scholarly journals Physical activity and left ventricular trabeculation in the UK Biobank community-based cohort study

Heart ◽  
2019 ◽  
Vol 105 (13) ◽  
pp. 990-998 ◽  
Author(s):  
Simon P Woodbridge ◽  
Nay Aung ◽  
Jose M Paiva ◽  
Mihir M Sanghvi ◽  
Filip Zemrak ◽  
...  
Keyword(s):  
Physical Activity ◽  
General Population ◽  
Vigorous Physical Activity ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Uk Biobank ◽  
Community Based ◽  
Ventricular Ejection Fraction ◽  
Female Ratio ◽  
Average Acceleration

ObjectiveVigorous physical activity (PA) in highly trained athletes has been associated with heightened left ventricular (LV) trabeculation extent. It has therefore been hypothesised that LV trabeculation extent may participate in exercise-induced physiological cardiac remodelling. Our cross-sectional observational study aimed to ascertain whether there is a ‘dose–response’ relationship between PA and LV trabeculation extent and whether this could be identified at opposite PA extremes.MethodsIn a cohort of 1030 individuals from the community-based UK Biobank study (male/female ratio: 0.84, mean age: 61 years), PA was measured via total metabolic equivalent of task (MET) min/week and 7-day average acceleration, and trabeculation extent via maximal non-compaction/compaction ratio (NC/C) in long-axis images of cardiovascular magnetic resonance studies. The relationship between PA and NC/C was assessed by multivariate regression (adjusting for potential confounders) as well as between demographic, anthropometric and LV phenotypic parameters and NC/C.ResultsThere was no significant linear relationship between PA and NC/C (full adjustment, total MET-min/week: ß=−0.0008, 95% CI −0.039 to –0.037, p=0.97; 7-day average acceleration: ß=−0.047, 95% CI −0.110 to –0.115, p=0.13, per IQR increment in PA), or between extreme PA quintiles (full adjustment, total MET-min/week: ß=−0.026, 95% CI −0.146 to –0.094, p=0.67; 7-day average acceleration: ß=−0.129, 95% CI −0.299 to –0.040, p=0.49), across all adjustment levels. A negative relationship was identified between left ventricular ejection fraction and NC/C, significantly modified by PA (ß difference=−0.006, p=0.03).ConclusionsIn a community-based general population cohort, there was no relationship at, or between, extremes, between PA and NC/C, suggesting that at typical general population PA levels, trabeculation extent is not influenced by PA changes.

Galectin-3 is inversely associated with cardiorespiratory fitness in the general population

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Haid ◽  
M Bahls ◽  
M Doerr ◽  
S Felix ◽  
S Zylla ◽  
...  
Keyword(s):  
General Population ◽  
Oxygen Uptake ◽  
Cardiorespiratory Fitness ◽  
Extreme Values ◽  
Cardiopulmonary Exercise Testing ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Linear Regression Models ◽  
Ventricular Ejection Fraction ◽  
Galectin 3

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Low cardiorespiratory fitness (CRF) is associated with high mortality and morbidity. Galectin-3 (Gal-3) is a prognostic biomarker for fibrosis, different cancers, renal impairment and, in particular, for heart failure. Further, higher Gal-3 levels are associated with increased cardiovascular mortality. Whether Gal-3 is related with the protective effects of a high CRF is unclear. Purpose The present study examined the relation between Gal-3 and CRF as determined by body weight adjusted peak oxygen uptake (VO2peak/kg), oxygen uptake at the anaerobic threshold (VO2@AT) and maximal workload (Wmax). Methods We used data of the population-based Study of Health in Pomerania (SHIP-TREND) from Northeast Germany. A total of n = 1,483 participants with a median age of 49 (IQR: 39 – 59 years, male 48%) were included in the analysis. CRF parameters were measured using standardized cardiopulmonary exercise testing on a bicycle ergometer. Plasma galectin-3 concentrations were determined using a quantitative sandwich enzyme immunoassay. Individuals with left ventricular ejection fraction < 40%, previous myocardial infarction, atrial fibrillation, chronic lung disease, severe renal disease (eGFR < 30 ml/min/mm2), a history of cancer, and extreme values for Gal-3 were excluded. Linear regression models adjusted for age, sex and lean mass were used to analyze the association between Gal-3 and CRF. Results A one ml/min/kg greater VO2peak was related to a 0.32 ng/ml (95% confidence interval [CI] -0.45 to -0.18, p <.001) lower Gal-3. Further, a one Watt larger power output was also associated with a 1.32 ng/ml (95% CI -2.10 to – 0.54, p <.001) lesser Gal-3. VO2@AT was not related to Gal-3 (β: -3.31 95% CI -8.68 to 2.05, p = .23). Conclusions In the general population Gal-3 is inversely associated with CRF. Further studies should investigate whether lower Gal-3, beyond its importance as a biomarker for heart disease, may even play a role in the protective effect of the CRF.

Subclinical Hypothyroidism as an Independent Determinant of Left Atrial Dysfunction in the General Population

2020 ◽  
Author(s):  
Koki Nakanishi ◽  
Masao Daimon ◽  
Yuriko Yoshida ◽  
Naoko Sawada ◽  
Kazutoshi Hirose ◽  
...  
Keyword(s):  
General Population ◽  
Subclinical Hypothyroidism ◽  
Left Atrial ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Volume Index ◽  
Left Ventricular Ejection ◽  
Left Heart ◽  
Ventricular Ejection Fraction ◽  
Significant Difference

Abstract Purpose Although subclinical hypothyroidism (SCH) is a common clinical entity and carries independent risk for incident heart failure (HF), its possible association with subclinical cardiac dysfunction is unclear. Left ventricular global longitudinal strain (LVGLS) and left atrial (LA) phasic strain can unmask subclinical left heart abnormalities and are excellent predictors for HF. This study aimed to investigate the association between the presence of SCH and subclinical left heart dysfunction in a sample of the general population without overt cardiac disease. Methods We examined 1078 participants who voluntarily underwent extensive cardiovascular health check-ups, including laboratory tests and 2-dimensional speckle-tracking echocardiography to assess LVGLS and LA reservoir, conduit, and pump strain. SCH was defined as an elevated serum thyroid-stimulating hormone level with normal concentration of free thyroxine. Results Mean age was 62 ± 12 years, and 56% were men. Seventy-eight (7.2%) participants exhibited SCH. Individuals with SCH had significantly reduced LA reservoir (37.1 ± 6.6% vs 39.1 ± 6.6%; P = 0.011) and conduit strain (17.3 ± 6.3% vs 19.3 ± 6.6%; P = 0.012) compared with those with euthyroidism, whereas there was no significant difference in left ventricular ejection fraction, LA volume index, LVGLS, and LA pump strain between the 2 groups. In multivariable analyses, SCH remained associated with impaired LA reservoir strain, independent of age, traditional cardiovascular risk factors, and pertinent laboratory and echocardiographic parameters. including LVGLS (standardized β −0.054; P = 0.032). Conclusions In an unselected community-based cohort, individuals with SCH had significantly impaired LA phasic function. This association may be involved in the higher incidence of HF in subjects with SCH.

Beta-blockers in patients with left ventricular ejection fraction >40%: results from a community-based registry

2003 ◽  
Vol 9 (5) ◽  
pp. S57
Author(s):  
Barry M. Massie ◽  
Joseph A. Franciosa ◽  
William T. Abraham ◽  
Jeanenne J. Nelson ◽  
Mary Ann Lukas ◽  
...  
Keyword(s):  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Beta Blockers ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Community Based ◽  
Ventricular Ejection Fraction

Association of Physical Activity and Prognostic Parameters in Elderly Patients With Heart Failure

2011 ◽  
Vol 19 (1) ◽  
pp. 1-15 ◽  
Author(s):  
Melissa Jehn ◽  
Arno Schmidt-Trucksäss ◽  
Henner Hanssen ◽  
Tibor Schuster ◽  
Martin Halle ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Nyha Class ◽  
Clinical Status ◽  
Heart Association ◽  
Left Ventricular ◽  
Functional Class ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Patients With Heart Failure

Objective:Assessment of habitual physical activity (PA) in patients with heart failure.Methods:This study included 50 patients with heart failure (61.9 ± 4.0 yr). Seven days of PA were assessed by questionnaire (AQ), pedometer, and accelerometer and correlated with prognostic markers including VO2peak, percent left-ventricular ejection fraction, N-terminal pro-B-type natriuretic peptide, and New York Heart Association (NYHA) functional class.Results:Accelerometry showed a stronger correlation with VO2peak and NYHA class (R = .73 and R = −.68; p < .001) than AQ (R = .58 and R = −.65; p < .001) or pedometer (R = .52 and R = −.50; p < .001). In the multivariable regression model accelerometry was the only consistent independent predictor of VO2peak (p = .002). Moreover, when its accuracy of prediction was tested, 59% of NYHA I and 95% of NYHA III patients were correctly classified into their assigned NYHA classes based on their accelerometer activity.Conclusion:PA assessed by accelerometer is significantly associated with exercise capacity in patients with heart failure and is predictive of disease severity. The data suggests that PA monitoring can aid in evaluating clinical status.

scholarly journals Transthoracic echocardiography in patients with chronic kidney disease

2019 ◽  
Vol 8 (1) ◽  
pp. 24-31
Author(s):  
Balaram Shrestha ◽  
Dhiraj Gurung ◽  
Sanjib Dhungel
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
College Teaching ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Female Ratio ◽  
Cardiac Lesions

Background: Evaluation of cardiac diseases in chronic kidney disease has been rarely investigated in Nepal. Objectives: Objective of this study is to evaluate cardiac lesions in admitted chronic kidney disease patients. Methodology: It is a prospective observational study of echocardiography of chronic kidney disease patients from April, 2007 to April, 2013 in Nepal Medical College Teaching Hospital. Results: One hundred chronic kidney disease patients were evaluated. Male to Female ratio was 1.8:1 and age ± SD was 46.3 ± 17.2 years. Forty eight percent of the chronic kidney disease patients had left ventricular hypertrophy. Patients with chronic kidney disease with left ventricular hypertrophy group had interventricular septum of 1.5 ± 0.3 cm vs. 1.1 ± 0.1 cm (p<0.0001) and posterior wall of 1.1 ± 0.2cm vs. 1.0 ± 0.1cm (p< 0.01) in comparison to chronic kidney disease without left ventricular hypertrophy. Forty one percent had left ventricular systolic dysfunction with left ventricular ejection fraction of 39 ± 9.9 %. Pulmonary arterial hypertension was noticed in 39% patients. Valvular regurgitant lesions were quite common (24.1%) usually as multivalvular lesions (4.4 lesions per patient). Mitral regurgitation was the commonest regurgitant lesion (81%). Conclusion: Echocardiographic cardiac evaluation is useful to diagnose concomitant cardiac lesions for standard care of chronic kidney disease patients.

Sudden Cardiac Death in the General Population: Can We Improve Risk Stratification and Prevention?

2021 ◽  
Author(s):  
Gary L. Murray ◽  
Joseph Colombo
Keyword(s):  
Oxidative Stress ◽  
Sudden Cardiac Death ◽  
General Population ◽  
Cardiac Death ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Improve Risk Stratification ◽  
Preventative Measures ◽  
Organic Heart Disease

AbstractA total of 15 to 20% of deaths worldwide are sudden (within 1 hour of symptom onset). Our ability to predict and prevent sudden cardiac death (SCD) in the general population, in which 85% have no known organic heart disease (OHD) or stable OHD with left ventricular ejection fraction >40%, is limited to poor. The purpose of this commentary is to suggest a new approach to SCD in this population. Oxidative stress is a common thread in development and progression of the major cardiac diseases associated with SCD. It has a profound adverse effect upon heart rate variability (HRV), sympathetic tone (S), and parasympathetic tone (P). Recently, developed technology finally has allowed accurate measures of S and P. Using this technique, the general population can be screened, those at risk for SCD can be identified with a higher degree of success, and preventative measures instituted. For example, in 133 geriatric type 2 diabetics with S and/or P abnormalities upon screening, the potent and natural antioxidant (r)α lipoic acid reduced SCD (relative risk reduction) 43% (p = 0.0076), mean follow-up 6.31 years. Diabetes mellitus patients have high glycemic oxidative stress. Addressing oxidative stress S and P abnormalities can reduce SCD. S and P screening of the general population will be discussed.

Cardiac Functions & Lipid Profile In Obese Children & Adolescents

2020 ◽  
Vol 7 (1) ◽  
pp. 13-16
Author(s):  
T. Ajit Kumar ◽  
Dr. Vineeta Pande ◽  
Dr. Sharad Agarkhedkar ◽  
Dr. Mayank Surana
Keyword(s):  
Physical Activity ◽  
Lipid Profile ◽  
Children And Adolescents ◽  
Cardiovascular Complications ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Obese Children ◽  
Ventricular Ejection Fraction ◽  
Cardiac Functions ◽  
The Difference

Background: Obesity is a disease which results from genetic or lifestyle factors. Such diseases are called Non communicable diseases. The epidemic of obesity among youth is spreading at an alarming rate due to lack of physical activity, dietary habits. The percentage of youths who are at risk of becoming overweight continues to increase. National data indicates that 16% of children aged six to nineteen years are overweight.(1)   Considering the high prevalence of  obesity among children and adolescents and its associated cardiovascular complications like hypertension, left ventricular hypertrophy, increased left ventricular mass, decreased left ventricular ejection fraction, the present study was planned to assess cardiac functions and lipid profile in obese children and adolescents. Early detection and intervention can help in reducing the complications associated with obesity. Objective: Primary objective is to assess cardiac functions and lipid profile in obese children and adolescents. Methodology: 100 obese children and adolescents in the age group 6-18 years were taken after excluding obese children with evidence of endocrine disease, malformation syndromes and iatrogenic obesity (drug treatments). Results: In the present study 7% subjects were hypertensive while 8% were prehypertensive. 71.43% children with hypertension were performing physical activity for < 30 min in 1-3 days/week while 49.11% normotensive children were performing physical activity for > 30 min per day. 3% obese children were having abnormal LVEF on 2DECHO .All the 3 obese children with abnormal LVEF were having physical activity less than 30 min in 1-3 days /week and the difference was statistically significant. All the three children with abnormal LVEF were hypertensive and the difference was statistically significant. 6% children were having raised serum cholesterol >190mg/dl.   Serum triglyceride >150mg/dl was observed in 17% obese children. HDL level <20mg/dl was observed in 7% children while LDL above 130mg/dl was observed in 6% children. The proportion among male and female children was comparable. Conclusion: Cardiovascular complications of adulthood in obese children and adolescents may be prevented by early identification and intervention in the form of healthy life style, dietary intake and physical activity.

scholarly journals P1428 Mortality in non-ischemic cardiomyopathy is low and close to the general population

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
D Melichova ◽  
T M Nguyen ◽  
I M Salte ◽  
L G Klaebo ◽  
B Sjoli ◽  
...  
Keyword(s):  
Primary Prevention ◽  
General Population ◽  
Ischemic Cardiomyopathy ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
All Cause Mortality ◽  
Annual Mortality

Abstract Funding Acknowledgements South Eastern Norway regional health authority Background Patients with non-ischemic dilated cardiomyopathy (NDCM) have lower mortality compared to patients with ischemic cardiomyopathy (ICM). Recent reports suggest less benefit of a primary prophylactic implantable cardioverter defibrillator (ICD) in NDCM. Purpose We aimed to investigate mortality rate and appropriate ICD therapy in a consecutive cohort of patients with NDCM and ICM. Methods In this prospective multi-center study, we consecutively included NDCM and ICM patients with left ventricular ejection fraction (LVEF) &lt; 40% from July 2014 to January 2018. ICM or NDCM classification was based on coronary angiography. Echocardiography was performed at inclusion and LVEF and global longitudinal strain (GLS) were assessed. All-cause mortality and primary prevention ICD therapies were recorded during follow-up. Results We included 290 patients (67 ± 13 years old, 74% males), 207 with ICM and 83 with NDCM. At inclusion LVEF was 31 ± 6% and GLS -10.5 ± -3.3%. Patients with ICM were older (68 ± 12 years vs. 63 ± 15 years, p &lt; 0.01), had better LVEF (32 ± 6% vs. 28 ± 7%, p &lt; 0.01), and shorter QRS duration (106 ± 23 ms vs. 122 ± 28 ms, p &lt; 0.01). A primary prevention ICD was implanted in 18 (9%) ICM patients and in 21 (25%) NDCM patients (p &lt; 0.001). During 22 ±12 months follow up, all-cause mortality was 27 (9%) in the entire population. In patients with ICM 1/18 (6%) received appropriate shock from their primary prevention ICD compared to 3/21 (14%) NDCM patients. Mortality was more frequent in ICM; 26/207 (13%) compared to 1/83 (1.2%) in NDCM (Log rank p &lt; 0.01). All-cause mortality or appropriate ICD shock was more frequent in ICM compared to NDCM (27 (13%) vs. 4 (5%) log rank p = 0.02) (Figure). Assuming the arrhythmias treated by the ICD shocks would have been lethal, annual mortality of 2.5% in the NDCM population was only slightly higher compared to the age matched general population (1% annual mortality) (blue line). Conclusion Patients with NDCM had better survival, and in general a lower event rate, compared to patients with ICM. However, subgroups of NDCM patients may benefit from their primary prophylactic ICD and further studies should investigate the need of primary prevention ICD in patients with NDCM. Abstract P1428 Figure.

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