Is the Training Intensity in Phase Two Cardiovascular Rehabilitation Different in Telehealth versus Outpatient Rehabilitation?

Telehealth cardiac rehabilitation (CR) is a feasible and effective alternative to conventional outpatient CR. Present evidence is limited on the comparison of exercise intensity adherence in telehealth and outpatient CR. The purpose of the study was to evaluate and compare training intensity adherence through 12-week phase II CR in telehealth and outpatient CR. A sample of 56 patients with coronary artery disease (CAD) with a mean age of 56.7 ± 7.1 entering comprehensive secondary prevention phase II was randomized into telehealth CR (n = 28) and control outpatient CR (n = 28) groups. The primary outcome was a comparison of training intensity adherence in both CR models and heart rate (HR) response from individual CR sessions, expressed by the HR reserve percentage. As a result, the parameter HR reserve percentage as the total average of the training intensity during the telehealth intervention and the outpatient CR did not differ statistically (p = 0.63). There was no death case, and all severe adverse cases required medical admission throughout an exercise training session in study subjects in both groups. This research evidence demonstrated that the telehealth CR model is similar in training intensities to the conventional outpatient CR in CAD patients with low to moderate cardiovascular risk.

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Development of an Exercise Training Protocol to Investigate Arteriogenesis in a Murine Model of Peripheral Artery Disease

International Journal of Molecular Sciences ◽

10.3390/ijms20163956 ◽

2019 ◽

Vol 20 (16) ◽

pp. 3956 ◽

Cited By ~ 4

Author(s):

Ayko Bresler ◽

Johanna Vogel ◽

Daniel Niederer ◽

Daphne Gray ◽

Thomas Schmitz-Rixen ◽

...

Keyword(s):

Peripheral Artery Disease ◽

Suitable Model ◽

Peripheral Artery ◽

Running Wheel ◽

Limb Perfusion ◽

Collateral Growth ◽

Artery Disease ◽

Set Up ◽

Exercise Induced ◽

And Control

Exercise is a treatment option in peripheral artery disease (PAD) patients to improve their clinical trajectory, at least in part induced by collateral growth. The ligation of the femoral artery (FAL) in mice is an established model to induce arteriogenesis. We intended to develop an animal model to stimulate collateral growth in mice through exercise. The training intensity assessment consisted of comparing two different training regimens in C57BL/6 mice, a treadmill implementing forced exercise and a free-to-access voluntary running wheel. The mice in the latter group covered a much greater distance than the former pre- and postoperatively. C57BL/6 mice and hypercholesterolemic ApoE-deficient (ApoE−/−) mice were subjected to FAL and had either access to a running wheel or were kept in motion-restricting cages (control) and hind limb perfusion was measured pre- and postoperatively at various times. Perfusion recovery in C57BL/6 mice was similar between the groups. In contrast, ApoE−/− mice showed significant differences between training and control 7 d postoperatively with a significant increase in pericollateral macrophages while the collateral diameter did not differ between training and control groups 21 d after surgery. ApoE−/− mice with running wheel training is a suitable model to simulate exercise induced collateral growth in PAD. This experimental set-up may provide a model for investigating molecular training effects.

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Condensing Heat Exchanger Microbial Growth and Control Study-Phase II

10.4271/932107 ◽

1993 ◽

Author(s):

Robert W. Marsh ◽

Mark E. Caron ◽

Carol Metselaar ◽

John Steele

Keyword(s):

Heat Exchanger ◽

Phase Ii ◽

Microbial Growth ◽

Study Phase ◽

Condensing Heat Exchanger ◽

And Control ◽

Control Study

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Netrin-1 in Atherosclerosis: Relationship between Human Macrophage Intracellular Levels and In Vivo Plaque Morphology

Biomedicines ◽

10.3390/biomedicines9020168 ◽

2021 ◽

Vol 9 (2) ◽

pp. 168

Author(s):

Susanna Fiorelli ◽

Nicola Cosentino ◽

Benedetta Porro ◽

Franco Fabbiocchi ◽

Giampaolo Niccoli ◽

...

Keyword(s):

Progressive Increase ◽

Human Macrophage ◽

Plaque Morphology ◽

Artery Disease ◽

Atherosclerotic Process ◽

And Function ◽

And Control ◽

Macrophage Accumulation

Netrin-1 is a laminin-like protein that plays a pivotal role in cell migration and, according to the site of its release, exerts both pro and anti-atherosclerotic functions. Macrophages, key cells in atherosclerosis, are heterogeneous in morphology and function and different subpopulations may support plaque progression, stabilization, and/or regression. Netrin-1 was evaluated in plasma and, together with its receptor UNC5b, in both spindle and round monocyte-derived macrophages (MDMs) morphotypes from coronary artery disease (CAD) patients and control subjects. In CAD patients, plaque features were detected in vivo by optical coherence tomography. CAD patients had lower plasma Netrin-1 levels and a higher MDMs expression of both protein and its receptor compared to controls. Specifically, a progressive increase in Netrin-1 and UNC5b was evidenced going from controls to stable angina (SA) and acute myocardial infarction (AMI) patients. Of note, spindle MDMs of AMI showed a marked increase of both Netrin-1 and its receptor compared to spindle MDMs of controls. UNC5b expression is always higher in spindle compared to round MDMs, regardless of the subgroup. Finally, CAD patients with higher intracellular Netrin-1 levels showed greater intraplaque macrophage accumulation in vivo. Our findings support the role of Netrin-1 and UNC5b in the atherosclerotic process.

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Abstract P273: Enhancing Documentation and Control of Lipids in a University-Based Cardiology Clinic

Circulation ◽

10.1161/circ.129.suppl_1.p273 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Keerthana K Karumbaiah ◽

Mazen B Omar ◽

Bassam A Omar

Keyword(s):

Clinic Visit ◽

Lipid Profiles ◽

Fasting State ◽

Lipid Management ◽

The Poor ◽

Cardiology Clinic ◽

Blood Pressures ◽

Artery Disease ◽

And Control ◽

Risk Equivalent

Background: Non-compliance with laboratory appointments, separate from clinic visit appointments, for measuring fasting cholesterol may hinder documentation and control of patients’ lipids. Methods: A university-based cardiologist’s clinic notes, from a single year (yr 1), when patients were asked to have a fasting cholesterol a week prior to the clinic visit, were analyzed (100 patients). The poor compliance prompted a same day as the clinic visit measurement (fasting or non-fasting) of lipids, for patients who could not comply with their laboratory appointment, during the following year (yr 2; 130 patients). Lipid values were managed by a subsequent call to the patient. All patients had coronary artery disease or risk equivalent mandating LDL levels < 100 mg/dL. Results: In yr 1, 62% (62/100) of patients had documented lipid profiles compared to 83% (108/130) of patients in yr 2. The average LDL in yr 1 was 115 +/- 36 mg/dL compared with 96 +/- 31 mg/dL in yr 2 (P < 0.01). Only 22% of the patients in yr 1 reached goal of < 100 mg/dL, compared with 65% in yr 2. There were no significant differences in the HDL, TG levels or blood pressures documented during the concurrent visits. Conclusion: Better documentation and control of lipids may be obtained when lipid profiles are done on clinic visit day, with fewer burdens on the patients who cannot comply with a separate laboratory appointment. Although there were many non-fasting levels as a result, the triglyceride levels where not significantly different among the two groups, probably reflecting an overall more intensive lipid management in yr 2, commensurate with the better documentation. Therefore, as has been shown by others, a lipid profile does not necessarily have to be fasting, especially in patients being treated for stricter targets such as our cohort, which may decrease the burden on patients unable to comply with a fasting state or added clinic visits.

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Epicardial Adipose Tissue as a Source of Nuclear Factor-κB and c-Jun N-Terminal Kinase Mediated Inflammation in Patients with Coronary Artery Disease

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2007-2579 ◽

2009 ◽

Vol 94 (1) ◽

pp. 261-267 ◽

Cited By ~ 71

Author(s):

A. R. Baker ◽

A. L. Harte ◽

N. Howell ◽

D. C. Pritlove ◽

A. M. Ranasinghe ◽

...

Keyword(s):

Cardiovascular Disease ◽

Coronary Artery Disease ◽

Adipose Tissue ◽

Coronary Artery ◽

Nuclear Factor Κb ◽

Nuclear Factor ◽

Toll Like Receptor ◽

Inflammatory Profile ◽

Artery Disease ◽

And Control

Abstract Context: Visceral adipose tissue (AT) is known to confer a significantly higher risk of type 2 diabetes and cardiovascular disease. Epicardial AT has been shown to be related to cardiovascular disease and myocardial function through unidentified mechanisms. Epicardial AT expresses an inflammatory profile of proteins; however, the mechanisms responsible are yet to be elucidated. Objectives: The objectives of the study were to: 1) examine key mediators of the nuclear factor-κB (NFκB) and c-Jun N-terminal kinase (JNK) pathways in paired epicardial and gluteofemoral (thigh) AT from coronary artery disease (CAD) and control patients and 2) investigate circulating endotoxin levels in CAD and control subjects. Design: Serums and AT biopsies (epicardial and thigh) were obtained from CAD (n = 16) and non-CAD (n = 18) patients. Inflammation was assessed in tissue and serum samples through Western blot, real-time PCR, ELISAs, and activity studies. Results: Western blotting showed epicardial AT had significantly higher NFκB, inhibitory-κB kinase (IKK)-γ, IKKβ, and JNK-1 and -2 compared with thigh AT. Epicardial mRNA data showed strong correlations between CD-68 and toll-like receptor-2, toll-like receptor-4, and TNF-α. Circulating endotoxin was elevated in patients with CAD compared with matched controls [CAD: 6.80 ± 0.28 endotoxin unit(EU)/ml vs. controls: 5.52 ± 0.57 EU/ml; P<0.05]. Conclusion: Epicardial AT from patients with CAD shows increased NFκB, IKKβ, and JNK expression compared with both CAD thigh AT and non-CAD epicardial AT, suggesting a depot-specific as well as a disease-linked response to inflammation. These studies implicate both NFκB and JNK pathways in the inflammatory profile of epicardial AT and highlight the role of the macrophage in the inflammation within this tissue.

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Cardiovascular and Neurological Complications Associated with Atrial Fibrillation

Indonesian Journal of Cardiology ◽

10.30701/ijc.v37i3.580 ◽

2017 ◽

pp. 164-72

Author(s):

Raymond Pranata ◽

Hadrian Deka ◽

Bambang Budi Siswanto

Keyword(s):

Atrial Fibrillation ◽

Cognitive Decline ◽

Cardiovascular Mortality ◽

Neurological Complications ◽

Mortality And Morbidity ◽

Major Cardiovascular Events ◽

Bidirectional Association ◽

Causes Of Mortality ◽

Artery Disease ◽

And Control

Atrial fibrillation (FA) is the most common type of sustained-arrhythmia and one of the leading causes of mortality and morbidity globally, with estimated five million incidents. FA was associated with increased all-cause mortality (RR 1.46), cardiovascular mortality (RR 2.03), major cardiovascular events (RR 1.96), stroke (RR 2.42), ischemic stroke (RR 2.33), dementia (HR 1.42) and cognitive decline, ischemic heart disease (RR 1.61), sudden cardiac death (RR 1.88), heart failure (RR 4.99), chronic kidney disease (RR 1.64), and peripheral artery disease (RR 1.31). Overall, all-cause and cardiovascular mortality increased. Cognitive decline and dementia are also a concern since they impair function and quality of life. Overall, FA has bidirectional association with other cardiovascular diseases hence it acts as a marker for them. Therefore, prevention and control of risk factors are of utmost importance.

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Abstract 150: Association Between Serum Ghrelin Levels and Coronary Artery Disease: a Meta-analysis

Circulation Research ◽

10.1161/res.117.suppl_1.150 ◽

2015 ◽

Vol 117 (suppl_1) ◽

Author(s):

Pradyumna Agasthi ◽

Sivakanth Aloor ◽

Avantika Chenna ◽

Anekwe Onwuanyi

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Meta Analysis ◽

Control Group ◽

Cross Sectional ◽

Median Serum ◽

Artery Disease ◽

Differentiation And Proliferation ◽

And Control ◽

Serum Gh

Background: Ghrelin (GH) is a gastrointestinal endocrine peptide regulating multiple biological processes including adipogenesis, glucose metabolism, cell differentiation and proliferation. Recent studies demonstrated that GH inhibits pro-atherogenic changes in vessel wall via inhibition of nuclear factor - B activity, a transcriptional factor mediating production pro-inflammatory cytokines and adhesion molecule expression in the endothelium. The aim of the current study is to conduct a meta-analysis to evaluate the relationship between serum GH levels and coronary artery disease (CAD). Methods: We searched MEDLINE, CINHAL and COCHRANE databases for studies reporting serum GH levels in the CAD and non CAD study population. We included case controls, cohort and cross-sectional studies. We calculated the weighted standardized mean difference (SMD) in serum GH levels between the CAD and control groups. Results: Our search strategy yielded 285 articles and we included 10 studies enrolling 1855 participants. The median age of the CAD group was 62 yrs. (IQR 60 - 63) compared to 61 yrs. (IQR 58 - 65) in the control group. The median body mass index in the CAD group was 28 kg/m2 (IQR 27.9 - 28) compared to 27 kg/m2 (IQR 26 - 27) in the control group. The unweighted median serum GH levels in the CAD group were 0.66 ng/ml (IQR 0.3 - 1.6) compared to 0.76 ng/ml (IQR 0.38 - 4.9) in the control group. The SMD of GH level was -0.44 (95% CI -0.56,-0.31) p<0.001 comparing those in the CAD group and control group. Conclusion: Serum GH levels are significantly and inversely associated with CAD. Current findings warrant the need to further investigate the role of GH in the pathogenesis of CAD.

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Home-based exercise with telemonitoring guidance in patients with coronary artery disease: Does it improve long-term physical fitness?

European Journal of Preventive Cardiology ◽

10.1177/2047487319892201 ◽

2019 ◽

Vol 27 (4) ◽

pp. 367-377 ◽

Cited By ~ 6

Author(s):

Andrea Avila ◽

Jomme Claes ◽

Roselien Buys ◽

May Azzawi ◽

Luc Vanhees ◽

...

Keyword(s):

Physical Activity ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Cardiac Rehabilitation ◽

Exercise Capacity ◽

Phase Ii ◽

Home Based ◽

Artery Disease ◽

One Year

Background Home-based interventions might facilitate the lifelong uptake of a physically active lifestyle following completion of a supervised phase II exercise-based cardiac rehabilitation. Yet, data on the long-term effectiveness of home-based exercise training on physical activity and exercise capacity are scarce. Objective The purpose of the TeleRehabilitation in Coronary Heart disease (TRiCH) study was to compare the long-term effects of a short home-based phase III exercise programme with telemonitoring guidance to a prolonged centre-based phase III programme in coronary artery disease patients. The primary outcome was exercise capacity. Secondary outcomes included physical activity behaviour, cardiovascular risk profile and health-related quality of life. Methods Ninety coronary artery disease patients (80 men) were randomly assigned to 3 months of home-based (30), centre-based (30) or a control group (30) on a 1:1:1 basis after completion of their phase II ambulatory cardiac rehabilitation programme. Outcome measures were assessed at discharge of the phase II programme and after one year. Results Eighty patients (72 (91%) men; mean age 62.6 years) completed the one-year follow-up measurements. Exercise capacity and secondary outcomes were preserved in all three groups ( Ptime > 0.05 for all), irrespective of the intervention ( Pinteraction > 0.05 for all). Eighty-five per cent of patients met the international guidelines for physical activity ( Ptime < 0.05). No interaction effect was found for physical activity. Conclusion Overall, exercise capacity remained stable during one year following phase II cardiac rehabilitation. Our home-based exercise intervention was as effective as centre-based and did not result in higher levels of exercise capacity and physical activity compared to the other two interventions. Trial registration ClinicalTrials.gov NCT02047942. https://clinicaltrials.gov/ct2/show/NCT02047942

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Improving Mental Performance in an Athletic Population with the Use of Ārepa®, a Blackcurrant Based Nootropic Drink: A Randomized Control Trial

Antioxidants ◽

10.3390/antiox9040316 ◽

2020 ◽

Vol 9 (4) ◽

pp. 316

Author(s):

Natalie Gibson ◽

Dane Baker ◽

Alice Sharples ◽

Andrea Braakhuis

Keyword(s):

Controlled Trial ◽

Training Session ◽

Rugby League ◽

Pine Bark ◽

Post Intervention ◽

Double Blind ◽

Dietary Polyphenols ◽

Bioactive Ingredients ◽

Post Trial ◽

And Control

A range of dietary bioactive ingredients have claimed to improve mental clarity and reduce fatigue, including blackcurrant, pine bark, and l-theanine. These active ingredients provide a good source of dietary polyphenols which could be useful in reducing mental fatigue in a sports setting. The aim of the investigation was to test the effect of Ārepa® a blackcurrant-based nootropic-drink also containing pine-bark and l-theanine (BC+), on mental clarity in a sport setting. Twenty-three rugby league players completed a cross-over design, randomized, double-blind, controlled trial. Intervention and control phases lasted 7 days, with a washout in between. Cognition was assessed pre and post intervention following a standardized training session. Our study found the total score, accuracy, and average time per response scores improved significantly more after drinking the BC+ drink (p = 0.001, 0.003, and 0.043 respectively). The BC+ improved the perception that participants were reliable (p = 0.02) and less distracted (p = 0.03), while placebo supplementation increased participant perception they could control their nervousness (p = 0.03). Thematic analysis of post-trial questionnaire indicated participants found the BC+ sour, most reported no side effects, and opinion on which drink was more effective was not unanimous. The results indicate that the BC+ drink may be useful for athletes.

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Trimethylamine N-oxide and the reverse cholesterol transport in cardiovascular disease: a cross-sectional study

Scientific Reports ◽

10.1038/s41598-020-75633-1 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Laura Bordoni ◽

Joanna J. Samulak ◽

Angelika K. Sawicka ◽

Iwona Pelikant-Malecka ◽

Adrianna Radulska ◽

...

Keyword(s):

Cardiovascular Disease ◽

Cross Sectional Study ◽

Cross Sectional ◽

Transfer Protein ◽

Control Subjects ◽

Atherosclerotic Lesions ◽

Complex Picture ◽

Artery Disease ◽

Genetically Determined ◽

And Control

Abstract The early atherosclerotic lesions develop by the accumulation of arterial foam cells derived mainly from cholesterol-loaded macrophages. Therefore, cholesterol and cholesteryl ester transfer protein (CETP) have been considered as causative in atherosclerosis. Moreover, recent studies indicate the role of trimethylamine N-oxide (TMAO) in development of cardiovascular disease (CVD). The current study aimed to investigate the association between TMAO and CETP polymorphisms (rs12720922 and rs247616), previously identified as a genetic determinant of circulating CETP, in a population of coronary artery disease (CAD) patients (n = 394) and control subjects (n = 153). We also considered age, sex, trimethylamine (TMA) levels and glomerular filtration rate (GFR) as other factors that can potentially play a role in this complex picture. We found no association of TMAO with genetically determined CETP in a population of CAD patients and control subjects. Moreover, we noticed no differences between CAD patients and control subjects in plasma TMAO levels. On the contrary, lower levels of TMA in CAD patients respect to controls were observed. Our results indicated a significant correlation between GFR and TMAO, but not TMA. The debate whether TMAO can be a harmful, diagnostic or protective marker in CVD needs to be continued.

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