bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract P272: Leg Strength and Gait Speed Predict Enrollment in an Exercise Study among Stroke Survivors with Mild-Moderate Disability
Authors: Keller Mallory L , Taylor-Piliae Ruth E
Published: July 2021

Background:
Stroke is the third leading cause of death in the United States and is the major contributor to physical and cognitive disability among this population. Exercise is an important aspect of stroke rehabilitation to reduce disability.

Objective:
To determine if functional disability, physical function, cognitive impairment, age or gender are predictive of enrollment in an exercise study among stroke survivors with mild-moderate disability.

Methods:
Cross-sectional design using data from stroke survivors (n=166) that consented to be screened for an exercise study, the “Tai Chi for Stroke Survivors Study.” All subjects completed a brief survey to determine eligibility, prior to screening. Screening tests included the Modified Rankin Scale (mRS, functional disability), Short Physical Performance Battery (SPPB, physical function), and Mini-Mental Status Exam (MMSE, cognitive function). First, we conducted bivariate logistic regression using mRS, SPPB-balance, gait speed and leg strength test times, MMSE, age and gender, as single predictors of study enrollment. Then, we conducted multiple logistic regression using significant predictors to determine the overall model.

Results:
Subjects (n=166) were on average 69±11 years old, and reported mild-moderate disability (mRS=2.0±0.8), had some impairments in physical functioning (SPPB=7.0±2.6), diminished leg strength (5-timed chair stands=19.3±7.2 seconds), and slow gait speed (0.76±0.3 meters/second) but, were without cognitive impairments (MMSE=27.8±3.3). Significant predictors of study enrollment were leg strength [X
2
(1)=16.37, p<0.01] and gait speed [X
2
(1)=6.89, p<0.01]. Multiple logistic regression indicated that leg strength and gait speed together were predictive of enrollment [X
2
(2)=22.38, p<0.01]. Prediction success was 77% overall. Leg strength was a significant predictor in the model (Wald=6.2, p=0.01), indicating that as test completion time increases, the odds of enrollment increases [Exp(B)=1.12, CI=1.03–1.23]. Gait speed was a significant predictor in the model (Wald=5.6, p=0.02), indicating that as gait speed increases, the odds of enrollment decreases [Exp(B)=0.14, CI=0.03–0.71]. A total of 60% (100/166) of screened subjects (women=46/100) enrolled in our study.

Conclusion:
Physical function has been shown to predict disability and overall decline in health and well-being in stroke survivors with mild-moderate disability. The SPPB is simple to administer, taking 5–10 minutes to complete. This test readily identified stroke survivors with diminished leg strength and slower gait speed, and was predictive of enrollment in our exercise study.
Abstract P276: Aerobic Endurance and Leg Strength are Predictive of Gait Velocity among Community-Dwelling Stroke Survivors
Authors: Taylor-Piliae Ruth E , Latt L. Daniel , Coull Bruce M
Published: July 2021

Background:
Gait velocity is an objective, fundamental indicator of post-stroke walking ability. Most stroke survivors have diminished aerobic endurance and paretic leg strength, with one or both of these conditions affecting their gait velocity. Other reported underlying factors affecting gait velocity include functional disability, balance and cognitive impairment.

Objective:
To examine potential independent predictors of gait velocity in chronic stroke.

Methods:
Cross-sectional design using baseline data from the first 100 community-dwelling stroke survivors enrolled in an exercise intervention study. Eligible subjects included men and women aged ≥ 50 years and at ≥ 3 months post-stroke. Subjects completed a comprehensive, self-administered health survey prior to their baseline study visit. At the baseline visit, functional disability (Modified Rankin Scale), aerobic endurance (2-minute step-test), leg strength (timed 5-chair stand test), balance (single-leg stance) and cognitive impairment (Mini-Mental Status Exam) were assessed. Gait speed was assessed using a valid and reliable timed 4-meter walk test designed for older adults with disabilities; to calculate gait velocity (meters/second). Multiple linear regression was conducted to explore potential independent predictors of gait velocity.

Results:
Subjects (n=100) were on average 70±10 years old, and 39±49 months post-stroke. The majority reported an ischemic stroke (68/100) with hemiparesis (80/100); and were married (59/100), White/European-American (78/100), college-educated (79/100), men (54/100). Subjects had an average gait velocity of 0.75±0.23 meters/second, categorized as limited community walkers. Approximately 37% of the variance in gait velocity, could be explained by the optimal combination of the independent variables in the model: functional disability, aerobic endurance, leg strength, balance, and cognitive impairment (R
2
=0.37, F
5,74
=8.64, p<0.01). Only better aerobic endurance (t
1,74
=3.41, p<0.01) and leg strength (i.e. faster chair stand time) (t
1,74
=–2.23, p=0.03) contributed uniquely and significantly to faster gait velocity.

Conclusion:
A hallmark of gait dysfunction in chronic stroke is slow gait velocity, even among well-educated, community-dwelling survivors. Gait velocity is simple to measure requiring only a stopwatch and flat surface for walking. Our findings are similar to reports by others that diminished aerobic endurance and leg strength are major contributors to slow gait velocity in chronic stroke. Long term rehabilitation efforts are needed to improve gait velocity in chronic stroke, and may need to incorporate multifaceted strategies concurrently, focusing on aerobic endurance and leg strength, to maximize community ambulation and reintegration.
Abstract P277: The Influence of Interval Training on Physical Capacity and Exercise-induced Ischemia in Patients with Coronary Artery Disease
Authors: Korzeniowska-Kubacka Iwona , Bilinska Maria , Rydzewska Ewa , Dobraszkiewicz-Wasilewska Barbara , Piotrowicz Ryszard
Published: July 2021

Introduction:
Patients(pts) with CAD referred for cardiac rehabilitation on the out-patient basis include those whose exercise stress test(EST) has been positive. The limit of the training heart rate(HR) is set below the ischemic threshold (IT), which result from angina and/or ischemic ST segment depression by ≥1 mm during an exercise test. The literature provides few original studies of this issue, and the answers to the question if ischemia during exercise should be avoided are inconsistent.

Objectives:
The aim of the study was to compare the safety and effectiveness of interval training at and below IT, and its influence on physical capacity and exercise-induced ischemia in pts with CAD and positive exercise stress test.

Methods:
The study comprised 30 clinically stable pts with positive EST, aged 55.22±10.29 years, after myocardial infarction and/or surgically treated ischemic heart disease, who were included in a cardiac rehabilitation program one month following MI or CABG. All subjects were divided into two groups: Group A-training at IT i.e. HR at which 1-mm ST depression appeared during the initial EST ( n=10),group B -training below IT i.e. HR10 bpm lower than the one at which 1-mm ST appeared ( n=20).All of them underwent a two-month interval training on cycloergometer three times a week. EST was performed before and after the completion of the training program(TP). The following variables were assessed: walking distance, WD (m), EST duration (min), metabolic equivalent (METs), time to 1 mm ST depression (min), max ST depression (mm).Also adverse events that occurred during training were analyzed.

Results:
After TP, following analyzed variables improved significantly in Group A: WD- 706.90±101.02 vs 770.90±139.78, p<0.05; EST duration - 10.15±3.89 vs 11.11±3.94, p<0.01; METs- 8.19±1.33 vs 9.27±1.89, p<0.05; time to 1mm ST depression- 9.08±4.27 vs 10.33±3.74,p< 0.01. The analyzed variables of Group B pts also improved: WD- 541.50±204.48 vs 646.30±175.72, p<0.01; EST duration- 8.49±3.01 vs 10.44±3.33, p<0.01; METs- 6.54±2.00 vs 7.83±1.2, p< 0.01; time to 1 mm ST depression- 7.89±3.30 vs 9.03±2.82,p <0.05 .Yet no significant decreasing of max ST depression in EST after TP in either group was observed. The assessment also included comparing the outcome of both forms of training finding no significant differences in the percentage changes in all parameters studied between the groups. No severe adverse events were reported during trainings. Conclusions 1.Both forms of interval training below and at ischemic threshold enhanced the physical capacity and had an anti-ischemic effect. 2.Interval training at ischemic threshold was an equally effective and safe form of rehabilitation as the training according to the current standards.
Abstract P284: Antibody Levels to Persistent Pathogens and Incident Stroke in Mexican Americans
Authors: Sealy-Jefferson Shawnita , Gillespie Brenda W , Aiello Allison E , Haan Mary N , Morgenstern Lewis B , Lisabeth Lynda D
Published: July 2021

Infectious pathogens such as Cytomegalovirus, Helicobacter Pylori, Toxoplasma gondii, Varicella Zoster and Herpes Simplex Virus Type 1 confer lifelong infections that are prone to reactivation. These pathogens may have an effect on ischemic stroke risk through an inflammatory pathway. Disparate rates of infectious disease and stroke risk have been documented for Mexican Americans (MAs) compared with Non-Hispanic Whites, thus exposure to persistent pathogens may help to explain the excess stroke burden in this population. We examined the hypothesis that high antibody response to 5 pathogens increases stroke risk in an elderly cohort of MAs. The study population included individuals followed from 1998-2008 as part of the Sacramento Area Latino Study on Aging (n=1789). Those with prevalent stroke at baseline were excluded (n=168). Seven annual in-person interviews and six semi-annual telephone interviews were conducted to ascertain clinical data and sociodemographics, with serum tested for IgG antibody levels. Antibody levels for each pathogen were modeled based on quartiles of the distributions. The outcome was self-reported incident stroke during follow-up. Associations between antibody levels for each pathogen and stroke risk were investigated using discrete-time logistic regression. We used baseline data and updated longitudinally collected covariate information if available. Mean age of our sample (n=1621) was 73.2 (SD=6.9), with 41% male. During the study, 164 incident strokes occurred. In demographic-adjusted models, no significant association was found between antibody levels for any of the pathogens and incident stroke. Similar results were found after additional adjustment for known stroke risk factors (
Table
). In conclusion, antibody levels to five persistent pathogens were not significantly associated with increased stroke risk in this elderly cohort of MAs. Given our results, future research should assess the effect of pathogen burden (or, the effect of >1 pathogen), on stroke risk in MAs.

Table.

Antibody Levels to Persistent Pathogens and Incident Stroke Risk in MAs, California 1998-2008

Cytomegalovirus
Herpes Simplex Virus Type1
Toxoplasma Gondii
Varicella Zoster Virus
Helicobacter Pylori

Odds Ratio
95% CI
P value
Odds Ratio
95% CI
P value
Odds Ratio
95% CI
P value
Odds Ratio
95% CI
P value
Odds Ratio
95% CI
P value

0.66

0.85

0.98

0.42

0.11

Quartile 2

0.79
0.48, 1.31

1.11
0.69, 1.80

0.94
0.59, 1.50

1.21
0.77, 1.92

0.94
0.56, 1.57

Quartile 3

0.99
0.62, 1.58

1.06
0.66, 1.69

0.94
0.58, 1.54

0.89
0.54, 1.46

1.53
0.97, 2.43

Quartile 4

0.79
0.48, 1.29

0.88
0.54, 1.43

0.91
0.56, 1.48

0.78
0.48, 1.28

1.51
0.94, 2.42

95% CI= 95% Confidence Interval; Adjusted for age, sex, diabetes, atrial fibrillation, smoking, coronary heart disease, hypertension, and hyperlipidemia
Abstract P289: Therapist-Based and Robot-Assisted Physical Training Have Differential Effects on Motor Control of Upper Limb and Quality of Life after Chronic Stroke
Authors: Wu Ching-yi , Chuang Li-ling , Chen Ming-De , Chen Yu-ting , Lin Keh-chung
Published: July 2021

Introduction:
Compensatory strategies for stroke-related motor impairment may cause a pattern of disuse that might limit the improvement of upper limb (UL) motor function, and incomplete UL motor recovery might detrimentally impact quality of life. Previous studies showed that bilateral arm physical training (BAT) can improve UL function after stroke and improves trunk stabilization. However, it remains uncertain that whether BAT can reduce trunk compensation during reaching. Furthermore, there is no study investigating therapist-guided bilateral arm training (TBAT) versus robot-assisted bilateral arm training (RBAT).

Hypothesis:
We tested the hypothesis that TBAT and RBAT, compared with control treatment (CT), would result in the better outcomes on movement control in the affected UL and less trunk compensation in reaching tasks and would improve quality of life. In addition, TBAT and RBAT may have differential effects on motor control and quality of life.

Methods:
Forty-two community dwelling chronic stroke survivors (54 years old; 18 months after stroke) were randomized to TBAT (N=14), RBAT (N=14), or CT (N=14) groups. Each group received a 90- to 105-minute training session, 5 days/week, for 4 weeks. The TBAT participants practiced a variety of bilateral functional tasks with each arm simultaneously under one-on-one supervision of therapists. In the RBAT, the robot-assisted arm trainer, Bi-Manu-Track, was introduced. The CT group involved some conventional therapeutic activities on the paretic arms, unilateral and bilateral fine motor tasks, and compensatory practice on functional tasks. Outcome measures consisted of kinematic analyses for motor control in unilateral and bilateral reaching tasks, and the Stroke Impact Scale for quality of life.

Results:
The kinematic results indicated that the TBAT group experienced better temporal efficiency and smoothness in unilateral reaching than the CT group. The TBAT group demonstrated less compensatory trunk movement than the CT or RBAT groups in both unilateral and bilateral tasks. In contrast, the RBAT engendered a larger improvement in shoulder flexion than the other groups. The RBAT demonstrated improved quality of life than the CT group characterized by better strength, physical function, and total scores of Stroke Impact Scale.

Conclusions:
TBAT and RBAT engendered differential effects on outcome measures than CT. TBAT may have better results on temporal efficiency, smoothness, and trunk control. In contrast, RBAT may experience the improved shoulder flexion and quality of life.
Abstract P294: Circulating Soluble ICAM-1 is Associated with Aorto-Iliac and Coronary Artery Calcified Plaque 10 years Later in Young Adults: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
Authors: Gross Myron D , Suarez-Lopez Jose R , Reiner Alex P , Thyagarajan Bharat , Carr J. J , Duprez Daniel A , Jacobs David R
Published: July 2021

Background:
Elevated serum soluble intercellular adhesion molecule-1 (sICAM-1) concentration has been associated with cardiovascular disease in older adults. Soluble ICAM-1may have a central role in the development of atherosclerosis, but few studies have investigated the relationship in young adults or evaluated prospective relationships.

Objective/Hypothesis:
To investigate the relationship between sICAM-1 and subclinical atherosclerosis measured 10 years later in young adults. sICAM-1 will have positive association with the presence of subclinical atherosclerosis.

Methods:
Soluble ICAM-1 concentrations were assayed in black and white men and women at average age 40 (range 32–47 years). Two markers of subclinical atherosclerosis, namely aorto-iliac calcified plaque (AoIC, n=1621, 55% with AoIC) and coronary artery calcium (CAC, n=1656, 30% with CAC), were measured 10 years later. Associations were evaluated by logistic regression methods.

Results:
Mean (standard deviation (SD)) of sICAM-1 was 155.1 (45.8) ng/ml. In a minimally adjusted (age, race, sex, clinic) model, sICAM-1 was associated with an increased risk of AoIC (OR=1.56 per SD, CI=1.37–1.78, p<0.0001,). This association remained highly significant (OR=1.22 per SD, CI=1.06–1.40, p<0.006) in a model fully-adjusted (adding education, body mass index, waist, blood lipids, cholesterol-lowering medication, smoking, blood pressure, antihypertensive medication, and exercise). CAC was associated with sICAM-1 (OR=1.41 per SD, CI=1.24–1.59, p<0.0001) in the minimally adjusted model as well as the fully-adjusted model (OR=1.18 per SD, CI=1.04–1.34, p<.01).

Conclusion:
Elevated concentrations of sICAM-1 were associated with subclinical atherosclerotic calcification, which in turn is known to be highly predictive of future cardiovascular disease. Soluble ICAM-1 assessed at average age 40 predicts the early development of advanced atherosclerosis, only partly mediated by effects of elevations of known risk factors.
Abstract P298: Progression Of Subclinical Atherosclerosis And Its Determinants In Early Postmenopausal Chinese Women - A Five-year Followup Study Of A Population-based Cohort
Authors: Ho (Chan) Suzanne , Yu Ruby HY , Ho Stella , Chan Sophie SG , Woo Jean LF , Lam Christopher WK , Tang Nelson
Published: July 2021

Introduction:
Subclinical atherosclerosis (SA) progresses silently over a period of time before the clinical manifestations of cardiovascular disease.

Hypothesis:
We hypothesize that early postmenopausal women with adverse cardiovascular risk factors or their progression to abnormal values have a higher risk of SA. This study aimed to investigate the progression of SA and its determinants in early postmenopausal Chinese women.

Methods:
This is a community-based 5-year followup study on a cohort of 518 women aged 50–64, within 10 years menopause, and recruited through random telephone dialing. Clinical assessments, fasting blood samples, lifestyle and dietary variables based on validated and structured questionnaires, as well as intima-media thickness (IMT) were obtained at baseline and at followup. IMT was measured using a 12.5-MHz linear probe of the HDI 5000 ultrasound scanner at the near and far walls of three 10-mm segments: distal common carotid, bifurcation, proximal internal carotid of both the left and right carotid arteries. Plaque was defined as a focal wall thickening of at least 1.5mm and graded as: grade 0, 1 and 2. Plaque progression was the difference of the plaque index at baseline and followup, and classified into 3 categories.

Results:
This study of Chinese early postmenopausal women (followup mean age 61.5 years at followup) has revealed a progression of IMT of 2.1% per year (standard deviation = 1.7). 17% were found to have a moderate and 8% severe plaque progression. Stepwise multiple regression analyses showed that baseline IMT, age, low density lipoprotein cholesterol (LDL-C), systolic and diastolic blood pressure were significant predictors of higher followup IMT, while vegetable and fruit intake were inversely related. Women with values belonging to the “normal” ranges of blood pressure, waist circumference, lipid and fasting blood glucose levels had lower IMT at followup compared to those with abnormal baseline values and those with progression from “normal” to the “abnormal” ranges. Women with high soy-vegetable-fruit intake at both baseline and followup had lower IMT than those with low intakes at both time points. Increasing age, waist circumference ≥80 cm, cholesterol ≥200 mg/L, having diabetes, regular drinking were significant predictors of plaque progression (adjusted odds ratios from 1.10 to 2.81), while higher vegetable and fruit intake lowered the risk.

Conclusion:
Age, central obesity, diabetes, dislipidaemia, high blood pressure, regular drinking were significant predictors for an increased risk of SA. Maintenance of these CVD factors within normal ranges through early menopausal years with adequate fruit and vegetable intake is important to reduce the progression of SA.
Abstract P305: Incidence of Coronary Artery Calcification and Its Association With Eicosapentaenoic Acids From The ERA JUMP Study
Authors: Sekikawa Akira , Ueshima Hirotsugu , J Curb David , Lee Sunghee , Shin Chol , Kadowaki Takashi , Masaki Kamal , Edmundowicz Daniel , Fujiyoshi Akira , Seto Todd B , Kadowaki Sayaka , Sutton-Tyrrell Kim , Kadota Aya , Evans Rhoert W , Okamura Tomonori , Miura Katsuyuki , Choo Jina , El-Saed Aiman , Kuller Lewis H
Published: July 2021

Objectives:
To compare incidence of coronary artery calcification (CAC) between men in Japan and the US and to examine whether marine n-3 fatty acids contribute to the difference in the incidence.

Methods:
The ERA JUMP Study is a population-based longitudinal study which has examined the progression of subclinical atherosclerosis in Japanese, Japanese American and white men aged 40-49 at baseline in 2002-2007. Incident cases of CAC were defined as those with CAC score=zero at baseline (n=278: 167 Japanese and 111 whites) and CAC score ≥10 at follow-up. Mean follow-up years were 6.2 for Japanese and 4.6 for whites. Stepwise robust logistic regression was used to determine baseline predictors of CAC incidence in each group. Generalized linear model was used to examine whether the difference in risk factors and marine n-3 fatty acids at baseline between Japanese and whites contributed to the difference in incidence rates.

Results:
Baseline characteristics show that levels of risk factors were similar between the two groups including LDL-C and BP. Exceptions were higher rates of smoking in Japanese (49 vs. 7%) and higher levels of HDL-C in Japanese (54 vs. 49 mg/dL). Levels of marine n-3 fatty acids were 100+% higher in Japanese. Incidence rate was significantly lower in Japanese than in whites (0.9 for Japanese vs. 2.9 for whites (per 100 person years) p<0.01). Logistic regression analyses showed that predictors of CAC incidence were HDL-C, BMI, and triglycerides for whites and BP and eicosapentaenoic acids (EPA) for Japanese. Generalized linear model showed that incidence rate ratio was 0.606 after adjusting for age, follow-up time, BMI, BP, HDL-C, LDL-C, and smoking (p<0.01), which remained significant after further adjusting for other risk factors. However, after further adjusting for EPA, the statistical significance disappeared (p=0.07). (
Table
)

Conclusions:
CAC incidence is significantly lower in Japanese than in white men. The data suggest that high levels of EPA contribute to the lower CAC incidence in Japanese.

Table.

Incidence rate ratio of coronary artery calcification between Japanese men and white men (n=278)

Incidence rate ratio between two groups (95% CI) (Japanese vs. whites)

p
-value

Model I
0.606 (0.427, 0.861)
<0.01

Model II
0.571 (0.392, 0.830)
<0.01

Model III
0.669 (0.431, 1.038)
0.07

Model I: Adjusted for age, follow-up time, BMI, BP sys, HDL-C pack-years of smoking and LDL-C Model II: Further adjusted for triglycerides, glucose, hypertension medication, lipid medication, CRP and alcohol Model III: Further adjusted for EPA (eicosapentaenoic acid)
Abstract P310: The Distribution of Total- and HDL Cholesterol and Triglycerides is Significantly Different across Quartiles of Vitamin D in Chest-Pain Patients with a Suspected Acute Coronary Syndrome
Authors: Naesgaard Patrycja A , Leon de la Fuente Ricardo A , Nilsen Stein Tore , Aarsland Torbjoern , Woie Leik , Grundt Heidi , Brede Cato , Staines Harry , Gallo Patricio , Dib Ashur Silvia , Torino Augusto , Nilsen Dennis W
Published: July 2021

Background:
The purpose of this study was to assess the distribution of serum lipids including total cholesterol, HDL cholesterol and triglycerides across quartiles of vitamin D in blood samples collected from 982 chest-pain patients with a suspected acute coronary syndrome (ACS) from Salta, Northern-Argentina.

Methods:
Vitamin D status was obtained by determination of 25-hydroxy-vitamin D (25(OH)D) in serum. Blood samples for measurement of 25(OH)D and circulating lipid fractions in serum were obtained immediately following admission.

Results:
In the total population the concentration of total cholesterol, HDL cholesterol and triglycerides was found to differ significantly across quartiles of 25(OH)D, p = 0.016, p = 0.01 and p = 0.000, respectively. See Figure 1, 2 and 3, respectively. In the Troponin T (TnT) positive population (TnT > 0.01 ng/mL), only total cholesterol and triglycerides differed significantly across the 25(OH)D quartiles, p = 0.000 and p = 0.003, respectively, whereas HDL cholesterol alone differed in the TnT negative group, p = 0.025.

Conclusion:
Concentrations of the main lipid fractions are related to the vitamin D status in patients admitted with chest pain and suspected ACS.
Abstract P313: De-Conditioning Adversely Affects Subclinical Atherosclerosis in a Unique Cohort of Spinal Cord Injury
Authors: Szlachcic Yaga , Adkins Rodney H , Reiter Jamie C , Li Yanjie , Hodis Howard N
Published: July 2021

Introduction:
Physical activity is presumed to improve cardiovascular disease (CVD), of which carotid artery intima-media thickness (CIMT) is a common indicator. Individuals with spinal cord injury (SCI) have limited mobility and therefore an expected increased risk for CVD. The purpose of this study was to determine which CVD risk factors predict CIMT among women with SCI, with the ultimate goal of targeting therapy to improve CVD in this population.

Methods:
One hundred twenty-two women with SCI who attended an outpatient SCI clinic and met inclusion and exclusion criteria participated in this study. SCI was categorized into 1 of 4 categories: complete tetraplegia, incomplete tetraplegia, complete paraplegia, and incomplete paraplegia. Maximum heart rate and VO2 max were obtained using bicycle ergometry with ventilatory gas exchange and continuous electrocardiogram. Hierarchical regression was used to predict CIMT, with the first block including demographic variables (age, race, smoking status) and the second block including physiologic variables (total cholesterol, heart rate, VO2 max, BMI, fasting serum glucose, hemoglobin A1c, and blood pressure).

Results:
Similar findings were observed for left and right CIMT, therefore only results from right CIMT are reported. The overall model was significant, F(16,46)=8.53, p=.000. Adjusted R square was .54 for the first block of variables and increased significantly (p=.006) to .66 when the second block of variables was added. Significant predictors at alpha=.05 included age (beta=.51, t=4.79, p=.000) and max/peak heart rate (beta=−.336, t=−2.39, p=.02). At alpha=.10, A1c was significant (beta=.187, t=1.99, p=.053).

Conclusions:
Although low aerobic conditioning is a purported CVD risk factor, quantitative measurements of such lack a demonstrable relationship with subclinical atherosclerosis (CIMT), perhaps because of its reduced importance relative to other CVD risk factors in a mobile population. We found expected relationships with CIMT in our SCI population (i.e., age), however we also found a quantitative measure of aerobic conditioning (max/peak heart rate) to be associated with CIMT. Our data indicate that SCI individuals may bear a greater CVD burden from cardiac de-conditioning than the general population and that investigation of a cohort with mobility limitation may provide a unique opportunity to study the impact of physical conditioning on CVD risk.
Abstract P317: Cognitive Impairment in Coronary Artery Disease Patients: Do Exercise Tolerance and Cerebral Oxygenation During Exercise Matter?
Authors: Gremeaux Vincent , Drigny Joffrey , Gayda Mathieu , Juneau Martin , Bherer Louis , Nigam Anil
Published: July 2021

Introduction:
Cardiovascular diseases have been associated with impaired cognitive performances, especially in functions. In contrast, it is clearly established that regular physical activity maintained throughout life protects against age-related cognitive decline.

Purpose:
to assess maximal oxygen uptake (VO2max), cardiac output, and cerebral hemodynamic changes, assessed by Near-Infrared Spectroscopy (NIRS), during a graded maximal exercise tests, and cognitive performance at rest in patients with stable coronary heart disease (CHD) and healthy matched adults.

Methods:
Ten stable CHD patients (67.1±10.5 years) and 9 age-matched controls (62.2± 11.4 years) were included in this pilot study. Measurements included: body composition (bioelectrical impedance), complete blood analysis in a fasting state, cognitive performance using validated neuropsychological tests, graded maximal exercise testing on ergocycle with gas exchange analysis, non-invasive cardiac output measurement (cardiac bioimpedance) and NIRS signals measurement at the left prefrontal brain level (oxyhaemoglobin: O2Hb, deoxyhaemoglobin: HHb ; total haemoglobin: THb, and differential haemoglogin: Hbdiff).

Results:
Several cognitive performance items were lower in the CHD group, especially regarding executive functions (Backward digit span score, p<0.05; trail making test B, p=0.05; Stroop test (inhibition/flexibility), p<0.05). There was no difference between CHD and controls in VO2 max (29.7±8.5 Vs 32±6.3 ml/kg/min) and maximal cardiac output (15.5±3.9 Vs 17±2.6 l/min), whereas cardiac output and cardiac index at the ventilatory threshold were lower in CHD (5.75±1 Vs 7.06±0.6 l/min/m2, p<0.05, and 11.2±2.2 Vs 14.1±2.8 l/min, p<0.01, respectively). There was a significant difference in the kinetics of NIRS signal with higher amplitude for CHD patients vs. controls for O2Hb (p<0.01); THb (p<0.05) and Hbdiff (p<0.05). Significant higher amplitude were also found for O2Hb, THb, Hbdiff (p<0.0001) in younger (62 years) participants. HHb (p<0.0001) and Hbdiff (p<0.01) amplitude was higher for fit (≥120% theoretical VO2max) vs. less fit (<120%) participants.

Discussion:
Compared to age-matched controls, our sample of stable fit CHD patients had a comparable maximal exercise tolerance and cardiac output, with higher NIRS cerebral signals amplitude for O2Hb, THb and Hbdiff. This latter parameter thus does not seem to influence cognitive performance at rest, that was lower in CHD patients, especially in executive functions. However, an important inter-individual variability of cerebral NIRS signal amplitude was observed, with age and fitness appearing as major contributors. We plan to recruit a larger sample of subjects to assess more clearly relationships between exercise, tolerance hemodynamic parameters and cognitive performance.
Abstract P322: Reproducibility, Validity, and Responsiveness of the 200-Meter Fast Walk Test in Patients Undergoing Cardiac Rehabilitation
Authors: Gremeaux Vincent , Hannequin Armelle , Deley Gaelle , Duclay Julien , Laroche Davy , Casillas Jean-Marie
Published: July 2021

Introduction:
The 200-Meter Fast Walk Test (200-mFWT) has recently been designed to assess functional capacities at a higher intensity level than does the 6-Minute Walk Test in healthy elderly people and in coronary artery disease (CAD) patient. Objective: to investigate the reliability, validity, and responsiveness of the 200-mFWT in coronary artery disease CAD patients engaged in a cardiac rehabilitation program. Design: Descriptive study. Setting: tertiary care hospital. Subjects: Thirty stable CAD patients (51.9±8.7 yrs), referred to the cardiac rehabilitation department after an acute coronary syndrom (ACS). Main measures: 6MWT distance, time to perform the 200-mFWT, peak power output of the graded maximal exercise test (GMET), before and after the program; SF-36 quality of life questionnaire at baseline. Walk tests were performed twice at baseline to assess reliability.

Results:
The 200-mFWT was highly reliable (ICC=0.97). It was significantly correlated with the GMET peak power and the 6-MWT at baseline (r=-0.417; p<0.05; and r=-0.566; p<0.01, respectively) and after the training program (r=-0.460, p<0.05; and r=-0.926; p<0.01respectively). At baseline, there was a strong correlation between the 200-mFWT time and the physical component score of the SF-36 (r=-0.77; P<0.01), but not between the 200-mFWT time and the SF-36 mental component score. Mean 200-mFWT time was significantly different between the patients performing ≤ 90Watts (n=11) or ≥ 100Watts (n=19) at the baseline GMET (121.7±13.6 vs 115.5±10.1 sec; P<0.05). The responsiveness was strong with a standardized response mean at 1.11.

Conclusion:
the 200-mFWT is a reliable, valid, discriminant, and responsive high-intensity walk test in CAD patients after an ACS. It can thus give additional information to those given by the 6-MWT and the GMET.
Abstract P330: Comparative Effectiveness of Atenolol and Metoprolol for Prevention of CVD Events in Hypertensive Patients
Authors: Parker Emily D , Margolis Karen L , Schneider Nicole K , Magid David J , Tavel Heather M , Shetterly Susan M , Ho P. Michael , Selby Joe V , Swain Bix E , Schmittdiel Julie A , O'Conner Patrick J
Published: July 2021

OBJECTIVE:
Randomized controlled trials have demonstrated the efficacy of selected beta blockers for preventing cardiovascular (CV) events in patients following myocardial infarction (MI) or with heart failure (HF). However, the effectiveness of atenolol for preventing CV in patients with hypertension (HTN) has been questioned recently.

METHODS:
Using data from Cardiovascular Research Network HTN registry, we compared incident MI, HF, and stroke in 21,960 patients who were new beta blocker users between 2000-2009. Patients had no prior history of CV disease and had not previously filled a prescription for either atenolol or metoprolol tartrate. Exposure to either atenolol or metoprolol tartrate was ascertained from pharmacy data. In order to control for confounding by indication, patients were matched 1:1 based on the propensity to have metoprolol dispensed. The propensity score model included age, sex, race/ethnicity, year of beta blocker initiation, number of visits in the previous year, insurance payer, systolic blood pressure at baseline, and prevalence of lipid disorders, diabetes, chronic kidney disease, and whether the patient was on additional anti-HTN medication at baseline. Incident CV events, patient and provider characteristics were determined from electronic heath record , health plan enrollment and claims data. Cox proportional hazards regression was used to examine the associations of different beta blockers with incident CV events.

RESULTS:
The propensity-matched 10,980 new metoprolol tartrate users were similar to the 10,980 new atenolol users with regard to demographic and clinical characteristics. During follow-up (median 3.9 years), there were 743 incident MI, 806 incident HF, and 749 incident stroke events. Hazard rate ratios for MI, HF and stroke were 1.00 (95% confidence interval 0.96-1.02), 0.98 (95% CI 0.96-1.02), and 0.99 (95% CI 0.96-1.02), respectively. The results from multivariate models adjusted for the variables in the propensity model were similar.

CONCLUSIONS:
There were no statistically significant differences in incident MI, HF, stroke between atenolol and metoprolol tartrate users. These results do not support recent concerns that atenolol may not be as safe as other beta-blockers for preventing CV morbidity in patients with HTN. Large registries similar to the one used in this analysis may be useful for addressing comparative effectiveness questions that are unlikely to be resolved by randomized trials.
Abstract P361: Body Composition in Healthy Young Women within Normal Body Mass Index in a Sample of Northeastern Brazilian Population
Authors: Costa Amanda C , Silva Ana Gabriela C , Ribeiro Cibele T , Dias Fernando A
Published: July 2021

BACKGROUND: Excess body fat is a risk factor for some metabolic and cardiovascular disease. Overweight is usually determined by body mass index (BMI), however, there is discussion about the cut-off point for healthy percentage body fat. The aim of this study was to evaluate the segmental body composition of healthy young women in a sample of northeastern Brazilian population. METHODS: Direct Segmental Multi-frequency (20kHz; 100kHz) Bioelectrical Impedance Method (DSM-BIA) measured by eight tactile electrodes (InBody R20) was used to assess body composition and the translated and validated International Physical Activity Questionnaire (IPAQ-Short Form) was used to assess Physical activity (PA) level in 35 young (18-26 years old) healthy volunteer women within the normal BMI range (18.5 to 24.9 Kg/m
2
).

RESULTS: The average weight and height were 58.07±5.17Kg and 1.63±0.06m; respectively. Other anthropometric measurements were as follow: BMI = 21.99±1.25Kg/m
2
; Waist circumference (WC) = 74.69±5.02cm; Hip Circumference = 97.53±3.80cm and Waist-to-Hip Ratio (WHR) = 0.76±0.04. None of the volunteers had WC above the cut-off point of 88cm and only 5 (14.3%) had a WHR above a suggested cut-off point for excess abdominal fat (>0.8). Percentage of body fat (%BF) was on average 33.18±4.78% (31.54-34.82, 95% confidence interval for the mean), ranging from minimal of 24.20% to 42.70%. Percentage of trunk fat averaged 33.99±4.64% (32.40-35.59, 95% CI for mean). PA of the volunteers were classified as low, moderate and high on 20%, 48.6% and 31.4% of the volunteers; respectively. There was a moderate to strong correlation of BMI and %BF (Pearson r= 0.594) even when a sub-analysis excluding the low PA volunteers was done (Pearson r=0.534). CONCLUSIONS: Our data demonstrated that the studied population appears to have a higher average %BF measured by DSM-BIA than expected for the BMI range, considering cut-off points for overweight in a very close age group as proposed by Gallangher et al., 2000. This suggests the importance of a large study to assess and maybe establish cut-off points for overweight and obesity in this population so weight loss and PA interventions can be appropriately prescribed.
Abstract P363: Association of Twenty-Four Hour Urine Calcium Excretion with Cardiovascular Events and Mortality: Data from the Heart and Soul Study
Authors: Welles Christine C , Schafer Anne L , Vittinghoff Eric , Shlipak Michael G , Whooley Mary A , Ix Joachim H
Published: July 2021

Background:
Recent studies have raised concerns about the cardiovascular (CV) safety of calcium supplementation, particularly in regards to risk of myocardial infarction (MI). However, most prior studies have been limited by imprecise calcium ascertainment using food frequency questionnaires. In contrast, twenty-four hour urinary calcium excretion (UCE) provides an objective, quantitative measure of total daily calcium intake. Therefore, we sought to evaluate the association of UCE with CV events or death in persons with stable coronary heart disease (CHD).

Methods:
Between 2000-02, 849 subjects with prevalent CHD provided twenty-four hour urine collections and UCE was measured. We used Cox proportional hazards models to evaluate the association of UCE with the composite endpoint of CV events (MI, heart failure, stroke) or all-cause mortality, which were determined by blinded review of medical records.

Results:
During a mean follow-up of 7 ± 2 years, 374 subjects (44%) had a CV event or died. The mean UCE was 105.7 ± 111.4 mg/day. Following multivariate adjustment for demographics, traditional CV risk factors, and kidney function, there was no association between UCE and the composite of CV events or all-cause mortality (
Table
). Evaluation of individual CV outcomes revealed no association between UCE (entered per 20 mg/day greater urine calcium) and heart failure (HR 1.01, 95% CI 0.98-1.05, p=0.48) or stroke (HR 0.94, 95% CI 0.87-1.02, p=0.13), but a lower rate of MI (HR 0.94, 95% CI 0.89-1.00, p=0.04). The association was similar by sex, presence of chronic kidney disease, and use of calcium supplements (all p interactions > 0.10).

Conclusions:
Greater UCE is not associated with higher overall CV event rates or mortality in outpatients with stable CHD, and may be associated with a modestly lower rate of MI. These findings suggest that greater daily calcium intake does not confer CV harm in outpatients with prevalent CHD.
Abstract P364: Preliminary Study of the Effects of Coffee Mannooligosaccharides Supplementation on Lipid Profile.
Authors: Tsai Stacy , RoyChoudhury Arindam , O'Keeffe Majella , St-Onge Marie-Pierre
Published: July 2021

Introduction: Coffee-derived mannooligosaccharides (MOS) have been shown to have prebiotic activity and improve body composition in overweight individuals. However, the effects of MOS consumption on metabolic risk factors have not been studied. The overall goal of this study was to determine the effects of MOS consumption on body composition and metabolic risk factors.

Hypothesis: We hypothesized that the intake of MOS would result in improvements in lipid profile after controlling for changes in body weight.

Design: Two separate randomized, placebo-controlled studies, weight maintenance or weight loss, were conducted to assess the role of MOS for weight management. For each study, participants consumed MOS (4 g/d) or Placebo coffee beverages for 12 wk. Fasting blood samples were taken at baseline and endpoint of both studies. Complete datasets were available for 31 participants who consumed MOS (13 in weight loss study) and 32 (17 in weight loss study) who consumed the Placebo beverage. Regression analysis wasperformed including body weight, age, sex, time and time x beverage interaction as covariates to determine the effects of MOS supplementation on serum lipid levels. The regression analysis was additionally performed on a sub-sample with mildly elevated low-density lipoprotein cholesterol (LDL-C ≥ 130 mg/dL).

Results: Participants had a mean age (SEM) and body mass index of 45.0 ± 11.3 y and 30.2 ± 2.6 kg/m2. In the whole sample analysis, there was no time x beverage interaction for any of the lipid parameters (all P> 0.05). Total cholesterol (TC) changed by -2.5 ± 15.8% in the MOS group and by -1.0 ± 11.3% in the Placebo group. LDL-C changed by -2.0 ± 30.1% in the MOS group and by -2.2 ± 21.4% in the Placebo group. In the sub-sample analysis (MOS n = 12, Placebo n = 18), there was no time x beverage interaction on TC (MOS-17.1 ± 9.1% vs Placebo -5.6±10.1%, P = 0.197). Similar results were observed for LDL-C (MOS -25.6 ± 14.4% vs Placebo -8.4 ± 17.3%, P = 0.164) and triglycerides (MOS -8.5 ± 100.2% vs Placebo -3.4± 25.9%, P = 0.358).

Conclusions: Our data provide preliminary information on the effects of MOS supplementation on cardiovascular risk profile. Although not significant, our results suggest that MOS consumption may be useful to improve lipid profile in individuals with elevated LDL-C but our sample size was inadequate to affirm this with confidence. Future studies should be specifically designed to determine the effects of MOS supplementation on lipid profiles of at risk individuals.
Abstract P365: The Beneficial Effect of Moderate Alcohol Consumption on Type 2 Diabetes Risk is Modified by Smoking Status and BMI in The French E3n Cohort
Authors: Fagherazzi Guy , Tondeur Laura , Lajous Martin , Clavel-Chapelon FranÇoise
Published: July 2021

Background
- A U-shape relationship between alcohol consumption and risk of type 2 diabetes (T2D) has already been suggested. While smoking has been shown to act synergically with alcohol, with improvement of insulin sensitivity in ex-smokers, little is known about a possible interaction between alcohol and body mass index (BMI) on T2D risk.

Material & Methods
- We investigated the relationship between alcohol consumption (categorized as non-consumers, 2 drinks/day, 1 drink=10g of ethanol) and T2D among 66,118 women from the French prospective E3N cohort, the French component of EPIC. Multivariate Cox models were performed to estimate hazard ratios (HR) and 95% confidence intervals (CI) and were then stratified by BMI and smoking status (non-, former and current smokers). Between 1992 and 2007, 1,369 cases of incident diabetes were identified and validated using a drug reimbursement dataset and a supplementary questionnaire.

Results
- The median alcohol intake among consumers was 0.8 drink/day. Compared to non-consumers, women in the [1-2 drinks/day] category had a significantly lower rate of T2D (HR=0.81 [0.66-0.99]). Higher or lower intakes were not significantly associated with risk of T2D but the pattern of HRs was U-shaped across categories (HR=1, 0.98, 0.94, 0.81 and 0.95 respectively; P=0.04 for the quadratic term). The inverse association between moderate drinking and T2D risk was restricted to overweight or obese women (HR=0.73 [0.57-0.94]). The association was strongest among former smokers (HR=0.60 [0.41-0.87]).

Conclusion
- The observed decrease in T2D risk associated with moderate alcohol consumption may be limited to overweight or obese women. Our findings also support the hypothesis of a combined beneficial effect of moderate alcohol consumption and smoking cessation on T2D risk.
Abstract P366: A High-carbohydrate Diet Increases Serum HDL-C and Apolipoprotein A-I and Decreases Weight and BMI in the Male A Carriers of the
APOA1
-75G/A Polymorphism
Authors: Song Yong Yan , Gong Ren Rong , Hu Min Shan , Zhang Zhen , Liu Hui , Zhu Xing Chun , Zhang Rong Rong , Jiang Zhe , Fan Mei , Li Yuan Hao , Fang Ding Zhi
Published: July 2021

Both apolipoprotein gene polymorphism and high-carbohydrate diet have been found to be associated with serum lipid levels. However, the effects of their interaction on serum lipid profiles have not been well elucidated yet. We assessed the hypothesis that the subjects with different genotypes of the -75G/A polymorphism in the promoter region of the apolipoprotein A-I gene (
APOA1
) have different serum lipid responses upon a high-carbohydrate diet. Fifty-six healthy university students (27 males and 29 females, 22.89±1.80 years) were given a washout diet of 54% carbohydrates for seven days, followed by a high-carbohydrate diet of 70% carbohydrates for six days without total energy restriction. Anthropometric indexes and serum lipids at baseline, after the washout diet, and after the high-carbohydrate diet, as well as the
APOA1
-75G/A polymorphism were analyzed. The male A carriers of the
APOA1
-75G/A polymorphism consistently had higher levels of apolipoprotein A-I (
p
=0.008 at baseline,
p
=0.031 after the washout diet, and
p
=0.009 after the high-carbohydrate diet diet), but higher levels of high-density lipoprotein cholesterol (HDL-C) only at baseline (
p
=0.048) and after the high-carbohydrate diet (
p
=0.042) than the males with the GG genotype, and experienced increases in HDL-C (
p
=0.023) and apolipoprotein A-I (
p
=0.012) and decreases in body weight (
p
=0.017) and body mass index (BMI) (
p
=0.018) after the high-carbohydrate diet when compared to those after the washout diet. In conclusion, the high-carbohydrate diet can increase the serum HDL-C and apolipoprotein A-I concentrations in the males carrying the A allele of the
APOA1
-75G/A polymorphism. The effects are associated with the decreases of body weight and BMI. These results may provide experimental evidences for the personalized dietary interference in the country with the largest population in the world.