bluuebunny/crossref_metadata_2025_split huggingface dataset:
A polyphenol-rich active substance (TOTUM-070) lowers LDL-cholesterol in subjects with moderate hypercholesterolemia. The OLALIP study
Authors: Otero Y , Sirvent P , Langhi C , Bargetto M , Sapone V , Flageul O , Le Guicher G , Pickering G , Macian N , Cazaubiel M , Peltier S , Bard J M 
Published: June 2024

Abstract

Background/Introduction
Hypercholesterolemia is a major risk factor for cardiovascular diseases. Some polyphenols have shown promising potential in modulating circulating cholesterol. The polyphenol-rich active substance TOTUM-070 (T070) is a blend of five plant extracts that have previously demonstrated beneficial effects in preclinical models, and in subjects with moderate hypercholesterolemia when used at 5g/day for 12 weeks (the HEART study NCT04760951).

Purpose
The OLALIP study is an open-label, single-centre, single-arm, clinical trial designed to assess the effects of consuming TOTUM-070 at 2.5g/day for 6 weeks on lipid metabolism in individuals at an increased cardio-metabolic risk.

Methods
Thirty-one subjects were recruited, including men and women aged 18 to 70 years, with a BMI ranging from 18.5 to 35 kg/m2, and moderate hypercholesterolemia not requiring immediate pharmacological lipid-lowering treatment. The subjects received a daily dose of 2.5g of T070, divided into two administrations (BID), for 6 weeks. The primary outcome was to evaluate the effect of T070 on LDL-cholesterol (assessed by Friedewald formula). Secondary outcomes included the effects on total cholesterol (TC), HDL-cholesterol, non-HDL cholesterol, triglycerides, Apo-A1, Apo-B and free fatty acids (FFA).

Results
A total of 31 subjects completed the study (21 males and 10 females; age: 48.9 ± 11.5 years; BMI 26.6 ± 2.9 kg/m2). After 6 weeks of supplementation, LDL-cholesterol decreased by 10% (1.31 ± 0.2 vs 1.46 ± 0.2 g/L at baseline, p&lt;0.0001). In a subpopulation of subjects with a baseline LDL-cholesterol level ≥ 1.3 g/L (n=23), the reduction in LDL-cholesterol reached 13% (p&lt;0.0001). Moreover, 96% of the subjects in this subpopulation presented reduced LDL-cholesterol levels after 6 weeks of T070 supplementation. Among the secondary outcomes, there was a decrease in TC (-8%, p&lt;0.0001), non-HDL cholesterol (-11%, p&lt;0.0001), Apo B (-7%, p&lt;0.05) at the end of the supplementation period. HDL-cholesterol was not significantly modified.

Conclusion
The polyphenol-rich active substance T070 showed beneficial effects on hypercholesterolemia when administered at a daily dose of 2.5g for 6 weeks. This represents half the dose and duration of previous studies, highlighting the relevance of using T070 in the management of hypercholesterolemia.
Unlinking sudden death from coronary artery disease - a systematic scoping review of the association of low-density lipoprotein cholesterol and sudden death
Authors: Beyer R E , Parekh S N , Inigo J D , Chitroceanu A M , Day G R , Koehler A , Simpson Jr R J 
Published: June 2024

Abstract

Background
Sudden death (SD) is a common first manifestation of cardiovascular disease (CVD) and accounts for more than 350 000 deaths per year in the U.S. (1) Coronary artery disease is held accounted for up to 80% of SD cases. (2) Whilst low-density lipoprotein (LDL-c) is a major modifiable risk factor for atherosclerosis and CVD, (3) it is still unclear whether elevated LDL-c is associated with SD. Recent studies found conflicting results, (4,5) challenging our understanding of the pathogenesis of SD.

Purpose
To address this apparent paradox for the association of LDL-c with sudden death and to investigate the role of this risk factor in SD, we performed a systematic scoping review of the literature reporting on LDL-c and SD.

Methods
Our review followed PRISMA-Scr guidelines. A comprehensive search string was developed at the guidance of an experienced librarian. Two independent reviewers screened PubMed and EMBASE for peer-reviewed case-control and cohort studies with LDL-c as an exposure variable, and SD as outcome variable. Articles were reviewed in a two-step process of (a) title and abstract screening and (b) full-text screening. Disagreements were resolved through consensus.

Results
Of 1835 articles retrieved, 570 met screening eligibility criteria. Studies that did not include LDL-c as exposure and SD as outcome or did not provide effect sizes were removed. We identified 9 relevant studies from 1982 to 2015, conducted in the U.S., Europe, and Asia, with a total of 9,639 SD cases. Two studies found an increased risk of SD with higher LDL-c and 2 studies found the contrary. 4 studies did not identify LDL-c as an independent associate of SD. One cohort study found a U-shaped relationship where both higher and lower levels led to higher risk for SD. Spectrum of included study type was broad, and definition of sudden death varied among studies. Results are displayed in Table 1.

Conclusion
Unlike other risk factors for coronary artery disease, LDL-cholesterol does not show a consistent association with sudden death. Focusing solely on lipid reduction may have limited impact on sudden death incidence. This suggests that sudden death may be of more multifactorial nature and require comprehensive strategies for effective prevention.
Do triglycerides impact cardiovascular outcomes? A 10-year follow up study from a Portuguese cohort
Authors: Santos Moreira H , Mangas Palma P , Rocha M , Pinho A , Oliveira O , Santos L , Cabrita A , Marques C , Araujo V , Rocha A , Rodrigues J , Dias P , Lebreiro A , Rodrigues R 
Published: June 2024

Abstract

Introduction
Hypertriglyceridemia has long been described as a marker of increased cardiovascular (CV) risk, but the intricate interplay of triglycerides (TG) and CV events is still a matter of ongoing debate, with previous studies showing controversial data.

Purpose
The aim of this study was to determine whether TG level in very-high risk patients (pts) following acute coronary syndromes (ACS) are associated with major adverse CV outcomes at long-term follow-up (FUP). The primary composite endpoint included all-cause mortality and hospital admissions due to CV events.

Methods
We performed a retrospective analysis of ACS pts, referred to a cardiac rehabilitation program (CRP) after discharge, in our centre, between 2008 and 2018. Comprehensive data including information from index event and posterior FUP was collected through medical records review. Pts were subsequently stratified in two groups according to TG level: group A with TG &lt; 150 mg/dL and group B with TG ≥ 150 mg/dL. Statistical analysis was performed in SPSS software.

Results
A total of 591 pts were enrolled with a predominant male representation (85.3%) and a mean age of 55 ± 10 years old. The most frequent diagnosis at admission was ST segment elevation myocardial infarction (49.6%, 293 pts). Smoking history (77.3%) and hypercholesterolemia (61.6%; p=0.185) were the most prevalent CV risk factors. After the acute phase, all pts underwent CRP, with nutritional support and lipid-lowering therapies intensification, namely high intensity statins. At the end of CRP visits, with a median duration time of 11 (IQR 1) months, 23.2% of pts were included in group B, with a median TG level of 190 (IQR 75) mg/dL. Both groups had comparable demographic and CV features, including a similar metabolic profile with overall median LDL level of 79 (IQR 39) mg/dL (p=0.672). The mean FUP time of our cohort was 10 (± 2) years and was not significantly different between groups A and B (p=0.351). During FUP, 159 (26.9%) pts reached the primary endpoint, mainly at the expenses of recurrent ACS (91 pts, 57%). However, there were no statistically significant differences between groups regarding the occurrence of the primary outcome (122 vs 37 pts, p = 0.972), nor event free survival time (figure 1).

Conclusion
In agreement with some recent trials, our pragmatic study has found no long-term clinical impact associated with TG level in a large cohort of pts with previous ACS, followed for a long period of time. Further large scale randomized controlled trials are needed to comprehensively assess the significance of TG and their targeted therapies in the realm of secondary CV prevention.
The effects of two different exercise protocols in patients with good controlled type 2 diabetes mellitus: proprioceptive exercise vs resistive exercise
Authors: Kaya Aytutuldu G , Subasi F E R Y A L , Akinci B U K E T , Arslan G U L G U N 
Published: June 2024

Abstract

Background
Exercise has benefits on glycemic control, increasing exercise capacity, and muscle strength in patients with type 2 diabetes mellitus (T2DM). In the progression of T2DM, proprioceptive deficits may develop, which can cause inadequate muscle strength and neuropathy. Preventive strategies are needed for T2DM patients without neuropathy even in the early stage of disease. Proprioceptive exercises has a potential to improve dynamic balance through an increase in peripheral sensitivity, and prevent from neuropathy and reduction in falls associated with sensory deficits.

Purpose
To compare the effects of proprioceptive exercise training or resistive exercise training on glycemic control, functional capacity, dynamic balance, sensation and muscle strength in patients with good-controlled T2DM.

Methods
Thirty patients with good-controlled T2DM were randomized into Proprioceptive Training Group (PG) (n=15, mean %glycated hemoglobin (HbA1c)=6.85±0.58, mean age=51.6±8.09/years, 12 F, 3 M) and Resistive Training Group (RG) (n=15, mean %HbA1c= 6.8±1.1, mean age= 50.86±7.51/years, 12 F, 3 M). Fasting blood glucose (FBG) and glycated hemoglobin (HbA1c) were analyzed. Functional capacity assessed with six-minute walking test (6MWT) and dynamic balance was evaluated using a dynamic balance system (Prokin PK200 platform). Proprioception sense measured with angle reproduction test in direction of dorsiflexion and plantar flexion and deviation. Cortical sensation was evaluated with two-point discrimination test. Quadriceps and Ankle muscle strength were assessed with a digital hand-held dynamometer (JTech PowerTrack II Commander). All subjects were performed moderate intensity of aerobic exercise 3 times/week for 6 weeks. In addition, patients in PG continued the proprioceptive training for the lower extremities while RG performed moderate intensity lower extremity resistive training 2 times/week.

Results
Significant but not clinically important decrease in HbA1c and FBG were obtained in the groups. Functional capacity, and lower extremity proprioception, cortical sensation and muscle strength showed in-group improvements in both groups. PG also showed significant intragroup improvements in dynamic balance. The groups were similar in terms of obtained changes in all parameters after training (Table 1 and Table 2).

Conclusion
The proprioceptive training leads similar benefits with resistance training on functional capacity and lower extremity sensation, and muscle strength in patients with good-controlled T2DM. Besides, proprioceptive training can be considered to improve dynamic balance.
Effects of reducing sedentary behaviour on cardiac structure and function in adults with metabolic syndrome: a six-month randomised controlled trial
Authors: Norha J , Saarenhovi M , Kallio P , Sjoros T , Garthwaite T , Laine S , Laitinen K , Houttu N , Vaha-Ypya H , Sievanen H , Loyttyniemi E , Vasankari T , Knuuti J , Kalliokoski K K , Heinonen I H A 
Published: June 2024

Abstract

Background
The effects of reducing sedentary behaviour (SB) on cardiac structure and function remain unknown, yet reducing SB may have potential for heart failure prevention.

Purpose
The aim of this study was to investigate whether reducing SB could lead to healthy cardiac remodelling.

Methods
Sixty-four physically inactive adults with metabolic syndrome were randomised into an intervention (n=33) or a control (n=31) group. The intervention group aimed at reducing SB by 1 h/day for six months and increasing non-exercise activities or standing and the control group was advised to continue as usual. All participants wore accelerometers for SB and physical activity (PA) assessment during the whole study. Conventional echocardiographic measurements of cardiac structure and (resting) function were taken before and after the study.

Results
The intervention resulted in a 40 min/day reduction in SB and a concomitant 20 min/day increase in moderate-to-vigorous PA. In the main analyses, no intervention effects on any echocardiographic variable were observed. However, when the participants were re-grouped according to the measured change in SB (i.e., less sedentary group: SB reduction at least 3 %-points [~27 min/day] vs. continuously sedentary group: SB reduction &lt;3 %-points or increase in SB), left ventricular (LV) mass index and LV end-diastolic diameter decreased statistically significantly more in the less sedentary group (group x time p=0.045 and 0.020, respectively; Figure 1). In the whole study group, the change in light PA correlated inversely with the change in LV mass index (r=-0.32, p=0.026). Furthermore, the change in standing correlated with the change in E/e’ ratio (r=0.28, p=0.048).

Conclusion
An intervention aimed at reducing SB by 1 h/day was not sufficient at affecting cardiac structure or function. However, successfully reducing SB may lead to healthy LV remodelling. Figure 1
Physical activity and autonomic function in patients with heart failure: a mediation analysis of functional exercise capacity
Authors: Tanriverdi A , Ozcan Kahraman B , Ozpelit E , Senturk B , Akdeniz B , Yilmaz M B , Savci S 
Published: June 2024

Abstract

Background
Daily physical activity is associated with autonomic nervous system activity in patients with heart failure (1). However, there is a lack of information on whether functional exercise capacity has a mediating effect on the relationship between physical activity and autonomic function in patients with heart failure.

Purpose
To investigate the mediating effect of functional exercise capacity on the relationship between physical activity and autonomic function in patients with heart failure.

Methods
Patients with heart failure with reduced ejection fraction (HFrEF) were enrolled in this cross-sectional study. Autonomic function was evaluated with the heart rate variability analysis obtained from ECG recording. Physical activity was objectively assessed with an accelerometer. Functional exercise capacity was evaluated with the six-minute walk test (6MWT). The mediation model was tested with the SPSS Hayes process macro (model 4) (2).

Results
We included 61 patients with HFrEF (mean age 61.9 8.5; mean ejection fraction 31.26 6.62). The majority of patients were male (70.8%), overweight (45.8%) and NYHA functional class II (56.9%). The root mean square successive differences (RMSSD) index was significantly correlated with daily moderate to vigorous physical activity (MVPA) (r=0.528, p&lt;0.001), and six-minute walk distance (6MWD) (r=0.594, p&lt;0.001). The standard deviation of all normal RR intervals (SDNN) index was significantly correlated with daily MVPA (r=0.467, p&lt;0.001), and 6MWD (r=0.490, p&lt;0.001). The direct effect of MVPA on RMSSD was still statistically significant (B = 0.161 95% CI 0.006 to 0.316) after adding 6MWD. 6MWD partially mediated the effect of MVPA on RMSSD (indirect effect (B) = 0.159 95% CI 0.082 to 0.283), with the mediating effect accounting for 49.69% of the total effect. However, after adding 6MWD, the direct effect of MVPA on SDNN was removed (B = 0.171 95% CI -0.005 to 0.348), indicating that 6MWD completely mediated the relationship between MVPA and SDNN (indirect effect (B) = 0.125 95% CI 0.044 to 0.218).

Conclusion
Functional exercise capacity mediates the relationship between physical activity and autonomic function in patients with HFrEF. These findings indicate that improving functional exercise capacity through a structured exercise program, physical activity counselling, or both, may enhance autonomic function in patients with HFrEF. Figure 1. Correlations between variables.
Evaluating a dietetic educational intervention delivered to patients during hospital-based cardiac rehabilitation (CR)
Authors: Akl N , Cullen K C , Gallagher J G , Cahill A C , Hannon B H , Carroll L C , Dodd D D , Bryceland C B , Mulligan E M 
Published: June 2024

Abstract

Background/Introduction
Cardiac rehabilitation (CR) is an outpatient chronic disease management model recommended in clinical practice guidelines for patients with all forms of atherosclerotic cardiovascular diseases (ASCVD). Nutrition counselling is a core component of the prevention of non-communicable diseases including cardiovascular disease. While striving to deliver care in line with clinical practice guidelines, it is equally important to communicate nutritional information in an accessible way which accommodates varying degrees of health literacy. Therefore, effective delivery of dietetic educational intervention is an integral part of CR. Furthermore, measurement of treatment effectiveness and patient satisfaction are also recognized as important indicators of healthcare quality.

Purpose
To evaluate the effectiveness of the nutritional intervention in CR by (a) assessing improvements in patient’s baseline nutritional knowledge post-intervention; and (b) evaluating patients’ satisfaction with the dietetic intervention provided during CR.

Methods
The group educational intervention was informed by ESC (2021) guidelines and delivered in a discursive manner with patients encouraged to play an active role in the process. To evaluate the intervention a short battery of measures were administered to patients pre and post intervention over a 4-month period (April-August 2023). The study-specific questionnaire was based on the validated GNKQ (General Nutrition Knowledge Questionnaire) which was specifically adapted for the CR population.

Results
Participants were predominantly referred following Acute Coronary Syndrome (ACS), coronary artery disease (CAD) ± revascularization and valve disease (78% male, mean age 62 years). Thirty patients completed both the pre and post intervention evaluation measures (response rate 63%). Post intervention, 29 patients scored &gt;60% on the nutritional knowledge measure (compared to 23 at baseline); 60% of patients were able to identify HDL as the good cholesterol (compared to 43% of patients not receiving the intervention). 77% of patients correctly answered the food labelling question after attending the dietetic session (compared to 63% of patients at baseline). 83% were also able to identify the recommended units of alcohol correctly compared to 47% of patients who did not receive the intervention. 18% of participants provided additional qualitative data which primarily indicated that patients viewed that their nutritional knowledge had improved but that further dietetic input was required.

Conclusion
Nutritional counselling is a core component of CR and the dietitian remains a vital member of the CR multi-disciplinary team. Although the dietetic intervention was successful in improving educational outcomes in some patients, resources should be directed to ensure patients receive optimal dietetic input and thus high-quality CR.
The effect of expiratory muscle strength training on oxidative stress and functional exercise capacity in patients with obstructive sleep apnea syndrome
Authors: Erturk N , Yaman H , Kahraman Yaman S , Celik A , Unal F , Calik Kutukcu E 
Published: June 2024

Abstract

Introduction
Obstructive sleep apnea syndrome (OSAS) is a respiratory sleep disorder with a risk of cardiovascular disease (CVD). Repeated episodes of hypoxemia and reoxygenation throughout the night lead to oxidative stress in OSAS. Expiratory muscle strength training (EMST) is a new effective intervention increasingly used in the rehabilitation of OSAS. In the literature, there is limited evidence about the effects of EMST in patients with OSAS.

Objective
We aimed to investigate the effect of EMST on CVD risk, oxidative stress and functional exercise capacity in patients with moderate OSAS who were refused or ineligible for other treatments.

Methods
Sixteen male patients (mean age: 44.12±6.13 years, mean BMI: 30.08±4.43 kg/m2) with moderate OSAS were included. CVD risk ratio calculated with SCORE2. The patients underwent a 12-week EMST program (60% of their maximal expiratory pressures, MEP) using a threshold loading device for 25 breaths per day, seven days per week. Respiratory muscle strength (inspiratory muscle strength-MIP and MEP) was measured. Total antioxidant level (TAS) and total oxidant level (TOS) were determined from serum blood samples. Oxidative stress index (OSI) was calculated. Functional exercise capacity was determined with a 6-minute walk test (6MWT).

Results
At baseline the patients SCORE 2 were min 1%-max 13%. After the 12-week EMST program, there was no significant difference in TAS values (p=0.205), while a significant decrease was observed in TOS (p&lt;0.001) and OSI (p&lt;0.001). MIP (p&gt;0.001), MEP (p&lt;0.001), 6MWT distance (p=0.001) significantly increased after training. No significant difference was observed in SCORE 2 ratios before and after treatment (p&gt;0.05). There was a positive correlation between the ∆OSI and ∆6MWT distance values (r=0.603, p=0.013).

Conclusion
EMST decreases oxidative stress levels and increases respiratory muscle strength and functional exercise capacity in moderate OSAS patients. The rate of reduction in oxidative stress was associated with an increase in exercise capacity. EMST training is a promising treatment modality for OSAS.
Sport-related acute myocardial and tobacco smoking; findings from a regional prospective registry
Authors: Chague F , Kouame I , Braghini N , Bichat F , Maza M , Saint Jalmes M , Porot G , Molins G , Mock L , Ravisy J , Lhuillier I , Vincent-Martin M , Cottin Y , Zeller M 
Published: June 2024

Abstract

Background
Cigarette consumption is a major cardiovascular (CV) risk factor, especially when smoking just before or during exercise. Only few data are available on smoking in sport-related myocardial infarction (SR-MI).

Methods
We analysed characteristics of the smokers of IMACS, a regional prospective multicentre cohort including all patients hospitalised for a SR-MI. SR-MI was defined as MI onset occurring during sport or within the 1st hour of recovery. A one-year follow-up was performed by phone call.

Results
From April 1st 2018 to October 17th 2023, 151 SRMI were included, of whom 13 (8.6%) were female, median age was 61-y. and 39 (25.8%) were current smokers, of whom only 1 was woman (Table). Cycling was the most frequent sport (33.8%) followed by fitness (11.9%), jogging (11.3%) and hiking (10.6%). (Figure). When compared with non-smokers, smokers were 6.5 -y younger (P = 0.001). However, the rate of CV risk factor, STEMI, CV history and prodromal symptoms before the sport session were similar whatever smoking status. Among smokers, 26 (66.7%) declared cigarette consumption within the 2 hours before the sport session or the event. Out of hospital cardiac arrest (OHCA) occurred in 19 (12.6%) patients, more commonly among patients with prior coronary artery disease (CAD) (p = 0.04). OHCA was more common among smokers (p = 0.04); 8 of them (88.9%) had smoked within the 2 hours before the sport session or the event. At follow-up, only one patient suddenly died 8 days after discharge and another one benefitted from cardioversion delivered by its implanted automatic defibrillator (while doing do-it-yourself). Among the survivors at one year follow-up (131 patients, no patient lost in follow up), 97 benefitted from a rehabilitation program and 30 from the 34 smokers quitted. Among the quitters, 5 switched to electronic cigarette.

Conclusions
Although smoking is at high CV risk, especially in the setting of sport, the rate of smokers remains high (&gt; 25%) in patients hospitalised for SR-MI. Moreover, almost two-third had smoked just before the event and appeared associated with occurrence of OCHA. These data highlight the need for prevention programs aiming to reduce the risk of tobacco, especially in sport setting. Figure.