scholarly journals Right heart exercise-training-adaptation and remodelling in endurance athletes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Valeria Conti ◽  
Filippo Migliorini ◽  
Marco Pilone ◽  
María I. Barriopedro ◽  
Juan José Ramos-Álvarez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Right Atrium ◽  
Positive Association ◽  
Negative Association ◽  
Endurance Athletes ◽  
Right Heart ◽  
Systolic Volume ◽  
Functional Changes ◽  
End Diastolic Volume

AbstractLong-term sports training leads to myocardial adaptations, with remodelling of the heart chambers. However, while myocardial adaptations of the left heart are well described, remodelling of the right heart and its impact on the development of arrhythmias is still debated. To conduct a systematic review on right ventricle (RV) and right atrium (RA) structural and functional changes in athletes who participate in long-term endurance training. Systematic review. A systematic literature search was conducted. All the articles reporting right heart echocardiographic (ECHO) and cardiac magnetic resonance (CMR) parameters evaluated in endurance athletes and sedentary subjects were considered eligible. A multivariate analysis was conducted to investigate whether age, sex, body surface area (BSA), intensity of training are associated with RV ECHO, CMR parameters and RA ECHO parameters. A positive association between age and right atrium area (RAA) (P = 0.01) was found. This is a negative association to RV E/A (P = 0.004), and RV end diastolic diameter (RVED) longitudinal (P = 0.01). A positive association between BSA and RVED middle (P = 0.001), as well between BSA and RAA (P = 0.05) was found, along with a negative association with RV E/A (P = 0.002). A positive association between intensity of training and RV end systolic area (RVESA) (P = 0.03), RV end diastolic volume indexed (RVEDVI) (P = 0.01), RV end systolic volume indexed (RVESVI) (P = 0.01) was found, along with a negative association with ejection fraction (EF %) (P = 0.01). Endurance athletes demonstrated an association between RV remodelling and age, BSA and intensity of training.

scholarly journals Sleep disordered breathing and enlargement of the right heart after myocardial infarction

2014 ◽  
Vol 45 (3) ◽  
pp. 680-690 ◽  
Author(s):  
Stefan Buchner ◽  
Michael Eglseer ◽  
Kurt Debl ◽  
Andrea Hetzenecker ◽  
Andreas Luchner ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Right Ventricular ◽  
Sleep Disordered Breathing ◽  
Left Ventricular ◽  
Right Atrial ◽  
Right Heart ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
End Systolic Volume ◽  
The Right

Structural and functional integrity of the right heart is important in the prognosis after acute myocardial infarction (AMI). The objective of this study was to assess the impact of sleep disordered breathing (SDB) on structure and function of the right heart early after AMI.54 patients underwent cardiovascular magnetic resonance 3–5 days and 12 weeks after AMI, and were stratified according to the presence of SDB, defined as an apnoea–hypopnoea index of ≥15 events·h−1.12 weeks after AMI, end-diastolic volume of the right ventricle had increased significantly in patients with SDB (n=27)versusthose without (n=25) (mean±sd14±23%versus0±17%, p=0.020). Multivariable linear regression analysis accounting for age, sex, body mass index, smoking, left ventricular mass and left ventricular end-systolic volume showed that the apnoea–hypopnoea index was significantly associated with right ventricular end-diastolic volume (B-coefficient 0.315 (95% CI 0.013–0.617); p=0.041). From baseline to 12 weeks, right atrial diastolic area increased more in patients with SDB (2.9±3.7 cm2versus1.0±2.4 cm2, p=0.038; when adjusted for left ventricular end systolic volume, p=0.166).SDB diagnosed shortly after AMI predicts an increase of right ventricular end-diastolic volume and possibly right atrial area within the following 12 weeks. Thus, SDB may contribute to enlargement of the right heart after AMI.

scholarly journals Osteoarthritis and the Mediterranean Diet: A Systematic Review

Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 1030 ◽  
Author(s):  
Isabel Morales-Ivorra ◽  
Montserrat Romera-Baures ◽  
Blanca Roman-Viñas ◽  
Lluis Serra-Majem
Keyword(s):  
Systematic Review ◽  
Mediterranean Diet ◽  
Positive Association ◽  
Cartilage Degradation ◽  
Epidemiological Evidence ◽  
Cross Sectional ◽  
The Mediterranean ◽  
The Relationship

Osteoarthritis (OA) affects 240 million people globally. Few studies have examined the links between osteoarthritis and the Mediterranean diet (MD). The aim of this paper was to systematically review and analyze the epidemiological evidence in humans on the MD and its association with OA. A systematic search of EMBASE identified three studies that explored the association between MD and OA. Two of them were cross-sectional and the third one was a 16-week randomized clinical trial. Prisma declaration was followed to carry out this review. These studies described a positive association between a higher adherence to a MD and the quality of life of participants suffering OA. The prevalence of OA was lower in participants with a higher adherence to a Mediterranean diet. Biomarkers of inflammation and cartilage degradation related to OA were also analyzed and significant differences were detected only for IL1-α, which decreased in the MD group. Exploring the relationship between MD and OA is complex, moreover, the limited evidence and methodological differences in such studies makes it difficult to compare results. In conclusion, the three studies included in this systematic review demonstrated some relation between osteoarthritis and a Mediterranean diet. However, prospective and longer interventions are required to evaluate the long-term efficacy of the Mediterranean diet to improve symptomatology and preventing osteoarthritis.

scholarly journals Role of D-Dimer in the Risk Stratification of Acute Coronary Syndrome Patients: Implications for Antithrombotic Treatment. A Systematic Review and Exploratory Meta-analysis.

2021 ◽  
Author(s):  
Flavio Giuseppe Biccirè ◽  
Alessio Farcomeni ◽  
Carlo Gaudio ◽  
Pasquale Pignatelli ◽  
Gaetano Tanzilli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Acute Coronary Syndrome ◽  
Poor Prognosis ◽  
Positive Association ◽  
Current Evidence ◽  
Thrombotic Risk ◽  
Coronary Syndrome ◽  
D Dimer

Abstract Background Data on the prognostic role of D-dimer in patients with acute coronary syndrome (ACS) are controversial. Our aim was to summarize current evidence on the association between D-dimer levels and short/long-term poor prognosis of ACS patients. We also investigated the association between D-Dimer and no-reflow (NR) phenomenon.Methods Systematic review and metanalysis of observational studies including ACS patients and reporting data on D-Dimer levels. PubMed and SCOPUS databases were searched. Data were combined with hazard ratio (HR) and metanalysed. The principal endpoint was a composite of cardiovascular events (CVEs) including myocardial infarction, all-cause and cardiovascular mortality. Results Overall, 32 studies included in the systematic review with 28,869 patients. Of them, 6 studies investigated in-hospital and 26 studies long-term outcomes. Overall, 23 studies showed positive association of high D-Dimer levels with CVEs. D-Dimer levels predicted poor prognosis in all studies reporting in-hospital outcomes. Five studies satisfied inclusion criteria and were included in the metanalysis, with a total of 8,616 patients. Median follow-up was 13.2 months with 626 CVEs. The pooled HR for D-dimer levels and CVEs was 1.264 (95% CI 1.134-1.409). Five out of 7 studies (4,195 STEMI patients) investigating the association between D-Dimer levels and NR showed a positive correlation of D-dimer levels with NR. Conclusions In patients with ACS D-Dimer was associated with higher in-hospital and short/long-term complications. D-Dimer was also higher in patients with NR phenomenon. The use of D-Dimer may help to identify patients with residual thrombotic risk after ACS.Trial registration: the review protocol was registered in PROSPERO International Prospective Register of Systematic Reviews: CRD42021267233.

Changes in ventricular twist and untwisting with orthostatic stress: endurance athletes versus normally active individuals

2010 ◽  
Vol 108 (5) ◽  
pp. 1259-1266 ◽  
Author(s):  
Ben T. Esch ◽  
Jessica M. Scott ◽  
Mark J. Haykowsky ◽  
Ian Paterson ◽  
Darren E. R. Warburton ◽  
...  
Keyword(s):  
Stroke Volume ◽  
Orthostatic Intolerance ◽  
Lower Body Negative Pressure ◽  
Left Ventricular ◽  
Endurance Athletes ◽  
Compensatory Mechanism ◽  
Filling Rate ◽  
Systolic Volume ◽  
End Diastolic Volume ◽  
Early Filling

Endurance-trained individuals exhibit larger reductions in left ventricular (LV) end-diastolic volume in response to lower body negative pressure (LBNP) compared with normally active individuals. However, the relationship between LV torsion and untwisting and the LV volume response to LBNP in endurance athletes is unknown. Eight endurance-trained athletes [maximal oxygen consumption (V̇o2max): 66.4 ± 7.2 ml·kg−1·min−1] and eight normally active individuals (V̇o2max: 41.9 ± 9.0 ml·kg−1·min−1) (all men) underwent two cardiac magnetic resonance imaging (MRI) assessments, the first during supine rest and the second during −30 mmHg LBNP. Right ventricular (RV) and LV volumes were assessed, myocardial tagging was applied in order to quantify LV peak torsion and peak untwisting rate, and filling rates were measured with phase-contrast MRI. In response to LBNP, endurance-trained individuals had greater reductions in RV and LV end-diastolic volume and stroke volume ( P < 0.05). Endurance athletes had reduced untwisting rates (20.3 ± 8.7°/s), while normally active individuals had increased untwisting rates (−16.2 ± 32.1°/s) in response to LBNP ( P < 0.05). Changes in peak untwisting rate were significantly correlated with change in peak torsion ( R = −0.87, P < 0.05), with the change in early filling rate and V̇o2max, but not with changes in end-diastolic or end-systolic volume ( P > 0.05). We conclude that increased untwisting rates in normally active subjects may mitigate the drop in early filling rate with LBNP and thus may be a compensatory mechanism for the reduction in stroke volume with volume unloading. The opposite response in athletes, who showed a decreased untwisting rate, may contribute to their larger reductions in LV end-diastolic and stroke volumes with volume unloading and their orthostatic intolerance.

Abstract 15424: Tricuspid Valve Geometry and Right Heart Remodeling: Insights Into the Mechanism of Atrial Functional Tricuspid Regurgitation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Hiroto Utsunomiya ◽  
Yu Harada ◽  
hitoshi susawa ◽  
Yusuke Ueda ◽  
Kanako Izumi ◽  
...  
Keyword(s):  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Right Atrium ◽  
Right Atrial ◽  
Right Heart ◽  
Systolic Volume ◽  
Therapeutic Implications ◽  
Heart Remodeling ◽  
Functional Tricuspid Regurgitation ◽  
End Systolic Volume

Introduction: Functional tricuspid regurgitation (TR) caused by chronic atrial fibrillation with structurally normal tricuspid valve (TV) leaflets, normal right ventricular (RV) function, and dilated right atrium (RA), is considered as a new clinical entity, atrial functional TR (AF-TR). We sought to investigate TV geometry and right heart remodeling in AF-TR compared with ventricular functional TR with sinus rhythm (VF-TR). Methods: Transesophageal 3D echocardiography datasets of the TV and the RV were acquired in 51 symptomatic severe TR. 3D RV endocardial surfaces were reconstructed throughout the cardiac cycle and then postprocessed using semiautomated integration and segmentation software to calculate position of papillary muscle (PM) tips (Figure). Results: Compared with VF-TR, AF-TR had more dilated and posteriorly displaced annulus and less leaflet tethering angles with more prominent right atrium and smaller RV end-systolic volume. On the XY (annular) plane, the center of annulus was getting closer towards the anterior and posterior PM tips and was going away from the medial PM tip caused by prominent annular dilatation in AF-TR. On the Z axis, the position of each PM tip in AF-TR was not so much displaced apically as that in VF-TR. Multiple linear regression analyses revealed that right atrial volume and right atrial/RV end-systolic volume ratio were determinants of annular area and orientation in AF-TR, respectively (both P <0.001). Additionally, the posteromedial directed component of posterior PM tip position and the apically directed component of the position of all 3 PM tips were independently associated with TV tethering angles of each leaflet in AF-TR (all P <0.02). In subgroup analysis, massive to torrential AF-TR had a larger RV volume with more apically displaced PM tips than severe AF-TR. Conclusion: Right heart remodeling and its association with TV geometry differ between AF-TR and VF-TR, which offers distinctive therapeutic implications.

scholarly journals The Impact of Shift-Work and Night Shift-Work on Thyroid: A Systematic Review

2020 ◽  
Vol 17 (5) ◽  
pp. 1527 ◽  
Author(s):  
Veruscka Leso ◽  
Ilaria Vetrani ◽  
Alessandra Sicignano ◽  
Rosaria Romano ◽  
Ivo Iavicoli
Keyword(s):  
Systematic Review ◽  
Shift Work ◽  
Night Shift ◽  
Management Strategies ◽  
Positive Association ◽  
Thyroid Stimulating Hormone ◽  
Hormonal Changes ◽  
Night Shift Work ◽  
Functional Changes ◽  
The Impact

Thyroid hormones are regulated by the pituitary thyroid stimulating hormone (TSH), whose secretion presents a circadian rhythmicity. Indeed, it is conceivable that shift- and night shift-work, affecting sleep-wake rhythms, may impact thyroid functionality. Therefore, the aim of the present review was to provide an overview on the association between shift- and night shift-work and thyroid hormonal changes and disease development. A systematic review of studies available in PubMed, Scopus, and ISI Web of Science databases was performed. A positive association between night shift-work and increased TSH concentrations was reported by most of the reviewed investigations. Inconclusive evidence was available on thyroid diseases. However, the limited number of studies, the noticeable heterogeneity in the shift-work scheduling, in terms of amount, duration, type of shift- or night shift-work, prevents easily integrating findings and extrapolating definite conclusions. Further investigation seems necessary to better define the relationship between shift schedules and different thyroid outcomes, and possible long-term implications of early functional changes. Overall, this may support the adoption of advanced risk assessment and management strategies aimed to achieve a safer workplace organization and a timely, responsible realization of all the benefits of a 24-h economy.

scholarly journals Psychosocial Risk Factors and the Association With Carpal Tunnel Syndrome: A Systematic Review

Hand ◽  
2017 ◽  
Vol 13 (5) ◽  
pp. 501-508 ◽  
Author(s):  
Michael Mansfield ◽  
Michael Thacker ◽  
Fiona Sandford
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Carpal Tunnel Syndrome ◽  
Psychosocial Factors ◽  
Carpal Tunnel ◽  
Positive Association ◽  
Psychosocial Risk Factors ◽  
Negative Association ◽  
Psychosocial Risk ◽  
Tunnel Syndrome

Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper limb. Research has shown that associative factors for CTS include occupational and biomechanical elements, sex, and age. To date, no systematic review has been undertaken to determine specifically whether there are any psychosocial risk factors in developing CTS. The objective is to determine whether psychosocial factors are associated with and/or predict the development of CTS. Methods: A systematic review was conducted including searches of PubMed (MEDLINE), EMBASE, and CINAHL from inception to May 30, 2017. Quantitative studies must have investigated a minimum of 1 or more psychosocial factors—cognitive, affective, behavioral, vocational, or interpersonal processes (eg, social support)—and include a point or risk estimate. One reviewer conducted the search and 2 reviewers independently assessed eligibility and completed methodological quality assessment using a modified Downs and Black checklist. Data were analyzed narratively. Results: Six moderate- to high-quality studies were included in the final review. Five studies reported a positive association between psychosocial factors and CTS, where psychosocial factors were more in those who reported CTS. One study reported no positive or negative association with CTS development. Four studies reported a negative association between psychosocial factors and CTS, where psychosocial factors were less in those who reported CTS. Conclusions: There is limited evidence for a positive association between psychosocial factors and CTS. However, this was not a consistent finding across all included studies. Further research is indicated in standardizing CTS diagnostic criteria and investigating other working environments.

Impaired subendocardial contractile myofiber function in asymptomatic aged humans, as detected using MRI

2006 ◽  
Vol 291 (4) ◽  
pp. H1573-H1579 ◽  
Author(s):  
Joost Lumens ◽  
Tammo Delhaas ◽  
Theo Arts ◽  
Brett R. Cowan ◽  
Alistair A. Young
Keyword(s):  
Left Ventricular ◽  
Lv Function ◽  
Aged Group ◽  
Systolic Volume ◽  
Local Loss ◽  
Functional Changes ◽  
End Diastolic Volume ◽  
Tissue Tagging ◽  
End Systolic Volume ◽  
Aged Subjects

With aging, structural and functional changes occur in the myocardium without obvious impairment of systolic left ventricular (LV) function. Transmural differences in myocardial vulnerability for these changes may result in increase of transmural inhomogeneity in contractile myofiber function. Subendocardial fibrosis and impairment of subendocardial perfusion due to hypertension might change the transmural distribution of contractile myofiber function. The ratio of LV torsion to endocardial circumferential shortening (torsion-to-shortening ratio; TSR) during systole reflects the transmural distribution of contractile myofiber function. We investigated whether the transmural distribution of systolic contractile myofiber function changes with age. Magnetic resonance tissue tagging was performed to derive LV torsion and endocardial circumferential shortening. TSR was quantified in asymptomatic young [age 23.2 (SD 2.6) yr, n = 15] and aged volunteers [age 68.8 (SD 4.4) yr, n = 16]. TSR and its standard deviation were significantly elevated in the aged group [0.47 (SD 0.12) aged vs. 0.34 (SD 0.05) young; P = 0.0004]. In the aged group, blood pressure and the ratio of LV wall mass to end-diastolic volume were mildly elevated but could not be correlated to the increase in TSR. There were no significant differences in other indexes of systolic LV function such as end-systolic volume and ejection fraction. The elevated systolic TSR in the asymptomatic aged subjects suggests that aging is associated with local loss of contractile myofiber function in the subendocardium relative to the subepicardium potentially caused by subclinical pathological incidents.

scholarly journals Reference Values of Right Ventricular Volumes and Ejection Fraction by Three-Dimensional Echocardiography in Adults: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Shitong Wang ◽  
Shuyu Wang ◽  
Qing Zhu ◽  
Yonghuai Wang ◽  
Guangyuan Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Reference Values ◽  
Meta Analysis ◽  
Three Dimensional ◽  
Systolic Pressure ◽  
Frame Rate ◽  
Pulmonary Artery Systolic Pressure ◽  
Specific Reference ◽  
Systolic Volume ◽  
End Diastolic Volume

Objective: This study was conducted in order to determine the reference values for right ventricular (RV) volumes and ejection fraction (EF) using three-dimensional echocardiography (3DE) and to identify sources of variance through a systematic review and meta-analysis.Methods: This systematic review was preregistered with the International Prospective Register of Systematic Reviews (https://www.crd.york.ac.uk/PROSPERO/) (CRD42020211002). Relevant studies were identified by searches of the PubMed, Embase, and Cochrane Library databases through October 12, 2020. Pooled reference values were calculated using the random-effects model weighted by inverse variance. Meta-regression analysis and Egger's test were used to determine the source of heterogeneity. A subgroup analysis was performed to evaluate the reference values across different conditions.Results: The search identified 25 studies of 2,165 subjects. The mean reference values were as follows: RV end-diastolic volume, 100.71 ml [95% confidence interval (CI), 90.92–110.51 ml); RV end-systolic volume, 44.19 ml (95% CI, 39.05–49.33 ml); RV end-diastolic volume indexed, 57.01 ml/m2 (95% CI, 51.93–62.08 ml/m2); RV end-systolic volume indexed, 25.41 ml/m2 (95% CI, 22.58–28.24 ml/m2); and RVEF, 56.20% (95% CI, 54.59–57.82%). The sex- and age-specific reference values were assessed according to the studies reporting the values of different sexes and age distributions, respectively. In addition, the vendor- and software-specific reference values were analyzed. The meta-regression analysis revealed that sex, frame rate, pulmonary artery systolic pressure, and software packages were associated with variations in RV volumes (P &lt; 0.05). Inter-vendor and inter-software discrepancies may explain the variability of RVEF.Conclusions: The reference values for RV volumes and RVEF using 3DE were assessed. The confounders that impacted the variability in RV volumes or RVEF contained the sex, frame rate, pulmonary artery systolic pressure, inter-vendor discrepancies, and inter-software discrepancies.

scholarly journals Prenatal Anxiety and Exercise. Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (23) ◽  
pp. 5501
Author(s):  
Miguel Sánchez-Polán ◽  
Cristina Silva-Jose ◽  
Evelia Franco ◽  
Taniya S. Nagpal ◽  
Javier Gil-Ares ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Meta Analysis ◽  
Positive Association ◽  
Negative Association ◽  
Mental Illnesses ◽  
Adverse Health Effects ◽  
Prenatal Anxiety ◽  
Before And After ◽  
Meta Analyses

The prevalence of prenatal anxiety has increased during the COVID-19 pandemic. Anxiety is associated with other cardiovascular, physiological, and mental illnesses, resulting in adverse health effects for the mother and foetus. The purpose of this study was to evaluate the effects of physical activity (PA) during pregnancy on the prevalence of prenatal anxiety or symptoms of anxiety. A systematic review and two meta-analyses were performed (Registration No. CRD42021275333). Peer-reviewed articles reporting the effect of a PA intervention on anxiety during pregnancy were included. The first meta-analysis (MA) included 10 studies reporting final scores of prenatal anxiety. A negative association between moderate PA during pregnancy and prenatal anxiety was found in this analysis (z = −2.62, p < 0.01; ES = −0.46, 95% CI = −0.80, −12, I2 = 84%, Pheterogeneity = 0.001). The second MA included eight studies in which measures both before and after a PA intervention were reported. The findings of this analysis revealed a positive association between exercise practice during pregnancy and a decrease in prenatal anxiety scores (z = −3.39, p < 0.001; ES = −0.48, 95% CI = −0.76, −0.20, I2 = 71%, Pheterogeneity = 0.001). Supervised PA during pregnancy could prevent and reduce prenatal anxiety and anxiety symptoms.

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