scholarly journals Vitamin D is associated with cardiopulmonary exercise capacity: results of two independent cohorts of healthy adults

2015 ◽  
Vol 115 (3) ◽  
pp. 500-508 ◽  
Author(s):  
A. Kaul ◽  
S. Gläser ◽  
A. Hannemann ◽  
C. Schäper ◽  
M. Nauck ◽  
...  
Keyword(s):  
Vitamin D ◽  
Exercise Capacity ◽  
Cardiopulmonary Exercise Testing ◽  
Cycle Ergometer ◽  
Healthy Adults ◽  
Peak Power Output ◽  
Exercise Tests ◽  
Hydroxyvitamin D ◽  
Cardiopulmonary Exercise ◽  
Cardiopulmonary Exercise Capacity

AbstractVitamin D has an important role in calcium homeostasis and is known to have various health-promoting effects. Moreover, potential interactions between vitamin D and physical activity have been suggested. This study aims to investigate the relationship between 25-hydroxyvitamin D (25(OH)D) and exercise capacity quantified by cardiopulmonary exercise testing (CPET). For this, 1377 participants from the Study of Health in Pomerania (SHIP-1) and 750 participants from the independent SHIP-TREND cohort were investigated. Standardised incremental exercise tests on a cycle ergometer were performed to assess exercise capacity by VO2 at anaerobic threshold, peakVO2, O2 pulse and peak power output. Serum 25(OH)D levels were measured by an automated chemiluminescence immunoassay. In SHIP-1, 25(OH)D levels were positively associated with all considered parameters of cardiopulmonary exercise capacity. Subjects with high 25(OH)D levels (4th quartile) showed an up to 25 % higher exercise capacity compared with subjects with low 25(OH)D levels (1st quartile). All associations were replicated in the independent SHIP-TREND cohort and were independent of age, sex, season and other interfering factors. In conclusion, significant positive associations between 25(OH)D and parameters of CPET were detected in two large cohorts of healthy adults.

Abstract 16002: Chronotropic Incompetence Limits Exercise Capacity in Patients Taking Beta-Blockers

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Maciej Tysarowski ◽  
Krzysztof Smarz ◽  
Beata Zaborska ◽  
Ewa Pilichowska-Paszkiet ◽  
Malgorzata Sikora-Frac ◽  
...  
Keyword(s):  
Exercise Capacity ◽  
Beta Blocker ◽  
Partial Correlation ◽  
Beta Blockers ◽  
Cardiopulmonary Exercise Testing ◽  
Peak Oxygen Uptake ◽  
Male Gender ◽  
Chronotropic Incompetence ◽  
Cardiopulmonary Exercise ◽  
Variance Explained

Introduction: Chronotropic incompetence in patients taking beta-blockers is associated with poor prognosis; however, its impact on exercise capacity (EC) remains unclear. Hypothesis: We assessed the hypothesis that chronotropic incompetence is associated with decreased exercise capacity in patients taking beta-blockers. Methods: We retrospectively analyzed data from consecutive patients taking beta-blockers referred for cardiopulmonary exercise testing. EC was expressed as peak oxygen uptake (VO 2 peak; mL/kg/min). Chronotropic incompetence was defined as chronotropic index (CI) ≤ 62%. CI was calculated as [(HR at peak-resting HR) / (maximum predicted HR-resting HR)] х 100%. Results: Among 140 patients all taking beta-blockers (age 61 ± 9.7 years; 73% males), there were 113 (80.7%) patients with chronotropic incompetence. EC was lower in the group with chronotropic incompetence than the group without it, VO 2 peak 18.3 ± 5.7 vs. 24.0 ± 5.3 mL/kg/min, p < 0.001. In multivariate analysis ( Table ), EC correlated positively with CI (β = 0.14, p < 0.001) and male gender (β = 5.12, p < 0.001), and negatively with age (β = –0.17, p < 0.001) and presence of heart failure (β = –3.35, p < 0.001). Beta-blocker dose was not associated with EC. Partial correlation attributable to CI (partial R 2 = 24.7%) accounted for more than one-third of the variance in EC explained by the model (adjusted R 2 = 59.8%). Conclusions: In patients taking beta-blockers, the presence of chronotropic incompetence was associated with lower EC, regardless of the beta-blocker dose. CI accounted for more than one-third of EC variance explained by our model.

Abstract 6: Vitamin D3 Repletion Improves Heart Failure Patient Quality of Life and Neurohormonal Indices

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Heidi Moretti ◽  
Bradley Berry ◽  
Vince Colucci
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Vitamin D ◽  
Vitamin D3 ◽  
Nyha Class ◽  
Heart Failure Patients ◽  
Hydroxyvitamin D ◽  
Cardiopulmonary Exercise ◽  
25 Hydroxyvitamin D

Background: Vitamin D deficiency has been associated with cardiovascular mortality and sudden cardiac death in heart failure patients. Vitamin D may influence parathyroid hormone, the renin-angiotensin axis, natriuretic peptide gene expression, cardiac contractility, and cardiopulmonary function. Heart Failure (HF) studies using vitamin D to date have typically not used adequate repletion doses. Objectives: The primary objectives of this research were to determine if vitamin D repletion over a six month period in New York Heart Association (NYHA) Class II-III HF patients would result in a change in neurohormonal markers, cardiopulmonary exercise parameters, circulating 25- hydroxyvitamin D, and quality of life. Methods: A randomized, double-blinded, placebo-controlled trial assessing adjunctive Vitamin D3 supplementation in the treatment of NYHA Class II-III HF patients was conducted. Patients received 10,000 International Units (IU) per day of vitamin D3 or placebo for 6 months. Inclusion Criteria: 1) 25-hydroxyvitamin D level ≤32 ng/ml 2) stable medical regimen for 3 months. Exclusion Criteria: 1) any clinically unstable medical disorder 2) supplementation of vitamin D3 or D2 of greater than or equal to 2,000 IU/day. Study endpoints were: 1) B-type Natriuretic Peptide (BNP), 2) cardiopulmonary exercise parameters using Shape HF, 3) 25-hydroxyvitamin D, 4) intact parathyroid hormone (PTH), and 5) quality of life with the Kansas City Cardiomyopathy Questionnaire (KCCQ). Statistical analysis included independent samples t-test and multivariate regression. Results: A total of 34 patients completed the study. When adjusted for baseline 25-hydroxyvitamin D, the difference between groups for BNP was significant ([[Unable to Display Character: &#8710;]]540 ±1928 pg/ml placebo vs [[Unable to Display Character: &#8710;]] 35 pg/ml ±1054 pg/ml treatment p=0.009). 25-hydroxyvitamin D was [[Unable to Display Character: &#8710;]]48.9 ±32 ng/ml treatment vs [[Unable to Display Character: &#8710;]]3.6 ± 9.4 ng/ml placebo, p<0.001 (mean 68 ng/ml treatment vs 23 ng/ml placebo). No toxicity was observed with treatment. PTH and exercise chronotropic response index trended towards improvement in the treatment group vs placebo group, respectively (([[Unable to Display Character: &#8710;]]-20 ±20 pg/ml vs [[Unable to Display Character: &#8710;]]7 ±54pg/ml (p=0.06)) and ([[Unable to Display Character: &#8710;]]0.13±0.26 versus [[Unable to Display Character: &#8710;]]-0.03 ± 0.23, p=0.12)). KCCQ quality of life total symptom ([[Unable to Display Character: &#8710;]]16 ±16 treatment vs [[Unable to Display Character: &#8710;]]-12 ±15 placebo, p< 0.001) and individual scores significantly improved from baseline in the treatment group. Conclusions: Preliminary results show that vitamin D3 treatment of 10,000 IU/day in heart failure patients is safe, results in adequate circulating 25-hydroxyvitamin D levels, and achieves improvement in surrogate endpoint markers of HF outcomes.

Abstract 16117: Nonresponders to Cardiac Rehabilitation and Outcomes

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Alban De Schutter ◽  
Carl Lavie ◽  
Eiman Jahangir ◽  
Arthur Menezes ◽  
Homeyar Dinshaw ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Cardiac Rehabilitation ◽  
Exercise Capacity ◽  
Poor Prognosis ◽  
Cardiopulmonary Exercise Testing ◽  
Significant Risk ◽  
Metabolic Equivalent ◽  
Cardiopulmonary Exercise ◽  
Before And After

Introduction: Studies of coronary heart disease (CHD) and cardiac rehabilitation (CR) have traditionally focused on increasing enrollment in CR. We examine here the prognosis of patients who enrolled and completed CR, but saw no significant improvement in exercise capacity [nonresponders (NR)]. Hypothesis: Nonresponders have a poor prognosis. Methods: 780 CHD patients who completed CR with cardiopulmonary exercise testing (CPX) before and after the intervention were divided according to improvement in exercise tolerance (ET; no change or decline vs improvement in metabolic equivalent). Mortality was tracked post CR for all patients; 1 to 161 months of follow-up (mean 6.4 years). Results: 243 (31%) subjects were NR. After adjustment for body mass index, age, gender, ejection fraction and baseline ET, lack of improvement in exercise capacity was associated with a statistically significant 55% increase in mortality (p=0.03; Figure 1). Higher age (OR 1.02; p 0.05) and baseline ET (OR 1.07; p 0.001) was significantly associated with being a NR, but depression, gender and ejection fraction were not significant risk factors. Conclusions: A substantial proportion of subjects referred to CR have no improvement in ET and comparatively demonstrate a poor prognosis. Further investigation into the identifying characteristics of this population is needed to examine if their prognosis can be altered.

Variation of circulating 25-Hydroxyvitamin D levels with life style in a cohort group in Sri Lanka

2019 ◽  
Vol 49 (4) ◽  
pp. 506-516 ◽  
Author(s):  
Shirani Ranasinghe ◽  
Thilak Jayalath ◽  
Sampath Thennakoon ◽  
Ranjith Jayasekara ◽  
Ran Shiva ◽  
...  
Keyword(s):  
Vitamin D ◽  
Sri Lanka ◽  
Feeding Habits ◽  
Serum Vitamin ◽  
Healthy Adults ◽  
Vitamin D Status ◽  
Content Type ◽  
Hydroxyvitamin D ◽  
Serum Vitamin D ◽  
25 Hydroxyvitamin D

Purpose Purpose of this study is to measure the Vitamin D status of healthy adults and to correlate with their lifestyle and feeding habits. Plasma 25-Hydroxyvitamin D (25(OH)D) is the most common marker of vitamin D status of an individual. Deficiency of vitamin D is defined as the serum level less than 20 ng/mL and insufficiency as 30 ng/mL which can be prevented. Design/methodology/approach Vitamin D status of healthy adults (n = 82), both male and females between the age of 18 – 50 years who were attending to the National Transport Authority, Kandy, Sri Lanka from February to March 2016, was measured and correlated with their lifestyle, feeding habits, etc. Findings The mean total serum D (25(OH)D in this study was 40.15 ± 3.74 nmol/l with the mean value of 42.8 ± 28.8 and 37.5 ± 16.6 for women and men, respectively. The serum calcium levels of both female and male were around 8 mg/dl and the serum total protein was 6.5 and 7 g/dl in women and men, respectively. The serum Vitamin D, calcium and total protein were not statistically significantly different between the sexes. In this study, 84 per cent of the total subjects were normocalcemic, and there was no significant relationship between vitamin D levels and their calcium levels. Research limitations/implications This study demonstrates that there was no statistically significant correlation between the serum vitamin D with age, serum calcium or total proteins. The majority of participants who had exposure to the sunlight more than 30 mins/day had sufficient level of vitamin D and less than 30 min/day exposure had deficiency of vitamin D. Daily intake of multivitamin influenced vitamin D status of the study group. Practical implications These findings will implicate the importance of cultural, feed and social habits for the nutritional status of an individual.and there are no reported studies on vitamin D status with reference to the variation of life style. Social implications It is very important to investigate the factors affecting to the vitamin D status of a population as such, vitamin D insufficiency or deficiency can be prevented. In Sri Lanka, the population is consisting with many ethnic groups, different ethnic groups may find some nutritional problems according to their main cultural habits. Originality/value The objectives of this study are to evaluate the Vitamin D status in a group of healthy adults between 20 and 50 years in both men and women and to find out the correlation of their vitamin D status with their lifestyle and feeding habits, etc.

scholarly journals Mismatch between self-estimated and objectively assessed exercise capacity in patients with congenital heart disease varies in regard to complexity of cardiac defects

2020 ◽  
pp. 1-7
Author(s):  
Julius M. Woile ◽  
Stefan Dirks ◽  
Friederike Danne ◽  
Felix Berger ◽  
Stanislav Ovroutski
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Oxygen Uptake ◽  
Exercise Capacity ◽  
Congenital Heart ◽  
Cardiopulmonary Exercise Testing ◽  
Peak Oxygen Uptake ◽  
Subjective Rating ◽  
Cardiac Defects ◽  
Cardiopulmonary Exercise

Abstract Aim: Regular evaluation of physical capacity takes a crucial part in long-term follow-up in patients with congenital heart disease (CHD). This study aims to examine the accuracy of self-estimated exercise capacity compared to objective assessments by cardiopulmonary exercise testing in patients with CHD of various complexity. Methods: We conducted a single centre, cross-sectional study with retrospective analysis on 382 patients aged 8–68 years with various CHD who completed cardiopulmonary exercise tests. Peak oxygen uptake was measured. Additionally, questionnaires covering self-estimation of exercise capacity were completed. Peak oxygen uptake was compared to patient’s self-estimated exercise capacity with focus on differences between complex and non-complex defects. Results: Peak oxygen uptake was 25.5 ± 7.9 ml/minute/kg, corresponding to 75.1 ± 18.8% of age- and sex-specific reference values. Higher values of peak oxygen uptake were seen in patients with higher subjective rating of exercise capacity. However, oxygen uptake in patients rating their exercise capacity as good (mean oxygen uptake 78.5 ± 1.6%) or very good (mean oxygen uptake 84.8 ± 4.8%) was on average still reduced compared to normal. In patients with non-complex cardiac defects, we saw a significant correlation between peak oxygen uptake and self-estimated exercise capacity (spearman-rho −0.30, p < 0.001), whereas in patients with complex cardiac defects, no correlation was found (spearman-rho −0.11, p < 0.255). Conclusion: The mismatch between self-estimated and objectively assessed exercise capacity is most prominent in patients with complex CHD. Registration number at Charité Universitätsmedizin Berlin Ethics Committee: EA2/106/14.

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