bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of resistance training on HbA1c and other cardiovascular risk factors in patients with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials
Authors: Michielsen M , Raats E N I D , Bos G , De Wilde C , Decorte E , Cornelissen V 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Obesity, hypertension, hyperlipidemia, and other cardiovascular risk factors are commonly clustered in patients with diabetes type II (T2DM). As a result, patients with T2DM are at increased cardiovascular (CV) risk. Exercise therapy is recommended in the prevention and management of patients with T2DM. In the last decade, dynamic resistance training has attracted more interest as an exercise therapy in the management of patients with diabetes. Though, the primary outcome in these intervention trials has mostly been glycated hemoglobin (HbA1c). Given the high prevalence of other CV risk factors in patients with T2DM, knowledge on the impact of dynamic resistance training on the overall CV risk profile of these patients is important.

Purpose
To perform a systematic review with meta-analysis to investigate the effects of resistance training on HbA1c and other traditional cardiovascular risk factors in patients with T2DM.

Methods and analyses
A systematic search was conducted in the electronic databases MEDLINE, Embase, SPORTdiscus and PEDro from the earliest date available until the first of September 2021 to identify peer reviewed randomized controlled trials investigating the effect of resistance training on HbA1C in adults with T2DM. Primary outcome was HbA1C. Secondary outcomes included traditional CV risk factors (i.e. blood pressure, blood lipids, body composition) and physical fitness (muscle strength, exercise capacity). Effect sizes were calculated using random effect models. Data are reported as weighted mean and 95% confidence limits.

Results
Fourteen trials could be included in the meta-analysis. Resistance training was found to significantly reduce HbA1c [-0.35 % (95% CL -0.61 to -0.11)], systolic blood pressure [-4.6 mmHg (95%CL -8.7 to -0.39)], diastolic blood pressure -2.25 (95%CL -4.45 to -0.048)) and body fat (-0 0.038). Muscle strength was significantly improved in the three studies reporting this outcome. Other cardiovascular risk factors including fasting plasma glucose, high-density-lipoprotein, low-density-lipoprotein, triglycerides and peak oxygen uptake capacity (VO2 peak) remained unchanged after resistance training in patients with T2DM.

Conclusion
The available data suggests that resistance training can exert favorable effects on HbA1C but also on blood pressure, body composition and muscle strength of patients with type 2 diabetes. Further research is needed to determine the impact of different resistance training characteristics such as volume, frequency and type of training on the overall CV risk profile of patients with type 2 diabetes.
Association of right and left atrial strain with laboratory, anthropometric and echocardiographic markers - the influence of COVID-19 pandemic
Authors: Dubatowka M , Chlabicz M , Sowa P , Jamiolkowski J , Solomacha S , Zieleniewska N , Lapinska M , Moniuszko-Malinowska A M , Kaminski K A 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): National Centre of Science.

Background
The exploration for the impact of surviving a coronavirus disease of 2019 (COVID-19) on the cardiovascular system and cause-and-effect relationships is still a challenge for researchers.

Purpose
The aim of the study was to evaluate the parameters of right and left atrial deformation using strain imaging in echocardiography (ECHO) among undergoing COVID-19, their relationship to the survival of this disease, and to investigate whether there is a relationship between these parameters and laboratory, anthropometric and echocardiographic markers.

Methods
The study consisted of 134 patients of the study group - subjects examined 6-9 months after hospitalisation due to COVID-19 infection, and 134 control subjects - participants of the Bialystok PLUS project, examined before the pandemic (the assumed start date of the pandemic in Poland is 18 March 2020). The groups were matched for age and gender. In all subjects, an extensive medical history was taken, anthropometric measurements, a comprehensive panel of laboratory tests, blood pressure, pulse wave velocity (PWV) were measured. ECHO was performed including assessment of right (RA) and left atrial (LA) strain parameters.

Results
Individuals after COVID-19 had significantly lower RA strain parameters, such as: global longitudinal strain (40.5±13.8% vs. control group 47.2±13.4%, p&lt;0.000) and global circumferential strain (26.9±16.5% vs. 32.8±16.5%, p=0.014), while no differences were found for LA strain. Significantly lower values of parameters characterising LV diastolic function, i.e. E/A (p=0.003) and septal e' velocity (p=0.012), were also observed in COVID survivors. Troponin (hs-TnT) (p&lt;0.000) and CRP protein (hs-CRP) (p=0.011) levels were significantly higher in the survivors group, while total cholesterol (p=0.001) and LDL fractions (p&lt;0.000) were significantly lower. Subjects after COVID-19 also had significantly higher neck, waist, hip circumferences (p=0.013; p=0.045, p=0.001 respectively) and body mass index (BMI) (p=0.045). The groups did not differ in metabolic markers (fasting glucose, glycated haemoglobin, HOMA-IR index). A multivariate linear regression analysis was conducted to assess which parameters might be related to the RA strain parameters. The results were shown in the table 1.

Conclusions
COVID-19 infection results in worsening of right atrial strain parameters. This phenomenon requires deeper analysis.
Assessing the need for rehabilitation programme for individuals living with atrial fibrillation
Authors: Alhotye M , Evans R , Ng A , Singh S 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Saudi Arabia cultural Bureau.

Introduction
Individuals living with Atrial Fibrillation (AF) can experience a variety of symptoms such as palpitation, dyspnea, fatigue and dizziness which lead to reduced physical activity levels and quality of life.(1) Current management of AF mainly focus on pharmacological treatments and invasive procedures, while no routine prescription of exercise or rehabilitation programme is offered.

Aims
To understand the severity of symptoms that individuals with AF may experience and their preference of a structured rehabilitation programme.

Methods
A cross-sectional survey was conducted through the phone and face to face between 20th of September and 20thof December 2021 for individuals with documented AF. The survey included fifteen multiple-choice closed questions and free text spaces for additional comments.

Results
Overall, 50 individuals (54% male, mean (SD) age 62 (15) years) with a clinical diagnosis of AF were approached and participated in the study. The majority of participants reported they had a severe shortness of breath 27 (54%) and 25 (50%) reported a severe levels of anxiety related to living with AF. In addition, 20 (40%) reported a severe levels of tiredness and 20 (40%) demonstrated a mild palpitations. Moreover, 8 (16%) reported a severe feeling of faint or lightheaded, while chest pain was the least symptom which only 3 (6%) rated it as a severe. (Figure 1). 47 (94%) of participants reported their desire to participate into a programme which could help managing their symptoms, and 35 (70%) reported their preference to receive the programme at home, while 30 (60%) reported a preference for a web-based rehabilitation programme with support from healthcare professionals (HCPs). (Figure 2).

Conclusion
The responses indicate a need for a rehabilitation programme for individuals living with AF. Shortness of breath, anxiety and tiredness were the main bothersome symptoms. Home-based rehabilitation was the most preferred way to deliver the programme followed by using digital interventions.
Meditation as a stress management strategy in cardiac rehabilitation for coronary artery disease patients: a randomized controlled trial
Authors: Vitorino Monteiro A , Pinto R , Lemos Pires M , Borges M , Pinto F , Zuzarte P , Abreu A 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
There is a growing body of empirical research that shows that psychological risk factors such as stress, type D personality, anger and hostility can lead to depression, anxiety, social isolation, and low socio-economics status. Psychological risk factors increase the risk of coronary artery disease (CAD) and contribute to a poorer quality of life (QoL) and worst cardiovascular prognosis. Stress, anxiety, and depression deteriorate the cardiovascular (CV) system through psycho-neuro-immunoendocrinology system and behavioural pathways. Meditation, as a form of body–mind interaction for primary and secondary prevention in CV disease has been discussed critically in the past and has been growing as a therapeutic practice. However, in CV rehabilitation programmes, more studies are needed to demonstrate meditation as a complementary therapy for CV patients.

Purpose
To evaluate the benefits of meditation as a stress management strategy, in a traditional CV rehabilitation programme, in terms of stress, anxiety, depression and QoL for people with CAD.

Methods
Eighty CAD patients were invited to join the meditation programme, 48 (60%) accepted and attended the initial assessment and 32 (40%) declined participation. The patients who accepted were attending for at least 6 months a 3x week exercise-based CV rehabilitation programme (usual care) and were randomized (1:1) into two distinct groups: the intervention group (IG) with meditation practice for 4 months and the control group (CG), usual care. In the IG, for one month, participants had a weekly session of 90 minutes consisting of Conscient breathing and Compassion Meditation (Karuna). During the next 3 months, all participants at the IG were asked to practice daily for 20 minutes alone or with the support material (video), with a weekly follow-up call. At the end of the 4th month, it was offered to the CG the same meditation programme. Outcome measures were assessed at the beginning (M0) and 4 months after (M1) including stress (Perceived Stress Scale), anxiety (Beck Anxiety Inventory), depression (Beck Depression Inventory) and QoL (HeartQoL questionnaire).

Results
Forty patients (65 ± 8 years, 80% male) completed all study requirements and were included in analyses. The IG reduced 44% of the depression levels when compared to the CG (-44.0 ± 32.0% vs -2.9 ± 5.0%; p&lt;0.001). There were 30% (p=0.04) and 31% (p=0.05) reductions in anxiety and stress levels in the IG, respectively. The emotional dimension of QoL increased 60% in the IG, p&lt;0.001. In contrast, physical QoL did not change between groups.

Conclusion
Meditation has proved to be an additional practice with effective reduction on stress, anxiety, and depression levels, as well as increasing QoL for patients with CAD who are attending a long-term CV rehabilitation programme.
Estimating cardiorespiratory fitness in heart failure patients with self-reported questionnaires
Authors: Van Leunen M , Van Hooff M , Meijer R , Spee R F , Lu Y , Schep G , Kemps H M C 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Cardiorespiratory fitness (CRF), assessed by peak oxygen uptake (VO2peak), is a powerful predictor of cardiovascular morbidity and mortality. However, performance of a cardiopulmonary exercise test (CPET) is often not feasible or desirable in (older) frail patients, because of physical limitations, transport difficulties, costs and the additional exposure to risks. Other CRF assessment tools, such as questionnaires, are potential alternatives, but have not been validated in frail elderly populations with chronic cardiovascular disease.

Purpose
The purpose of this study was to investigate the accuracy of two self-reported questionnaires, the FitMáx©-questionnaire and The Fitness Calculator, for assessment of CRF in chronic heart failure (CHF) patients.

Methods
CHF patients referred for CPET as part of a cardiac rehabilitation programme were eligible for the study. VO2peak was measured with a symptom limited maximal CPET. Participants completed two questionnaires to estimate VO2peak: the FitMáx-questionnaire and The Fitness Calculator. The FitMáx-questionnaire consists of three questions on walking, cycling and climbing stairs [1], and The Fitness Calculator is based on the HUNT3 study [2] and is currently advised by the American heart association as a non-exercise estimate for CRF [3].

Results
29 CHF patients (21 men, 64.2 years ± 12.0) were included with mean VO2peak of 15.7 ± 4.2 mL/kg/min at CPET. Correlation analysis indicated a moderate association between VO2peak assessed by the FitMáx-questionnaire and measured by CPET (r = 0.52) with a mean bias of 1.7 mL/kg/min (95% CI -6.0 – 9.4, p = 0.03). No association was found between VO2peak assessed by CPET and The Fitness Calculator (r = 0.24), mean bias 14.6 mL/kg/min (95% CI -0.5 – 29.7, p &lt;.01).

Conclusion
The FitMáx©-questionnaire is a moderately accurate tool for estimating CRF in the CHF population. For use in individual patients, efforts should be made to improve the accuracy in this specific patient group. To establish its clinical utility, additional research is needed to evaluate its reproducibility and sensitivity to detect interventional changes in this population.
Prevalence of abnormal cardiovascular magnetic resonance findings in athletes recovered from COVID-19
Authors: Tsampasian V , Catumbela R W , Androulakis E , Gati S , Papadakis M , Vassiliou V S 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Athlete’s heart is characterised by structural and functional cardiac adaptations that stem from high level athletic training1. There is evidence showing that non-specific myocardial fibrosis as shown in cardiac magnetic resonance (CMR) studies is more frequently encountered in athletes compared to sedentary individuals2. With the spread of COVID-19 pandemic, concerns were raised as to whether athletes would be at increased risk of myocardial involvement and subsequent adverse events. This systematic review and meta-analysis aims to assess the prevalence of CMR derived myocardial tissue characterisation abnormalities in athletes with COVID-19 infection.

Methods
PubMed, Cochrane and Web of Science databases were systematically searched from inception to 15th of September 2022. The statistical analyses were conducted using the Stata software (StataCorp. 2019. Stata Statistical Software: Release 16. College Station, TX: StataCorp LLC).

Results
We identified 476 articles out of which 12 studies with a total of 3,338 athletes were included in the meta-analysis 3–14. The median of the time period between the participants’ positive COVID test and their CMR scan ranged across the studies from 16 to 44 days. The pooled prevalence of LGE in athletes infected with COVID-19 was 5.85% (95% CI 2.17, 10.92, p &lt;0.001) (figure 1). Publication bias by Egger’s linear regress test was not significant (p = 0.16). Two studies with a total of 292 athletes compared the presence of LGE between athletes with COVID-19 and healthy control athletes 4,6. This showed a statistically significant higher prevalence of LGE in athletes infected with COVID-19 (figure 2).

Conclusion
CMR has an important role in the evaluation of highly trained individuals. This meta-analysis demonstrates that COVID-19 infection is associated with high prevalence of LGE and abnormal T1/T2 values in highly trained athletes. Whether this remains in the longer-term and whether it might associate with adverse events remains to be seen and further case control studies are needed in order to understand the implications of COVID-19 infection in the risk assessment of athletes.
The association between air pollution and the occurrence of atrial fibrillation (EP-PARTICLES study)
Authors: Kurasz A , Dobrzycki S , Kuzma L 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Science Centre Poland NCN (UMO-2021/41/B/NZ7/03716).

Background
Atrial fibrillation (AF) is the most common arrhythmia and environmental conditions are one of its risk factors. The "Polish smog" that occurs in Eastern Poland - due to its composition and the conditions in which it is formed - is characterized by extremely adverse health effects.

Aim
To assess the relationship between Polish smog and the occurrence of AF episodes.

Material and methods
The study area included voivodeship cities of Eastern Poland. Data on hospitalizations for 2016-2020 were obtained from regional departments of the National Health Fund. In the statistical analysis, a case-crossover study (CCO) method was used.

Results
During the analyzed period, a total of 40,471 hospitalizations for AF were recorded, including 18,139 emergency ones. The main pollutant affecting the occurrence of AF episodes was NO2 – a 10 μg/m3 increase in NO2 concentrations (OR=1.047, 95% CI 1.026-1.068; P&lt;0.001) resulted in an increase in emergency hospitalizations for AF. The effect of NO2 on AF was greater in the cold season than in the warm season (ORcold=1.562 95%CI 1.222-1.997, P&lt;0.001 vs ORwarm=1.055 95%CI 1.018-1.093, P&lt;0.001; P&lt;0.001). No age and sex differences in the influence of NO2 were observed. However, when it comes to the lag effect, the impact of NO2 was significantly greater among men than women on lag1 ORman=1.036 95%CI 1.007-1.066, P=0.01 vs ORwomen=0.978 95%CI 0.951-1.006, P=0.12; P&lt;0.001).

Conclusions
Variations in air pollution levels, especially NO2, can increase the risk of acute AF incidents. We associate the more pronounced adverse health effects noted during the heating season with the particularly toxic effects of Polish smog.
Gender disparities in Cardiac Rehabilitation - Are we concealing apples from Eve?
Authors: Martins A M , Aguiar-Ricardo I , Alves Da Silva P , Cunha N , Gregorio C , Abrantes A , Mourato C , Sequeira C , Pinto F J , Abreu A 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Cardiovascular disease is a leading cause of death in both men and women and cardiac rehabilitation (CR) is recommended as part of secondary prevention for these patients. Despite this, there are still important asymmetries when it comes to enrolment of women in CR programs.

Purpose
To determine differences between referral and outcomes of cardiac rehabilitation programs among women.

Methods
Prospective cohort study which included consecutive pts who were participating in a centre-based CR program lasting 8 weeks from 2019 to 2021. We analyzed prevalence of risk factors, lab echocardiographic and CPET data in women who were enrolled in the program. Statistical analysis was performed with Mann-Whitney and Wilcoxon tests Results: From a total of 349 patients, 60 women completed a CR program – 17,8% of pts – representing a far smaller percentage when accounting to acute coronary syndrome events in our center in those 2 years (31% women). Mean age of female participants was 60 ± 11,8 years; 74% had hypertension, 64% dyslipidemia, 19% diabetes and only 40% had never smoked. There were no significant differences when compared to male, except for thyroid disease which was more frequent among women (p&lt;0.01). Regarding lab data we noticed an improvement of LDL-c, total cholesterol, HDL-c, although only NTproBNP showed a statistically significant reduction (p=0.001). There was also an improvement of LVEF, once again without statistical significance (in contrast to the male population).
After completion of the program, there was an improvement regarding CPET duration and workload (p&lt;0.001 and p=0.019). Interestingly there was no difference in terms of peak VO2/kg, a data that goes in line with some reports of less impact of exercise based CR in this parameter in women.
Moreover, there were no differences between genders in terms of outcome, namely admissions or cardiovascular death.

Conclusion
Women still have a lower rate of enrolment in CR programs, despite results showing a similar benefit to men. CR effectiveness by CPET should include other parameters besides VO2 peak. Strategies should be developed to improve women participation in CR.
Chronotropism in CPET - Is incompetence limiting functional capacity?
Authors: Alves Da Silva P , Aguiar-Ricardo I , Martins A M , Brito J , Cunha N , Gregorio C , Mourato C , Caldeira E , Miguel S , Sequeira C , Pinto F J , Abreu A 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Chronotropic incompetence (CI) is defined as the inability to reach 80% of the expected reserve frequency for age during exertion, and it is frequently observed in stress tests of patients undergoing cardiac rehabilitation programs due to a combination of factors, that include the use of betablockers. Despite the theoretical basis for suggesting that a lower peak heart rate is related to a lower tolerance to exertion, we lack data correlating the CI to the maximal functional capacity, measured in cardiopulmonary tests as the maximal oxygen volume consumption (peak VO2).

Purpose
To correlate the impact of CI on functional capacity in patients (pts) undergoing a cardiac rehabilitation program and try to find the best value of chronotropic incompetence that could predict a worse prognosis.

Methods
Prospective cohort study which included consecutive pts who were submitted to cardiopulmonary exercise test (CPET) during 5 years in a tertiary hospital. Demographic data were analyzed and medication with beta blocker was registered. CI and chronotropic index were calculated using the equation (220-age) for estimating maximum HR. ROC curve method and Kaplan-Meier survival analysis were used to evaluate the cut-off efficacy.

Results
We analyzed 358 CPET and 74,1% patients (n=206) were under beta blocker therapy (7,6% high dose). The majority of the patients had CI (83.5%); CI was more frequent in pts under BB therapy although it didn’t reach statistical significance (p=0.12). A low maximum predicted heart rate (mpHR) was associated with low peak VO2 (p=0.02) and a mpHR &lt; 61% was the best value to predict peak VO2&lt; 12mL/(kg.min) (AUC=0.746, S=72; E=65), despite not showing association with cardiovascular events.
Regarding the chronotropism, 96.9% of the pts were categorized as having a low chronotropic index . A CI &lt; 0.38 was the best cut-off to predict a peak VO2&lt;12 mL/(kg.min) (AUC=0.81, S=72, E 76) and it was predictor of all-cause hospitalizations (p=0.015).

Conclusion
This study shows a high percentage of pts with CI. A low cronotropic index was associatated with low peak VO2 and was a predictor of all-cause hospitalizations.