Increased afternoon step count increases heart rate variability in patients with cardiovascular risk factors.

AIMS AND OBJECTIVES: The present study investigated whether morning or afternoon activity is more effective at increasing the high-frequency (HF) index, a parasympathetic index, in patients with cardiovascular risk factors. BACKGROUND: A decreased HF index, a heart rate variability (HRV) parameter, is a well-established marker of poor cardiovascular prognosis. Because blood pressure and sympathetic tone are higher in the morning, physical activity and exercise in the afternoon has been recommended for patients with cardiovascular diseases. However, there have been no reports concerning the superior effects of afternoon exercise on parasympathetic activity and sleep. DESIGN: This observational study was a post hoc comparison. METHODS: Patients' physical activity was measured for 1 month to determine their habits. Patients' HF index was measured by 24-h Holter electrocardiography. The study enrolled 56 patients. Each patient's morning step count (before lunch) and afternoon step count (between lunch and dinner) were compared. We adhered to the STROBE guidelines in the present study. RESULTS: Thirty-one patients took more steps in the morning, and 25 patients took more steps in the afternoon. The present study showed that those who took more steps in the afternoon had a significantly higher HF index during the first hour after sleep onset and during sleep than those who took more steps in the morning (p = .003, .047). CONCLUSIONS: The present study showed that those who took more steps in the afternoon had a significantly higher HF index during the first hour after sleep onset and a higher HF index during sleep than those who took more steps in the morning. RELEVANCE TO CLINICAL PRACTICE: Exercise in the afternoon may improve the prognosis in patients with cardiovascular disease by not only preventing excessive blood pressure, afterload, and sympathetic tone but also positively influencing the parasympathetic system and sleep.

Decreased continuous sitting time increases heart rate variability in patients with cardiovascular risk factors.

AIM: The purpose of the present study was to elucidate the relationship between high-frequency heart rate variability (HF HRV) and continuous daytime sitting time in patients with cardiovascular risk factors such as mild hypertension and/or stable angina pectoris. BACKGROUND: Decreased HF HRV precedes the progression and worsening of cardiovascular diseases. Continuous sitting behavior is a major risk factor for developing metabolic syndrome and is associated with cardiovascular disease, diabetes mellitus, renal failure, sarcopenia and osteoporosis. Risk factors for cardiovascular disease can be affected by continuous daytime sitting behaviors. DESIGN: The present study design was a post-hoc comparison. METHODS: Patients treated at two different primary care clinics from 2014 to 2018 were enrolled in this study (n = 53). We assessed HF HRV and continuous sitting time using 24-hour Holter electrocardiography and an activity meter at baseline and 6 months. HF HRV was calculated during sleep. RESULTS: Sitting time had decreased in 22 patients (decreased group) and increased in 31 patients (increased group) after 6 months. The mean patient ages were 73.1 and 72.0 years in the decreased and increased sitting time groups, respectively (p = 0.503). HF HRV during sleep had increased after 6 months in the decreased sitting time group. Compared with the increased group, the decreased group showed significantly higher HF HRV during sleep after 6 months by two-way repeated-measures ANOVA after adjustment for age, sex and change in activity (p = 0.045). CONCLUSION: These results suggest that a decrease in sitting time might induce parasympathetic activity during sleep. Therefore, reducing continuous sitting time during the day might contribute, in part, to improving the prognosis of patients with cardiovascular risk factors not only by avoiding muscle loss but also by providing positive influences on parasympathetic tone during sleep.

Increased Activity in Patients with Cardiovascular Risk Factors Increases Heart Rate Variability.

This study evaluated the effect of increased physical activity on high-frequency (HF) heart rate variability (HRV) during the first hour after sleep onset in patients with hypertension and/or stable angina pectoris. Physical activity and HF were measured using activity monitors and 24-hour Holter monitors at baseline and 6 months later. The physical activity increased in 28 patients (increase group) and decreased in 20 patients (decrease group) after 6 months. In this study, after 6 months, compared to the decreased physical activity group, the increased physical activity group showed a significant increase in the HF index during the first hour after sleep onset. Therefore, the increase in the HF index may have been due to the increase in physical activity. An increase in physical activity suggests that the quality of sleep early in the sleep cycle may be improved, which may affect the patient's prognosis.

Napping Improves HRV in Older Patients With Cardiovascular Risk Factors.

Heart rate variability (HRV), especially increased high frequency (HF), has been reported to provide clinically useful prognostic information regarding cardiovascular disease. Napping is an excellent sleep management strategy in older adults. This study was conducted to clarify the effect of napping on HRV in older adult patients with cardiovascular risk factors. The patients were divided into two groups: one group of 32 patients who reported napping (nap group) and another group of 45 patients who did not report napping (nonnap group). The HRV was calculated in terms of the HF component over 24 hr during wakefulness, sleep, and 1 hr after sleep onset. The HF in the nap group was significantly higher than that in the nonnap group during all times measured. In addition, napping was a significant predictor of increased HF. This study shows the effectiveness of napping in the daily lives of patients with cardiovascular risk factors.

Life activities improve heart rate variability in patients with mild hypertension and/or the initial stage of heart failure.

AIMS AND OBJECTIVES: To determine the effects on heart rate variability of home-based daily activity in patients with mild hypertension and/or stable angina pectoris and to clarify the relationship between daily activity and sympathovagal balance. BACKGROUND: Several prior studies have assessed the ability of exercise training to improve functional capacity and produce beneficial effects on mortality and physical capacity in patients with cardiovascular disease. DESIGN: A non-randomised six-month prospective longitudinal study. METHODS: This study consisted of 41 patients (59-83 years old) with mild hypertension and/or stable angina pectoris. The home-based daily activity and heart rate variability were measured at the start of the study (BASE) and six months after the start of the study (6MoA). At 6MoA, the active mass increased in 23 patients (the IC group), while it decreased in the remaining 18 patients (the DC group). RESULTS: There were significant increases in the high-frequency component in the IC group between the data at BASE and 6MoA. There were significant decreases in the low frequency to high-frequency ratio (low frequency/high-frequency) during sleep in the IC group between the data at BASE and 6MoA. The active mass was classified into life activities and walk activities in terms of intensity of activity. In a multivariate model, increased life activitiesrevealed a trend towards an association with increased high-frequency. CONCLUSIONS: In patients with mild hypertension and/or stable angina pectoris, an increase in active mass improved heart rate variability outcomes with increased high-frequency and decreased low frequency/high-frequency during sleep. To increase life activitiesmight improve heart rate variability and prognosis in patients. RELEVANCE TO CLINICAL PRACTICE: This study demonstrated that the potential importance of low-intensity daily activities in patients with mild hypertension and/or stable angina pectoris.

Lung large cell carcinoma producing granulocyte-colony-stimulating factor.

In recent years, tumors producing granulocyte-colony-stimulating factor have been reported in an increasing number of patients, the majority of which have lung cancer. We experience a case of lung carcinoma producing granulocyte-colony-stimulating factor treated by resection and chemotherapy. He remains well 2 years and 10 months after surgery, with no recurrence of the carcinoma.

Frozen-section diagnosis of small adenocarcinoma of the lung for intentional limited surgery.

PURPOSE: To determine if Noguchi's classification can be evaluated accurately by frozen-section diagnosis before limited surgery. METHODS: We performed frozen-section diagnosis in 31 of 343 patients who underwent excision of primary lung cancer at our hospital between 1993 and 2004. All 31 patients had pulmonary adenocarcinoma, with a tumor diameter of < or = 20 mm. There were 20 men and 11 women, ranging in age from 42 to 79 years (mean, 63.2 years). We assessed the rate of correct Noguchi's classification by categorizing all lesions into the following three groups on the basis of tumor diameter: < or = 10 mm, 11-15 mm, and 16-20 mm. RESULTS: The overall rate of correct frozen-section diagnosis during surgery was 67.7%; being 100%, 41.7%, and 70% in the < or = 10 mm, 11-15 mm, and 16-20 mm groups, respectively. CONCLUSION: Limited surgery for primary lung cancer can be performed when the tumor diameter is < or = 10 mm, by confirming it as either type A or B according to Noguchi's classification, using frozen-section diagnosis. Thus, examination of frozen sections might be an important diagnostic procedure before intentional limited surgery for lung cancer.