bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in mortality due to cardiovascular diseases among people aged 65 and over in Poland from 2000 to 2019
Authors: Monika Burzynska M B , Malgorzata Pikala M P 
Published: June 2024

Abstract

Background
Demographic forecasts predict that in 2050 the percentage of people aged 65 years and over in Poland will be nearly 40%. The main cause of death in this age group is cardiovascular disease, accounting for 41.1% of all deaths. The risk of developing the disease increases with age which poses a challenge to the health care system and public health.

Purpose
The aim of the study was to assess changes in mortality due to cardiovascular diseases among people aged 65 and over in Poland from 2000 to 2019.

Methods
The study used a database of all deaths of Polish residents aged 65+ due to cardiovascular diseases (I00-I99). Trends have been analysed in two age groups: early old age (65-74 years) and late old age (over 75 years). The analysis has been carried out with the use of joinpoint models. The Annual Percentage Change (APC) for each segments of broken lines, the Average Annual Percentage Change (AAPC) for the whole study period (95% CI), and standardized death rates (SDRs) were calculated.

Results
Diseases of the circulatory system were the most common major group of causes of death among Polish residents aged over 65 years. The percentage of deaths due to diseases of the circulatory system decreased in all the studied subgroups in analysed period. The fastest percentage decline was observed in the group of women in early old age. The standardized death rate in this group decreased from 1027.3 in 2000 to 471.5 in 2019 (AAPC=-4.1%, p&lt;0.05). Among cardiovascular diseases, ischemic heart diseases were the most common cause of death, except for women in late old age, where it was diseases of arteries, arterioles and capillaries. The third most common cause of death in the cardiovascular disease group was cerebrovascular diseases. In each of these mentioned subgroups of causes of death among diseases of the circulatory system, in all the analysed gender and age subgroups, decreasing trends were observed in the analysed period. However, more detailed analyse show that SDRs due to ischemic heart disease have been increasing for a few years. In the early old age group of women and men, the upward trend began in 2015 and 2016 (APC=2.1% and 2.0%). In the late old age group of women and men, the increase in SDR between 2014 and 2019 was statistically significant. APC was 3.5% in the female group and 2.5% in the male group (p&lt;0.05).

Conclusions
In the population of elderly people, the greatest health risks are cardiovascular diseases, primarily ischemic heart disease. This indicates the need to focus on health education, prevention, mainly in the areas of modifiable risk factors such as physical activity, eating habits, alcohol and tobacco consumption, and health promotion from an early age.
Cardiopulmonary exercise test registry for patients with obesity: comparison of cardiorespiratory fitness prediction equations and generation of a new predictive model for patients with obesity
Authors: Vecchiato M , Aghi A , Nerini R , Borasio N , Gasperetti A , Quinto G , Battista F , Bettini S , Di Vincenzo A , Neunhaeuserer D , Busetto L , Ermolao A 
Published: June 2024

Abstract

Introduction
Cardiorespiratory fitness (CRF) is a critical marker of overall health and a key predictor of morbidity and mortality, but the existing prediction CRF equations are primarily derived from general populations and may not be suitable for patients with obesity (PwO).

Purpose
This study examined the use of non-exercise prediction equations for estimating CRF (pCRF) in PwO and evaluated their accuracy compared to directly measured CRF (mCRF) through cardiopulmonary exercise testing (CPET).

Methods
pCRF from different non-exercise prediction equations was compared with mCRF of PwO who underwent maximal CPET. Multiple linear regression was used to develop a non-exercise prediction model for treadmill including age, sex, BMI, and physical activity level.

Results
660 PwO underwent CPET during the study period (age = 44.2 ± 11.3 years, female = 69%, BMI = 41.8 ± 6.8 kg/m2). R2 values had a range of 0.24-0.46 with standard error of estimate ranged from 2.84-3.26 ml/kg/min. pCRF was statistically different from mCRF for 19 included equations. Only 50% of PwO were correctly classified into the mCRF categories according to pCRF. A multivariable model for a treadmill CRF prediction was generated (R2 = 0.57; standard error of estimate = 1.12 ml/kg/min) and validated using two cross-validation methods.

Conclusions
Most used equations provided inaccurate estimates of CRF in PwO, particularly in cases of severe obesity and low CRF. Therefore, a new prediction equation was developed and validated for PwO, offering a more precise tool for clinical CPET interpretation and risk stratification in this specific population. Figure 1 Figure 2
Association between the obesity and outcomes after out-of-hospital cardiac arrest - does sex matter?
Authors: Czapla M , Domenech-Briz V , Lewandowski L , Juarez-Vela R , Smerka J , Gea-Caballero V , Martinez-Sabater A 
Published: June 2024

Abstract

Introduction
Out-of-hospital cardiac arrest (OHCA) is a global public health problem. Obesity is one of the factors that reduces the odds of a return of spontaneous circulation (ROSC). The aim of this study was to assess whether there are sex differences in the prognostic impact of obesity on ROSC in OHCA patients.

Methods
A retrospective study and analysis of 33,636 (female: 12,000 and male: 21,636) medical records of patients with OHCA (ICD 10-I46) in Poland from 01.2021 to 06.2022 was performed. Patient comorbidity, information on: obesity, location of OHCA and initial rhythm were collected. Statistical analysis was performed using Python 3.9.13.
The study was approved by the Independent Bioethics Committee of the Medical University of Wroclaw (No KB-895/2022).

Results
There was no difference in age between the two sexes. Upon subsequent stratification of the two sexes by obesity status, a markedly higher incidence of diabetes(p&lt;0.001), hypertension(p&lt;0.001), and heart failure(p&lt;0.001) was observed, regardless of sex. In the univariate model, obesity decreased the odds of ROSC by 25.47% among women (p ≈ 0.034) and 19.76% (p ≈ 0.035) among men. In full model, obesity became insignificant (p ≈ 0.051) (Table 1). In models with all factors, the individuals with the VF/pVT initial rhythm were 4.204-fold more likely (vs. Asystole/PEA) to develop ROSC among the female individuals, but only 3.655-fold more likely among male individuals. If OHCA happened in a public place, both sexes showed similar, over 2-fold increase in odds of ROSC (2.204 among females, 2.130 among males). The impact of age on these odds was similar among the two sexes, decreasing the odds for ROSC (by 1.21% and 1.52% in women and men, respectively, per one-year increase in age). After stratification by both sex and obesity (Table 2), several factors appeared to have a different influence on the odds for ROSC. Although the public place location greatly increased the odds for ROSC among both sexes, women showed to have significantly lower location-associated OR if they were obese (2.126 vs. 4.264 in obese and non-obese women, respectively). Moreover, exclusively among non-obese women, hypertension decreased the odds of ROSC by 11.11% (p ≈ 0.032).

Conclusion
In both men and women, OHCA in a public place and an initial VF/pVT rhythm increased the odds of ROSC, while age (per one-year increase in age) decreased the odds. However, in women without obesity, VT/pVT increased the odds of ROSC by more than 4.2 times and in women with obesity by 2.7 times. In men without obesity, the initial VF/pVT rhythm increased the odds of ROSC by 3.7-fold and in men with obesity by only 1.9-fold. No such discrepancies were observed for OHCA location and age, where the odds of ROSC were similar. Prevention of obesity should be a global health priority.
Fat mass index in coronary artery disease patients and its associations with risk factors
Authors: Novakovic M , Salgueiro D , Pires M , Borges M , Sa G , Pinto F J , Fras Z , Abreu A , Pinto R 
Published: June 2024

Abstract

Introduction
Cardiac rehabilitation (CR) after a coronary artery disease (CAD) event is recommended to improve risk factor control, as some of them remain poorly controlled (e.g. obesity, physical activity), while new ones are emerging (e.g. sedentary behaviour). The aim of our study was to examine how traditional risk factors, physical activity and sedentary behaviour affect body fat mass in CAD patients.

Methods
In this cross-sectional study, CAD patients entering a community-based phase III CR were assessed for the following: a) fat mass index (FMI) assessed by dual-energy radiographic absorptiometry; b) physical activity level and sedentary behaviour wearing an accelerometer; c) cardiopulmonary exercise testing; d) lipid profile.

Results
There were 111 CAD patients, their average age was 61.7 ± 9.8 years, 15 (13.5%) were female. Patients were divided into three groups, based on the FMI: normal (n=19), overweight (n=62) and obese (n=30). Obese patients, compared to patients with normal FMI, had significantly higher systolic blood pressure (120 (112-130) vs. 104 (94-120) mmHg, p=0.019), total sedentary time (4773 (4315-5196) vs. 4372 (4188-4612) minutes/week, p=0.029) non-HDL and triglycerides levels (97 (80-129) vs. 78 (63-96) mg/dL, p=0.024, and 100 (79-160) vs. 91 (69-110) mg/dL, p=0.032, respectively). On the contrary, there were no significant differences in physical activity level, diastolic blood pressure, total cholesterol, HDL and LDL cholesterol. In a multivariate linear regression analysis, sedentary time emerged as an independent predictor of FMI, while physical activity level was not.

Conclusion
Obese CAD patients have poorer control of blood pressure, lipid status and sedentary behaviour when compared to normal and overweight CAD patients. New strategies are needed to reduce sedentary behaviour in this population, which may induce a parallel reduction in body fat.
Carotid intima-media thickness progression and plaque formation in recreational male endurance athletes - a 10-year follow-up study
Authors: Schoenfeld J , Schindler M J , Fegers-Wustrow I , Pressler A , Wolfarth B , Haller B , Halle M , Scherr J 
Published: June 2024

Abstract

Background
Lifelong endurance exercise is associated with increased arteriosclerosis and, in particular, an accelerated rate of coronary artery calcification (CAC) and higher plaque burden. The mechanisms underlying the progression of CAC remain incompletely understood.

Purpose
We aimed to determine the potential pathomechanism for carotid artery plaque formation or accelerated carotid intima-media thickness (cIMT) progression in recreational male endurance athletes after a follow-up of 10 years.

Methods
Middle-aged (43±8 years) former participants (healthy male marathon runners) of the Beer, Marathon, Genetics, Inflammation, and the Cardiovascular System (Be-MagIC) study who ran&gt;10 km/week or cycled &gt;20 km/week and participated in &gt;5 endurance competitions during the last 10 years underwent baseline and 10-year morphological assessment using carotid ultrasound. Sporting characteristics were assessed via a questionnaire and cardiopulmonary exercise tests. Plaque formation and cIMT progression were defined as follows: Plaque at baseline and/or after 10 years of follow-up. Progression in cIMT was calculated from baseline to 10-year follow-up. Linear and logistic regression analyses were performed to determine the association between age, body fat, resting systolic blood pressure, fasting glucose, total cholesterol at baseline, loading systolic blood pressure max. at 10-year follow-up, km per week during the last 10 years and cIMT progression/plaque formation.

Results
A total of 96 former male marathon runners were included. Former runners ran for a median of 30 [interquartile range, IQR 20-40] km per week and participated in an average of 26 (min-max: 5–508) endurance events during the last 10 years. After 10 years, the V02peak amounted to 42.8±7.9 mL/min/kg. cIMT increased from 0.57mm [0.51 – 0.66mm] to 0.62mm [0.55 – 0.73mm] (p&lt;0.001) after 10 years. Plaque was present in 21% at baseline and 37% after 10 years (p&lt;0.001). In total, 20% of the previous plaque-free participants developed new plaque during the 10-year follow-up. No significant association in the progression of cIMT with the investigated variables was observed (Figure 1). Plaque formation showed an independent significant association with age, body fat, and km per week (odds ratio [95%CI]: 1.24 [1.12 to 1.36], p&lt;0.001; 1.15 [1.02 to 1.31], p=0.019 and 0.97 [0.94 to 0.99], p=0.016, respectively, Figure 1). Furthermore, no indications of non-monotonic correlations were found.

Conclusion
The mean progression of cIMT in male recreational athletes was 0.05mm per year. The percentage change of plaque in recreational endurance athletes after 10 years was 76%. Furthermore, age, body fat, and km per week were associated with plaque progression during the 10-year follow-up in male endurance athletes.
Exercise behavior and its impact on structural and functional parameters in patients with arrhythmogenic (right ventricular) cardiopathy
Authors: Blaettler R , Bohm P , Brunckhorst C , Niederseer D , Duru F , Saguner A , Schmied C 
Published: June 2024

Abstract

Introduction
The impact of exercise on patients with Arrhythmogenic (Right Ventricular) Cardiopathy (ARVC/VC) is particular and comprises two crucial factors: Beside a massively increased risk for exercise-induced arrhythmia, there is evidence that exercise may worsen structural and functional cardiac parameters. However, regular exercise leads to undisputed health benefits, particularly in the prevention of cardiovascular disease. The aim of our study was to assess exercise behavior in a cohort of ARVC/AC patients and to analyse its impact on arrhythmia and other cardiac parameters.

Methods
44 patients with ARVC/AC, carrying an ICD, were assessed regarding their exercise behavior during the last 5 years and their aims and fears when it comes to regular sport. The results of two established questionnaires (modified GPAQ und IPAQ) were correlated with data from ICD, echocardiography and laboratory examinations during this period.

Results
Only one third (35.2%) of the ARVC/AC patients (average age 52.7, 29.5% females) met the current recommendations for regular exercise of the World Health Organisation (WHO). Although 79% of the patients expressed the wish to do more sport, 50% had fear for sudden cardiac arrest, in 35.3% physician’s restrictions and in 14.7% a lack of physical capacity prohibited sufficient physical activity. During a 5 year observational period, no significant correlation with negative structural or functional cardiac affections or relevant arrhythmia could be found.

Conclusion
The exercise behavior of ARVC/AC patients is insufficient and most of the patients not even reach the lower cut-off for health benefits. Although most of the patients wish to do exercise and perform regular sport, there are widespread fears of a fatal outcome or restrictions, even on the basis of daily life physical efforts. Despite the fact that concise exercise recommendations for ARVC/AC patients still have to be defined, the lack of sufficient physical activity is alarming and patients should be motivated and reassured for adequate exercise behavior in everyday life.
Measuring and monitoring VO2max with an innovative, noninvasive and time efficient device before, during and after a 5 month sports program
Authors: Beier C , Wicharz J 
Published: June 2024

Abstract

Background/Introduction
In recent years, the scientific importance of measuring, estimating, and monitoring cardiorespiratory fitness has increased due to new methods and applications of noninvasive measurement techniques like seismocardiography (SCG). In our study, we have used a noninvasive seismographic device (figure 1) to measure and monitor the change in VO2max achieved by a sports program in healthy volunteers as a measure of cardiovascular fitness.

Purpose
The aim of the study was to show that the usage of a noninvasive seismographic device allows for an intuitive and quick way of determining the personal individual fitness level by VO2max measurement. Furthermore, the study aimed at showing that improvements in cardiorespiratory fitness due to training programs can be measured by the noninvasive and intuitive seismographic device.

Methods
The device measures vibrations that arise from heart beats and are transmitted to the chest. The sensor communicates with an accompanying app via Bluetooth® (subject height, weight, age and gender are entered). The recording of the signal takes about 45 seconds. The signal is transferred to secure servers and being analyzed. The estimated VO2max is being calculated. The tool’s validity and reliability have been proven in previous trials. We recruited a total of n = 30 healthy German volunteers between 46 and 65 years of age (ø 57.4 ± 5.3 years, 43.33% female) who voluntarily participated in a 5-month training program with the goal of running a half-marathon at the end of the program. VO2max (ø 30.56 mlO2/min/kg ± 6.75) was measured at each visit with the device to allow for comparisons over time. As control variables, weight (ø 79.9 kg ± 18.34), BMI (ø 26.8 kg/m² ± 4.37) and resting heart rate (ø 67.17 bpm ± 10.57) were also recorded at baseline and at each of the 9 training visits.

Results
All 30 participants completed the training program, and n = 25 (83.33%) finished the half-marathon. At the final measurement after 5 months of training initiation VO2max measured by the device increased by 2.59 mlO2/min/kg (± 4.89, p = 0.007) as compared to baseline. The participants also reported improvements in weight (- 2.82 kg ± 3.21, p &lt; 0.001), BMI (- 1.07 kg/m² ± 1.13, p &lt; 0.001) and resting heart rate (- 4.28 bpm ± 10.59, p = 0.035). Measurements of VO2max with the intuitive seismographic device were rated as uncomplicated and easy by all participants.

Conclusion(s)
The device (figure 2) proved to be an intuitive and time efficient method of noninvasive VO2max measurement. The results confirmed that VO2max is an indicator of cardiovascular fitness as participants showed improvements not only in VO2max, but also weight, BMI and resting heartrate. We promote the use of the intuitive seismographic device to measure and monitor VO2max as an indicator of cardiovascular fitness. seismographic device and necessary input. results displayed on the mobile phone.
The assessment of the impact of physical exercise level on the quantity of endothelial cell precursor progenitor cells in patients after ACS on the background of cardiac rehabilitation measures
Authors: Kovalchuk Y , Tereshchenko N , Shumakov V , Malynovska I , Belyaeva D 
Published: June 2024

Abstract

Introduction
At the present stage, there are discussions about the predictive value of the level of progenitor cells of endothelial cell precursors (EPCs) in peripheral blood for cardiovascular complications in high-risk patients, particularly after acute myocardial infarction. Since endothelial dysfunction is one of the initiating mechanisms of myocardial infarction, it is important to assess the risks of recurrent cardiovascular events in patients during cardiac rehabilitation with increased physical exercise.

Objective
To identify the correlation between the restoration of physical exercise tolerance (PET) level and the quantity of EPCs in peripheral blood of patients after acute coronary syndrome (ACS).

Materials and methods
Ninety male patients were examined, including 79 (87.8±6.8%) with a diagnosis of myocardial infarction, of which 65 (82.3±8.4%) had STEMI and 14 (17.7±8.4%) had NSTEMI, and 11 (12±6.8%) with unstable angina. Among the comorbidities, hypertension was present in all patients (100±4.1%), diabetes mellitus in 23 (25.6±9.0%), obesity in 25 (27.8±9.3%), and overweight in 29 (32.2±9.7%). Grade II heart failure was observed in 65 patients (72.2±9.3%). The mean age of the examined patients was (56.5±10.5) years. Coronary angiography revealed atherosclerotic involvement of one vessel in 23 patients (25.6±9.0%), two vessels in 26 (28.9±9.4%), and three vessels in 41 (45.6±10.3%). Hemodynamically significant three-vessel involvement was found in 24 patients (26.7±9.1%), two-vessel involvement in 31 (34.4±9.8%), and one-vessel involvement in 35 (38.9±10.1%).
All patients underwent exercise testing using the graded exercise method, assessment of intracardiac hemodynamics using two-dimensional and Doppler echocardiography, coronary angiography, biochemical and general clinical blood tests, and quantification of EPCs levels in peripheral blood. The results are presented as the mean value with standard deviation or frequency with a 95% confidence interval.

Results
The obtained data indicate that there is an associative relationship between better restoration of PET levels after acute coronary syndrome and the restoration of endothelial function in patients with a favorable course of the post-infarction period during repeated examination, compared to patients whose PET levels did not exceed 50 watts (low PET). This is evidenced by a statistically significant higher number of EPCs after physical exercise in the group with a favorable course and high PET (Group A) compared to the group with an unfavorable course and low PET (Group B).

Conclusions
Studying the response in terms of changes in EPCs quantity in response to physical exercise can help determine the progression of systemic endothelial dysfunction, which affects the patient's prognosis.