bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of exercise blood pressure response with subclinical abnormalities of cardiac remodeling and function in middle-aged women
Authors: Piche M , Paquin A , Gigleux I , Premont C , Marin-Couture E , Mathieu M A , Neyron A S , Couture P , Despres J P , Lamarche B 
Published: June 2024

Abstract

Background/Introduction
Hypertension is the most common risk factor in women and confers the highest risk for developing heart failure among women. Hypertensive response to exercise (HRE) is observed in individuals with normal resting blood pressure (BP). An excessive elevation of systolic BP (SBP) during exercise has been independently associated with future hypertension and the development of heart failure. However, limited evidence exists on the associations of exercise SBP response and subclinical abnormalities of cardiac remodeling and function in women.

Purpose
We examined the association between the SBP response to exercise and parameters of subclinical cardiac remodeling and function in middle-aged women.

Methods
150 normotensive women with abdominal adiposity (waist circumference &gt;80 cm) and without cardiac condition were recruited. None were treated for BP. Anthropometric, metabolic and echocardiographic data were collected. Exercise BP was assessed during a maximal exercise treadmill test. All exercising BP measurements were collected manually using standard auscultatory methods according to current guidelines. HRE was defined as ≥90th percentile from age- and sex-specific normative data. Standard echocardiography and speckle tracking echocardiography were obtained.

Results
A total of 126 women (66% menopausal) aged 54 ± 11 years and pre-test resting SBP of 114 ± 9 mmHg were included. Women with HRE (n=30, 24% of women) had similar age and BMI compared to women without HRE (p&gt;0.05). Waist-to-hip ratio and resting SBP (118±8 vs 112±9 mmHg) were higher in the HRE group (p&lt;0.05). Exercise duration and metabolic equivalents were comparable between women with or without HRE (p&gt;0.05). Abnormalities of cardiac remodeling (increased left ventricular (LV) wall thickness and LV mass) were found in women with HRE (p&lt;0.01). No difference was between groups observed for parameters of diastolic function (mitral velocities and the E/A ratio, left atrial dimension, and the E/E' ratio) and systolic function (LV global longitudinal strain) after adjustment for age (all p&gt;0.05). In univariate analyses (all women), maximal SBP was significantly associated with pre-test resting SBP, LV wall thickness, and LV mass, all p&lt;0.01). In multivariate analyses, maximum exercise SBP remained independently associated with cardiac remodeling indices (p&lt;0.01).

Conclusion
Normotensive women with abdominal obesity and exaggerated exercise BP response are more likely to have adverse cardiac remodeling, which may predispose toward the development of heart failure. An excessive exercise BP in women may be an inexpensive screening tool to identify women at highest risk for developing future hypertension and heart failure.
Age-standardized comparison of cardiovascular events and all-cause mortality in people living with HIV and in general population
Authors: Camps-Vilaro A , Teira R , Subirana I , Domingo P , Curran A , Galindo M J , Montero M , Romero A , Guerri R , Degano I R , Marrugat J 
Published: June 2024

Abstract

Background
Antiretroviral therapy (ART) has improved the prognosis of HIV infection, but people living with HIV (PLWH) still experience disparities in life expectancy and comorbidities prevalence.

Purpose
This study aimed to compare the standardized incidence rates of atherosclerotic cardiovascular disease (ASCVD) and all-cause mortality between PLWH and the general population in Spain.

Methods
Two cohorts were included: the VACH cohort (PLWH) and the REGICOR cohort (general population). Participants aged 25-74 years without prior ASCVD were followed for a duration of 15 years. Baseline data on demographics, cardiovascular risk factors, and comorbidities were collected. Fifteen-year ASCVD incidence [coronary artery disease (CAD) and stroke] and all-cause mortality rates were standardized by age. Incidence of ASCVD and all-cause mortality were compared between the cohorts using the log-rank test and Cox proportional hazards models. All the analyses were stratified by sex and age groups (25-54, and 55-74 years).

Results
We included 10,218 general population participants and 6,829 PLWH. PLWH were 12 years younger, predominately male, and they had elevated triglyceride levels and a higher incidence of smoking compared to the general population. In contrast, they had lower levels of LDL cholesterol, total cholesterol, and BMI. Men with HIV aged 25-54 years had significantly higher ASCVD standardized incidence rates compared to men in the general population. No significant differences were observed in old men and young women in incidence rates. Both young men and women with HIV had significantly higher all-cause standardized mortality rates compared to the general population (Table 1). After adjusting for ASCVD risk factors, no significant difference remained in the risk of CAD and stroke among PLWH and the general population. However, the adjusted risk of all-cause mortality was 3-5 times higher in PLWH (Table 2).

Conclusion
The higher incidence of ASCVD among PLWH as compared to general population is explained by differences in the prevalence of risk factors. All-cause mortality risk in young PLWH, however, was almost three times higher that of general population.
Feasibility exergaming as a physical activity for older adults: a systematic literature review
Authors: Klompstra L , Stromberg A , Jaarsma T , Rytterstrom P 
Published: June 2024

Abstract

Background
Physical activity among older adults is important for both primary and secondary prevention of cardiovascular disease (CVD). Increases in physical activity by any level are associated with reduced cardiovascular risk, and physical activity contributes to overall well-being by managing risk factors, enhancing cardiovascular function, and supporting a healthy lifestyle for individuals already affected by CVD.
Exercising with virtual reality technology has the potential to improve physical activity. Exergaming (a combination of exertion and video games) has an effect equivalent to other types of exercising on improving walking distance in older adults. To implement exergaming in cardiovascular care of general prevention of CVD feasibility for older adults using exergaming should be considered.

Purpose
To assess the feasibility of exergaming in older adults based on the experiences of acceptability, demand, implementation, and practicality of exergames.

Methods
A systematic literature review based on qualitative research. We assessed 4 online electronic databases (PubMed, Scopus, CINAHL and Web of Science) in December 2023 for peer-reviewed literature. The following search string was utilized across the databases: ((exergames OR exergaming OR active AND video AND games) AND (experiences OR perceptions OR attitudes OR views) AND (qualitative AND research OR qualitative AND study OR qualitative AND methods OR interview) AND (elderly OR aged OR older OR elder OR geriatric)).

Results
In total 158 articles were identified by the databases, whereof 31 were included in the analysis (see figure).
Acceptability: Participants found exergaming enjoyable, especially with social interaction. Exergaming was seen a part of functioning in daily life.
Demand: Exergaming was seen as physical and cognitive demanding. There could be technical (e.g. visuals in fast space) and safety (e.g. difficulties maintaining balance) challenges with exergaming.
Practicality of exergaming: Introducing exergaming to older adults necessitates a thorough familiarization process. It is crucial for them to receive a comprehensive introduction, they should receive written and video instructions, along with follow-up calls to provide motivation for engaging in exergaming. Moreover, exergaming should be possible within the home environment.
Implementation: To be able to follow improvement and being challenged in the exergame was seen as important to implementation. Participants expressed how to implement exergaming into their daily life and the importance that exergaming was age appropriate.

Conclusion
Exergaming is feasible for older adults and could be considered for use in preventive cardiology to stimulate physically activity. The study also helps to identify specific adaptations that need to be made to accommodate older adults.
Treatment method and adherence in patients with hypertension and type 2 diabetes mellitus
Authors: Swiatoniowska-Lonc N 
Published: June 2024

Abstract

Introduction
Type 2 diabetes (DM) and hypertension (HA), are recognized as a leading health, social and economic problem. The prevalence of HA among Polish adults is 31%, of which 70% are patients with DM. The treatment regimen for type 2 DM is often complex and includes elements of behavioral therapy, pharmacotherapy and insulin therapy. However, in order for the patient to adhere to the therapeutic regimen, treatment must be tailored to the patient's capabilities. The more difficult the therapeutic regimen, the lower the adjustment to adherence.
The purpose of this study was to evaluate the relationship between the method of treatment and the level of adherence to therapeutic recommendations by patients suffering from HA and type 2 DM simultaneously.

Material and methods
The Adherence to Refills and Medications Scale (ARMS) and the Diabetes Treatment Satisfaction Scale (DTSQ) were used in the study. The study included 150 patients divided into 3 groups according to the method of treatment (group I (n=86)-treated with pills, group II (n=20)-treated with insulin, group III (n=44)-treated with botills and insulin.

Results
A comparative analysis of the level of adherence to pharmacological recommendations as perceived by patients showed significant differences between the groups, and the highest level was achieved by the group treated with insulin only 16.7±7.4, and the lowest level in the group treated with a combined regimen (tablet+insulin) 19.6±8.1; p=0.020). In the assessment of satisfaction with treatment, statistically significant differences in satisfaction were observed in the group of patients treated with the combination regimen, where more than half (55%) of the respondents showed complete lack of satisfaction with treatment. In univariate correlation analysis, the type of treatment regimen was not related to the level of adherence to pharmacological recommendations and adherence to health behaviors. However, a significant effect of comorbidities, acute complications of diabetes, early neurological incidents in the course of diabetes, and age and education of the respondents was observed. In multivariate analysis, a statistically significant independent determinant of adherence to pharmacological recommendations was the absence of comorbidities and the level of adherence to health recommendations was influenced by the age of the respondents.

Conclusions
The method of diabetes treatment has no effect on the level of health behavior in patients with NT and type 2 DM. The highest level of adherence to pharmacological recommendations of diabetes treatment is found in patients treated with insulin only and the lowest in patients treated with pills and insulin. Patients treated with the combination regimen have low levels of treatment satisfaction.
The impact of intensive glycemic control on prognosis in diabetes patients with severe coronary artery disease across different age groups
Authors: Li Q X , Yuan J Q 
Published: June 2024

Abstract

Background
Glycemic control is crucial for patients with diabetes mellitus (DM) and coronary artery disease (CAD). Some studies suggested that strict glycemic control does not significantly improve outcomes in patients with DM and CAD. Individualized glycemic control plans should be developed based on the patient's condition. However, there is limited research on the correlation between strict glycemic control and prognosis in patients with severe coronary artery disease, and the optimal level of glycemic control remains unclear.

Methods
This study ultimately included 2,051 consecutive patients with triple-vessel coronary disease enrolled from April 2004 to February 2011 at Fuwai Hospital in China, after excluding those with missing glycated hemoglobin (HbA1c) data and with hemoglobin &lt;90 g/L. Patients were categorized into five groups based on their HbA1c levels: &lt;6.0%, 6.0%-6.4%, 6.5%-6.9%, 7.0%-7.9%, and ≥8.0%. The primary endpoint was all-cause death, and the secondary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), including all-cause death, non-fatal myocardial infarction, and non-fatal stroke.

Results
The median follow-up time was 5.88 years. During this period, a total of 323 (15.7%) all-cause deaths and 537 (26.2%) MACCEs were recorded. The relationship between HbA1c levels and the risk of endpoint events showed a non-linear U-shaped pattern. Patients with HbA1c levels between 6.0% and 6.9% had a lower risk of adverse outcomes, while those with HbA1c ≥8.0% had the highest risk of endpoint events. Further analysis revealed a significant interaction between HbA1c and age (p = 0.001). In the subgroup with age &lt;70 years, as HbA1c increased, the risk of adverse events gradually rose, with patients having HbA1c &lt;6.0% exhibiting the lowest risk of death and MACCE. In the subgroup with age ≥70 years, there was an L-shaped relationship between HbA1c levels and endpoint events. Patients with HbA1c &lt;6.0% had a significantly higher risk of death and MACCE compared to other groups. The restricted cubic spline analysis also demonstrated similar results. In patients aged ≥70 years, the risk of death and MACCE gradually increased at HbA1c levels below 6.8% and 7.3%, respectively.

Conclusion
Our study revealed a U-shaped relationship between admission HbA1c levels and adverse outcomes in patients with triple-vessel coronary disease and concomitant diabetes. The descending arm of the U-shaped curves is primarily contributed by older patients, while the ascending arm is mainly contributed by younger patients. In younger patients with triple-vessel coronary disease, strict glycemic control may contribute to improving prognosis. However, in older patients with triple-vessel coronary disease, it is advisable to avoid excessively low HbA1c levels and adopt a more lenient glycemic control approach. Forest plots. Restricted cubic spline plots.
Digital health readiness for Japanese patients with cardiovascular disease
Authors: Ozaki S , Kaihara T , Kuramoto T , Nishina H , Falter M , Scherrenberg M , Xu L , Dendale P , Akashi Y 
Published: June 2024

Abstract

Background
Digital health has been increasingly applied to the cardiovascular field, especially since the COVID era. Japan is a super-aged society with an average life expectancy of 81 years for men and 87 years for women in 2023. However, there are no existing tools to measure digital health readiness and learnability to implement "digital cardiology" in such a society.

Purpose
The purpose of this study is to validate the Japanese translation of the Digital Health Readiness Questionnaire (DHRQ) created in Belgium to assess the digital readiness of Japanese patients with cardiovascular disease.

Methods
A multicentre cross-sectional study of 210 patients with cardiovascular disease in Kawasaki, an urban, aging city, was conducted at a university hospital and a city hospital. Regarding the translation of the DHRQ, the back translation method was used and the differences between the translated version and the original version were discussed. The DHRQ consists of the DHRQ score and the learnability score. Multivariate analysis and confirmatory factor analysis were performed.

Results
A total of 208 complete questionnaires were included in the analysis. The average age was higher than in Belgium (68 ± 14 vs. 62 ± 15 years), of which 82 (39%) were female. The highest age was 96 and the lowest was 24. Smartphone ownership was higher than in Belgium (86% vs. 81%), but smartwatch and PC ownership was lower than in Belgium (18% vs. 28% and 54% vs. 87%). In multiple regression analysis, age, education level, and smartphone ownership were significant predictors of DHRQ and learnability scores (p ≤ 0.001), while gender and income were not significant predictors. Cronbach's alpha analysis was above 0.8 for all domains of the DHRQ, which implied acceptable internal consistency. The fit indices of the confirmatory factor analysis (Table) showed good fit. The goodness of fit improved when one topic of digital usage with low factor loading ("I use a wearable.") was removed.

Conclusion
In Japan, a super-aged society, the trend is almost the same as in Belgium, and DHRQ can be used. The introduction of digital cardiology needs to be individualized, paying attention to age, education level (the higher the better), and smartphone ownership (but not dependent on income).
Home-based cardiac rehabilitation with a smartwatch and a smartphone gamification application: a pilot Study
Authors: Arima Y , Kaihara T , Takizawa S , Doi S , Honda K , Kobayashi Y , Kasagawa A , Kawagoe Y , Suzuki T , Kai T , Koga M , Mitarai T , Higuma T , Tanabe Y , Akashi Y 
Published: June 2024

Abstract

Background
Home-based cardiac rehabilitation (HBCR) is emerging in the COVID era, but few studies have addressed "gamification", the use of game elements in non-game contexts.

Purpose
This pilot study investigates the applicability of gamification application to HBCR.

Methods
Patients who were hospitalized with acute coronary syndrome and agreed to undergo HBCR using a smartphone/smartwatch immediately after discharge were candidates for the study. The smartphone application included gamification, whereby the patients earned points for achieving exercise within an appropriate heart rate range and received feedback based on their points. The primary endpoint was the frequency of performing HBCR with the application from discharge to the date of the first outpatient visit. Secondary endpoints were the frequency of complications and correlations in several parameters of the application.

Results
The study included data from 16 patients. The mean duration of intervention was 29 ± 6 days. Total smartphone application use was 59.9% (282/471 days). Peak VO2 increased significantly after HBCR (18.4 ± 4.1 vs. 21.1 ± 5.4 mL/min/kg, p = 0.004) and the patients had no complications. Total application use was significantly positively correlated (r = 0.665, p = 0.007) with the application use persistence index (calculated by dividing the duration of application use in the second half of the intervention by the duration of use in the first half).

Conclusion
The smartphone application with gamification can be safely applied to HBCR. Continued use of the application creates a virtuous circle for patients, and gamification may be one of the keys to this.
Happiness and cardiovascular mortality: the HAPIEE study
Authors: Pikhart H , Lin F , Tamosiunas A , Kozela M , Capkova N , Pikhartova J , Bobak M 
Published: June 2024

Abstract

Background
There is mixed evidence on the relationship between happiness and cardiovascular mortality (CVD), and how it is affected by health and other variables, with almost no evidence in the region of Central and Eastern Europe (CEE) with high CVD mortality. This analysis aims to evaluate such association in longitudinal data from three countries of CEE, and investigate the role of other variables in this association.

Methods
This analysis is based on data from 18,362 men and women from the prospective longitudinal Health, Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) study conducted in the Czech Republic, Lithuania and Poland who were 45-70 years old at the baseline. Happiness was based on 4-points Likert scale answers to the question "Taking all things together, would you say you are …", with the answers "Very happy", "Quite happy", "Not very happy", and "Not at all happy". Cardiovascular mortality was obtained from local or national mortality registers. Cox proportional hazards regression was used to estimate the hazard ratios (HRs).

Results
1,051 cardiovascular deaths have been recorded over the 11 years of follow-up (among 2,718 all-cause deaths). After adjustment for country and age the HR comparing very happy and unhappy was 0.39 (95%CI: 0.26-0.58) in men and 0.70 (0.43-1.13) in women. This association was reduced after adjusting for socioeconomic characteristics, health behaviours and conventional risk factors (HR 0.65 in men and 0.95 in women); and disappeared in both sexes after controlling for self-rated health. No evidence for country interaction was identified.

Conclusions
Happiness has been shown to predict CVD mortality in this population sample from CEE although it may be explained by established risk factors and self-rated health.
Biological sex matters: cognitive performances and their predictors differ in female and male patients with heart failure
Authors: Gagnon C , Berube B , Besnier F , Vachon F , Sellier F , Iglesies-Grau J , Gayda M , Dionne V , Benhalima H , Nigam A , Juneau M , L L'allier P , Bouabdallaoui N , Rouleau J , Bherer L 
Published: June 2024

Abstract

Objectives
1) To compare cognitive performances in male and female individuals with HF; 2) to determine whether cardiorespiratory fitness, Myers score and functional capacity predict cognition differently according to biological sex.

Methods
68 patients, 25 female (68±9 yrs) and 48 male participants (67±8 yrs) with HF, completed a 6-minute walking test (6MWT), a cardiopulmonary exercise test (CPET) (VO2peak and MYERS score, both are prognostic parameters) and the following cognitive assessment: global cognition (Montreal Cognitive Assessment), memory (Rey Auditory Verbal Learning Test (RAVLT)), executive functions (Stroop, Verbal fluency, Trail Making Test B), processing speed (Coding, Trail Making Test Part A).

Results
Male and female patients were comparable for age, NYHA class and LVEF (all ps&gt;.05). For cognition, after adjusting for age and education, male and female participants differed significantly on RAVLT immediate recall, M=6.48±3.51, F=8.21±3.30, p&lt;.05, and phonological and switching verbal fluency, respectively, M=12.09±4.61, F=14.09±4.28 and M=10.93±2.95, F=12.45±3.23, (p&lt;.05). Simple linear regressions showed that in female participants, RAVLT immediate recall (R= .466, p&lt;.05) and switching verbal fluency (R=.450, p&lt;.05) were predicted by the MYERS score: higher risk score was associated with poorer performances in both tests. Also, performances in phonological and switching fluency in female participants were predicted by the 6MWT, respectively, R=.458, p&lt;.05, and R=.491, p&lt;.05; walking a greater distance was associated with better performances. In male participants, RAVLT immediate recall (R=.462, p&lt;.01) and switching verbal fluency (R=.372, p&lt;.05) were only predicted by the 6MWT; walking a longer distance was associated with better performances.

Conclusion
Female patients with HF obtained better performances on memory and executive function tests vs men. Performances on these tests were predicted by different clinical fitness markers. In female participants, the MYERS score predicted their performances on memory and executive functions, and the 6MWT predicted executive function performances. In contrast, in male participants, only the 6MWT predicted performances on these tests. Albeit only a first step, these results suggest that cognition is influenced differently in male and female patients with HF. This could eventually open the door to personalized treatment approaches targeting the proper clinical fitness indicator to improve cognition.