bluuebunny/crossref_metadata_2025_split huggingface dataset:
It takes more than a coronary event to make me be physically active
Authors: Flammer F , Marques-Vidal P 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Swiss National Science Foundation

Background
Physical activity (PA) is indicated to prevent recurrence after a coronary event. Whereas patients increase their PA after a coronary event has seldom been assessed.

Methods
Data from a prospective study conducted in Switzerland. We assessed PA before and after a first coronary event: self-reported PA the last 4 weeks using data from the first (2009-2012) and second (2014-2017) follow-up, and accelerometry-assessed PA for 2 weeks using data from the second and the third (2018-2021) follow-up. Sedentary, light, moderate and vigorous PA were computed as percentage of daily activity and expressed as median and [interquartile range].

Results
For reported PA, data from 85 patients (34 women, 63±9 years) was used. No differences were found for all PA levels before and after the event (see table). Comparison with age- and gender-matched healthy controls (ratio 3 controls : 1 case) showed no differences regarding trends in reported PA (not shown). For accelerometry-assessed PA, data from 34 patients (17 women, 66±9 years) was used. Again, no differences were found for all PA levels before and after the event (see table).

Conclusion
Patients do not seem to change their PA levels after a first coronary event. Our results should be confirmed in larger samples.
Meta-analysis of randomized controlled trials examining the safety and efficacy of bempedoic acid
Authors: Borgatta L , Sturts A , Zaman N , Grewal S , Nudy M 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Bempedoic acid (BA), an inhibitor of ATP citrate lyase, has emerged as a new therapy for patients with dyslipidemia. The objective of this study was to perform a meta-analysis of BA's safety and cholesterol lowering efficacy.

Methods
A meta-analysis was performed using RCTs testing the safety and efficacy of BA versus placebo. The primary analysis calculated the odds ratio (OR) and 95% confidence interval (CI) of any adverse events, muscular-related AEs including myopathy, muscle weakness, and myalgias, as well as serious AEs as self-defined by the individual RCT. Additionally, we evaluated the mean difference (MD) and CI of low density lipoprotein-cholesterol (LDL-C), non-high density lipoprotein-cholesterol (non-HDL-C), total cholesterol (TC), and apolipoprotein B (ApoB) at 12 weeks, as well as LDL-C at 24 weeks of BA use as compared to placebo.

Results
Four RCTs were identified comparing BA to placebo. There was no increased risk of any AE [OR 1.04; 95%CI 0.89, 1.22], serious AE [OR 1.07; 95%CI 0.87, 1.34], or muscular-related AE [OR 1.25; 95%CI 0.98, 1.58] with BA use compared to placebo. BA resulted in a significant reduction in LDL-C [MD -21.06; 95%CI -24.49, -17.62], TC [MD -16.02; 95%CI -19.09, -12.93], non-HDL-C [MD -17.84; 95%CI -21.34, -14.34], and ApoB [MD -14.19; 95%CI -17.18, -11.21] at 12 weeks, and LDL-C at 24 weeks [MD -16.42; 95%CI -18.15, -14.69] compared to placebo.

Conclusion
In this meta-analysis testing BA versus placebo, BA significantly reduced levels of LDL-C, TC, non-HDL-C, and ApoB at 12 weeks and LDL-C at 24 weeks, and was not associated with an increased risk of any AE, muscular-related AE or serious AE. Further studies with longer time of follow up are needed to confirm the safety and long term cholesterol effects of BA.
Should we be afraid of watching sport events?
Authors: Ferraz LM , Martins JL , Afreixo V , Carvalho P , Adrega T , Faustino A , Neves A 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Behavioral and emotional factors may trigger cardiovascular events (CVE). Watching sports when there is an emotional connection between the supporters and the supportive team, is believed to be potentially associated with CVE. However, epidemiological studies have been inconsistent, with several studies showing an increase in CVE, while others reporting a protective effect.

Purpose
To assess the effect of watching sport events on the incidence of cardiovascular events.

Methods
Pubmed, and Embase were systematically searched to identify appropriate articles. Reference lists were then hand searched for additional relevant articles. To be included, articles had to assess the association between CVE and sport events supporters (adeptos). Pooled association measures, using random effects analysis, were calculated for mortality; arrhythmias; myocardial infarction (MI). Subgroup analysis was conducted based on gender. Publication bias and between-study heterogeneity were evaluated.

Results
There were nineteen studies included in the analysis. The pooled relative risks for mortality, arrhythmias and MI were 1.45(0.98-2.15; 95%CI; I2=70%; p=0.02); 1.31(0.98-1.77; 95%CI; I2=85%; p&lt;0.01); 1.11(0.98-1.24; 95%CI; I2=91%; p&lt;0.01) respectively (Figure 1A). The null association persisted in the subgroup analyses by gender for mortality (Figure 1B) as well as for MI and for the combined endpoint MI/stroke (non significant relative risks).

Conclusions
Overall this analysis suggests that watching sport events does not increase cardiovascular events regardless of gender.
Coronavirus-related stress, anxiety, and obsessive thinking in patients undergoing cardiac rehabilitation during the COVID19 pandemic
Authors: Jug B , Farkas Lainscak J , Sedlar N , Stojnic D , Lainscak M 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Slovenian Research Agency and Ministry of Health of the Republic of Slovenia

Background
The coronavirus (COVID19) pandemic has disrupted the provision of health care, including cardiac rehabilitation. Reduced healthcare provision has been associated with reduced accessibility, wheares patients’ perspectives – such as COVID19-related anxiety, stress and obsessive thinking – have been less thouroghly addressed.

Methods
This was a cross-sectional study of COVID19-related anxiety, stress and obsessive thinking in consecutive patients undergoing outpatient cardiac rehabilitation after myocardial infarction at two centres — a general hospital catering a predominantly rural area and a university hospital in an urban area. From April to October 2021 we captured patients’ clinical and socio-economic characteristics, and resposes to the Hospital Anxiety and Depression Scale (HADS) as well as to three dedicated COVID19-related questionnaires – the Coronavirus Anxiety Scale, the Obsession with COVID-19 Scale and a customized COVID-19 Stress Scale.

Results
We included 109 patients (mean age 59±10 years, 20% women). Fifteen (13.8%) and eleven (11%) patients reached a HADS treshold for depression and anxiety, respectively. Pateints expressed most concenrs regarding the safety of COVID19 vaccinces (60.6%) on the COVID19 Stress Scale, sleeping disturbances (14.8%) on the Coronavirus Anxiety Scale, and fear of interacting with infected people (30.3%) on the Obsession with COVID-19 Scale. No significant differences were observed between respondents from the general and the university hospital. HADS score and social status—but not age, sex and clinical characteristics—were associated with scores on the COVID-19-specific questionnaires; HADS-anxiety domain score remained an independent predictor of COVID19-related stress (p=0.009), obsessive thinking (p&lt;0.001) and anxiety (p=0.009) after multivariate adjustment.

Conclusions
Patients undergoing cardiac rehabilitation expressed relatively low levels of COVID19-related stress and anxiety. Higher levels of COVID19-related stress, anxiety, and obsessive thinking were observed in patients with higher levels of anxiety, but not in association with demographic or clinical characteristics.
The effect of hemoglobin level on the prognostic value of peak exercise oxygen uptake differs between obese and non-obese patients with heart failure
Authors: Bhat S , Laffin L , Kondoleon N , Van Iterson E 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Obesity and low hemoglobin content (Hgb &lt;13 and &lt;12 g/dL, men/women, respectively) are commonly observed in patients with heart failure and reduced ejection fraction (HFrEF). This overlap typically yields reductions in peak exercise oxygen uptake (V̇O2peak) which exceed those observed in both non-obese and obese patients exhibiting normal Hgb levels. However, when matched for body size, non-obese patients exhibiting low Hgb levels also demonstrate worse V̇O2peak impairment than normal Hgb level counterparts. To date, it is unclear whether the effect of Hgb level on V̇O2peak also affects the association between V̇O2peak and mortality risk in both non-obese and obese patients.

Purpose
To assess whether V̇O2peak that is predictive of mortality risk is directly impacted by Hgb level regardless of whether a patient is non-obese or obese.

Methods
Adults with HFrEF (n=346; LVEF ≤40%; 76% men) completed cardiopulmonary exercise testing (CPET) as part of routine clinical management. The majority of patients performed Naughton or Modified Naughton CPET protocols. Patients with a BMI ≥30 kg/m2 were classified as obese (n=135; 81% men). Patients were followed up to one-year for the endpoint of all-cause mortality.

Results
Age (63±7 vs 61±8 yrs), total body weight (77±13 vs 107±15 kg), BMI (25.2±3.0 vs 34.5±4.0 kg/m2), and Hgb (12.6±1.8 vs 13.1±1.8 g/dL) differed between non-obese and obese patients (all P&lt;0.01), respectively. There were no significant differences between non-obese and obese patients for % men (73 vs 81 %), % ischemic etiology (46 vs 42 %), and LVEF (23±8 vs 24±9 % (all P&gt;0.05), respectively. Peak exercise RER (1.13±0.12 vs 1.10±0.11), V̇O2peak (13.0±3.8 vs 11.9±3.3 mL/kg/min), and absolute V̇O2peak (1.01±0.37 vs 1.28±0.40 L/min) differed between non-obese and obese patients (all P&lt;0.02), respectively. Over the 1-year tracking period, 25 and 13 deaths were observed and crude survival was 85% and 88% in non-obese and obese patients (Log-rank, P=0.465), respectively. In obese patients, V̇O2peak and Hgb interacted (χ2=4.855, P=0.028), resulting in up to a 22% reduction in all-cause mortality risk per 1.0 mL/kg/min rise in V̇O2peak for Hgb levels ≤13.1 g/dL. In non-obese patients, V̇O2peak and Hgb did not interact (χ2=0.001, P=0.977), and when Hgb was removed from the Cox regression, this resulted in up to a 29% reduction in all-cause mortality risk per 1.0 mL/kg/min rise in V̇O2peak (χ2=23.618, P&lt;0.001).

Conclusion
Demonstrating low Hgb and V̇O2peak levels yields comparable effects on all-cause mortality risk in non-obese and obese patients. However, at normal Hgb levels, V̇O2peak loses prognostic value in the obese, suggesting for these patients other CPET variables should be used to complement V̇O2peak when CPET is built into risk stratification models.
Are there correlations between lung volume and exercise capacity in children and adolescents with native Ebstein's anomaly?
Authors: Hock J , Nagdyman N , Meierhofer C , Ewert P , Hager A 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Patients with Ebstein’s Anomaly (EA) represent a wide clinical range with patients needing surgery in infancy and others needing no surgery throughout life. Exercise capacity in EA is often impaired. However, lung function is rarely investigated.

Purpose
This study examines lung volumes in native EA and their correlation with exercise capacity.

Methods
This retrospective study investigated 35 children with native EA (14 ± 4 years, 17 female), who underwent a cardiopulmonary exercise test (CPET) including spirometry to examine peak oxygen uptake (peakV’O2), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and its ratio (FEV/FVC). Percentage in peakV’O2 &lt;80% represents a reduced exercise capacity, and values &lt;60% are defined as impaired. Z-scores below -1.64 categorize restrictive (FVC) or obstructive (FEV1/FVC) patterns. To analyse correlations between CPET and lung volumes Spearman’s rank test was performed.

Results
Reduced exercise capacity was found in 17 children (47%), and further seven (20%) children showed impaired exercise capacity. Seven patients (20%) had a restrictive lung volume pattern and three patients (9%) showed obstructive patterns. One patient showed both. Eleven (92%) patients with an impaired lung function had at least a reduced exercise capacity with a median of 64 [53;73] %predicted. Lung volumes correlate significantly with %peakV’O2 (z-FVC: r=0.500, p=0.002 and z-FEV1: r=0.443, p=0.008).

Conclusions
Most young patients with native EA have impaired results in exercise capacity and a third has reduced lung volumes. Low lung volumes correlate with worse exercise capacity. Thus, the lung function should also be taken into consideration when looking at the performance of these and medical aftercare.
Cardiac Optimal Point: Identifying high risk patients for an optimal approach
Authors: Brito J , Silva P , Aguiar-Ricardo I , Cunha N , Pinto R , Raposo M , Gregorio C , Sousa P , Caldeira E , Miguel S , Abreu A 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
In recent years it has been proposed the concept of cardiorespiratory optimal point (COP) to best characterize populations who underwent cardiac rehabilitation programmes (CRP). The COP is defined as the minimum ratio between ventilation and oxygen consumption (VE/VO2) obtained during the cardiopulmonary exercise test (CPET) and it has been suggested that COP values &gt; 30 conveyed worse prognosis.

Purpose
To validate OP as a predictor of events and its correlation with exercise activity and quality of life on the long term.

Methods
Single center observational study of patients enrolled on CRP - from February 2018 to May 2019 – who did CPET as part of routine evaluation. COP was defined as the lowest point of VE/VO2 ratio. Clinical and laboratorial characteristics were obtained at admission and discharge of CRP. Exercise practice was accessed using IPAQ questionnaire and quality of life was assessed based on a validated inquire - Kansas City Cardiomyopathy Questionnaire (KCCQ-23) – both by phone interview.

Results
A total of 78 patients (mean age 63.2 ±11.6, 84.6% male) were evaluated and followed for a mean follow-up of 2,68±0,53 years. Main aetiology was ischemic heart disease (86%), followed by dilated cardiomyopathy (5,1%) and valvular heart disease (2,6%).
A COP value above 30 correlated with a worse global score in KCC-23 (r =0.283, p = 0.47), and in particular domains such as frequency and severity of symptoms (p = 0.046, r 0.335 and p=0.16, r= 0.4, respectively), quality of life (p=0.039, r= 0.293) and social limitation (p = 0.001, r=0.5). COP also correlated with VO2 peak in basal CPET (p&lt;0.001, r= 0.450) and on follow-up CPET (p= 0.39, r= 0.303).
COP failed to predict events or levels of exercise activity on the long term, as evaluated by the IPAQ score. However, COP&gt;30 did seem to correlate with a higher mortality rate on the follow-up although such trend was not statistically significant (possibly due to short follow-up time and sample size).

Conclusion
COP values &gt; 30 identify patients with worse prognosis, predicting worse quality of life and higher mortality. Although it did not seem to be a good predictor of exercise adherence after CRP.
Comparison of inpatient and outpatient cardiac rehabilitation following myocardial infarction
Authors: Jankowski P , Topor-Madry R , Pinkas J , Gasior M 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Cardiac rehabilitation (CR) following myocardial infarction (MI) improves prognosis. Models of second phase CR differ across countries. The aim of the study was to compare outcomes in MI survivors participating in outpatient and inpatient CR programmes.

Methods
We included all patients hospitalized due to acute MI in Poland between October 2017 and December 2018 (n=96634). Among them 4411 patients were referred to and commenced outpatient CR, whereas 11626 patients started inpatient CR within 30 days following discharge. All the patients were the subject of prospective follow-up. The primary endpoint was defined as death from any cause.

Results
The mean follow-up was 332.8±128.1 days. Younger age, male sex, and a cancer in the history were related to higher probability, whereas diabetes, heart failure, chronic kidney disease, chronic obstructive pulmonary disease, ST-elevation myocardial infarction, and myocardial revascularization were related to lower probability of participation in the outpatient CR. Participation in outpatient CR was related to the risk of all-cause mortality both in univariable (hazard ratio [95% confidence intervals] 0.37 [0.26-0.51]) and multivariable analysis (0.53 [0.38-0.74]). Participation in the outpatient CR was also related to the lower risk of death or MI or stroke (0.57 [0.48-0.67] and 0.72 [0.61-0.84]) and a lower risk of death or hospitalization due to cardiovascular reasons: 0.78 (0.73-0.84) and 0.85 (0.80-0.91) for the univariable and multivariable analyses respectively. The analysis of propensity score matched groups confirmed the results.

Conclusion
Outpatient CR following MI may be related to improved prognosis compared to the inpatient programme.
Physical and psychological reconditioning in long covid syndrome patients: results of a structured physical exercise program
Authors: Palermi S , Compagno S , Pescatore V , Brugin E , Tegon G , Sarto M , Marin R , Calzavara V , Nizzetto M , Scevola M , Albertin C , Biffi A , Giada F 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Long Covid Syndrome (LCS) is used to describe signs and symptoms that continue or develop after acute COVID-19 infection. Natural history and treatments of this syndrome is still poorly understood. In literature there is currently a lack of data on the real effectiveness of a multidisciplinary rehabilitation program based on structured physical exercise (SPE) in these patients.

Purpose
To evaluate safety, effectiveness and feasibility of a structured individualized rehabilitation program in improving physical and psychological parameters in patients with LCS.

Methods
Twenty-eight patients with LCS (19 males, mean age 57 years) underwent an accurate medical screening process, body composition evaluation, cardiopulmonary exercise test (CPET), muscular strength assessment, quality of life (QoL), psychological assessment and counselling, before and after a 12-sessions SPE program.

Results
At baseline, all LCS patients showed severe impairments in physical performance, QoL and psychological parameters. No adverse effects and dropouts were observed during training session. After the rehabilitation program, significant improvement in CPET parameters, upper and lower limb muscular strength, perceived physical and mental health, body composition, depression and anxiety and Covid residual symptoms was observed.

Conclusions
The present study confirms severe impairment of patients with LCS and suggest that a multidisciplinary rehabilitation program based on SPE could promote their physical and psychological recovery.
Reduced psychological distress three months after intensive group-based cognitive therapy in cardiac patients
Authors: Holdgaard A , Eklo Kjesbu I , Eckhardt-Hansen C , Funch Lassen C , Prescott E , Kruuse Rasmusen H 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): TrygFondenHelseFonden

Background/Introduction
Patients with coronary artery disease (CAD) and valvular heart disease (VHD) often suffer from psychological distress, which in turn leads to impaired quality of life, delayed return to work and increased morbidity and mortality. Manageable interventions addressing psychological distress in cardiac patients are needed.

Purpose
To develop an efficient and cost-effective model for cardiac patients to reduce psychological distress.

Methods
A multi-centre, prospective, randomized clinical trial in patients with newly diagnosed CAD and/or surgically treated VHD and concomitant psychological distress defined as Hospital Anxiety and Depression (HADS A(Anxiety) or D(Depression) ≥8) and part of the work force. The patients were randomized to either usual out-patient cardiac rehabilitation (CR) comprising an 8-week multidisciplinary program or usual care supplemented by five group-based cognitive therapy sessions performed by trained CR nurses. The primary outcome was total HADS score at three months.

Results
We included 147 patients with HADS score &gt;=8; mean age was 55, 74% were male and 92% had CAD (Table 1). At three months, total HADS score improved by 8 (CI: 8.0-10.7) in the intervention versus 3,9 (CI: 11.8-15.4) in the usual care group (p for difference &lt;0.001). Both subscales, anxiety and depression improved significantly more in the intervention group (Figure 1).

Conclusion
Brief cognitive behavioral therapy provided by cardiac nurses to patients with a high HADS score significantly reduced psychological destress after 3 months when compared to usual care.
Baseline demographic and clinical characteristics
Table 1
SD: Standard deviation, IQR: Interquartile range, CAD: Coronary artery disease, PCI Percutaneous Coronary intervention, CABG: coronary artery bypass graft, LVEF: Left ventricular ejection fraction