One-year visual and anatomical outcomes of intravitreal faricimab injection for neovascular age-related macular degeneration after prior brolucizumab treatment.

This single-center retrospective cohort study analyzed the 1-year real-world treatment outcomes of 63 consecutive eyes (of 60 patients) with neovascular age-related macular degeneration (nAMD) that were switched from intravitreal brolucizumab (IVBr) to intravitreal faricimab (IVF) and managed on a treat-and-extend regimen with discontinuation criteria. After the switch, patients opted to continue IVF, to switch back to IVBr, or receive photodynamic therapy (PDT). Thirty-eight patients continued IVF, 16 patients were switched back to IVBr, 2 patients received PDT, and 4 patients paused treatment. Best-corrected visual acuity (BCVA), central subfield thickness (CST), subfoveal choroidal thickness (sf-CT), and injection intervals were compared immediately before and 1 year after the initial IVF. Whereas there was no change in BCVA and CST; 0 [- 0.0969 to 0.125, P = 0.58], - 1.5 [- 27.8 to 13.5, P = 0.11] µm, respectively, sf-CT decreased significantly; - 19.5 [- 45.5 to 7.75, P = 0.015] µm. The patients switched back showed no significant change in sf-CT. The injection interval extended significantly in the IVF continuation and the switch-back group (2.0 and 3.0 weeks, respectively; [P = 0.0007 and 0.0078]) in eyes with a pre-switching interval of less than 12 weeks. Faricimab shows promise as a safe and effective alternative to brolucizumab for treating nAMD.

Effects of pre-exercise intake of plant- and animal-based foods on arterial function and aerobic exercise capacity in healthy young men: a randomized cross-over trial.

The purpose of this study was to examine the effects of plant- versus animal-based food intake before exercise on arterial function and subsequent aerobic exercise capacity. Eleven healthy adult males (mean age, 22.6 ± 1.8 years) participated in this study. A plant- or animal-based randomized meal type crossover comparison was conducted on separate days with a uniform protein, fat, and carbohydrate balance. Both carotid-femoral pulse wave velocity (cfPWV), femoral-ankle pulse wave velocity (faPWV), and brachial artery flow-mediated dilatation (FMD) were measured as indexes of aortic and peripheral arterial stiffness and vascular endothelial function, respectively, before and at 120 min after the meal. After these measurements, maximal oxygen uptake was assessed using a graded power test on an electronically braked cycle ergometer. The results revealed that cfPWV was significantly lower, whereas FMD was significantly higher, at 120 min after compared with before the plant-based meal (p = 0.01 and 0.02, respectively). By contrast, cfPWV and FMD did not change at 120 min after compared with before the animal-based meal. In addition, faPWV did not change at 120 min after compared with before the meal for either meal type. Maximal oxygen uptake was higher in the plant- than in the animal-based meal type (p = 0.02). These results suggest that pre-exercise plant-based food intake may improve central arterial stiffness and vascular endothelial function, which may have favorable implications for aerobic exercise capacity.

Factors Associated With Intraocular Inflammation in Neovascular Age-Related Macular Degeneration Patients Treated With Brolucizumab.

Purpose: To identify factors associated with intraocular inflammation (IOI) in patients with neovascular age-related macular degeneration (nAMD) treated with brolucizumab. Methods: In this prospective observational study, we collected aqueous humor samples from 96 eyes of 96 patients receiving treatment with brolucizumab; IOI subsequently developed in 19 eyes of 19 patients. To identify cytokines upregulated in eyes with subsequent development of IOI, we compared the aqueous humor cytokine levels between the IOI and non-IOI groups. We also collected plasma from 20 patients who developed IOI and 20 age- and sex-matched controls to identify differences in plasma biomarkers and the subfraction of CD4+ cells. Using stepwise variable selection and multivariate binary regression analysis, we developed an algorithm that accurately assessed the likelihood of IOI occurrence. Results: The IOI group showed elevated aqueous humor levels of P-selectin (584 vs. 324 pg/mL, P = 0.013), TNF-α (0.89 vs. 0.60 pg/mL, P = 0.018), and IL-1α (2.0 vs. 1.4 pg/mL, P = 0.035) compared with the non-IOI group. Serum MMP-9 concentrations were higher in the IOI group than the non-IOI group (18,310 vs. 13,450 pg/mL, P = 0.029). Furthermore, the percentage of Th2 cells was significantly decreased in the IOI compared with the non-IOI group (3.1% vs. 4.2%, P = 0.013). The receiver operating characteristic curves for the optimal models showed an area under the curve ranging from 0.71 to 0.89, indicating good performance. Conclusions: The combination of elevated concentrations of multiple aqueous humor cytokines and of serum MMP-9 and a lower number of plasma Th2 cells is associated with brolucizumab-related IOI in patients with nAMD.

One-year outcome of brolucizumab for neovascular age-related macular degeneration in Japanese patients.

A new anti-vascular endothelial growth factor agent, brolucizumab, was approved by the United States Food and Drug Administration in 2019. We evaluated whether brolucizumab reduces the treatment burden of neovascular age-related macular degeneration (nAMD) after switching by examining 1-year treatment outcomes in a real-world setting. This retrospective single-institution study included 107 consecutive eyes with nAMD treated with brolucizumab. Among these eyes, 30 with treatment-naïve nAMD and 77 treated with other anti-VEGF agents for more than a year were included. All eyes were managed using a treat and extend (TAE) or modified TAE regimen. The last injection intervals at 52 weeks were 12.9 and 12.1 weeks in the treatment-naïve and switch therapy groups, respectively. Among switch therapy group patients whose pre-switch injection intervals were shorter than 120 days (n = 62 eyes), the injection interval was significantly longer after the switch than before, with a mean difference of 2.7 weeks (P < 0.0001). Intraocular inflammation events occurred in 2 and 7 treatment-naïve and switch therapy patients, respectively. In conclusion, brolucizumab might reduce the treatment burden in patients who required the injection of other anti-VEGF agents with a 120-day interval or shorter, despite a relatively high discontinuation rate due to intraocular inflammation.

Habitual isomaltulose intake reduces arterial stiffness associated with postprandial hyperglycemia in middle-aged and elderly people: a randomized controlled trial.

Endothelin-1 (ET-1), produced by vascular endothelial cells, plays a pivotal role in the regulation of vascular tone. Isomaltulose, a naturally occurring sweetener and structural isomer of sucrose, reduces postprandial hyperglycemia, but its effect on arteriosclerosis due to hyperglycemia is unknown. The effects of 12 weeks of isomaltulose administration on ET-1 levels, a peptide that regulates arterial stiffness, blood pressure, and vascular tone, were tested before and after an oral glucose tolerance test. Fifty-four healthy middle-aged and older adults (30 men and 24 women) were divided into two groups: (1) a 25 g isomaltulose jelly drink intake group (Group I, 27 participants, mean age 55 ± 1 years) and (2) a sucrose jelly drink intake group (Group S, 27 participants, mean age 55 ± 1 years), each consuming isomaltulose or sucrose daily for 12 weeks, and a randomized, controlled study was conducted. Participants visited the laboratory before the intervention and 4, 8, and 12 weeks after the intervention to measure carotid-femoral (cf) and brachial-ankle (ba) pulse wave velocity (PWV), systolic blood pressure (BP), plasma glucose (PG), insulin, and ET-1 levels before and 60 and 120 min after a 75-g OGTT. baPWV, and ET-1 levels before intervention were significantly increased after 75-g OGTT compared to before 75-g OGTT in both groups (p < 0.05). The post-intervention baPWV, and ET-1 levels were significantly increased after 75-g OGTT in Group S compared to before 75-g OGTT (p < 0.05), whereas no significant changes were observed in Group I. These results suggest that consumption of isomaltulose, which has a lower GI than sucrose, is more effective in preventing the increases in systemic arterial stiffness associated with postprandial hyperglycemia in healthy middle-aged and older adults.

Effects of acute aerobic exercise on arterial stiffness in transgender men.

Testosterone replacement therapy (TRT) in transgender men (TM) results in side effects such as elevated triglycerides and increased arterial stiffness. Exercise may be useful to ameliorate such effects, but no studies have examined the effects of acute aerobic exercise in TM. This study aimed to investigate the effects of acute aerobic exercise on arterial stiffness in TM. Thirty-six participants were included, comprising 12 TM (duration of TRT: 57.4 ± 30.3 months), 12 males and 12 females. All participants performed acute aerobic exercise on a treadmill at 50% heart rate reserve for 30 min. Arterial stiffness as measured by brachial-ankle pulse wave velocity (baPWV) was measured before exercise (Pre), 30 min after exercise (Post30), and 60 min after exercise (Post60). Serum sex hormone levels, and serum lipid profile were determined only before exercise. Serum low-density lipoprotein cholesterol (LDL-C) levels before exercise were significantly higher in TM than in males or females (males: p < 0.01; females: p < 0.05). At all points, baPWV in TM was significantly higher than in females (p < 0.05) and significantly lower than in males (p < 0.05). However, when comparing changes in baPWV over time in each group, significant decreases in Post30 and Post60 were seen in males compared to Pre (both p < 0.05), but no significant change after aerobic exercise was seen in TM or females. These results suggest that acute aerobic exercise yield different effects in TM than in males, but is unlikely to reduce arterial stiffness in TM receiving TRT.

Visual and Anatomical Outcomes After Initial Intravitreal Faricimab Injection for Neovascular Age-Related Macular Degeneration in Patients with Prior Treatment History.

INTRODUCTION: The aim of this study was to investigate the safety and efficacy of a single injection of intravitreal faricimab (IVF) in patients with neovascular age-related macular degeneration (nAMD) who had a prior treatment history. METHODS: A retrospective analysis was conducted on a consecutive cohort of 80 eyes of 75 patients with nAMD who had a prior history of treatment with an injection of anti-vascular endothelial growth factor. Best-corrected visual acuity (BCVA), central subfield thickness (CST), and central choroidal thickness (CCT) were compared before the initial IVF injection and after a treatment interval matching the previous duration. RESULTS: Central choroidal thickness decreased significantly following the IVF injection, but there was no significant change in BCVA or CST. Mean (± standard deviation) BCVA changed from 0.34 ± 0.37 to 0.36 ± 0.40 (P = 0.29), CST changed from 242 ± 72 to 242 ± 82 µm (P = 0.99), and CCT changed from 189 ± 98 to 179 ± 97 µm (P < 0.0001). When the changes were evaluated according to the previous anti-VEGF agent administered, CCT was found to be significantly decreased by 8.7 ± 2.5 µm (P < 0.0001) in eyes previously treated with brolucizumab and by 13.1 ± 3.6 µm (P < 0.0001) in eyes previously treated with aflibercept. No adverse events were observed during the study period. CONCLUSION: Intravitreal faricimab injection is a safe and effective treatment for nAMD in terms of short-term outcomes. Further long-term study is necessary.

Arterial stiffness and physical fitness on cognitive function in community-dwelling middle-aged and older adults.

PURPOSE: This study examined whether decline in cognitive function is related to arterial stiffness and reduction in physical fitness in middle-aged and older adults. METHODS: A total of 1554 healthy middle-aged and older adults participated in this study. The trail making test parts-A (TMT-A) and B (TMT-B), brachial-ankle pulse wave velocity (baPWV), grip strength, the 30-s chair stand (CS-30) test, the 6-min walk (6MW) test, the 8-foot up-and-go (8UG) test and gait assessment were performed. Participants were classified into a middle-aged group (40-64 years; mean, 50.4 ± 0.2 years) or an older group (≥ 65 years; mean, 73.1 ± 0.5 years), as well as into three cognition (COG) groups (high, moderate, and low) based on median TMT-A and -B scores (high scores on both, either, or neither TMT-A and -B, respectively). RESULTS: The results revealed that baPWV was significantly lower in the high-than in the moderate- and low-COG groups in both middle-aged and older adults (P < 0.05). In addition, except for a few parameters (e.g., 6MW test in middle-aged adults), physical fitness was significantly higher in the high-than in the moderate- and low-COG groups in both middle-aged and older adults (P < 0.05). Multivariate regression analysis revealed that baPWV (P < 0.05) and some physical fitness indicators (grip strength, CS-30, and 8UG) were significantly independently associated with both TMT-A and -B in the middle-aged and older groups (P < 0.05). CONCLUSION: These results suggest that increased arterial stiffness and reduced physical fitness are associated with impaired cognitive function in middle-aged and older adults.

Peripheral Arterial Stiffness is Associated with Maximal Oxygen Uptake in Athletes.

Increased central arterial stiffness is associated with decreased maximal oxygen uptake (V̇O2max). Endurance exercise training improves arterial function throughout the whole body, but the relationship between central and peripheral arterial stiffness and V̇O2max is unknown. The present study investigated the relationship between central and peripheral arterial stiffness and V̇O2max in endurance-trained athletes. Twenty-one young male endurance-trained athletes and 12 sedentary controls were included in this study. Resting values for carotid-femoral velocity and femoral-ankle pulse wave velocity were obtained to assess central and peripheral arterial stiffness, respectively. V̇O2max was obtained by incremental cycle ergometer testing. Both carotid-femoral pulse wave velocity (P=0.019) and femoral-ankle pulse wave velocity (P=0.028) were lower in athletes than in controls. V̇O2max was significantly higher in athletes compared to controls (P<0.001). Significant correlations were found between carotid-femoral pulse wave velocity and V̇O2max (r=-0.510, P=0.018) and between femoral-ankle pulse wave velocity and V̇O2max (r=-0.472, P=0.031) in athletes. However, no correlations were evident in controls. These results suggest that higher V̇O2max is associated with lower peripheral arterial stiffness in addition to central arterial stiffness among endurance-trained athletes.

Effects of free weight and body mass-based resistance training on thigh muscle size, strength and intramuscular fat in healthy young and middle-aged individuals.

NEW FINDINGS: What is the central question of this study? How do free weight resistance training (RT) and body mass-based RT for 8 weeks compare for isometric muscular strength, muscle size and intramuscular fat (IMF) content in the quadriceps femoris? What is the main finding and its importance? Free weight and body mass-based RTs could induce muscle hypertrophy; however, decreased IMF content was observed following the body mass-based RT alone. ABSTRACT: The objective of this study was to investigate the effects of free weight and body mass-based resistance training (RT) on muscle size and thigh intramuscular fat (IMF) in young and middle-aged individuals. Healthy individuals (aged 30-64 years) were assigned to either a free weight RT group (n = 21) or a body mass-based RT group (n = 16). Both groups performed whole-body resistance exercise twice a week for 8 weeks. Free weight resistance exercises (squats, bench press, deadlift, dumbbell rows and back range) involved 70% one repetition maximum, with three sets of 8-12 repetitions per exercise. The nine body mass-based resistance exercises (leg raise, squats, rear raise, overhead shoulder mobility exercise, rowing, dips, lunge, single-leg Romanian deadlifts and push-ups) included the maximum possible repetitions per session, which were performed in one or two sets. Mid-thigh magnetic resonance images using the two-point Dixon method were taken pre- and post-training. The muscle cross-sectional area (CSA) and IMF content in the quadriceps femoris were measured from the images. Both the groups showed significantly increased muscle CSA post-training (free weight RT group, P = 0.001; body mass-based RT group, P = 0.002). IMF content in the body mass-based RT group significantly decreased (P = 0.036) but did not significantly change in the free weight RT group (P = 0.076). These results suggest that the free weight and body mass-based RTs could induce muscle hypertrophy; however, in healthy young and middle-aged individuals, decreased IMF content was induced following the body mass-based RT alone.

Cytokine profiles in the aqueous humor following brolucizumab administration for exudative age-related macular degeneration.

PURPOSE: To identify the inflammatory cytokine profile in the aqueous humor (AH) of patients with intraocular inflammation (IOI) after intravitreal administration of brolucizumab (IVBr) for neovascular age-related macular degeneration. METHODS: Eight eyes from seven patients with IOI after initial IVBr (IVBrIOI +) were enrolled. Sixteen eyes from 16 patients without IOI after IVBr (IVBrIOI -) and aflibercept (IVA) were used as controls. AH samples were analyzed using a multiplex immunoassay. RESULTS: C-C motif chemokine ligand (CCL)2, C-X-C motif chemokine ligand (CXCL)1, CXCL10, CXCL13, interleukin (IL)-6, IL-8, IL-10, matrix metalloproteinase (MMP)-1, MMP-9, granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), intercellular adhesion molecule (ICAM)-1, E-selectin, and P-selectin levels were significantly higher in IVBrIOI + than in IVBrIOI - and IVA. Vascular endothelial growth factor (VEGF) was significantly lower in IVBrIOI - compared to that in IVBrIOI + and IVA. In the IVBrIOI + group, there were significant correlations between CCL2, CXCL1, IL-6, IL-8, IL-10, G-CSF, GM-CSF, ICAM-1, and E-selectin, which also exhibited significant correlations in the IVBrIOI - group. CONCLUSION: The number of inflammatory cytokines increases during IOI, which is associated with type IV hypersensitivity and vascular inflammation. Some cytokines exhibit correlations even in non-inflamed eyes, indicating a subclinical response to IVBr.

Effect of Online Home-Based Resistance Exercise Training on Physical Fitness, Depression, Stress, and Well-Being in Middle-Aged Persons: A Pilot Study.

PURPOSE: This study investigated the effect of online home-based resistance exercise training on fitness, depression, stress, and well-being. A total of 67 individuals participated. Of them, 28 participants (13 men and 15 women, average age: 45.1 ± 12.2 years) performed the same exercise training online (n = 17), using Zoom, or in person (n = 11) in 2020 (Study 1). In addition, 39 participants (15 men and 24 women; average age: 47.6 ± 10.8 years) performed eight weeks of online home-based resistance exercise training in 2021 (Study 2). The participants performed low-load resistance exercises twice a week for eight weeks (16 sessions). Muscle strength, thigh muscle cross-sectional area, fitness parameters, blood pressure, mental health (Center for Epidemiologic Studies-Depression Scale-CES-D; and Kessler Psychological Distress scale-K6), and well-being (Well-Being Index-WHO-5) were measured pre-and post-resistance training. In Study 1, eight weeks of online home-based resistance training improved CES-D (p = 0.003), and a similar tendency was observed in resistance training (RT) with the in-person group (p = 0.06). There was a significant improvement in CES-D symptoms after the online home-based resistance training in Study 2 (p = 0.009). However, there were no significant changes in the WHO-5 and K6. Our results suggest that online low-load resistance training improves fitness parameters and curbs depressive status.

Eight-week neuromuscular electrical stimulation training produces muscle strength gains and hypertrophy, and partial muscle quality improvement in the knee extensors.

This study investigated the effect of an 8-week neuromuscular electrical stimulation (NMES) training programme (3 days/week) on muscle quantity and quality and single-joint performance in the knee extensors. Thirty-nine untrained young male participants were randomly assigned to NMES training (n = 21) and control (n = 18) groups. The 8-week NMES training induced significant increase in the isometric maximal voluntary contraction (MVC) torque of the knee extensors (≈9.3%), muscle volume of the individual and entire quadriceps muscles determined by magnetic resonance imaging (≈3.3%-6.4%), and a significant decrease in the ultrasound echo intensity of the vastus lateralis (≈-4.0%); however, hypertrophy of the vastus intermedius (i.e., the deep muscle) was limited (≈3.3%). In the NMES training group, the repeated measures correlations of the isometric MVC torque with the muscle volume of the entire quadriceps muscle and each quadriceps muscle were significant (rrm (20) = 0.551-0.776), whereas that of the isometric MVC torque with the ultrasound echo intensity of the vastus lateralis was not significant. These findings suggest that NMES training produces muscle strength gains, muscle hypertrophy, and partial muscle quality improvement and that the NMES training-induced muscle strength gains is caused by muscle hypertrophy in the knee extensors.

Decreases in Arterial Stiffness and Wave Reflection after Isometric Handgrip Training Are Associated with Improvements in Cognitive Function in Older Adults.

This study aimed to investigate whether decreases in arterial stiffness and wave reflection after isometric handgrip (IHG) training improve cognitive function in older adults. Twenty-two older adults (mean age ± standard error: 75 ± 2 years) were randomly assigned to either a group that performed IHG training (IHG group, n = 11) or a sedentary control group (CON group, n = 11). The IHG exercise comprised four unilateral 2-minute isometric contractions at 30% of maximal voluntary contraction using a programmed handgrip dynamometer with 1-minute rest periods, performed 5 days per week for 8 weeks. Carotid pulse wave velocity (cPWV) and carotid augmentation index (cAIx) were measured, and the trail-making test (TMT) parts A (TMT-A) and B (TMT-B) were performed before (baseline) and after 8 weeks of training in both groups. After 8 weeks of training, cPWV, cAIx, TMT-A, and TMT-B were significantly reduced in the IHG group (p < 0.05). Significant positive correlations were found between the amount of change in cPWV and cAIx and that in TMT-A (p < 0.05 each). In addition, positive correlation trends were observed between the amount of change in cPWV and cAIx and that in TMT-B (p = 0.06, p = 0.05, respectively). The results of the present study suggest that IHG training-induced decreases in arterial stiffness and wave reflection are associated with improvements in cognitive function in older adults.

The Effect of Online Low-intensity Exercise Training on Fitness and Cardiovascular Parameters.

Online exercise is undoubtedly useful and important; however, chronic adaptations to online exercise, particularly strength gain, muscle hypertrophy, and cardiovascular parameters, remain unclear. We investigated the effect of online exercise training using Zoom on fitness parameters compared with the same exercises supervised directly. In the present study, 34 subjects (age: 42.9±14.4 years) were included. Twenty-three subjects performed 8 weeks of body mass-based exercise training online using Zoom, and eleven subjects performed the same exercise supervised directly as the control group. The subjects performed low-load resistance exercises twice a week for 8 weeks for a total of 16 sessions. The sessions included 9 exercises: leg raises, squats, rear raises, shoulder presses, rowing, dips, lunges, Romanian dead lifts, and push-ups. Chair-stand, push-up, and sit-and-reach tests were performed on all subjects. Overall, the home exercise program effectively increased strength and muscle mass and decreased blood pressure and arterial stiffness, but there were no differences between the groups. Changes in chair-stand and sit-and-reach test results were higher in the control group than in the online group. Our results show that there is a similar training response to body mass-based training in both groups, even with virtual experiences using Zoom.

Central Haemodynamics Are Associated With Pulmonary Function in Postmenopausal Women.

PURPOSE: Increased arterial stiffness predicts cardiovascular disease, which is associated with deteriorated pulmonary function and worsened chronic obstructive pulmonary disease. The present study examined whether arterial function was associated with pulmonary function in postmenopausal women. METHODS: This study evaluated 41 postmenopausal women (age range: 59-85 years). Arterial function was measured as central systolic blood pressure (cSBP), central pulse pressure (cPP), brachial systolic BP (bSBP), brachial diastolic BP (bDBP), brachial PP (bPP), brachial mean arterial pressure (bMAP) and the augmentation index (AIx). AIx was adjusted for a heart rate of 75 beats per minute (bpm) (AIx@75) and served as the index of arterial stiffness determined by the reflected wave at the central artery. Pulmonary function was measured as forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and the FEV1/FVC ratio. RESULTS: Univariate regression analysis demonstrated that cPP, bDBP and bPP were correlated with FVC and FEV1 (p<0.05, respectively), while AI@75 was correlated with FVC, FEV1 and FEV1/FVC ratio (p<0.01, respectively). A stepwise multivariate regression analysis revealed that bDBP was independently associated with FVC (p=0.032), while AI@75 was independently associated with FVC, FEV1 and FEV1/FVC ratio (p=0.001, p=0.003 and p=0.017, respectively). The FVC, FEV1 and FEV1/FVC ratio were lower in participants with a high AIx versus with a low AIx (p=0.0001, p=0.001 and p=0.044, respectively). CONCLUSION: These results suggest that increased AIx is associated with lower pulmonary function in postmenopausal women.

Is individual day-to-day variation of arterial stiffness associated with variation of maximal aerobic performance?

BACKGROUND: Maximal aerobic capacity, e.g. maximal oxygen uptake (V̇O2max), is not constant, and it has a time-dependent variation based on the condition of individual. On the other hand, arterial properties play an important role in determining aerobic performance, and lower arterial stiffness is associated with higher cardiorespiratory fitness levels. This study examined whether individual variations in maximal aerobic performance are associated with arterial stiffness. METHODS: Twenty-four (mean age, 19.8 ± 0.2 y) and 10 (mean age, 21.2 ± 0.2 y) recreationally active young men and women participated in Experiment 1 (Ex1) and in Experiment 2 (Ex2), respectively. Aerobic performance was assessed using a graded power test (Ex1) or a 1500-m time trial (Ex2). Simultaneously, brachial-ankle pulse wave velocity (baPWV) was measured as an index of arterial stiffness in both Ex1 and Ex2 before the exercise trials. In both experiments, subjects returned for measurement of baPWV and V̇O2max or 1500-m time trial at 1 month after first measurements. RESULTS: No significant differences in mean baPWV, V̇O2max or 1500-m run time were seen between first and second visits. Mean baPWV was significantly lower on days when participants showed higher V̇O2max or better 1500-m run time (P = 0.001 each) than on days when participants showed lower V̇O2max or worse 1500-m run time. In addition, a significant relationship was seen between individual changes in baPWV from first to second visits and changes in V̇O2max (P=0.0001) or 1500-m run time (P=0.04). CONCLUSION: These findings suggest that individual day-to-day variations in maximal aerobic performance are associated with variations in arterial stiffness.

Arterial Stiffness and Left Ventricular Diastolic Function in Endurance Athletes.

The present study investigated the relationship between arterial stiffness and left ventricular diastolic function in endurance-trained athletes. Sixteen young male endurance-trained athletes and nine sedentary of similar age men participated in this study. Resting measures in carotid-femoral pulse wave velocity were obtained to assess arterial stiffness. Left ventricular diastolic function was assessed using 2-dimensional echocardiography. The athletes tended to have lower arterial stiffness than the controls (P=0.071). Transmitral A-waves in the athletes were significantly lower (P=0.018) than the controls, and left ventricular mass (P=0.034), transmitral E-wave/A-wave (P=0.005) and peak early diastolic mitral annular velocity at the septal site (P=0.005) in the athletes were significantly greater than the controls. A significant correlation was found between arterial stiffness and left ventricular diastolic function (E-wave: r=- 0.682, P=0.003, E-wave/A-wave: r=- 0.712, P=0.002, peak early diastolic mitral annular velocity at the septal site: r=- 0.557, P=0.025) in the athletes, whereas no correlation was found in controls. These results suggest that lower arterial stiffness is associated with higher left ventricular diastolic function in endurance-trained athletes.

Full-Thickness Macular Hole with Coats Disease: A Case Report.

We report a case of full-thickness macular hole (FTMH) which developed during follow-up for Coats disease. To our knowledge, this is the first report on a case of FTMH which developed during follow-up for Coats disease. A 17-year-old boy was referred to our institution with blurred vision in his left eye. Fundus examination showed yellowish subretinal exudates with overlying telangiectatic retinal vessels in the temporal periphery in the left eye; the right eye was normal. Fluorescein angiography revealed diffusion indicative of temporal peripheral vascular leakage. We made a diagnosis of stage 2A Coats disease and performed argon laser photocoagulation (PC). Moreover, he received intravitreal injection of anti-vascular endothelial growth factor. At 30 months after the first visit, the best-corrected visual acuity (BCVA) of the left eye worsened to 20/50. We observed tensioned internal limiting membrane (ILM), serous macular detachment (SMD) and retinal thinning; the intraretinal exudate remained. We performed PC and at 36 months after the first visit, BCVA further declined to 20/63 in his left eye and FTMH was observed. We then performed a 27-gauge pars plana vitrectomy and ILM peeling following which the FTMH was found to have closed by 4 days after vitrectomy. SMD gradually decreased, and BCVA improved to 20/20. Chronic inflammation by peripheral vascular leakage and PC application might have caused FTMH. In this case, the vitrectomy for FTMH with Coats disease provided good visual and anatomic outcomes.