bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac rehabilitation participation and risk of falls in older individuals with cardiovascular disease
Authors: Chacin-Suarez A , Zhang L , Medina Inojosa J R , Taylor J L , Fischer K , Manemann S M , Gomes P F , Bonikowske A R , Smith J R , Squires R W , Brenes Salazar J A , Terzic C M , Thomas R J 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Falls are the leading cause of injury-related morbidity and mortality among older adults in the United States, including those with cardiovascular disease. Cardiac rehabilitation (CR) helps to optimize functional capacity, strength, and balance in patients with cardiovascular disease and, in theory, may reduce the risk of falls. However, little evidence has been published in this regard.

Purpose
The purpose of this study was to assess the association between CR participation and risk of falls in a community-based sample of individuals 65 years of age and older with cardiovascular disease who were eligible for CR participation.

Methods
Individuals from Southeastern MN and Western WI, USA, 65 years of age and older who had experienced a cardiovascular event that qualified them for CR (MI, PCI, CABG, Valve Surgery, Transplant) between January 1, 2000, and December 31, 2018, were included in this study. Participation in CR (≥1 sessions, CR-group) and subsequent falls (moderate or severe, using the Campbell classification system) were ascertained using the Rochester Epidemiology Project records-linkage system. Logistic model to create propensity weighting were used to test the association between CR participation and falls after adjustment for potentially confounding factors.

Results
A total of 5004 individuals met inclusion criteria for the study, with 2183 (44%) included in the CR group and 2821 (56%) in the non-CR group (CR was indicated, but the individual did not participate). Overall, 1122 patients experienced a fall within the first 5 years (16% of those in the CR-group, 23% of those in the non-CR group). After adjustment, CR participation was not associated with falls, but older individuals, females, and those with a history of falls were more likely to have had a fall, compared to young individuals, males, and those without a history of a fall.

Conclusions
While CR is beneficial for patients with cardiovascular disease, our study did not find evidence of an association between CR participation and fall risk in individuals 65 years of age and older who have cardiovascular disease. Additional research is needed to evaluate the role of CR components that may potentially reduce modifiable risk factors for falls and thereby reduce the risk of falls.
Trends in diabetes mellitus among hospital hospitalizations in Switzerland
Authors: Marques-Vidal P , Abu Obaid H 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
In Switzerland, the prevalence of diabetes mellitus (DM) has increased in the general population, but little is known regarding DM-related hospitalizations and their impact on mortality and health costs.

Objective
To assess 1) the evolution of hospitalizations for DM as first diagnosis and as comorbidity; 2) the association of DM with ICU admission, length of stay (LOS), in-hospital mortality and costs.

Methods
Swiss hospital discharge data for period 2012-2020. Type 1 (T1DM), type 2 (T2DM) and other types (OTDM) of DM were considered. Costs were estimated using Swiss diagnosis related groups.

Results
Between 2012 and 2020, the number of hospitalizations (% total) increased from 4204 (0.27) to 4980 (0.45) for T2DM, 539 (0.05) to 854 (0.08) for T1DM and 221 (0.02) to 381 (0.03) or OTDM. Hospitalizations with DM as comorbidity increased from 89,752 (8.6) to 128,700 (11.7) for T2DM, 2934 (0.29) to 3536 (0.32) or T1DM and 5774 (0.58) to 9143 (0.83) for OTDM. Compared to non-DM hospitalizations, hospitalizations for T1DM had a higher likelihood of ICU admission: odds ratio and 95% CI: 3.49 (3.30-3.71), while T2DM had higher LOS: 6.0±1.0 vs. 5.1±1.0 days, and all DM types had a lower odd of in-hospital mortality. Patients with any type of DM as comorbidity had a longer LOS than patients without. Total cost of DM rose from CHF 42 million in 2012 to almost 100 million in 2019 and decreased afterwards.

Conclusion
DM represents an increasing health and economic burden in Switzerland.
Impact of lipid lowering therapies after an acute coronary syndrome, applied through telematic consultation, in a cohort of elderly patients
Authors: Jimenez Mendez C , Perez Asensio A , Mialdea Salmeron D , Puche Garcia J E , Silva E , Delgado Nava W , Bartolome D , Alarcon De La Lastra I , Lubian Esplugues J , Benjumea Rodriguez J , Heras Jimenez L , Grez Gutierrez T , Tey Aguilera M J , Gheorghe L , Vazquez Garcia R 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
After Covid-19 pandemic, telematic cardiology consultations are a reality in most developed countries. However, the impact and safety of telemedicine in the elderly population needs to be clarified. Elderly patients may need help to understand and use telemedicine effectively, being thus its benefits differential.
Objetives: To assess the impact of lipid lowering therapies, after an acute coronary syndrome (ACS), applied through telematic consultation, in a cohort of elderly patients (≥70 years).

Methods
We performed a prospective cohort study that consecutively recruited all patients admitted to our centre with an ACS from January 1, 2020 to December 31, 2020. All patients were discharged with high-intensity statins and other currently recommended cardiovascular drugs. Lipid profile was evaluated one month after discharge. Patients were then contacted by phone, treatment was confirmed, and their lipid- lowering therapy was adjusted according to the results of the blood test. This procedure was repeated every month until LDL-c target (≤ 55 mg/dl) was achieved in accordance with current European clinical practice guidelines.

Results
346 patients, 32% women, were included. Mean age was 67.3 ± 12.4 years, being 48% ≥ 70 years. Mean follow-up was 17.3 months. Patient’s main characteristics are summarized in Table 1. Comparing both subgroups, patients ≥ 70 years more frequently were women, and had past history of hypertension, diabetes, heart failure and myocardial infarction. There were no differences in clinical presentation at admission (predominantly non-ST elevation myocardial infarction). Patients ≥70 years reached the goal of LDL ≤55 mg/dl in a similar proportion to the younger subgroup (80.1% vs 82.8% p 0.051). There were no statistically significant differences in prescription between groups, with a tendency to a higher prescription of statins and ezetimibe in younger patients (62.8% vs 50.6%, p = 0.05). At follow-up, overall mortality was higher in the subgroup ≥70 years (7.8% vs 1.2%, p 0.026) at the expense of non-cardiovascular mortality (4.8% vs 0.6% p 0.013). There were no differences in cardiovascular mortality, stroke, non-fatal myocardial infarction, or non-urgent angioplasty.

Conclusion
Lipid lowering therapies applied through telematic consultation in a population ≥ 70 years old after an ACS is as effective and safe as in younger patients. There is however a higher mortality in this subgroup, predominantly because of non-cardiovascular causes.
Sudden cardiac arrest and role of sport preparticipation screening in children
Authors: Graziano F , Schiavon M , Cipriani A , Savalla F , De Gaspari M , Bauce B , Rizzo S , Calore C , Thiene G , Paiaro P , Corrado D , Basso C , Zorzi A 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Competitive sports activity may increase the risk of life-threatening ventricular arrhythmias and sudden cardiac death (SCD) in athletes with underlying cardiovascular diseases (CVD). Preparticipation screening (PPS) offers the potential to early identify CVD and reduce this risk, but the optimal age of sport PPS start is not known.

Purpose
The aim of this study is to assess the burden of sudden cardiac arrest (SCA) and the diagnostic yield of PPS for CVD at risk of SCA in two different age groups: 8-11 year-old and 12-15 year-old.

Methods
Data on the incidence and causes of SCA from 2011 to 2020 were retrieved from the sudden death registry of our region, hospital records and local press. During the same period, we assessed 25,251 young competitive athletes aged 8-15 years who underwent 58,185 annual PPS (mean 2.3/athlete) including history, physical examination, ECG and exercise testing. Further tests were required in case of abnormalities at first-line screening.

Results
Over 10 years, 21 sudden deaths and 5 resuscitated SCA occurred: 6 in athletes (incidence 0.7/100.000/year) versus 20 in non-athletes (0.7/100.000/year). 67% athletes versus 5% non-athletes who suffered SCA were successfully resuscitated (aborted sudden cardiac death=aSCD), (results according to the age-group in Figure 1). Idiopathic ventricular fibrillation was the most common diagnosis accounting for 14/26 (54%) cases. The incidence of SCA was 0.2/100.000/year in the age group 8-11 year-old versus 1.3/100.000/year in the age group 12-15 year-old. By PPS, 26 (0.1%) athletes received a diagnosis of at-risk CVD, significantly more often in children ≥12 year-old (0.06%/evaluation) than &lt;12 year-old (0.02%/evaluation, p=0.02), (Figure 2). During follow-up, 2 screened athletes suffered SCA due to idiopathic ventricular fibrillation, both ≥12 year-old at the time of PPS.

Conclusions
The incidence of SCA was 6 times higher in the age group 12-15 years compared with the 8-11 years group. Similarly, the diagnostic yield of PPS for at-risk CVD was significantly higher after 12 years of age. This suggests that systematic PPS may not be justified before 12 year-old.
Cardiac rehabilitation in women. Have we improved care in recent years?
Authors: Eliche Mozas P , Rus Mansilla C , Duran Torralba Mª C , Cortez Quiroga G , Cubillas Quero A , Cruz Romero L 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None. Main funding source(s): Ninguna.

Introduction
Cardiovascular disease is the main cause of morbidity and mortality worldwide, but there are inequalities in diagnosis and treatment between men and women. Although there is greater awareness of cardiovascular disease in women, diagnostic techniques are less used in women, they receive fewer pharmacological and invasive treatments, and have less access to cardiac rehabilitation.

Objective
To compare the assistance offered to men and women in our Cardiac Rehabilitation Unit up to 2018 with the assistance given from 2019 to 2022.

Methods
Patients treated in the Cardiac Rehabilitation Unit before 2018 (group 1) and from 2019 to 2022 (group 2) were analyzed, comparing the characteristics of male and female patients, as well as the attendance rate to Cardiac Rehabilitation and treatments indicated.

Results
In group 1, we analyzed the data of 399 patients, 19.8% women. In group 2, which included 167 patients, the rate of women rose to 26.3%, this difference being statistically significant (p&lt;0. 05). Women were older than men in both groups (63 vs 59 years in group 1; 64 vs 59 years in group 2), less smokers (26.3% vs 57.3% in group 1; 25% vs 50.4% in group 2). The percentage of hypertensive patients was the same in both sexes in group 2. Until 2018, fewer coronary angiographies were performed on women (94% vs 99%, p&lt;0.05); however, in the second period (group 2, 2019-2022), the percentage was similar in both sexes, (96% vs 98%, p= n.s.). Revascularization is less, possibly due to the characteristics of coronary disease in women (Table 1). Lipid-lowering treatments are used equally in both groups (Table 1).

Conclusion
In recent years, care for cardiovascular disease in women has been improving. The percentage of women who are included in Cardiac Rehabilitation program and who undergo coronary angiography has increased. The raising awareness that this disease has the same severity in both sexes has allowed the optimal medical treatment implemented to be similar.
The relationship between vitamin D and sarkopenia in patients with metabolic syndrome
Authors: Ulker Eksi B , Akinci B , Yigit S , Korkmaz Dayican D , Calikoglu B F , Yeldan Karagoz I , Satman I 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.
Backround: Vitamin D is essential for the optimal function of many bodily systems and it is associated with various types of metabolic illnesses such as obesity, diabetes mellitus, insulin resistance, and cardiovascular diseases including hypertension. Decreased absorption of vitamin D may pose a risk for sarcopenia by affecting the lipid profile responses in metabolic syndrome (MetS).

Purpose
Our aim is to examine the relationship between vitamin D level and selected sarkopenia parameters such as muscle and fat mass, muscle strength, body composition, and walking speed in patients with MetS.

Method
67 patients (mean age=50.3±7.69/years, F:51, M:16) aged 35-65 years and diagnosed with MetS (according to NCEP-ATP III criteria) were included in the study. Body mass index (BMI), muscle and fat mass of the participants were assessed using bioelectrical impedance analysis (TANITA). Waist and hip circumferences were measured. Right and left quadriceps muscle strength (J-Tech CommanderTM Muscle Tester) and grip strength (Jamar dynamometer) of the dominant hand (all patients were right dominant) were measured with dynamometer. Walking speed was calculated by dividing the distance walked by minutes in the 6-minute walking test.

Results
Of the patients, 9 (13.4%) were categorized as deficiency (&lt;12 ng/mL), 10 (14.9%) had inadequacy (≥12 and &lt;20 ng/mL) and 48 (71.6%) had sufficiency (≥ 20 ng/mL) level of vitamin D. There was a significant correlation between vitamin D level and body fat mass (r=-0.29, p=0.017), BMI (r=-0.29, p=0.014), hip circumference (r=-0.28, p=0.021) and left quadriceps muscle strength (r=-0.288, p=0.018). There was no correlation between vitamin D level, 6 minutes walking speed, body muscle mass, right quadriceps muscle strength and hand grip strength (p&gt;0.05).

Conclusion
In this study, although vitamin D level was associated with left lower extremity muscle strength in patients with MetS, it was not associated with other sarcopenia parameters such as muscle mass, upper extremity muscle strength and walking speed. The relationship between vitamin D level, fat mass and body composition seen in our study may be due to altered lipid metabolism responses. We think that the effects of vitamin D on sarcopenia in MetS should be prospectively examined in a larger sample including elderly patients and considering the vitamin D intake.
Hemoglobin, maximal heart rate and work capacity, as well as time to exhaustion are significantly improved with combined hypoxia and aerobic exercise training in healthy adults: a meta-analysis
Authors: Cahalin L , Landis E , Formiga M 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background/Introduction
Hypoxic conditions have been used for a variety of reasons and have been implemented in multiple ways in an attempt to improve physiologic performance. Hypoxic conditions are administered via real or simulated altitude or by breathing lower levels of oxygen via facemask to improve different physiologic processes. Maximal work capacity (MWC) and time to exhaustion (TTE) are important factors related to sports performance. It is unclear how aerobic exercise (AE) with hypoxia effects MWC, TTE, and maximal heart rate (MHR) as well as hemoglobin (Hgb) and hematocrit (Hct) concentrations.

Purpose
Examine the effects of chronic AE with and without hypoxia on MWC, TTE, MHR, Hgb, and Hct.

Methods
A comprehensive search using PubMed, Cochrane, and PEDro was performed using a variety of keyword permutations on "hypoxia" and "aerobic exercise" in healthy adults. Inclusion criteria were studies with both a control and experimental group in which chronic AE was performed with and without hypoxia and MWC and TTE were provided in Watts and seconds, respectively. Study quality was assessed using the PEDro scale. Statistical analyses were performed using R with sub-analyses examining changes in Hgb, Hct, and MHR.

Results
A total of 16 studies met the inclusion criteria yielding a total sample size of 389 healthy adults. Study quality ranged from 4 to 6 out of 10 (mode=5). Significant tests for the overall effect of AE with hypoxia compared to AE without hypoxia on MWC and TTE were found under random-effects models (Z=2.83, p&lt;.001, 95% C.I. = 0.29-1.60 and Z=2.94, p&lt;.001, 95% C.I. = 0.80-4.00, respectively). A significant test for the overall effect of AE with hypoxia compared to AE without hypoxia on Hgb was also found (Z=2.06, p=.03, 95% C.I. = 0.01-0.60; fixed-effects model), but a non-significant overall effect on Hct was observed (Z=1.24, p=.21, 95% C.I. = -0.19-0.85; random-effects model). A significant test for the overall effect of AE with hypoxia compared to AE without hypoxia on MHR was also found (Z=2.84, p&lt;.001, 95% C.I. = 0.19-1.04). Substantial heterogeneity was observed in all analyses (I2 range of 64% - 89%).

Conclusions
Chronic AE with hypoxia elicits a significantly greater increase in MWC and TTE compared to AE without hypoxia in healthy adults. The significant improvement in Hgb and increased MHR provides a rationale for the improvement in MWC and TTE associated with chronic AE combined with hypoxia. Improvements in MWC and TTE have the capacity to improve sport performance. Further investigation of AE with and without hypoxia on specific sports and on other physiologic measures is warranted.
Electrical and structural remodelling in female athlete's heart: a study in women practising competitive sports
Authors: Cavigli L , D'ascenzi F , Marchese A , Taddeucci S , Cappelli E , Roselli A , Bastone G , Lemme E , Squeo M R , Serdoz A , Maestrini V , Pelliccia A 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Athlete’s heart is associated with a physiological electrical and structural remodelling induced by training. While several data have been published in male athletes, data on female competitive athletes, and their comparison with male counterparts or sedentary women, are still inconclusive.

Objectives
This study aimed to analyze the electrical, structural, and functional cardiac remodelling in female and male competitive athletes and sedentary controls.

Methods
Competitive athletes were evaluated by 12-lead resting ECG and echocardiography and compared to the sedentary controls.

Results
The study population was composed of 1,096 individuals (360 female Olympic athletes, 410 male Olympic athletes, 130 sedentary women and 196 sedentary men). Female athletes had lower resting heart rate, longer PR interval, higher voltage of P, R, and T waves and more frequently incomplete RBBB, left ventricular (LV) hypertrophy, early repolarization, and anterior T-wave inversion as compared with non-athletes. Biventricular dimensions and LV wall thickness were greater in female athletes as compared to non-athletes. However, women showed a lower degree of training-induced structural remodelling than men. A progressive increase in biventricular dimensions and LV wall thickness was observed from athletes engaged in skill and power to those practicing mixed and endurance disciplines. However, in women, but not in men, the type of sport did not significantly influence ECG remodelling.

Conclusions
Highly-trained women demonstrate a relevant training-induced electrical and structural remodelling. However, the type of sport did not influence ECG parameters in women while it impacted on biventricular remodelling, with female endurance athletes showing the greatest degree of adaptation.
New biomarkers in peripheral artery disease cardiovascular rehabilitation - keep it simple
Authors: Adam C A , Marcu D T M , Anghel R A , Mitu O , Mitu F 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.
Cardiac rehabilitation (CR) plays an essential role in the management of patients with peripheral artery disease (PAD) [1]. Patients enrolment in an integrative and multidisciplinary program, can improve the functional status, quality of life, and long-term morbidity and mortality [2]. We conducted a prospective cohort study on 97 patients with PAD admitted to a single tertiary referral center. Based on a long-term mortality prognostic index in PAD [3], we enrolled two groups of patients: low and low-intermediate risk (group 1, n=45) versus high-intermediate and high risk (group 2, n=52). We analyzed demographics, clinical, and paraclinical parameters, focusing on novel inflammatory biomarkers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), white blood cells-to-MPV ratio (WMR) and lymphocyte-to-C-reactive protein ratio (LCR). The 6 months follow-up showed that a minimum 50% decrease compared to initial levels was associated with both short and long-term clinical and functional improvement. A decrease in NLR (p &lt; 0.001), PLR (p = 0.028), WMR (p = 0.009) and LCR (p = 0.036) levels correlated positively with improved metabolic profile - low-density lipoprotein cholesterol (p= 0.015), triglycerides (p= 0.041) , fasting glucose (p=0.011) -, as well as improved exercise capacity - assessed through peak oxygen uptake (p = 0.008), pain-free walking distance (p = 0.024) and maximum walking distance (p = 0.032) at 6 months follow-up for group 1. Assessment of these inflammatory biomarkers had a statistically significant prognostic role in our study, being an accessible tool for clinical cardiologists in evaluating CR programs effectiveness in patients with PAD.