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1.
Med Sci Sports Exerc ; 2019 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-31246716

RESUMO

PURPOSE: To investigate the association between estimated cardiorespiratory fitness (eCRF) and risk of atrial fibrillation (AF), and examine how long-term changes in eCRF affects the AF risk. METHODS: This prospective cohort study includes data of 39 844 men and women from the HUNT2 (August 15, 1995 - June 18, 1997) and the HUNT3 study (October 3, 2006 - June 25, 2008). The follow-up period was from HUNT3 until AF diagnosis or November 30, 2015. AF diagnoses were retrieved from hospital registers and validated by medical doctors. A non-exercise test based on age, waist circumference, resting heart rate and self-reported physical activity was used to estimate CRF. Cox regression was performed to assess the association between eCRF and AF. RESULTS: The mean age was 50.6 ± 14.6 years for men and 50.2 ± 15.2 years for women. Mean follow-up time was 8.1 years. 1 057 cases of AF were documented. For men, the highest risk reduction of AF was 31% in the 4 quintile of eCRF when compared to the 1 quintile (HR, 0.69; 95% CI, 0.53-0.89). For women, the highest risk reduction was 47% in the 5 quintile when compared to the 1 quintile (HR, 0.53; 95% CI, 0.38-0.74). One metabolic equivalent increase in eCRF over a 10-year period was associated with 7% lower risk of AF (HR, 0.93; 95% CI, 0.86-1.00) Participants with improved eCRF had 44% lower AF risk compared to those with decreased eCRF (HR, 0.56; 95% CI, 0.36-0.87). CONCLUSION: eCRF was inversely associated with AF, and participants with improved eCRF over a 10-year period had less risk of AF. These findings support the hypothesis that fitness may prevent AF.

2.
J Am Heart Assoc ; 8(9): e010293, 2019 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-30991880

RESUMO

Background The majority of studies evaluating cardiorespiratory fitness ( CRF ) as a cardiovascular risk factor use cardiovascular mortality and not cardiovascular disease events as the primary end point, and generally do not include women. The aim of this study was to investigate the association of estimated CRF ( eCRF ) with the risk of first acute myocardial infarction ( AMI ). Methods and Results We included 26 163 participants (51.5% women) from the HUNT study (Nord-Trøndelag Health Study), with a mean age of 55.7 years, without cardiovascular disease at baseline. Baseline eCRF was grouped into tertiles. AMI was derived from hospital records and deaths from the Norwegian Cause of Death Registry. We used Fine and Gray regression modeling to estimate subdistribution hazards ratio ( SHR ) of AMI , accounting for competing risk of death. During a mean (range) follow-up of 13 (0.02-15.40) years (347 462 person-years), 1566 AMI events were recorded. In fully adjusted models men in the 2 highest eCRF had 4% ( SHR : 0.96, 95% CI : 0.83-1.11) and 10% ( SHR : 0.90, 95% CI : 0.77-1.05) lower SHR of AMI , respectively, when compared with men in the lowest tertile. The corresponding numbers in women were 12% ( SHR : 0.88, 95% CI : 0.72-1.08) and 25% ( SHR : 0.75, 95% CI : 0.60-0.95). Conclusions eCRF was inversely associated with risk of AMI event among women but not in men. Our data suggest that high eCRF may have substantial benefit in reducing the risk of AMI . Therefore, our data suggest that an increased focus on eCRF as a cardiovascular disease risk marker in middle-aged and older adults is warranted.

3.
Mayo Clin Proc ; 94(5): 803-810, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30935704

RESUMO

OBJECTIVE: To investigate whether C-reactive protein (CRP, a general marker of inflammation), neopterin (activated macrophages), lactoferrin (activated neutrophils), and endothelial function (flow-mediated vasodilation [FMD]) are associated with cardiorespiratory fitness (peak oxygen uptake [VO2peak]), sex, body mass index (BMI), and the metabolic syndrome (MetSyn) in a healthy adult population. PATIENTS AND METHODS: This was a cross-sectional association study based on the population-based HUNT3 Fitness Study performed from May 15, 2007, through June 23, 2008. Seven hundred forty self-reported healthy respondents (327 women) identified as having the MetSyn were age- and sex-matched with 692 controls (307 women) from the same cohort. Associations between the inflammatory biomarkers and VO2peak, FMD, and the MetSyn were analyzed by multivariate linear regression. RESULTS: The CRP level was negatively associated with VO2peak (P<.001), positively associated with the MetSyn (with a stronger effect in men) (P<.001) and BMI (with a stronger effect in women) (P<.01), but not with FMD (P=.34). Lactoferrin was positively associated with the MetSyn (P<.001), but neither neopterin nor lactoferrin were associated with VO2peak or FMD. CONCLUSION: The CRP level was strongly associated with VO2peak and the MetSyn, but not with FMD. The associations among inflammation, VO2peak, and the MetSyn were strongly influenced by sex and BMI. These data support that low cardiorespiratory fitness should be considered an etiologic factor contributing to systemic inflammation and that reducing body weight and improving VO2peak are methods that may positively affect CRP levels.

4.
J Mol Cell Cardiol ; 131: 53-65, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31005484

RESUMO

AIMS: Atrial contractile dysfunction is associated with increased mortality in heart failure (HF). We have shown previously that a metabolic syndrome-based model of HFpEF and a model of hypertensive heart disease (HHD) have impaired left atrial (LA) function in vivo (rat). In this study we postulate, that left atrial cardiomyocyte (CM) and cardiac fibroblast (CF) paracrine interaction related to the inositol 1,4,5-trisphosphate signalling cascade is pivotal for the manifestation of atrial mechanical dysfunction in HF and that quantitative atrial remodeling is highly disease-dependent. METHODS AND RESULTS: Differential remodeling was observed in HHD and HFpEF as indicated by an increase of atrial size in vivo (HFpEF), unchanged fibrosis (HHD and HFpEF) and a decrease of CM size (HHD). Baseline contractile performance of rat CM in vitro was enhanced in HFpEF. Upon treatment with conditioned medium from their respective stretched CF (CM-SF), CM (at 21 weeks) of WT showed increased Ca2+ transient (CaT) amplitudes related to the paracrine activity of the inotrope endothelin (ET-1) and inositol 1,4,5-trisphosphate induced Ca2+ release. Concentration of ET-1 was increased in CM-SF and atrial tissue from WT as compared to HHD and HFpEF. In HHD, CM-SF had no relevant effect on CaT kinetics. However, in HFpEF, CM-SF increased diastolic Ca2+ and slowed Ca2+ removal, potentially contributing to an in-vivo decompensation. During disease progression (i.e. at 27 weeks), HFpEF displayed dysfunctional excitation-contraction-coupling (ECC) due to lower sarcoplasmic-reticulum Ca2+ content unrelated to CF-CM interaction or ET-1, but associated with enhanced nuclear [Ca2+]. In human patients, tissue ET-1 was not related to the presence of arterial hypertension or obesity. CONCLUSIONS: Atrial remodeling is a complex entity that is highly disease and stage dependent. The activity of fibrosis related to paracrine interaction (e.g. ET-1) might contribute to in vitro and in vivo atrial dysfunction. However, during later stages of disease, ECC is impaired unrelated to CF.

6.
Prog Cardiovasc Dis ; 62(2): 193-202, 2019 Mar - Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30867130

RESUMO

The benefits of physical activity in cardiovascular diseases have long been appreciated. However, the molecular mechanisms that trigger and sustain the cardiac benefits of exercise are poorly understood, and it is anticipated that unveiling these mechanisms will identify novel therapeutic targets. In search of these mechanisms we took advantage of unbiased RNA-sequencing (RNA-seq) technology to discover cardiac gene targets whose expression is disrupted in heart failure (HF) and rescued by exercise in a rat model. Upon exhaustive validation in a separate rat cohort (qPCR) and human datasets, we shortlisted 16 targets for a cell-based screening, aiming to evaluate whether targeted disruption of these genes with silencing RNA would affect the abundance of a CVD biomarker (BNP, B-type natriuretic peptide) in human cardiomyocytes. Overall, these experiments showed that Proline Dehydrogenase (PRODH) expression is reduced in human failing hearts, rescued by exercise in a rat model of HF, and its targeted knockdown increases BNP expression in human cardiomyocytes. On the other hand, overexpression of PRODH increases the abundance of metabolism-related gene transcripts, and PRODH appears to be crucial to sustain normal mitochondrial function and maintenance of ATP levels in human cardiomyocytes in a hypoxic environment, as well as for redox homeostasis in both normoxic and hypoxic conditions. Altogether our findings show that PRODH is a novel molecular target of exercise in failing hearts and highlight its role in cardiomyocyte physiology, thereby proposing PRODH as a potential experimental target for gene therapy in HF.


Assuntos
Exercício/fisiologia , Insuficiência Cardíaca , Prolina Oxidase/metabolismo , Animais , Biomarcadores/metabolismo , Modelos Animais de Doenças , Perfilação da Expressão Gênica , Insuficiência Cardíaca/metabolismo , Insuficiência Cardíaca/prevenção & controle , Humanos , Mitocôndrias Cardíacas/metabolismo , Ratos , Transdução de Sinais
7.
J Strength Cond Res ; 2019 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-30741867

RESUMO

Dalen, T, Sandmæl, S, Stevens, TGA, Hjelde, GH, Kjøsnes, TN, and Wisløff, U. Differences in acceleration and high-intensity activities between small-sided games and peak periods of official matches in elite soccer players. J Strength Cond Res XX(X): 000-000, 2019-The purpose of this study was to compare whether the physical performance of players during 4 vs. 4 + goalkeeper (4 vs. 4) and 6 vs. 6 + goalkeeper (6 vs. 6) small-sided games (SSGs) is equivalent to those experienced during the most intense 5-minute period of soccer match play. Twenty-six male soccer players from an elite Norwegian league team took part. Players were monitored during 18 matches, 56 SSGs: twenty-eight 4 vs. 4 and twenty-eight 6 vs. 6 games. The ZXY Sport Tracking System was used to measure for each player the total distance covered, high-intensity running distance, sprint distance, number of accelerations, and player load (all expressed per minute). To compare the physical performance variables on players during the SSGs formats and match play, a 1-way analysis of variance with repeated measures was used. Players performed the same number of accelerations and player load in 4 vs. 4 (1.7 and 248, respectively) as in peak match (1.6 and 227, respectively), whereas in 6 vs. 6, there were 63% fewer accelerations and 15% lower player load (1.2 and 198, respectively), than in peak match. High-intensity running and sprint distance were significantly lower than mean match values in both 4 vs. 4 (4.1 and 0.2 m vs. 8.2 and 1.7 m) and 6 vs. 6 games (2.7 and 0.21 m vs. 8.2 and 1.7 m) (p < 0.05). In conclusion, only 4 vs. 4 SSGs are highly valuable, and in that, they elicit player load and accelerations to a level that is (at least) equivalent with peak periods of official match play.

8.
Prog Cardiovasc Dis ; 62(2): 127-134, 2019 Mar - Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30796942

RESUMO

PURPOSE: Sedentary behaviour (SB) and low physical activity (PA) are independently associated with non-alcoholic fatty liver disease (NAFLD). Compared to PA, high cardiorespiratory fitness (CRF) has been associated with a higher protection against all-cause mortality and a number of specific diseases. However, this relationship has not been investigated in NAFLD. This study examined the roles of SB and CRF on: i) the likelihood of having NAFLD in the general population, and ii) the risk of mortality over 9 years within individuals having NAFLD. METHODS: A cross-sectional analysis of 15,781 adults (52% female; age range 19-95 years) was conducted. Self-reported SB was divided into tertiles. CRF was estimated using validated non-exercise models, and the presence of NAFLD from the Fatty Liver Index. Adjusted Odds Ratios and 95% Confidence Intervals for NAFLD were estimated using logistic regression analyses. Hazard Ratios for all-cause mortality were estimated using Cox proportional hazard regression in individuals with NAFLD. RESULTS: For each additional 1 h/d of SB, the likelihood of having NAFLD was significantly increased by 4% (CI, 3-6%). In combined analyses, compared with the reference group [high CRF and low (≤4 h/d) SB], individuals with low CRF had a markedly higher likelihood of having NAFLD (OR, 16.9; CI 12.9-22.3), even if they had SB ≤ 4 h/d. High CRF attenuated the negative role of SB up to 7 h/d on NAFLD. Over 9.4 ±â€¯1.3 years of follow-up, individuals with NAFLD and low CRF had the risk of mortality increased by 52% (CI, 10-106%) compared to those with high CRF, regardless of SB or meeting PA guidelines. CONCLUSIONS: Low CRF increases the risk of premature death in individuals with NAFLD, and is strongly associated with higher likelihood of having NAFLD, outweighing the influence of SB.


Assuntos
Aptidão Cardiorrespiratória/fisiologia , Doenças Cardiovasculares , Exercício/fisiologia , Hepatopatia Gordurosa não Alcoólica , Comportamento Sedentário , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/prevenção & controle , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Hepatopatia Gordurosa não Alcoólica/psicologia , Noruega/epidemiologia , Avaliação de Resultados (Cuidados de Saúde) , Prevalência , Serviços Preventivos de Saúde/métodos , Modelos de Riscos Proporcionais , Medição de Risco/métodos , Fatores de Risco , Autorrelato
9.
Prog Cardiovasc Dis ; 62(2): 179-185, 2019 Mar - Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30797801

RESUMO

Despite all the evidence of health benefits related to physical activity (PA) and cardiorespiratory fitness (CRF), low levels of PA have reached pandemic proportions, and inactivity is the fourth leading cause of death worldwide. Lack of time, and inability to self-manage are often cited as main barriers to getting adequate PA. Recently, a new personalized metric for PA tracking named Personal Activity Intelligence (PAI) was developed with the aim to make it easier to quantify how much PA per week is needed to reduce the risk of premature mortality from non-communicable diseases. PAI can be integrated in self-assessment heart rate devices and defines a weekly beneficial heart rate pattern during PA by considering the individual's sex, age, and resting and maximal heart rates. Among individuals ranging from the general population to subgroups of patients with cardiovascular disease (CVD), a PAI score ≥100 per week at baseline, an increase in PAI score, and a sustained high PAI score over time were found to delay premature death from CVD and all causes, regardless of whether or not the current PA recommendations were met. Importantly, a PAI score ≥100 at baseline, maintaining ≥100 PAIs and an increasing PAI score over time was associated with multiple years of life gained. Moreover, obtaining a weekly PAI ≥100 attenuated the deleterious association between CVD risk factor clustering and prolonged sitting time. PAI and objectively measured CRF (as indicated by VO2peak) were positively associated in a graded fashion, and individuals with a PAI score between 100 and 150 had expected age and sex specific average VO2peak values. A PAI score ≥100 was associated with higher VO2peak in both men (4.1 mL·kg-1·min-1; 95% CI, 3.5 to 4.6) and women (2.9 mL·kg-1·min-1; 95% CI, 2.4 to 3.3), compared to the reference group of <100 PAI. The combined analysis of PAI, PA and VO2peak demonstrated that a PAI score ≥100 was associated with high VO2peak values regardless of meeting or not meeting the current PA recommendations. Collectively, these findings suggest that PAI has the potential to be a useful tool to motivate people to become and stay physically active by quantifying the amount of PA needed to produce significant health benefits.


Assuntos
Doenças Cardiovasculares , Exercício/fisiologia , Monitores de Aptidão Física/normas , Aptidão Cardiorrespiratória/fisiologia , Aptidão Cardiorrespiratória/psicologia , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/prevenção & controle , Doenças Cardiovasculares/psicologia , Nível de Saúde , Frequência Cardíaca , Humanos , Inteligência , Mortalidade Prematura , Projetos de Pesquisa , Fatores de Risco , Comportamento de Redução do Risco
10.
Prog Cardiovasc Dis ; 62(2): 94-101, 2019 Mar - Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30802460

RESUMO

To date there is no cure available for dementia, and the field calls for novel therapeutic targets. A rapidly growing body of literature suggests that regular endurance training and high cardiorespiratory fitness attenuate cognitive impairment and reduce dementia risk. Such benefits have recently been linked to systemic neurotrophic factors induced by exercise. These circulating biomolecules may cross the blood-brain barrier and potentially protect against neurodegenerative disorders such as Alzheimer's disease. Identifying exercise-induced systemic neurotrophic factors with beneficial effects on the brain may lead to novel molecular targets for maintaining cognitive function and preventing neurodegeneration. Here we review the recent literature on potential systemic mediators of neuroprotection induced by exercise. We focus on the body of translational research in the field, integrating knowledge from the molecular level, animal models, clinical and epidemiological studies. Taken together, the current literature provides initial evidence that exercise-induced, blood-borne biomolecules, such as BDNF and FNDC5/irisin, may be powerful agents mediating the benefits of exercise on cognitive function and may form the basis for new therapeutic strategies to better prevent and treat dementia.


Assuntos
Aptidão Cardiorrespiratória/psicologia , Demência , Treino Aeróbico/métodos , Fatores de Crescimento Neural/fisiologia , Neuroproteção/fisiologia , Cognição/fisiologia , Demência/fisiopatologia , Demência/prevenção & controle , Exercício/fisiologia , Exercício/psicologia , Humanos
11.
Eur J Sport Sci ; 19(8): 1015-1023, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30632940

RESUMO

The aim of the current study was (1) to investigate whether the number of accelerations is a more precise estimate of performance decline in soccer compared to distances with high-speed running (HSR) and (2) to compare changes in the number of accelerations and HSR distances across playing positions in order to examine whether the match profiles of the physical measures are consistent or demonstrate high interposition variability. The dataset includes domestic home games (N = 34) over three full seasons (2012-2014) for a team in the Norwegian Elite League. The change in the number of accelerations throughout the match demonstrates a more clear pattern compared to the distance covered by HSR. In numbers of accelerations, a systematic and linear decrease can be observed throughout the match, with 34% less accelerations from the first to the last 5-minute period of the game (6.7 vs. 4.4 accelerations). This pattern of results captures the change in the number of accelerations across all positions. HSR distance had more variability during the match. All five positions investigated displayed a similar trend in accelerations and HSR profiles after the peak periods in each half. In contrast to the absolute number of accelerations, there were major positional differences in the mean HSR distance during the match. Our data suggest a more visible performance decline in the number of accelerations from the start to the end of the game, than the decline in the distance covered by HSR distance.

13.
Prog Cardiovasc Dis ; 62(2): 140-146, 2019 Mar - Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30685470

RESUMO

High intensity interval training (HIIT) is now recognized in international clinical-based exercise guidelines as an appropriate and beneficial adjunct to moderate intensity continuous training. HIIT involves alternating periods of high intensity aerobic exercise with light recovery exercise or no exercise, allowing for greater physiological stimulus and adaptation than moderate intensity continuous training (MICT) for cardiorespiratory fitness and other cardiometabolic processes. However, there is no universal criteria or framework for the prescription and monitoring of HIIT in clinical populations, and safety concerns remain a common barrier for implementing HIIT as standard care. Historically, exercise intensity has been prescribed using heart rate (HR) targets derived from either a predicted maximal HR (HRmax) or from an attempt to objectively measure HRmax. However, using this approach alone has a number of limitations. Here we provide guidelines to improve the delivery of HIIT in cardiometabolic populations using 1) a framework for HIIT prescription using a combination of objective and subjective measures of exercise intensity, and 2) clinical considerations for assessment and monitoring to maximize patient safety. The framework involves an individualized step-by-step process to calculate, validate, and calibrate HR target zones for HIIT training to allow for appropriate workload prescription and progression. We strongly recommend this framework be used in future clinical trials investigating HIIT.


Assuntos
Aptidão Cardiorrespiratória/fisiologia , Doenças Cardiovasculares/prevenção & controle , Exercício/fisiologia , Frequência Cardíaca , Treinamento Intervalado de Alta Intensidade , Monitorização Fisiológica , Segurança do Paciente/normas , Adaptação Fisiológica , Doenças Cardiovasculares/fisiopatologia , Tolerância ao Exercício , Treinamento Intervalado de Alta Intensidade/métodos , Treinamento Intervalado de Alta Intensidade/normas , Humanos , Monitorização Fisiológica/métodos , Monitorização Fisiológica/normas
14.
PLoS One ; 13(12): e0208703, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30533031

RESUMO

PURPOSE: Exercise training increases aerobic capacity and is beneficial for health, whereas low aerobic exercise capacity is a strong independent predictor of cardiovascular disease and premature death. The purpose of the present study was to determine the metabolic profiles in a rat model of inborn low versus high capacity runners (LCR/HCR) and to determine the effect of inborn aerobic capacity, aging, and exercise training on skeletal muscle metabolic profile. METHODS: LCR/HCR rats were randomized to high intensity low volume interval treadmill training twice a week or sedentary control for 3 or 11 months before they were sacrificed, at 9 and 18 months of age, respectively. Magnetic resonance spectra were acquired from soleus muscle extracts, and partial least square discriminative analysis was used to determine the differences in metabolic profile. RESULTS: Sedentary HCR rats had 54% and 30% higher VO2max compared to sedentary LCR rats at 9 months and 18 months, respectively. In HCR, exercise increased running speed significantly, and VO2max was higher at age of 9 months, compared to sedentary counterparts. In LCR, changes were small and did not reach the level of significance. The metabolic profile was significantly different in the LCR sedentary group compared to the HCR sedentary group at the age of 9 and 18 months, with higher glutamine and glutamate levels (9 months) and lower lactate level (18 months) in HCR. Irrespective of fitness level, aging was associated with increased soleus muscle concentrations of glycerophosphocholine and glucose. Interval training did not influence metabolic profiles in LCR or HCR rats at any age. CONCLUSION: Differences in inborn aerobic capacity gave the most marked contrasts in metabolic profile, there were also some changes with ageing. Low volume high intensity interval training twice a week had no detectable effect on metabolic profile.


Assuntos
Envelhecimento/fisiologia , Músculo Esquelético/metabolismo , Resistência Física/fisiologia , Corrida/fisiologia , Animais , Animais não Endogâmicos , Espectroscopia de Prótons por Ressonância Magnética , Distribuição Aleatória , Ratos , Comportamento Sedentário , Especificidade da Espécie
15.
Sci Rep ; 8(1): 17772, 2018 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-30538258

RESUMO

Given the association between high aerobic capacity and the prevention of metabolic diseases, elucidating the mechanisms by which high aerobic capacity regulates whole-body metabolic homeostasis is a major research challenge. Oxidative post-translational modifications (Ox-PTMs) of proteins can regulate cellular homeostasis in skeletal and cardiac muscles, but the relationship between Ox-PTMs and intrinsic components of oxidative energy metabolism is still unclear. Here, we evaluated the Ox-PTM profile in cardiac and skeletal muscles of rats bred for low (LCR) and high (HCR) intrinsic aerobic capacity. Redox proteomics screening revealed different cysteine (Cys) Ox-PTM profile between HCR and LCR rats. HCR showed a higher number of oxidized Cys residues in skeletal muscle compared to LCR, while the opposite was observed in the heart. Most proteins with differentially oxidized Cys residues in the skeletal muscle are important regulators of oxidative metabolism. The most oxidized protein in the skeletal muscle of HCR rats was malate dehydrogenase (MDH1). HCR showed higher MDH1 activity compared to LCR in skeletal, but not cardiac muscle. These novel findings indicate a clear association between Cys Ox-PTMs and aerobic capacity, leading to novel insights into the role of Ox-PTMs as an essential signal to maintain metabolic homeostasis.

16.
Prog Cardiovasc Dis ; 2018 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-30445160

RESUMO

The cardiovascular disease (CVD) pandemic has placed considerable strain on healthcare systems, quality of life, and physical function, while remaining the leading cause of death globally. Decades of scientific investigations have fortified the protective effects of cardiorespiratory fitness (CRF), exercise training, and physical activity (PA) against the development of CVD. This review will summarize recent efforts that have made significant strides in; 1) the application of novel analytic techniques to increase the predictive utility of CRF; 2) understanding the protective effects of long-term compliance to PA recommendations through large cohort studies with multiple points of assessment; 3) and understanding the potential harms associated with extreme volumes of PA.

17.
Eur Heart J ; 2018 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-30496487

RESUMO

Aims: The majority of previous research on the association between cardiorespiratory fitness (CRF) and cardiovascular disease (CVD) is based on indirect assessment of CRF in clinically referred predominantly male populations. Therefore, our aim was to examine the associations between VO2peak measured by the gold-standard method of cardiopulmonary exercise testing and fatal and non-fatal coronary heart disease (CHD) in a healthy and fit population. Methods and results: Data on VO2peak from 4527 adults (51% women) with no previous history of cardiovascular or lung disease, cancer, and hypertension or use of antihypertensive medications participating in a large population-based health-study (The HUNT3 Study), were linked to hospital registries and the cause of death registry. Average VO2peak was 36.0 mL/kg/min and 44.4 mL/kg/min among women and men, and 83.5% had low 10-year risk of CVD at baseline. Average follow-up was 8.8 years, and 147 participants reached the primary endpoint. Multi-adjusted Cox-regression showed 15% lower risk for the primary endpoint per one-MET (metabolic equivalent task) higher VO2peak [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.77-0.93], with similar results across sex. The highest quartile of VO2peak had 48% lower risk of event compared with the lowest quartile (multi-adjusted HR 0.52, 95% CI 0.33-0.82). Oxygen pulse and ventilatory equivalents of oxygen and carbon dioxide also showed significant predictive value for the primary endpoint. Conclusion: VO2peak was strongly and inversely associated with CHD across the whole fitness continuum in a low-risk population sample. Increasing VO2peak may have substantial benefits in reducing the burden of CHD.

18.
BMC Geriatr ; 18(1): 208, 2018 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-30200893

RESUMO

BACKGROUND: Making older adults exercise and keeping them in exercise programs is a major challenge. Understanding how older adults prefer to exercise may help developing tailored exercise programs and increase sustained exercise participation in ageing populations. We aimed to describe exercise patterns, including frequency, intensity, type, location and social setting of exercise, in older adults instructed to follow continuous moderate-intensity training (MCT) or high-intensity interval training (HIIT) over a one-year period. METHODS: Frequency, intensity, type, location and social setting (alone vs. together with others) of exercise were assessed using exercise logs from 618 older adults (aged 70-77 years) randomized to MCT or HIIT. All participants completed exercise logs after each exercise session they performed during one year. Pearson Chi-square tests were run to assess the association between intensity, type, location and social setting of exercise with training group. RESULTS: Both groups performed 2.2 ± 1.3 exercise sessions per week during the year. Walking was the most common exercise type in both groups, but MCT had a higher proportion of walking sessions than HIIT (54.2% vs. 41.1%, p < 0.01). Compared to MCT, HIIT had a higher proportion of sessions with cycling (14.2% vs. 9.8%, p < 0.01), combined endurance and resistance training (10.3% vs. 7.5%, p < 0.01), jogging (6.5% vs. 3.2%, p < 0.01) and swimming (2.6% vs. 1.7%, p < 0.01). Outdoors was the most common exercise location in both training groups (67.8 and 59.1% of all sessions in MCT and HIIT, respectively). Compared to MCT, HIIT had a higher proportion of sessions at a gym (21.4% vs. 17.5%, p < 0.01) and sports facility (9.8% vs. 7.6%, p < 0.01). Both groups performed an equal amount of sessions alone and together with others, but women had a higher proportion of sessions together with others compared to men (56% vs. 44%, p < 0.01). CONCLUSION: This is the first study that has followed older adults instructed to perform MCT or HIIT over a one-year period, collected data from each exercise session they performed and provided important knowledge about their exercise patterns. This novel information may help researchers and clinicians to develop tailored exercise programs in an ageing population.

19.
Prog Cardiovasc Dis ; 2018 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-30227185

RESUMO

BACKGROUND: Personal Activity Intelligence (PAI) is a novel activity metric that translates heart rate variations during exercise into a weekly score. Weekly PAI scores assessed at a single point in time were found to associate with lower risk of premature cardiovascular disease (CVD) mortality in the general healthy population. However, to date, the associations between long-term longitudinal changes in weekly PAI scores and mortality have not been explored. PURPOSE: The aim of the present study was to prospectively examine the association between change in weekly PAI scores estimated 10 years apart, and risk of mortality from CVD and all-causes. METHODS: We performed a prospective cohort study of 11,870 men and 13,010 women without known CVD in Norway. By using data from the Nord-Trøndelag Health Study (HUNT), PAI was estimated twice, ten years apart (HUNT1 1984-86 and HUNT2 1995-97). Mortality was followed-up until December 31, 2015. Adjusted hazard ratios (AHR) and 95% confidence intervals (CI) for death from CVD and all-causes related to temporal changes in PAI were estimated using Cox regression analyses. RESULTS: During a mean (SD) of 18 (4) years of follow-up, there were 4782 deaths, including 1560 deaths caused by CVD. Multi-adjusted analyses demonstrated that participants achieving a score of ≥100 PAI at both time points had 32% lower risk of CVD mortality (AHR 0.68; CI: 0.54-0.86) for CVD mortality and 20% lower risk of all-cause mortality (AHR 0.80; CI: 71-0.91) compared with participants obtaining <100 weekly PAI at both measurements. For participants having <100 PAI in HUNT1 but ≥100 PAI in HUNT2, the AHRs were 0.87 (CI: 0.74-1.03) for CVD mortality, and 0.86 (CI: 0.79-0.95) for all-cause mortality. We also found an inverse linear relationship between change in PAI and risk of CVD mortality among participants with 0 PAI (P < 0.01), and ≤50 PAI (P = 0.04) in HUNT1, indicating that an increase in PAI over time is associated with lower risk of mortality. Excluding the first three years of follow-up did not substantially alter the findings. Increasing PAI score from <100 PAI in HUNT1 to ≥100 PAI in HUNT2 was associated with 6.6 years gained lifespan. CONCLUSION: Among men and women without known CVD, an increase in PAI score and sustained high PAI score over a 10-year period was associated with lower risk of mortality.

20.
Int J Cardiol ; 272: 194-201, 2018 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-30173922

RESUMO

BACKGROUND: Disruption of endoplasmic reticulum (ER) homeostasis is a common feature of cardiac diseases. However, the signaling events involved in ER stress-induced cardiac dysfunction are still elusive. Here, we uncovered a mechanism by which disruption of ER homeostasis impairs cardiac contractility. METHODS/RESULTS: We found that ER stress is associated with activation of JNK and upregulation of BNIP3 in a post-myocardial infarction (MI) model of cardiac dysfunction. Of interest, 4-week treatment of MI rats with the chemical ER chaperone 4-phenylbutyrate (4PBA) prevented both activation of JNK and upregulation of BNIP3, and improved cardiac contractility. We showed that disruption of ER homeostasis by treating adult rat cardiomyocytes in culture with tunicamycin leads to contractile dysfunction through JNK signaling pathway. Upon ER stress JNK upregulates BNIP3 in a FOXO3a-dependent manner. Further supporting a BNIP3 mechanism for ER stress-induced deterioration of cardiac function, siRNA-mediated BNIP3 knockdown mitigated ER stress-induced cardiomyocyte dysfunction by reestablishing sarcoplasmic reticulum Ca2+ content. CONCLUSIONS: Collectively, our data identify JNK-dependent upregulation of BNIP3 as a critical process involved in ER stress-induced cardiomyocyte contractile dysfunction and highlight 4PBA as a potential intervention to counteract ER stress-mediated BNIP3 upregulation in failing hearts.

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