bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of moderate-to-vigorous intensity physical activity prior to enrollment in cardiac rehabilitation
Authors: Kambic T , Hadzic V , Lainscak M 
Published: June 2024

Abstract

Background
Patients with cardiovascular diseases, especially coronary artery disease (CAD) frequently have high levels of sedentary behaviour and low levels of moderate-to-vigorous physical activity (MVPA). While some determinants of sedentary behaviour have been established in patients completing out-patient cardiac rehabilitation (CR), the factors influencing MVPA levels remain largely unknown in CAD patients prior to enrolment to CR.

Purpose
This study aimed to investigate the associations between baseline clinical characteristics, body composition, (sub)maximal physical performance, blood biomarkers and MVPA levels in patients with CAD prior to enrolment to CR.

Methods
Sixty-four patients with CAD were recruited in the routine, out-patient CR and 61 completed the study (72% men): mean (SD) age = 61 (8), height = 172 (8) cm, weight = 85 (15) kg, left ventricular ejection fraction = 53 (9) %. In two measurement days, maximal aerobic capacity (ramp test), glucose and blood lipids (total cholesterol, triglycerides, HDL, LDL), body composition using bioimpedance (body weight, waist-to-hip circumference, fat and lean mass), (sub)maximal physical performance of upper and lower limbs (hand grip test, arm curl test, maximal leg press strength, 10 sit-to-stand test, six min walk test) and physical activity (eight wear days of triaxial accelerometer on right hip) were measured. The predictors of MVPA levels were determined using stepwise multivariate linear regression models.

Results
Patients were predominantly sedentary (daily time = 493 [93] min, daily % = 61 [9] %), with low levels of MVPA (daily time = 66 [28] min, daily % = 8 [4] %). Only maximal aerobic capacity (r = 0.487; p &lt; 0.001), body fat percentage (r = -0.460; p &lt; 0.001), maximal leg press strength (r = 0.256; p = 0.049), arm curl test (r = 0.370; p = 0.003), 10 sit-to-stands (r = -0.415; p = 0.001) and six min walk test distance (r = 0.317; p = 0.013) were correlated with MVPA. After stepwise regression, only maximal aerobic capacity and logarithm (log.) of body fat percentage predicted MVPA and explained 53% of variability in MVPA levels (F = 11,153; p &lt; 0.001). Higher levels of baseline maximal aerobic capacity (beta = + 0.324; p = 0.019) and lower log. body fat mass percentage (beta = - 0.278; p = 0.043) significantly predicted higher levels of MVPA (regression equation: MVPA = 115.57 min + 1.86*maximal aerobic capacity – 58.53* log. body fat mass percentage).

Conclusions
Prior to enrolment in out-patient CR, only maximal endurance and body composition predict baseline levels of MVPA in patients with CAD.
Obesity awareness-insight is inversely associated with body composition and physical activity behaviour in women with obesity at the admission to a lifestyle modification program
Authors: Gunes S , Aytutuldu G , Akinci B 
Published: June 2024

Abstract

Backgroud
Increased obesity awareness may improve the compliance and adherence to secondary prevention initiations and has the potential to reduce obesity-related morbidity and mortality. In the literature, obesity awareness and its impact on body composition was investigated in various populations. However, the association between obesity awareness-insight with physical activity behaviour has not been investigated.

Purpose
The aim of this study is to examine obesity awareness-insight in relation to body composition and physical activity behavior in women with obesity who admitted to a lifestyle modification program.

Methods
Eighty-two women with obesity (age= 38.22±12.49/years; 46 moderate, 26 severe, 10 morbid) were included. Body composition was assessed. Obesity Awareness and Insight scale(OASIS), Sedentary Behaviour Questionnaire (SBQ) and International Physical Activity Questionnaire-Short Form (IPAQ-SF) were questioned.

Results
OASIS total score was positively correlated with SBQ total weekday time (p=0.009), SBQ total weekend time (p=0.024), SBQ total weekly time (p=0.008), BMI (p&lt;0.0001), waist circumference (p=0.003), visceral fat (p&lt;0.0001) and body fat percentage (p=0.003). A negative correlation was found between OASIS negative outcome awareness sub score and IPAQ-SF moderate physical activity (p=0.04). OASIS mean total score (p&lt;0.001, Z= -4.06), illness awareness from OASIS subgroups (p=0.00, Z= -2.89), symptom attribution (p=0.00, Z= -3.06), awareness of need for treatment (p=0.00, Z= -3.20), and awareness of negative outcomes (p=0.01, Z= -2.57) were found to be significantly higher in Class-2 obesity than in Class-1 obesity. Illness awareness of OASIS subgroups (p=0.04, Z= -1.99) and awareness of need for treatment (p=0.01, Z= -2.54) were higher in Class-3 obesity than in Class-1 obesity.

Conclusion
This study demonstrated that increased obesity awareness-insight correlated with deteriorating body composition and increased sedentary behavior among women with obesity who were admitted to the lifestyle modification program. Furthermore, awareness of obesity-related adverse outcomes revealed an inverse association between with moderate physical activity. Behavioral strategies are needed to motivate women with obesity to compliance in lifestyle change to improve body composition and participation to physical activity.
Physical inactivity and sedentary behavior profiles over a week in patients with heart failure: comparison with healthy subjects and its determinants
Authors: Dias K L , Machado F , Pitta F , Hernandes N A 
Published: June 2024

Abstract

Background
Patients with heart failure (HF) are physically inactive and often exhibit excessive sedentary behavior. Understanding the magnitude of inactivity and time in sedentarism and its determinants could be useful in establish rehabilitation interventions to those patients.

Purpose
i) To evaluate how much patients with HF are more inactive and sedentary in daily life than their matched controls; ii) to compare the physical activity in daily life (PADL) levels of those patients during weekdays and weekend; and to study its determinants.

Methods
In a cross-sectional study, patients with HF and age-, gender- and BMI-matched controls were included. The participants had their PADL objectively evaluated by an activity monitor worn during awake time, for seven consecutive days. Step count, time spent in sedentary behavior (SB), light and moderate-to-vigorous physical activities (MVPA) were recorded; the mean or sum of the days was used for the analyses. Anthropometric data, functional exercise capacity (six-minute walk test, 6MWT), exertional dyspnea (Borg scale), anxiety and depression symptoms (Hospital Anxiety and Depression Scale, HADS) and health-related quality of life (Minnesota Living with Heart Failure questionnaire, MLHFQ) of the patients with HF were assessed as potential determinants of PADL.

Results
Forty-three patients with HF (23 males; 65±11 yrs; LVEF: 47±15 %; BMI: 30±5 Kg.m-2) and 30 matched controls (11 males; 62±10 yrs; BMI: 29±5 Kg.m-2) were studied. The comparison of PADL profile between patients with HF and controls is presented in the Table 1. Considering the mean and the sum of the days, patients with HF presented time in MVPA, approximately, 60% lower than their controls. Time in SB and in light PA were similar between groups. On average, patients with HF presented 2190 steps/day (or 33%) less than the controls. In comparison to weekdays, patients with HF are even more inactive during weekends, considering both MVPA (9 [4-21] vs. 6 [3-12] min/day; P=0.005) and step count (4550±2366 vs. 4055±2228; P=0.02). Results of multiple stepwise regression models revealed that, in patients with HF, the step count was determined by the 6MWT and dyspnea sensation during the test (r2=0.37); MVPA was determined only by age (r2=0.19); light PA only by depression symptoms (r2=0.10); and SB was determined by the 6MWT, dyspnea sensation during the test and depression symptoms (r2=0.32).

Conclusions
Patients with HF are more physically inactive when compared to healthy individuals; conversely, they are as sedentary as their matched controls. During weekends, patients with HF are even more inactive than during weekdays. Functional capacity and exertional dyspnea determined the number of steps covered during a day and, in addition to depression symptoms, predicted also sedentary behavior in HF.
Prevalence and determinants of fear of movement in adult patients with congenital deart disease
Authors: Ter Hoeve N , Snaterse M , Jorstad H T , Sunamura M , Van Groen J C , Kauling R M , Robbers-Visser D , Van Den Bosch A E 
Published: June 2024

Abstract

Background
Low levels of physical activity is a common concern among adults with congenital heart disease (ACHD). Fear of movement, also known as kinesiophobia, has been suggested as an important contributor to these low levels of physical activity in the general cardiovascular disease population. However, levels of kinesiophobia have not been investigated in ACHD patients.

Objective
To investigate kinesiophobia prevalence in ACHD patients, and to identify potential predictors of fear of movement. Second, we investigated the impact of kinesiophobia on physical activity levels.

Methods
ACHD patients from two Dutch university hospitals participated in this study by completing a series of questionnaires, including the Tampa Scale for Kinesiophobia Heart (TSK-NL Heart). The TSK-NL Heart, with a scoring range from 13 to 52, identifies scores ≥29 as indicative of high levels of kinesiophobia. Baseline characteristics, including age, sex, NYHA class, number of cardiac surgeries, prior participation in cardiac rehabilitation, educational level, and participation in physical activity were self-reported. Descriptive statistics were used to determine prevalence of high levels of kinesiophobia. Logistic regression was used to identify factors associated with high levels of kinesiophobia and to assess its impact on physical activity (corrected for age and sex).

Results
A total of 794 ACHD patients (50% female, aged 45 (+/- 14) years) completed all questionnaires, whereof 232 patients (29%) reported high levels of kinesiophobia. A total of 494 patients (62%) reported to be in NYHA class 1, 249 patients (31%) in NYHA class 2, 46 patients (6%) in NYHA class 3 and 5 patients (1%) in NYHA class 4. Men were more likely to experience kinesiophobia (OR 1.53, 95% CI 1.09-2.15). Higher self-reported NYHA class was associated with increased likelihood of kinesiophobia (NYHA class 2 vs 1: OR 2.92, 95% CI 2.03-4.20; and NYHA class 3 or 4 vs 1: OR 12.61, 95% CI 6.24-25.47, see Figure). A high level of kinesiophobia decreased the probability of being physically active for at least 30 min/day during 5 days/week (OR 0.66, 95% CI 0.47-0.97).

Conclusion
This study reveals a considerable prevalence of kinesiophobia among ACHD patients. High levels of kinesiophobia were associated with lower levels of physical activity. The identified predictors, including sex and NYHA class, provide valuable insights for designing targeted interventions aimed at mitigating kinesiophobia and promoting increased physical activity in ACHD patients. Determinants of Fear of Movement.
Examining the impact of a 10-week HIIT exercise program on recent cardiac rehabilitation graduates: a case for cardiac maintenance
Authors: O'neill C D , Moller O , Fowles J 
Published: June 2024

Abstract

Introduction
Exercise-based cardiac rehabilitation has been shown to improve aerobic capacity and mental health (i.e. anxiety and depression) and reduce the risk of a secondary cardiac event. Following hospital-based cardiac rehabilitation programs, patients are left largely on their own to return to their normal routines with no continuation of support for continued exercise training; many lack sufficient exercise experience and confidence to continue a regimen independently. High intensity interval training (HIIT) is effective when integrated into cardiac rehabilitation, but its effectiveness in a community setting is not established.

Purpose
To evaluate implementation of a HIIT exercise protocol into a community cardiac maintenance program, developed to provide supervised exercise training for graduates of hospital-based cardiac rehabilitation.

Methods
Recent (&lt;1 year) graduates of hospital based cardiac rehabilitation patients were recruited to complete the 10-week program. Exercise sessions occurred 3 days per week for 50 minutes per session and consisted of the following: 1 day of strength training, 1 day of individual HIIT, and 1 day of group-based HIIT. Intensity prescription was based on ratings of perceived exertion (RPE). Aerobic intervals consisted of 4 minutes of high intensity (i.e. RPE of 15-17) and 3 minutes of low intensity (i.e. RPE of 9-11) on a modality of the participants choosing. RPE was recorded at the beginning, mid-point, and end of each interval to ensure intensity targets were being met. Assessments were completed at pre- and post-program for (1) physical fitness using the Seniors Fitness test; (2) mental health using the hospital anxiety and depression scale (HADS) and subscales HADS, for anxiety (HADS-A) and depression (HADS-D); and, (3) self-efficacy using the self-efficacy for exercise (SEE) questionnaire.

Results
To date, 17 participants (age: 66.9 ± 7.6 years (range: 48-75) [100% male]) have completed the 10-week HIIT program, and data collection is ongoing. Significant improvements have been observed in physical fitness, specifically in the 6MWT (pre: 526 post: 570m; p-value = &lt;0.01) and in SEE (pre: 30.7 ± 9.0 post: 73.9 ± 12.8, p-value = &lt;0.01). While no significant changes have occurred in the HADS-A (pre: 3.8 ± 3.4 post: p-value = 0.22) or HADS-D (pre: 3.9 ± 2.1, post: 2.2 ± 1.9; p-value = 0.17) clinically meaningful changes were noted in the HADS-D.

Conclusion
These results suggest that continued supervised exercise training in a community setting is effective for improving physical and mental health and increases self-efficacy for exercise in recent hospital-based cardiac rehabilitation settings. Future research should evaluate ways to increase female participation.
Cardiovascular risk factor control in acute coronary syndrome survivors in a cardiac rehabilitation program - are we achieving sustained results?
Authors: Mangas Palma P P , Rocha M R , Moreira H M , Oliveira C O , Ana Pinho A P , Luis Santos L S , Cabrita A C , Marques C M , Rodrigues J R , Rocha A R , Dias P D , Rodrigues R R 
Published: June 2024

Abstract

Introduction
The benefits of cardiac rehabilitation (CR) following acute coronary syndromes (ACS) are well established. CR programs effectively promote a healthy lifestyle and manage risk factors (RF), thereby reducing all-cause and cardiovascular morbidity and improving health related quality of life. Despite its effectiveness, many patients relapse to pre-morbid habits upon returning to their daily routines (1).

Purpose
To characterize RF control after an exercise-based CR program and relapse 1 year after discharge from the program.

Methods
We performed a retrospective single-centre cohort study which included patients who were referred to CR program from 2020 to 2022 and completed a phase II exercise-based CR program. Achievement of low-density lipoprotein (LDL) cholesterol, HbA1c, weight loss and smoking cessation was assessed. Lipid profile parameters were assessed and compared at three time points - hospitalization, end of the program and 1 year after primary care follow-up.

Results
A total of 75 patients were included (85% male, with a mean age of 51.6 + 9.60 years). 61.3% had an ST-elevation myocardial infarction. The most prevalent risk factors were smoking (57.3%), dyslipidemia (54.7%), hypertension (42.7%), obesity (20%) and diabetes mellitus (16.0%).
Mean LDL cholesterol at admission was 118 + 55.7mg/dL and 60.1 + 17.9mg/dL at the end of the CRP (p&lt;0.001), with 64.4% under the &lt;55mg/dL target. Mean glycated hemoglobin (HbA1c) at admission was 6.35 + 1.65% and 6.16 + 0.76 at the end of the CRP (p=0.114), with 83% under the &lt;7% target. Weight loss was achieved in 40.0% of obese patients and complete smoking cessation in 58.5% of smokers during the CRP.
At 1 year follow-up, mean LDL cholesterol was 66.8 + 30.5mg/dL and mean HbA1c 6.69 + 0.96%. Only 40% were under the LDL target and a median weight gain of 2.02kg (7.75 IQR) was also observed.

Conclusions
This study highlights the efficacy CR program in achieving the treatment targets outlined in the European Society of Cardiology prevention guidelines. There is, however, a pressing need for the implementation of novel strategies aimed at enhancing long- term adherence and maintenance of RF control, particularly within the primary care setting. Addressing this challenge will contribute significantly to the sustained success of cardiovascular health interventions.
Post COVID symptoms of fatigue or dyspnea in young patients are not related to impaired aerobic capacity measured be cardiopulmonary exercise testing
Authors: Dritsas A , Papatheodorou E , Koltsida O , Tsiakos K , Sventzouri S , Laoutaris I D , Sterpis S I , Xenou M I , Thomopoulou S , Georgiadou P , Rapti A , Anastasakis A 
Published: June 2024

Abstract

Background
Up to 5-10% of patients (pts) report long-term cardiac symptoms associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Aim
To evaluate by cardiopulmonary exercise testing (CPET) pts with laboratory confirmed SARS-CoV-2 infection who reported fatigue or dyspnea symptoms 3 months after infection.

Methods
Pts hospitalization data, demographics, severity of COVID-19 disease and comorbidities were collected. Evidence of cardiac involvement during hospitalization was documented. All pts underwent an extensive clinical protocol with biomarkers, electrocardiography, 2D echocardiography, 24 hour Holter monitoring and a treadmill CPET.

Results
The cohort consisted of 85 pts (mean age 44 ± 8 yrs): 55 hospitalized pts (mean hospitalization 11.8 ± 4.3 days) and 30 non-hospitalized pts. Five percent of the cohort had evidence of troponin rise upon infection. A relevant cardiac diagnosis was identified in 48% of the cohort. The dominant diagnoses were cardiomyopathy (18%) and healed myocarditis (13%) followed by diastolic heart failure (5%), pulmonary hypertension (4%) and cardiac arrhythmias (3%). Fifty eight (68%) pts of the cohort (mean age 43±8) underwent a treadmill CPET, 25 (43%) of them complaining of fatigue and (28) 57% of effort dyspnea at presentation. However, they showed an overall satisfactory exercise capacity on CPET by achieving (mean 88±15 %) of the max predicted pVO2 with achieved VE/VCO2 also within normal range (mean 31±4).

Conclusions
Cardiac involvement is identified in almost half of young patients with long-Covid symptoms of fatigue or dyspnea who were referred to a tertiary cardiac center. However, despite symptoms their aerobic capacity objectively measured by CPET was not impaired.
Gender differences in hypertrophic cardiomyopathy assessed by cardiovascular magnetic resonance feature tracking
Authors: Tomoaia R , Anderton T , Botis I , Lwin M , Soo C , Javed W , Kamani C , Plein S 
Published: June 2024

Abstract

Introduction
The recognition of gender differences in cardiovascular disease is increasing. Cardiac magnetic resonance imaging (CMR) offers high spatial and temporal resolution images irrespective of body shape and size. This enables precise evaluation of deformational mechanics of cardiac contraction which can be impaired even when the ejection fraction is normal. While previous studies have suggested gender differences using echocardiography speckle-tracking in hypertrophic cardiomyopathy (HCM), there is no similar data on the use of CMR.
The aim of the study was to compare cardiac deformation parameters obtained using CMR 3D feature tracking imaging (FTI) for male and female individuals with HCM.

Methods
Consecutive patients with HCM, LVEF&gt;55% and HCM-related fibrosis were included in the study. CMR FTI parameters included left ventricular (LV) global longitudinal (GLS), circumferential (GCS) and radial (GRS) strain derived from multi-slice 2D cine image stacks in the short LV short axis plane. FTI was calculated using Circle Cvi42 software.

Results
A total of 28 patients with HCM were included in the analysis, with an equal number of 14 men and 14 women. All patients demonstrated impaired longitudinal, but preserved circumferential and radial deformation parameters as compared to FTI reference values (mean GLS -was of 9.5% ± 3.9, mean GCS of -15.7% ± 8, mean GRS of 36.1% ± 13.5). There were no significant differences in terms of age (69.7 ± 12.2 vs. 63.9 ± 6 years, p=0.14), body mass index, number of hypertrophic segments (4.7 ± 2.7 vs. 4.3 ± 1.4, p=0.6), or number of segments with fibrosis (3.3 ± 2.2 vs. 3.3 ± 1.8) between women and men. When considering standard CMR parameters, women had lower left ventricular end-diastolic volumes (71.1 ± 17.5 ml vs. 87.7 ± 18.3 ml/m2, p=0.02), left ventricular mass (65.4 ± 19.6 vs. 86.1 ±2 9 g/m2, p=0.04), and right ventricular end-diastolic volumes (52.8 ±1 5.4 vs. 75.2 ± 13.3 ml/m2, p=0.0004). The LV and right ventricular (RV) ejection fractions were similar between males and females. Regarding FTI parameters, both GCS (-14.3% ± 9.5 vs. -16% ± 9, p=0.63) and GRS (36.4% ± 10.7 vs. 37.4% ± 8.3, p=0.77) values were similar in both groups. However, women exhibited superior left ventricular systolic function compared to males in terms of GLS (-11.5% ± 2.5 vs. -8.1% ± 5.2, p=0.03).

Conclusions
HCM patients exhibited gender differences in 3D GLS on feature tracking CMR. This may have clinical relevance as impairment of left ventricular deformation is a powerful indicator of cardiovascular prognosis in hypertrophic cardiomyopathy (HCM), even in the presence of preserved global systolic LV function. GLS 3D differences according to gender.
Exposure to workplace sexual harassment and risk of cardiometabolic disease: a prospective cohort study of 88 904 Swedish men and women
Authors: KC Prakash , Madsen Ida E H , Rugulies Reiner , Xu Tianwei , Westerlund Hugo , Nyberg Anna , Kivimäki Mika , Hanson Linda L Magnusson 
Published: June 2024

Abstract

Aims
Exposure to work-related sexual harassment may increase the risk for certain adverse behavioural and emotional outcomes but less is known about its association with somatic diseases such as cardiovascular disease (CVD) and type 2 diabetes. This study investigated the prospective association of work-related sexual harassment and risk of cardiometabolic diseases.

Methods and results
This cohort study included 88 904 Swedish men and women in paid work who responded to questions on workplace sexual harassment in the Swedish Work Environment Survey (1995–2015) and were free from cardiometabolic diseases at baseline. Cardiometabolic diseases (CVD and type 2 diabetes) were identified from the National Patient Register and Causes of Death Register through linkage. Cox proportional hazard regression was used, adjusting for socio-demographic, work-related psychosocial, and physical exposure at baseline. Overall, 4.8% of the participants (n = 4300) reported exposure to workplace sexual harassment during the previous 12 months. After adjustment for sex, birth country, family situation, education, income, and work-related factors, workplace sexual harassment was associated with increased incidence of CVD [hazard ratio (HR) 1.25, 95% confidence interval 1.03–1.51] and type 2 diabetes (1.45, 1.21–1.73). The HR for CVD (1.57, 1.15–2.15) and type 2 diabetes (1.85, 1.39–2.46) was increased for sexual harassment from superior or fellow workers, and sexual harassment from others was associated with type 2 diabetes (1.39, 1.13–1.70). The HR for both CVD (1.31, 0.95–1.81) and type 2 diabetes (1.72, 1.30–2.28) was increased for frequent exposure.

Conclusion
The results of this study support the hypothesis that workplace sexual harassment is prospectively associated with cardiometabolic diseases. Future research is warranted to understand causality and mechanisms behind these associations.