jacobs, Marshall Lewis; Maruszewski, Bohdan; Lacour-Gayet, Francois G; Tchervenkov, Christo I; Tobota, Zdzislaw; Stellin, Giovanni; Kurosawa, Hiromi; Murakami, Arata; Gaynor, J William; Pasquali, Sara K; Clarke, David R; Austin, Erle H; Mavroudis, Constantine

    2012-11-01

    Outcomes evaluation is enhanced by assignment of operative procedures to appropriate categories based upon relative average risk. Formal risk modelling is challenging when a large number of operation types exist, including relatively rare procedures. Complexity stratification provides an alternative methodology. We report the initial application in the Congenital Heart Surgery Databases of the Society of Thoracic Surgeons (STS) and the European Association for Cardio-thoracic Surgery (EACTS) of an empirically derived system of complexity adjustment to evaluate surgical case mix and results. Complexity stratification is a method of analysis in which the data are divided into relatively homogeneous groups (called strata). A complexity stratification tool named the STS-EACTS Congenital Heart Surgery Mortality Categories (STAT Mortality Categories) was previously developed based on the analysis of 77,294 operations entered in the Congenital Heart Surgery Databases of EACTS (33,360 operations) and STS (43,934 patients). Procedure-specific mortality rate estimates were calculated using a Bayesian model that adjusted for small denominators. Operations were sorted by increasing risk and grouped into five categories (the STAT Mortality Categories) that were designed to minimize within-category variation and maximize between-category variation. We report here the initial application of this methodology in the EACTS Congenital Heart Surgery Database (47,187 operations performed over 4 years: 2006-09) and the STS Congenital Heart Surgery Database (64,307 operations performed over 4 years: 2006-09). In the STS Congenital Heart Surgery Database, operations classified as STAT Mortality Categories 1-5 were (1): 17332, (2): 20114, (3): 9494, (4): 14525 and (5): 2842. Discharge mortality was (1): 0.54%, (2): 1.6%, (3): 2.4%, (4): 7.5% and (5): 17.8%. In the EACTS Congenital Heart Surgery Database, operations classified as STAT Mortality Categories 1-5 were (1): 19874, (2): 12196, (3

  4. Long-Term Effect of Endothelin Receptor Antagonism With Bosentan on the Morbidity and Mortality of Patients With Severe Chronic Heart Failure: Primary Results of the ENABLE Trials.

    PubMed

    Packer, Milton; McMurray, John J V; Krum, Henry; Kiowski, Wolfgang; Massie, Barry M; Caspi, Avi; Pratt, Craig M; Petrie, Mark C; DeMets, David; Kobrin, Isaac; Roux, Sebastien; Swedberg, Karl

    2017-05-01

    The objective of this clinical trial was to evaluate the long-term effect of endothelin receptor antagonism with bosentan on the morbidity and mortality of patients with severe chronic heart failure. Endothelin may play a role in heart failure, but short-term clinical trials with endothelin receptor antagonists have reported disappointing results. Long-term trials are lacking. In 2 identical double-blind trials, we randomly assigned 1,613 patients with New York Heart Association functional class IIIb to IV heart failure and an ejection fraction <35% to receive placebo or bosentan (target dose 125 mg twice daily) for a median of 1.5 years. The primary outcome for each trial was clinical status at 9 months (assessed by the hierarchical clinical composite); the primary outcome across the 2 trials was death from any cause or hospitalization for heart failure. Bosentan did not influence clinical status at 9 months in either trial (p = 0.928 and p = 0.263). In addition, 321 patients in the placebo group and 312 patients in the bosentan group died or were hospitalized for heart failure (hazard ratio [HR]: 1.01; 95% confidence interval [CI]: 0.86 to 1.18; p = 0.90). The bosentan group experienced fluid retention within the first 2 to 4 weeks, as evidenced by increased peripheral edema, weight gain, decreases in hemoglobin, and an increased risk of hospitalization for heart failure, despite intensification of background diuretics. During follow-up, 173 patients died in the placebo group and 160 patients died in the bosentan group (HR: 0.94; 95% CI: 0.75 to 1.16). About 10% of the bosentan group showed meaningful increases in hepatic transaminases, but none had acute or chronic liver failure. Bosentan did not improve the clinical course or natural history of patients with severe chronic heart failure and but caused early and important fluid retention. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  5. Coronary Artery Calcium Improves Risk Assessment in Adults with a Family History of Premature Coronary Heart Disease: Results from MESA

    PubMed Central

    Patel, Jaideep; Al Rifai, Mahmoud; Blaha, Michael J.; Budoff, Matthew J.; Post, Wendy S.; Polak, Joseph F.; Bluemke, David A.; Scheuner, Maren T.; Kronmal, Richard A.; Blumenthal, Roger S.; Nasir, Khurram; McEvoy, John W.

    2017-01-01

    Background The prognostic value of coronary artery calcium (CAC) or carotid intima-media thickness (CIMT) among asymptomatic adults with a family history (FH) of premature coronary heart disease (CHD) is unclear. Methods and Results MESA enrolled 6814 adults without known atherosclerotic cardiovascular disease (ASCVD). Hard ASCVD events were ascertained over a median follow-up of 10.2 years. We estimated adjusted-hazard ratios (HRs) across CAC and CIMT categories using Cox regression, both between and within FH status groups. Improvement in discrimination with CAC or CIMT added to variables from the ASCVD pooled-cohort equation was also evaluated using receiver operator characteristic curve and likelihood ratio analysis. Of 6125 individuals (62 ± 10 years, 47% males) who reported information on FH, 1262 (21%) had a FH of premature CHD. Among these, 104 hard ASCVD events occurred. Crude incidence-rates (per 1,000 person years) for hard ASCVD were 4.4 for CAC=0 (N=574, 46% of the sample), 8.8 for CAC 1–99 (N=368), 14.9 for CAC 100–399 (N=178), and 20.8 for CAC ≥400 (N=142). Relative to CAC=0, adjusted hard ASCVD HRs for each CAC category among persons with a FH were; 1.64 (95% CI, 0.94–2.87), 2.45 (1.31–4.58), and 2.80 (1.44–5.43), respectively. However, there was no increased hazard for hard ASCVD in high versus low CIMT categories. In participants with a FH of premature CHD, CAC improved discrimination of hard ASCVD events (p<0.001). However, CIMT did not discriminate ASCVD (p=0.70). Conclusions Nearly half of individuals reporting FH have zero CAC and may receive less net benefit from aspirin or statin therapy. Among persons with a FH, CAC is a robust marker of absolute and relative risk of ASCVD, whereas CIMT is not. PMID:26047825

  6. Depression and Risk of Sudden Cardiac Death and Coronary Heart Disease in Women: Results from the Nurses’ Health Study

    PubMed Central

    Whang, William; Kubzansky, Laura D.; Kawachi, Ichiro; Rexrode, Kathryn M.; Kroenke, Candyce H.; Glynn, Robert J.; Garan, Hasan; Albert, Christine M.

    2008-01-01

    Objectives We assessed the association between depression and sudden cardiac death (SCD) and cardiac events among individuals without baseline coronary heart disease (CHD). Background Depression is a risk factor for cardiac events and mortality among those with CHD, possibly from arrhythmia. Methods We studied depressive symptoms, and a proxy variable for clinical depression consisting of severe symptoms and/or antidepressant medication use, and their relationship to cardiac events in the Nurses’ Health Study. Questionnaires in 1992, 1996, and 2000 assessed symptoms with the Mental Health Index (MHI-5), and antidepressant use was assessed in 1996 and 2000. Primary endpoints included SCD, fatal CHD, and non-fatal myocardial infarction (MI). Results Among 63,469 women without prior CHD/stroke in 1992, 7.9% had MHI-5 scores (<53) previously found to predict clinical depression. Depressive symptoms were associated with CHD events, and the relationship was strongest for fatal CHD, where the association remained significant even after controlling for CHD risk factors (HR=1.49; 95% CI 1.11–2.00 for MHI-5 score<53). In models from 1996 onward, our proxy variable for clinical depression was most associated with SCD in multivariable models (HR=2.33, 95% CI 1.47–3.70), and this risk was primarily due to a specific relationship between antidepressant use and SCD (HR=3.34, 95% CI 2.03–5.50). Conclusions In this cohort of women without baseline CHD, depressive symptoms were associated with fatal CHD, and a measure of clinical depression including antidepressant use was specifically associated with SCD. Although antidepressant use may be a marker of worse depression, its specific association with SCD merits further study. CONDENSED ABSTRACT We prospectively analyzed the association between depression and cardiac events in the Nurses’ Health Study. Symptoms of depression as measured by Mental Health Index (MHI-5) score were directly associated with risk of CHD events

  7. Effects of daily hemodialysis on heart rate variability: results from the Frequent Hemodialysis Network (FHN) Daily Trial.

    PubMed

    Chan, Christopher T; Chertow, Glenn M; Daugirdas, John T; Greene, Tom H; Kotanko, Peter; Larive, Brett; Pierratos, Andreas; Stokes, John B

    2014-01-01

    End-stage renal disease is associated with reduced heart rate variability (HRV), components of which generally are associated with advanced age, diabetes mellitus and left ventricular hypertrophy. We hypothesized that daily in-center hemodialysis (HD) would increase HRV. The Frequent Hemodialysis Network (FHN) Daily Trial randomized 245 patients to receive 12 months of six versus three times per week in-center HD. Two hundred and seven patients had baseline Holter recordings. HRV measures were calculated from 24-h Holter electrocardiograms at both baseline and 12 months in 131 patients and included low-frequency power (LF, a measure of sympathetic modulation), high-frequency power (HF, a measure of parasympathetic modulation) and standard deviation (SD) of the R-R interval (SDNN, a measure of beat-to-beat variation). Baseline to Month 12 change in LF was augmented by 50% [95% confidence interval (95% CI) 6.1-112%, P =0.022] and LF + HF was augmented by 40% (95% CI 3.3-88.4%, P = 0.03) in patients assigned to daily hemodialysis (DHD) compared with conventional HD. Changes in HF and SDNN were similar between the randomized groups. The effects of DHD on LF were attenuated by advanced age and diabetes mellitus (predefined subgroups). Changes in HF (r = -0.20, P = 0.02) and SDNN (r = -0.18, P = 0.04) were inversely associated with changes in left ventricular mass (LVM). DHD increased the LF component of HRV. Reduction of LVM by DHD was associated with increased vagal modulation of heart rate (HF) and with increased beat-to-beat heart rate variation (SDNN), suggesting an important functional correlate to the structural effects of DHD on the heart in uremia.

  8. Effect of beta-adrenergic blockade with carvedilol on cachexia in severe chronic heart failure: results from the COPERNICUS trial.

    PubMed

    Clark, Andrew L; Coats, Andrew J S; Krum, Henry; Katus, Hugo A; Mohacsi, Paul; Salekin, Damien; Schultz, Melissa K; Packer, Milton; Anker, Stefan D

    2017-08-01

    Cardiac cachexia frequently accompanies the progression of heart failure despite the use of effective therapies for left ventricular dysfunction. Activation of the sympathetic nervous system has been implicated in the pathogenesis of weight loss, but the effects of sympathetic antagonism on cachexia are not well defined. We prospectively evaluated changes in body weight in 2289 patients with heart failure who had dyspnoea at rest or on minimal exertion and a left ventricular ejection fraction <25%. Patients were randomly assigned (double-blind) to receive either placebo (n = 1133) or carvedilol (n = 1156) and were followed for the occurrence of major clinical events for up to 29 months (COPERNICUS trial). Patients were not enrolled if they had signs of clinically significant fluid retention due to heart failure. Patients in the carvedilol group were 33% less likely than patients in the placebo group to experience a further significant loss of weight (>6%) (95% confidence interval: 14-48%, P = 0.002) and were 37% more likely to experience a significant gain in weight (≥5%) (95% confidence interval: 12-66%, P = 0.002). Carvedilol's ability to prevent weight loss was most marked in patients with increased body mass index at baseline, whereas its ability to promote weight gain was most marked in patients with decreased body mass index at baseline. Increases in weight were not accompanied by evidence of fluid retention. Baseline values for body mass index and change in body weight were significant predictors of survival regardless of treatment. Carvedilol attenuated the development and promoted a partial reversal of cachexia in patients with severe chronic heart failure, supporting a role for prolonged sympathetic activation in the genesis of weight loss. © 2017 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders.

  9. Aerobic Fitness for the Moderately Retarded.

    ERIC Educational Resources Information Center

    Bauer, Dan

    1981-01-01

    Intended for physical education teachers, the booklet offers ideas for incorporating aerobic conditioning into programs for moderately mentally retarded students. An explanation of aerobic fitness and its benefits is followed by information on initiating a fitness program with evaluation of height, weight, body fat, resting heart rate, and…

  10. The Decline in American Children's Fitness Levels.

    ERIC Educational Resources Information Center

    Kuntzleman, Charles T.; Reiff, Guy G.

    1992-01-01

    Examines whether physical fitness levels in U.S. children and youth have changed over time. Research indicates that weight and skinfolds have increased over 50 years and distance run times have worsened over 10 years. The article includes information on relationships between cardiovascular fitness and coronary heart disease risks in children. (SM)

  11. The Decline in American Children's Fitness Levels.

    ERIC Educational Resources Information Center

    Kuntzleman, Charles T.; Reiff, Guy G.

    1992-01-01

    Examines whether physical fitness levels in U.S. children and youth have changed over time. Research indicates that weight and skinfolds have increased over 50 years and distance run times have worsened over 10 years. The article includes information on relationships between cardiovascular fitness and coronary heart disease risks in children. (SM)

  12. Inhibition of Heart Formation by Lithium is an Indirect Result of the Disruption of Tissue Organization within the Embryo

    PubMed Central

    Martin, Lisa K.; Bratoeva, Momka; Mezentseva, Nadejda V.; Bernanke, Jayne M.; Rémond, Mathieu C.; Ramsdell, Ann F.; Eisenberg, Carol A.; Eisenberg, Leonard M.

    2011-01-01

    Lithium is a commonly used drug for the treatment of bipolar disorder. At high doses, lithium becomes teratogenic, which is a property that has allowed this agent to serve as a useful tool for dissecting molecular pathways that regulate embryogenesis. This study was designed to examine the impact of lithium on heart formation in the developing frog for insights into the molecular regulation of cardiac specification. Embryos were exposed to lithium at the beginning of gastrulation, which produced severe malformations of the anterior end of the embryo. Although previous reports characterized this deformity as a posteriorized phenotype, histological analysis revealed that the defects were more comprehensive, with disfigurement and disorganization of all interior tissues along the anterior-posterior axis. Emerging tissues were poorly segregated and cavity formation was decreased within the embryo. Lithium exposure also completely ablated formation of the heart and prevented myocardial cell differentiation. Despite the complete absence of cardiac tissue in lithium treated embryos, exposure to lithium did not prevent myocardial differentiation of precardiac DMZ explants. Moreover, precardiac tissue freed from the embryo subsequent to lithium treatment at gastrulation gave rise to cardiac tissue, as demonstrated by upregulation of cardiac gene expression, display of sarcomeric proteins, and formation of a contractile phenotype. Together these data indicate that lithium’s effect on the developing heart was not due to direct regulation of cardiac differentiation, but an indirect consequence of disrupted tissue organization within the embryo. PMID:22150286

  13. Cardiorespiratory Fitness Levels and its Correlates Among Adults with Diabetes

    PubMed Central

    Loprinzi, Paul D.; Pariser, Gina

    2013-01-01

    Purpose The purpose of this study is to report cardiorespiratory fitness levels among adults with diabetes and report differences by demographic (eg, body mass index) and behavioral (eg, physical activity) variables. Methods Data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) were used in the analyses. Cardiorespiratory fitness was assessed using a non-exercise prediction equation and through a submaximal treadmill-based test using heart rate extrapolation. Participants completed a questionnaire to assess various demographic and behavior variables. Seventy eight participants met inclusion criteria and constituted the analyzed sample. Results The majority (55.1%) of participants were estimated as having low or moderate cardiorespiratory fitness. Results showed that for both methods normal weight individuals had greater cardiorespiratory fitness than obese individuals, and for the non-exercise prediction equation, participants who sat during the day and did not walk very much had lower cardiorespiratory fitness (mean = 26.1 mL/kg/min [95% CI: 18.9-33.4]) than those doing heavy work or carrying heavy loads (mean = 34.6 mL/kg/min [95% CI: 30.2-39.1]). Conclusion These results suggest that obese and inactive adults with diabetes may be at an increased risk for morbidities and mortality associated with low cardiorespiratory fitness. Physical therapists are encouraged to apply evidence-based principles for exercise prescription and physical activity counseling to help patients with diabetes regulate their blood glucose control and improve cardiorespiratory fitness. PMID:23801902

  14. Cross-sectional study of ethnic differences in physical fitness among children of South Asian, black African–Caribbean and white European origin: the Child Heart and Health Study in England (CHASE)

    PubMed Central

    Nightingale, C M; Donin, A S; Kerry, S R; Owen, C G; Rudnicka, A R; Brage, S; Westgate, K L; Ekelund, U; Cook, D G; Whincup, P H

    2016-01-01

    Objective Little is known about levels of physical fitness in children from different ethnic groups in the UK. We therefore studied physical fitness in UK children (aged 9–10 years) of South Asian, black African–Caribbean and white European origin. Design Cross-sectional study. Setting Primary schools in the UK. Participants 1625 children (aged 9–10 years) of South Asian, black African–Caribbean and white European origin in the UK studied between 2006 and 2007. Outcome measures A step test assessed submaximal physical fitness from which estimated VO2 max was derived. Ethnic differences in estimated VO2 max were estimated using multilevel linear regression allowing for clustering at school level and adjusting for age, sex and month as fixed effects. Results The study response rate was 63%. In adjusted analyses, boys had higher levels of estimated VO2 max than girls (mean difference 3.06 mL O2/min/kg, 95% CI 2.66 to 3.47, p<0.0001). Levels of estimated VO2 max were lower in South Asians than those in white Europeans (mean difference −0.79 mL O2/min/kg, 95% CI −1.41 to −0.18, p=0.01); levels of estimated VO2 max in black African–Caribbeans were higher than those in white Europeans (mean difference 0.60 mL O2/min/kg, 95% CI 0.02 to 1.17, p=0.04); these patterns were similar in boys and girls. The lower estimated VO2 max in South Asians, compared to white Europeans, was consistent among Indian, Pakistani and Bangladeshi children and was attenuated by 78% after adjustment for objectively measured physical activity (average daily steps). Conclusions South Asian children have lower levels of physical fitness than white Europeans and black African–Caribbeans in the UK. This ethnic difference in physical fitness is at least partly explained by ethnic differences in physical activity. PMID:27324713

  15. Fitness level and body composition indices: cross-sectional study among Malaysian adolescent

    PubMed Central

    2014-01-01

    Background The importance of fitness level on the well-being of children and adolescent has long been recognised. The aim of this study was to investigate the fitness level of school-going Malaysian adolescent, and its association with body composition indices. Methods 1071 healthy secondary school students participated in the fitness assessment for the Malaysian Health and Adolescents Longitudinal Research Team (MyHEART) study. Body composition indices such as body mass index for age, waist circumference and waist height ratio were measured. Fitness level was assessed with Modified Harvard Step Test. Physical Fitness Score was calculated using total time of step test exercise and resting heart rates. Fitness levels were divided into 3 categories - unacceptable, marginally acceptable, and acceptable. Partial correlation analysis was used to determine the association between fitness score and body composition, by controlling age, gender, locality, ethnicity, smoking status and sexual maturation. Multiple regression analysis was conducted to determine which body composition was the strongest predictor for fitness. Results 43.3% of the participants were categorised into the unacceptable fitness group, 47.1% were considered marginally acceptable, and 9.6% were acceptable. There was a significant moderate inverse association (p < 0.001) between body composition with fitness score (r = -0.360, -0.413 and -0.403 for body mass index for age, waist circumference and waist height ratio, respectively). Waist circumference was the strongest and significant predictor for fitness (ß = -0.318, p = 0.002). Conclusion Only 9.6% of the students were fit. There was also an inverse association between body composition and fitness score among apparently healthy adolescents, with waist circumference indicated as the strongest predictor. The low fitness level among the Malaysian adolescent should necessitate the value of healthy lifestyle starting at a young age. PMID:25436933

  16. Effects of carvedilol in heart failure due to dilated cardiomyopathy. Results of a double-blind randomized placebo-controlled study (CARIBE study).

    PubMed

    Chizzola, P R; Freitas, H F; Caldas, M A; da Costa, J M; Meneghetti, C; Marinho, N V; Mansur, A J; Ramires, J A; Bocchi, E A

    2000-03-01

    To assess the effects of carvedilol in patients with idiopathic dilated cardiomyopathy. In a double-blind randomized placebo-controlled study, 30 patients (7 women) with functional class II and III heart failure were assessed. Their ages ranged from 28 to 66 years (mean of 43 +/- 9 years), and their left ventricular ejection fraction varied from 8% to 35%. Carvedilol was added to the usual therapy of 20 patients; placebo was added to the usual therapy of 10 patients. The initial dose of carvedilol was 12.5 mg, which was increased weekly until it reached 75 mg/day, according to the patient's tolerance. Clinical assessment, electrocardiogram, echocardiogram, and radionuclide ventriculography were performed in the pretreatment phase, being repeated after 2 and 6 months of medication use. A reduction in heart rate (p = 0.016) as well as an increase in left ventricular shortening fraction (p = 0.02) and in left ventricular ejection fraction (p = 0.017) occurred in the group using carvedilol as compared with that using placebo. Carvedilol added to the usual therapy for heart failure resulted in better heart function.

  17. A Structured Physical Activity and Fitness Programme for Older Adults with Intellectual Disabilities: Results of a Cluster-Randomised Clinical Trial

    ERIC Educational Resources Information Center

    van Schijndel-Speet, M.; Evenhuis, H. M.; van Wijck, R.; van Montfort, K. C. A. G. M.; Echteld, M. A.

    2017-01-01

    Background: The physical activity level of older adults with intellectual disabilities (ID) is extremely low, and their fitness levels are far beneath accepted norms for older people with normal intelligence and comparable with frail older people. A physical activity programme, including an education programme, was developed for older adults with…

  18. Is There a Relationship between Physical Fitness and Academic Achievement? Positive Results from Public School Children in the Northeastern United States

    ERIC Educational Resources Information Center

    Chomitz, Virginia R.; Slining, Meghan M.; McGowan, Robert J.; Mitchell, Suzanne E.; Dawson, Glen F.; Hacker, Karen A.

    2009-01-01

    Objectives: To determine relationships between physical fitness and academic achievement in diverse, urban public school children. Methods: This cross-sectional study used public school data from 2004 to 2005. Academic achievement was assessed as a passing score on Massachusetts Comprehensive Assessment System (MCAS) achievement tests in…

  19. A Structured Physical Activity and Fitness Programme for Older Adults with Intellectual Disabilities: Results of a Cluster-Randomised Clinical Trial

    ERIC Educational Resources Information Center

    van Schijndel-Speet, M.; Evenhuis, H. M.; van Wijck, R.; van Montfort, K. C. A. G. M.; Echteld, M. A.

    2017-01-01

    Background: The physical activity level of older adults with intellectual disabilities (ID) is extremely low, and their fitness levels are far beneath accepted norms for older people with normal intelligence and comparable with frail older people. A physical activity programme, including an education programme, was developed for older adults with…

  20. [Implantable artificial heart].

    PubMed

    Nojiri, Chisato

    2005-11-01

    Heart transplants have been decreasing globally due to the lack of available donor hearts. As a result, the increased use of artificial hearts is anticipated as an alternative therapy. Although biocompatibility issues, such as thrombus formation/thromboembolism and infection, are still the main cause of mortality associated with artificial hearts, more than 20 different types are now clinically available after a half-century of development and experimental trials. These devices range from extracorporeal pneumatic to implantable battery-powered artificial hearts. The early development of artificial hearts logically focused on volumetric pump designs incorporating functions similar to the natural heart. Today, development has shifted toward designs that are significantly different from the natural heart. These pumps utilize axial or centrifugal flow allowing for a much simpler design, which is smaller in size and has very few moving parts. With rapid advances in technology, this new generation of artificial heart pumps is beginning to emerge as an alternative to heart transplants.

  1. Surgical Experience and Long-term Results of Baroreflex Activation Therapy for Heart Failure With Reduced Ejection Fraction.

    PubMed

    Weaver, Fred A; Abraham, William T; Little, William C; Butter, Christian; Ducharme, Anique; Halbach, Marcel; Klug, Didier; Lovett, Eric G; Madershahian, Navid; Müller-Ehmsen, Jochen; Schafer, Jill E; Senni, Michele; Swarup, Vijay; Wachter, Rolf; Zile, Michael R

    2016-01-01

    The purpose of this publication is to describe the intraoperative experience along with long-term safety and efficacy of the second-generation baroreflex activation therapy (BAT) system in patients with heart failure (HF) and reduced ejection fraction HF (HFrEF). In a randomized trial of New York Heart Association Class III HFrEF, 140 patients were assigned 1:1 to receive BAT plus medical therapy or medical therapy alone. Procedural information along with safety and efficacy data were collected and analyzed over 12 months. Within the cohort of 71 patients randomized to BAT, implant procedure time decreased with experience, from 106 ± 37 minutes on the first case to 83 ± 32 minutes on the third case. The rate of freedom from system- and procedure-related complications was 86% through 12 months, with the percentage of days alive without a complication related to system, procedure, or underlying cardiovascular condition identical to the control group. The complications that did occur were generally mild and short-lived. Overall, 12 months therapeutic benefit from BAT was consistent with previously reported efficacy through 6 months: there was a significant and sustained beneficial treatment effect on New York Heart Association functional Class, quality of life, 6-minute hall walk distance, plasma N-terminal pro-brain natriuretic peptide, and systolic blood pressure. This was true for the full trial cohort and a predefined subset not receiving cardiac resynchronization therapy. There is a rapid learning curve for the specialized procedures entailed in a BAT system implant. BAT system implantation is safe with the therapeutic benefits of BAT in patients with HFrEF being substantial and maintained for at least 1 year.

  2. Gender related differences in clinical profile and outcome of patients with heart failure. Results of the RICA Registry.

    PubMed

    Conde-Martel, A; Arkuch, M E; Formiga, F; Manzano-Espinosa, L; Aramburu-Bodas, O; González-Franco, Á; Dávila-Ramos, M F; Suárez-Pedreira, I; Herrero-Domingo, A; Montero-Pérez-Barquero, M

    2015-10-01

    To analyze the differential clinical characteristics according to gender of patients with heart failure in terms of etiology, comorbidity, triggers, treatment, hospital stay and overall mortality at one year. We employed data from the RICA registry, a multicenter prospective cohort of patients hospitalized in internal medicine departments for heart failure, with a follow-up of one year. We analyzed the differences between the gender in terms of the etiology of the heart disease, comorbidity, triggers, left ventricle ejection fraction, functional state, mental condition, treatment, length of stay and mortality at 1 year. A total of 1772 patients (47.2% men) were included. The women were older than the men (p<.001) and had a higher prevalence of hypertension, obesity, chronic kidney disease, atrial fibrillation and preserved left ventricle ejection fraction (p<.001). The men's medical history had a predominance of myocardial infarction, chronic obstructive pulmonary disease, peripheral arteriopathy (p<.001) and anemia (p=.02). In the women, a hypertensive etiology was predominant, followed by valvular. The main triggers were hypertension and atrial fibrillation. Treatment with beta-blockers, ACEIs and/or ARBs did not differ by sex. The women had poorer functional capacity (p<.001), according to the Barthel index. After adjusting for age and other prognostic factors, the mortality at one year was lower among the women (RR: 0.69; 95% CI 0.53-0.89; p=.004). HF in women occurs at a later age and with different comorbidities. The hypertensive and valvular etiology is predominant, with preserved left ventricle ejection fraction, and the age-adjusted mortality is lower than in men. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  3. Exponentially fitted symplectic integrator

    NASA Astrophysics Data System (ADS)

    Simos, T. E.; Vigo-Aguiar, Jesus

    2003-01-01

    In this paper a procedure for constructing efficient symplectic integrators for Hamiltonian problems is introduced. This procedure is based on the combination of the exponential fitting technique and symplecticness conditions. Based on this procedure, a simple modified Runge-Kutta-Nyström second-order algebraic exponentially fitted method is developed. We give explicitly the symplecticness conditions for the modified Runge-Kutta-Nyström method. We also give the exponential fitting and trigonometric fitting conditions. Numerical results indicate that the present method is much more efficient than the “classical” symplectic Runge-Kutta-Nyström second-order algebraic method introduced by M.P. Calvo and J.M. Sanz-Serna [J. Sci. Comput. (USA) 14, 1237 (1993)]. We note that the present procedure is appropriate for all near-unimodal systems.

  4. Cardiopoietic cell therapy for advanced ischaemic heart failure: results at 39 weeks of the prospective, randomized, double blind, sham-controlled CHART-1 clinical trial

    PubMed Central

    Davison, Beth A.; Filippatos, Gerasimos S.; Radovanovic, Slavica; Beleslin, Branko; Merkely, Bela; Musialek, Piotr; Wojakowski, Wojciech; Andreka, Peter; Horvath, Ivan G.; Katz, Amos; Dolatabadi, Dariouch; El Nakadi, Badih; Arandjelovic, Aleksandra; Edes, Istvan; Seferovic, Petar M.; Obradovic, Slobodan; Vanderheyden, Marc; Jagic, Nikola; Petrov, Ivo; Atar, Shaul; Halabi, Majdi; Gelev, Valeri L.; Shochat, Michael K.; Kasprzak, Jaroslaw D.; Sanz-Ruiz, Ricardo; Heyndrickx, Guy R.; Nyolczas, Noémi; Legrand, Victor; Guédès, Antoine; Heyse, Alex; Moccetti, Tiziano; Fernandez-Aviles, Francisco; Jimenez-Quevedo, Pilar; Bayes-Genis, Antoni; Hernandez-Garcia, Jose Maria; Ribichini, Flavio; Gruchala, Marcin; Waldman, Scott A.; Teerlink, John R.; Gersh, Bernard J.; Povsic, Thomas J.; Henry, Timothy D.; Metra, Marco; Hajjar, Roger J.; Tendera, Michal; Behfar, Atta; Alexandre, Bertrand; Seron, Aymeric; Stough, Wendy Gattis; Sherman, Warren; Cotter, Gad; Wijns, William

    2017-01-01

    Aims Cardiopoietic cells, produced through cardiogenic conditioning of patients’ mesenchymal stem cells, have shown preliminary efficacy. The Congestive Heart Failure Cardiopoietic Regenerative Therapy (CHART-1) trial aimed to validate cardiopoiesis-based biotherapy in a larger heart failure cohort. Methods and results This multinational, randomized, double-blind, sham-controlled study was conducted in 39 hospitals. Patients with symptomatic ischaemic heart failure on guideline-directed therapy (n = 484) were screened; n = 348 underwent bone marrow harvest and mesenchymal stem cell expansion. Those achieving > 24 million mesenchymal stem cells (n = 315) were randomized to cardiopoietic cells delivered endomyocardially with a retention-enhanced catheter (n = 157) or sham procedure (n = 158). Procedures were performed as randomized in 271 patients (n = 120 cardiopoietic cells, n = 151 sham). The primary efficacy endpoint was a Finkelstein–Schoenfeld hierarchical composite (all-cause mortality, worsening heart failure, Minnesota Living with Heart Failure Questionnaire score, 6-min walk distance, left ventricular end-systolic volume, and ejection fraction) at 39 weeks. The primary outcome was neutral (Mann–Whitney estimator 0.54, 95% confidence interval [CI] 0.47–0.61 [value > 0.5 favours cell treatment], P = 0.27). Exploratory analyses suggested a benefit of cell treatment on the primary composite in patients with baseline left ventricular end-diastolic volume 200–370 mL (60% of patients) (Mann–Whitney estimator 0.61, 95% CI 0.52–0.70, P = 0.015). No difference was observed in serious adverse events. One (0.9%) cardiopoietic cell patient and 9 (5.4%) sham patients experienced aborted or sudden cardiac death. Conclusion The primary endpoint was neutral, with safety demonstrated across the cohort. Further evaluation of cardiopoietic cell therapy in patients with elevated end-diastolic volume is warranted. PMID:28025189

  5. Risk-standardized Acute Admission Rates Among Patients With Diabetes and Heart Failure as a Measure of Quality of Accountable Care Organizations: Rationale, Methods, and Early Results

    PubMed Central

    Spatz, Erica S.; Lipska, Kasia J.; Dai, Ying; Bao, Haikun; Lin, Zhenqiu; Parzynski, Craig S.; Altaf, Faseeha K.; Joyce, Erin K.; Montague, Julia A.; Ross, Joseph S.; Bernheim, Susannah M.; Krumholz, Harlan M.; Drye, Elizabeth E.

    2017-01-01

    Background Population-based measures of admissions among patients with chronic conditions are important quality indicators of Accountable Care Organizations (ACOs), yet there are challenges in developing measures that enable fair comparisons among providers. Methods Based on consensus standards for outcome measure development and with expert and stakeholder input on methods decisions, we developed and tested two models of risk-standardized acute admission rates (RSAARs) for patients with diabetes and heart failure using 2010–2012 Medicare claims data. Model performance was assessed with deviance R-squared; score reliability was tested with intraclass correlation coefficient. We estimated RSAARs for 114 Shared Savings Program ACOs in 2012 and we assigned ACOs to 3 performance categories: no different, worse than, and better than the national rate. Results The diabetes and heart failure cohorts included 6.5 and 2.6 million Medicare fee-for-service (FFS) beneficiaries aged ≥65 years, respectively. Risk-adjustment variables were age, comorbidities and condition-specific severity variables, but not socioeconomic status or other contextual factors. We selected hierarchical negative binomial models with the outcome of acute, unplanned hospital admissions per 100 person-years. For the diabetes and heart failure measures respectively, the models accounted for 22% and 12% of the deviance in outcomes and score reliability was 0.89 and 0.77. For the diabetes measure, 51 (44.7%) ACOs were no different, 45 (39.5%) were better, and 18 (15.8%) were worse than the national rate. The distribution of performance for the heart failure measure was: 61 (53.5%);,37 (32.5%) and 16 (14.0%), respectively. Conclusion Measures of RSAARs for patients with diabetes and heart failure meet criteria for scientific soundness and reveal important variation in quality across ACOs. PMID:26918404

  6. Heart-to-Heart

    NASA Image and Video Library

    2017-06-26

    NASA didn’t miss a (heart)beat when the opportunity arose to study the cardiovascular systems of identical twin astronauts, one aboard the International Space Station and the other on Earth. Results from the Cardio Ox investigation, part of the research of the One Year Mission of astronaut Scott Kelly, may provide a better understanding of cardiovascular disease risk that astronauts encounter during and after long-duration spaceflight. Stuart Lee, the lead scientist for the Cardiovascular and Vision Laboratory at NASA’s Johnson Space Center, explains the importance of spaceflight weightlessness research on the cardiovascular system and how results could be used to create countermeasures, preventing potential health consequences for future space travelers as well as those of us on Earth. For more on ISS science, follow us on Twitter: @ISS_research or at https://twitter.com/ISS_Research or at: https://www.nasa.gov/mission_pages/station/research/index.html

  7. Fitness Load and Exercise Time in Secondary Physical Education Classes.

    ERIC Educational Resources Information Center

    Li, Xiao Jun; Dunham, Paul, Jr.

    1993-01-01

    Investigates the effect of secondary school physical education on fitness load: the product of the mean heart rate above threshold (144 bpm) and the time duration of heart rate above that threshold. Highly and moderately skilled students achieved fitness load more frequently than their lower skilled colleagues. (GLR)

  8. Fitness Load and Exercise Time in Secondary Physical Education Classes.

    ERIC Educational Resources Information Center

    Li, Xiao Jun; Dunham, Paul, Jr.

    1993-01-01

    Investigates the effect of secondary school physical education on fitness load: the product of the mean heart rate above threshold (144 bpm) and the time duration of heart rate above that threshold. Highly and moderately skilled students achieved fitness load more frequently than their lower skilled colleagues. (GLR)

  9. Novel experimental results in human cardiac electrophysiology: measurement of the Purkinje fibre action potential from the undiseased human heart.

    PubMed

    Nagy, Norbert; Szél, Tamás; Jost, Norbert; Tóth, András; Gy Papp, Julius; Varró, András

    2015-09-01

    Data obtained from canine cardiac electrophysiology studies are often extrapolated to the human heart. However, it has been previously demonstrated that because of the lower density of its K(+) currents, the human ventricular action potential has a less extensive repolarization reserve. Since the relevance of canine data to the human heart has not yet been fully clarified, the aim of the present study was to determine for the first time the action potentials of undiseased human Purkinje fibres (PFs) and to compare them directly with those of dog PFs. All measurements were performed at 37 °C using the conventional microelectrode technique. At a stimulation rate of 1 Hz, the plateau potential of human PFs is more positive (8.0 ± 1.8 vs 8.6 ± 3.4 mV, n = 7), while the amplitude of the spike is less pronounced. The maximal rate of depolarization is significantly lower in human PKs than in canine PFs (406.7 ± 62 vs 643 ± 36 V/s, respectively, n = 7). We assume that the appreciable difference in the protein expression profiles of the 2 species may underlie these important disparities. Therefore, caution is advised when canine PF data are extrapolated to humans, and further experiments are required to investigate the characteristics of human PF repolarization and its possible role in arrhythmogenesis.

  10. Heart Disease

    MedlinePlus

    ... type of heart disease you have. Symptoms of heart disease in your blood vessels (atherosclerotic disease) Cardiovascular disease ... can sometimes be found early with regular evaluations. Heart disease symptoms caused by abnormal heartbeats (heart arrhythmias) A ...

  11. Heart failure

    PubMed Central

    2011-01-01

    Introduction Heart failure occurs in 3% to 4% of adults aged over 65 years, usually as a consequence of coronary artery disease or hypertension, and causes breathlessness, effort intolerance, fluid retention, and increased mortality. The 5-year mortality in people with systolic heart failure ranges from 25% to 75%, often owing to sudden death following ventricular arrhythmia. Risks of cardiovascular events are increased in people with left ventricular systolic dysfunction (LVSD) or heart failure. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of multidisciplinary interventions for heart failure? What are the effects of exercise in people with heart failure? What are the effects of drug treatments for heart failure? What are the effects of devices for treatment of heart failure? What are the effects of coronary revascularisation for treatment of heart failure? What are the effects of drug treatments in people at high risk of heart failure? What are the effects of treatments for diastolic heart failure? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2010 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 80 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: aldosterone receptor antagonists, amiodarone, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, anticoagulation, antiplatelet agents, beta-blockers, calcium

  12. 'Fit for school' - a school-based water, sanitation and hygiene programme to improve child health: Results from a longitudinal study in Cambodia, Indonesia and Lao PDR.

    PubMed

    Duijster, Denise; Monse, Bella; Dimaisip-Nabuab, Jed; Djuharnoko, Pantjawidi; Heinrich-Weltzien, Roswitha; Hobdell, Martin; Kromeyer-Hauschild, Katrin; Kunthearith, Yung; Mijares-Majini, Maria Carmela; Siegmund, Nicole; Soukhanouvong, Panith; Benzian, Habib

    2017-04-05

    The Fit for School (FIT) programme integrates school health and Water, Sanitation and Hygiene interventions, which are implemented by the Ministries of Education in four Southeast Asian countries. This paper describes the findings of a Health Outcome Study, which aimed to assess the two-year effect of the FIT programme on the parasitological, weight, and oral health status of children attending schools implementing the programme in Cambodia, Indonesia and Lao PDR. The study was a non-randomized clustered controlled trial with a follow-up period of two years. The intervention group consisted of children attending public elementary schools implementing the FIT programme, including daily group handwashing with soap and toothbrushing with fluoride toothpaste, biannual school-based deworming; as well as construction of group handwashing facilities. Control schools implemented the regular government health education curriculum and biannual deworming. Per school, a random selection of six to seven-year-old grade-one students was drawn. Data on parasitological infections, anthropometric measurements, dental caries, odontogenic infections and sociodemographic characteristics were collected at baseline and at follow-up (24 months later). Data were analysed using the χ(2)-test, Mann Whitney U-test and multilevel logistic and linear regression. A total of 1847 children (mean age = 6.7 years, range 6.0-8.0 years) participated in the baseline survey. Of these, 1499 children were available for follow-up examination - 478, 486 and 535 children in Cambodia, Indonesia and Lao PDR, respectively. In all three countries, children in intervention schools had a lower increment in the number of decayed, missing and filled permanent teeth between baseline and follow-up, in comparison to children in controls schools. The preventive fraction was 24% at average. The prevalence of soil-transmitted helminth infection (which was unexpectedly low at baseline), the prevalence of thinness and

  13. Heart Rate Monitor

    NASA Technical Reports Server (NTRS)

    1984-01-01

    In the mid 70's, NASA saw a need for a long term electrocardiographic electrode suitable for use on astronauts. Heart Rate Inc.'s insulated capacitive electrode is constructed of thin dielectric film applied to stainless steel surface, originally developed under a grant by Texas Technical University. HRI, Inc. was awarded NASA license and continued development of heart rate monitor for use on exercise machines for physical fitness and medical markets.

  14. [The results of experimental study of six-hour heart-lung preservation by autoperfusion method--its evaluation of optimal conditions and lung function after preservation].

    PubMed

    Matsuoka, M; Makino, S; Hattori, R; Imura, M; Higashi, K; Morimoto, T; Yada, I; Namikawa, S; Yuasa, H; Kusagawa, M

    1989-04-01

    Up to date, it has been reported that the maintenance of ideal function of the preserved lungs were much more difficult than that of the hearts in heart-lung preservation. In this communication the authors have reported the results of experimental study for optimal conditions for preserving better function of the lungs by autoperfusion method by means of heart-lung preparation using 43 dogs. In this study the conditions of the preservation were fixed as following: perfusing blood temperature 29 degrees C, blood flow 30 ml/kg/min., FiO2 30%, FiCO2 5%, tidal volume 15 ml/kg, ventilation rate 10/min., and PEEP 5 cmH2O. Glucose-Insulin-Potassium (0.03 gm., 0.05 U., 0.02 mEq/kg/hr. respectively) were administered continuously by an infusion pump. The results showed that extravascular lung water contents after 6 hours of preservation was 0.79 (mean) +/- 0.01 (SD), which was increased only 1% over than the control group: 0.78 +/- 0.01. There was no significant difference of static lung compliance in two groups: the preserved group was 0.47 +/- 0.02 ml/gm.cmH2O compared to 0.51 +/- 0.06 in the control group. These results suggest that the autoperfusion method on our preserving conditions seems to be very promising and very effective to keep much better condition of the lungs in heart-lung preservation.

  15. Assessing fitness in endurance horses.

    PubMed

    Fraipont, Audrey; Van Erck, Emmanuelle; Ramery, Eve; Fortier, Guillaume; Lekeux, Pierre; Art, Tatiana

    2012-03-01

    A field test and a standardized treadmill test were used to assess fitness in endurance horses. These tests discriminated horses of different race levels: horses participating in races of 120 km and more showed higher values of VLA4 (velocity at which blood lactate reached 4 mmol/L) and V200 (velocity at which heart rates reached 200 beats per min) than horses of lower race levels.

  16. [Artificial heart and heart transplantation].

    PubMed

    Moosdorf, R

    2012-12-01

    The advances in the treatment of many different heart diseases have on the one side led to a significant prolongation of life expectancy but have also contributed to an increase of patients with heart failure. This tendency is supported even more so by the demographic development of our population. The replacement of insufficient organs has always been in the focus of medical research. In the 1960's Shumway and Lower developed the technique of cardiac transplantation and also worked intensively on the treatment and diagnosis of rejection. However, it was Barnard who, in 1967 performed the first human cardiac transplantation. Other centers followed worldwide but the mortality was high and the new therapy was controversially discussed in many journals. By the introduction of cyclosporin as a new immunosuppressive agent in 1978, results improved rapidly and cardiac transplantation became an accepted therapeutic option for patients with end stage heart failure and also for children and newborns with congenital heart defects. Today, with newer immunosuppressive regimens and improved techniques, cardiac transplantation offers excellent results with a long-term survival of nearly 50% of patients after 15 years and among the pediatric population even after 20 years. However, the donor organ shortage as well as the increasing number of elderly patients with end stage heart failure has necessitated work on other alternatives. Neither stem cell transplantation nor xenotransplantation of animal organs are yet an option and there are still some obstacles to be overcome. In contrast, the development of so-called artificial hearts has made significant progress. While the first implants of totally artificial hearts were associated with many comorbidities and patients were seriously debilitated, new devices today offer a reasonable quality of life and long-term survival. Most of these systems are no longer replacing but mainly assisting the heart, which remains in place. These

  17. Cardiomyocyte overexpression of iNOS in mice results in peroxynitrite generation, heart block, and sudden death

    PubMed Central

    Mungrue, Imran N.; Gros, Robert; You, Xiaomang; Pirani, Asif; Azad, Azar; Csont, Tamas; Schulz, Richard; Butany, Jagdish; Stewart, Duncan J.; Husain, Mansoor

    2002-01-01

    Increased inducible nitric oxide synthase (iNOS) expression is a component of the immune response and has been demonstrated in cardiomyocytes in septic shock, myocarditis, transplant rejection, ischemia, and dilated cardiomyopathy. To explore whether the consequences of such expression are adaptive or pathogenic, we have generated a transgenic mouse model conditionally targeting the expression of a human iNOS cDNA to myocardium. Chronic cardiac-specific upregulation of iNOS in transgenic mice led to increased production of peroxynitrite. This was associated with a mild inflammatory cell infiltrate, cardiac fibrosis, hypertrophy, and dilatation. While iNOS-overexpressing mice infrequently developed overt heart failure, they displayed a high incidence of sudden cardiac death due to bradyarrhythmia. This dramatic cardiac phenotype was rescued by specific attenuation of transgene activity. These data implicate cardiomyocyte iNOS overexpression as sufficient to cause cardiomyopathy, bradyarrhythmia, and sudden cardiac death. PMID:11901182

  18. The valvo-pump, an axial blood pump implanted at the heart valve position: concept and initial results.

    PubMed

    Yamazaki, K; Okamoto, E; Yamamoto, K; Mitamura, Y; Tanaka, T; Yozu, R

    1992-06-01

    The valvo-pump, an axial nonpulsatile blood pump implanted at the heart valve position, has been developed. The valvo-pump consists of an impeller and a motor, which are encased in a housing. An impeller with 5 vanes (22.0 mm in diameter) is used. The impeller is connected to a samarium-cobalt-rare earth magnet direct current (DC) brushless motor measuring 21.3 mm in diameter and 18.5 mm in length. Sealing is achieved by means of a ferrofluidic seal. A pump flow of 10.5 L/min was obtained at a pump differential pressure of 3.3 kPa (25 mm Hg), and a flow of 4.9 L/min was obtained at 7.0 kPa (53 mm Hg). Sealing was kept perfect against a pressure of 29.3 kPa (220 mm Hg) at 9,000 rpm.

  19. Valvular manifestations of human immunodeficiency virus infection--results from the prospective, multicenter HIV-HEART study.

    PubMed

    Reinsch, Nico; Esser, Stefan; Gelbrich, Götz; Brockmeyer, Norbert; Potthoff, Anja; Schadendorf, Dirk; Erbel, Raimund; Neumann, Till

    2013-10-01

    HIV infection is associated with an elevated rate of cardiac diseases. The aim of the current study was to assess the prevalence of valvular disorders in a large population of HIV-infected patients. We enrolled 803 adults (age 44 ± 10 years, 16.6% women) in this prospective, multicenter cohort study. All patients underwent a comprehensive two-dimensional transthoracic echocardiography examination including Doppler evaluation of valvular function. Statistical analyses were performed in respect of severity of HIV infection. Overall, the rate of patients with pathologic function of cardiac valves was 77.6% (N = 623). Most of these patients had signs of valvular regurgitation (N = 620; 77.2%), whereas stenoses were rare (N = 23; 2.9%). Clinically relevant valvular disorders (excluding mild stages) were seen in only 4.7% (N = 38; regurgitation: N = 36, 4.5%; stenosis: N = 3, 0.4%). Clinical stages of HIV infection, defined by the Centers for Disease Control and Prevention (CDC) classification, were associated with higher rates of valvular diseases (CDC-stage B/C versus A: 6.2 versus 2.3%, P = 0.015). However, there was no association between current CD4 cell count or virus load and the prevalence of valvular disorders (both P > 0.2). None of the patients had signs of active endocarditis in the present study. Valvular heart diseases are common in HIV-infected patients. Fortunately, most of these disorders are mild today. We found an association between the onset of valvular heart disease and clinical stages of HIV infection.

  20. Iron deficiency and health-related quality of life in chronic heart failure: results from a multicenter European study.

    PubMed

    Enjuanes, Cristina; Klip, Ijsbrand T; Bruguera, Jordi; Cladellas, Merce; Ponikowski, Piotr; Banasiak, Waldemar; van Veldhuisen, Dirk J; van der Meer, Peter; Jankowska, Ewa A; Comín-Colet, Josep

    2014-06-15

    Patients affected by chronic heart failure (CHF) present significant impairment of health-related quality of life (HRQoL). Iron deficiency (ID) is a common comorbidity in CHF with negative impact in prognosis and functional capacity. The role of iron in energy metabolism could be the link between ID and HRQoL. There is little information about the role of ID on HRQoL in patients with CHF. We evaluate the impact of ID on HRQoL and the interaction with the anaemia status, iron status, clinical baseline information and HRQoL, measured with the Minnesota Living with Heart Failure questionnaire (MLHFQ) was obtained at baseline in an international cohort of 1278 patients with CHF. Baseline characteristics were median age 68 ± 12, 882 (69%) were males, ejection fraction was 38% ± 15 and NYHA class was I/II/III/IV (156/247/487/66). ID (defined as ferritin level< 100 µg/L or serum ferritin 100-299 µg/L in combination with a TSAT<20%) was present in 741 patients (58%). 449 (35%) patients were anaemic. Unadjusted global scores of MLHFQ (where higher scores reflect worse HRQoL) were worse in ID and anaemic patients (ID+: 42 ± 25 vs. ID-: 37 ± 25; p-value=0.001 and A+: 46 ± 25 vs. A-: 37 ± 25; p-value<0.001). The combined influence of ID and anaemia was explored with different multivariable regression models, showing that ID but not anaemia was associated with impaired HRQoL. ID has a negative impact on HRQoL in CHF patients, and this is independent of the presence of anaemia.

  1. Cumulative Resting Heart Rate Exposure and Risk of All-Cause Mortality: Results from the Kailuan Cohort Study

    PubMed Central

    Zhao, Quanhui; Li, Haibin; Wang, Anxin; Guo, Jin; Yu, Junxing; Luo, Yanxia; Chen, Shuohua; Tao, Lixin; Li, Yuqing; Li, Aiping; Guo, Xiuhua; Wu, Shouling

    2017-01-01

    The relationship between cumulative exposure to resting heart rate (cumRHR) and mortality remain unclear in the general population. In the Kailuan cohort study, resting heart rate (RHR) was repeatedly measured at baseline and at years 2 and 4 by electrocardiogram among 47,311 adults aged 48.70 ± 11.68. The cumRHR was defined as the summed average RHR between two consecutive examinations multiplied by the time interval between with two examinations [(beats/min) * year]. A higher RHR was defined as ≥80 beats/min, and the number of visits with a higher RHR was counted. During a median of 4.06 years of follow-up, a total of 1,025 participants died. After adjusting for major traditional cardiovascular risk factors and baseline RHR, the hazard ratio for the highest versus lowest quartile of cumRHR was 1.39 (95% CI: 1.07–1.81) for all-cause mortality. Each 1-SD increment in cumRHR was associated with a 37% (HR: 1.37, 95% CI: 1.23–1.52) increased risk of death and displayed a J-shaped relationship. Compared with no exposure, adults who had a higher RHR at all 3 study visits were associated with a 1.86-fold higher risk (95% CI: 1.33–2.61) of mortality. In summary, cumulative exposure to higher RHR is independently associated with an increased risk of mortality. PMID:28067310

  2. SynCardia temporary total artificial heart as bridge to transplantation: current results at la pitié hospital.

    PubMed

    Kirsch, Matthias E W; Nguyen, Anthony; Mastroianni, Ciro; Pozzi, Matteo; Léger, Philippe; Nicolescu, Michaela; Varnous, Shaida; Pavie, Alain; Leprince, Pascal

    2013-05-01

    The SynCardia temporary total artificial heart (t-TAH) provides complete circulatory support by replacing both native cardiac ventricles and all cardiac valves. We performed a retrospective analysis of demographics, clinical characteristics and survival of patients bridged to transplantation using the SynCardia t-TAH (SynCardia Systems Inc, Tucson, AZ). From 2000 to 2010, the SynCardia t-TAH was implanted in 90 consecutive patients (80 males; mean age, 46 ± 13 years) suffering cardiogenic shock secondary to idiopathic (n = 40, 46%) or ischemic (n = 24, 27%) cardiomyopathy or other causes. Before implantation, 7 (9%) patients had cardiac arrest, 27 (33%) were on ventilator, and 18 (22%) were on extracorporeal life support. Pre-implant creatinine values were 1.7 ± 0.97 mg/dL and total bilirubin levels were 45 ± 32 μmol/L; mean duration of support was 84 ± 102 days. Thirty-five (39%) patients died while on support after a mean of 62 ± 107 days. Actuarial survival on device was 74% ± 5%, 63% ± 6%, and 47% ± 8% at 30, 60, and 180 days after implantation. While on support, 9 (10%) patients suffered stroke, 13 (14%) had mediastinitis, and 35 (39%) required surgical reexploration for bleeding, hematoma, or infection. Multivariate analysis revealed that older recipient age and preoperative mechanical ventilation were risk factors for death while on support. Fifty-five (61%) patients were transplanted after a mean of 97 ± 98 days of support. Actuarial survival rates were 78% ± 6%, 71% ± 6%, and 63% ± 8% at 1, 5, and 8 years after transplantation. The SynCardia t-TAH provided acceptable survival to transplantation rates with a remarkably low incidence of neurologic events. Posttransplant survival was similar to that of patients undergoing primary heart transplantation in France. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  3. Mortality Among Patients Hospitalized With Heart Failure and Diabetes Mellitus: Results From the National Inpatient Sample 2000 to 2010.

    PubMed

    Win, Theingi Tiffany; Davis, Herbert T; Laskey, Warren K

    2016-05-01

    Case fatality and hospitalization rates for US patients with heart failure (HF) have steadily decreased during the past several decades. Diabetes mellitus (DM), a risk factor for, and frequent coexisting condition with, HF continues to increase in the general population. We used the National Inpatient Sample to estimate overall as well as age-, sex-, and race/ethnicity-specific trends in HF hospitalizations, DM prevalence, and in-hospital mortality among 2.5 million discharge records from 2000 to 2010 with HF as primary discharge diagnosis. Multivariable logistic and Poisson regression were used to assess the impact of the above demographic characteristics on in-hospital mortality. Age-standardized hospitalizations decreased significantly in HF overall and in HF with DM. Age-standardized in-hospital mortality with HF declined from 2000 to 2010 (4.57% to 3.09%, Ptrend<0.0001), whereas DM prevalence in HF increased (38.9% to 41.9%, Ptrend<0.0001) as did comorbidity burden. Age-standardized in-hospital mortality in HF with DM also decreased significantly (3.53% to 2.27%, Ptrend<0.0001). After adjusting for year, age, and comorbid burden, males remained at 17% increased risk versus females, non-Hispanics remained at 12% increased risk versus Hispanics, and whites had a 30% higher mortality versus non-white minorities. Absolute mortality rates were lower in younger versus older patients, although the rate of decline was attenuated in younger patients. In-hospital mortality in HF patients with DM significantly decreased during the past decade, despite increases in DM prevalence and comorbid conditions. Mortality rate decreases among younger patients were significantly attenuated, and mortality disparities remain among important demographic subgroups. © 2016 American Heart Association, Inc.

  4. The use of wearable cardioverter-defibrillators in Europe: results of the European Heart Rhythm Association survey.

    PubMed

    Lenarczyk, Radosław; Potpara, Tatjana S; Haugaa, Kristina H; Hernández-Madrid, Antonio; Sciaraffia, Elena; Dagres, Nikolaos

    2016-01-01

    The aim of this European Heart Rhythm Association (EHRA) survey was to collect data on the use of wearable cardioverter-defibrillators (WCDs) among members of the EHRA electrophysiology research network. Of the 50 responding centres, 23 (47%) reported WCD use. Devices were fully reimbursed in 17 (43.6%) of 39 respondents, and partially reimbursed in 3 centres (7.7%). Eleven out of 20 centres (55%) reported acceptable patients' compliance (WCD worn for >90% of time). The most common indications for WCD (8 out of 10 centres; 80%) were covering the period until re-implantation of ICD explanted due to infection, in patients with left ventricular impairment due to myocarditis or recent myocardial infarction and those awaiting heart transplantation. Patient life expectancy of <12 months and poor compliance were the most commonly reported contraindications for WCD (24 of 46 centres, 52.2%). The major problems encountered by physicians managing patients with WCD were costs (8 of 18 centres, 44.4%), non-compliance, and incorrect use of WCD. Four of 17 centres (23.5%) reported inappropriate WCD activations in <5% of patients. The first shock success rate in terminating ventricular arrhythmias was 95-100% in 6 of 15 centres (40%), 85-95% in 4 (26.7%), 75-85% in 2 (13.3%), and <75% in 3 centres (20%). The survey has shown that the use of WCD in Europe is still restricted and depends on reimbursement. Patients' compliance remains low. Heterogeneity of indications for WCD among centres underscores the need for further research and a better definition of indications for WCD in specific patient groups. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

  5. Disparities in physicians' interpretations of heart disease symptoms by patient gender: results of a video vignette factorial experiment.

    PubMed

    Maserejian, Nancy N; Link, Carol L; Lutfey, Karen L; Marceau, Lisa D; McKinlay, John B

    2009-10-01

    Previous studies have documented the underdiagnosis of coronary heart disease (CHD) in women, but less is known about which alternate diagnoses take precedence and whether additional patient factors modify possible gender bias. To measure gender variation in clinical decision making, including (1) the number, types, and certainty levels of diagnoses considered and (2) how diagnoses vary according to patient characteristics, when patients have identical symptoms of CHD. This was a factorial experiment presenting videotaped CHD symptoms, systematically altering patient gender, age, socioeconomic status (SES) and race, and physician gender and level of experience. The primary end point was physicians' most certain diagnosis. Physicians (n = 128) mentioned five diagnoses on average, most commonly heart, gastrointestinal, and mental health conditions. Physicians were significantly less certain of the underlying cause of symptoms among female patients regardless of age (p = 0.006), but only among middle-aged women were they significantly less certain of the CHD diagnosis (p < 0.001). Among middle-aged women, 31.3% received a mental health condition as the most certain diagnosis, compared with 15.6% of their male counterparts (p = 0.03). An interaction effect showed that females with high SES were most likely to receive a mental health diagnosis as the most certain (p = 0.006). Middle-aged female patients were diagnosed with the least confidence, whether for CHD or non-CHD conditions, indicating that their gender and age combination misled physicians, particularly toward mental health alternative diagnoses. Physicians should be aware of the potential for psychological symptoms to erroneously take a central role in the diagnosis of younger women.

  6. Dietary sodium intake in a sample of adult male population in southern Italy: results of the Olivetti Heart Study.

    PubMed

    Venezia, A; Barba, G; Russo, O; Capasso, C; De Luca, V; Farinaro, E; Cappuccio, F P; Galletti, F; Rossi, G; Strazzullo, P

    2010-05-01

    To assess dietary habitual sodium intake and the association between daily sodium intake and anthropometric indices, food habits and hypertension in the sample of adult male population participating in the Olivetti Heart Study. The study population was composed of 940 men participating in the 2002-2004 follow-up examination of the Olivetti Heart Study. Blood pressure, anthropometric indices, biochemical parameters and sodium excretion in a 24-h urine collection were measured. The frequency of consumption of selected foods was estimated by a food frequency questionnaire (FFQ) capturing the previous year data. In a subgroup of the study population (n=138), the fractional excretion of sodium was estimated by endogenous lithium clearance. Dietary sodium intake estimated by 24 h urinary excretion was 203+/-70 mmol/day. Sodium excretion was significantly lower in treated hypertensive patients and higher in overweight/obese participants when compared with normotensive and normal-weight individuals, respectively. In addition, the inverse correlation detected in normal-weight individuals (r=-0.321; P<0.05) between fractional proximal tubula