VascuFit: vascular effects of non-linear periodized exercise training in sedentary adults with elevated cardiovascular risk - protocol for a randomized controlled trial.

BACKGROUND: Early vascular aging (EVA) is increasingly prevalent in the general population. Exercise is important for primary cardiovascular prevention, but often insufficient due to ineffective training methods and a lack of biomarkers suitable to monitor its vascular effects. VascuFit will assess the effectiveness of non-linear periodized aerobic exercise (NLPE) in a non-athletic sedentary population to improve both established and promising biomarkers of EVA. METHODS: Forty-three sedentary adults, aged 40-60 years, with elevated cardiovascular risk will either engage in 8 weeks of ergometer-based NLPE (n = 28) or receive standard exercise recommendations (n = 15). The primary outcome will be the change of brachial-arterial flow-mediated dilation (baFMD) after versus before the intervention. Secondary outcomes will be the change in static vessel analysis (SVA; clinical biomarker of microvascular endothelial function), endomiRs (microRNAs regulating key molecular pathways of endothelial cell homeostasis) and circulating cellular markers of endothelial function (mature endothelial cells, endothelial progenitor cells). Tertiary outcomes will be the change in sphingolipidome, maximum oxygen capacity, and traditional cardiovascular risk factors (blood pressure, triglycerides, cholesterol, fasting glucose, high-sensitivity C-reactive protein). DISCUSSION: We expect an improvement of baFMD of at least 2.6% and significant pre-post intervention differences of SVA and endomiRs as well as of the tertiary outcomes in the intervention group. VascuFit may demonstrate the effectiveness of NLPE to improve endothelial function, thus vascular health, in the general sedentary population. Furthermore, this project might demonstrate the potential of selected molecular and cellular biomarkers to monitor endothelial adaptations to aerobic exercise. TRIAL REGISTRATION: The trial was registered on www. CLINICALTRIALS: gov (NCT05235958) in February 11th 2022.

Traditional T1-S1 Measurement of the Spinal Length on X-ray Images Does Not Correlate With the True Length of the Spine.

BACKGROUND: The T1-S1 distance to evaluate spinal length is traditionally measured as a straight line on an anteroposterior radiograph. However, this method may not reflect the true 3-dimensional (3D) spinal length. The objective of the study was to evaluate the difference between the traditional T1-S1 measurement and a 3D reconstruction from standard x-ray imaging. METHODS: Radiological assessment and 3D reconstruction of spinal length in pediatric patients with various spine deformities. The 3D reconstruction derived from standard biplanar spine x-ray images using a specialized but free available software and calibration device. Direct comparison of length, intraobserver variance for repeated measurements, as well as interobserver correlation for both measurement methods and between different levels of training were evaluated. Furthermore, the influence on spinal length by the degree of spinal deformity as well as other factors was analyzed. RESULTS: A total of 39 x-ray images from 35 patients at a mean age of 15.4 years (8.9-26.8 years) were evaluated. There was excellent agreement for intra- and interobserver correlation for both measurement techniques. Spinal length assessed using 3D reconstruction was significantly longer compared with the traditional T1-S1 distance, on average 2.7 cm (0.5-6.1 cm). There was also a significant positive correlation between the maximum extent of the deformity and the difference in spinal length. CONCLUSIONS: Traditional T1-S1 distance significantly underestimates the true length of the spine. A 3D measurement reflects the real length of the spine more adequately. CLINICAL RELEVANCE: Such information is relevant to the treating spine surgeon when planning or assessing therapeutic measures, especially in advanced deformities.

Investigating the circulating sphingolipidome response to a single high-intensity interval training session within healthy females and males in their twenties (SphingoHIIT): Protocol for a randomised controlled trial.

Introduction: Growing scientific evidence indicates that sphingolipids predict cardiometabolic risk, independently of and beyond traditional biomarkers such as low-density lipoprotein cholesterol. To date, it remains largely unknown if and how exercise, a simple, low-cost, and patient-empowering modality to optimise cardiometabolic health, influences sphingolipid levels. The SphingoHIIT study aims to assess the response of circulating sphingolipid species to a single session of high-intensity interval training (HIIT). Methods: This single-centre randomised controlled trial (RCT) will last 11 days per participant and aim to include 32 young and healthy individuals aged 20-29 (50% females). Participants will be randomly allocated to the HIIT (n= 16) or control groups (physical rest, n= 16). Participants will self-sample fasted dried blood spots for three consecutive days before the intervention (HIIT versus rest) to determine baseline sphingolipid levels. Dried blood spots will also be collected at five time points (2, 15, 30, 60min, and 24h) following the intervention (HIIT versus rest). To minimise the dietary influence, participants will receive a standardised diet for four days, starting 24 hours before the first dried blood sampling. For females, interventions will be timed to fall within the early follicular phase to minimise the menstrual cycle's influence on sphingolipid levels. Finally, physical activity will be monitored for the whole study duration using a wrist accelerometer. Ethics and dissemination: The Ethics Committee of Northwest and Central Switzerland approved this protocol (ID 2022-00513). Findings will be disseminated in scientific journals and meetings. Trial Registration The trial was registered on www.clinicaltrials.gov (NCT05390866, https://clinicaltrials.gov/ct2/show/NCT05390866) on May 25, 2022.