bluuebunny/crossref_metadata_2025_split huggingface dataset:
Representativeness of women and racial/ethnic minorities in randomized clinical trials on bempedoic acid
Authors: Cicero A , Gori D , Fogacci F 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Women and racial minorities have continued for a long time to be underrepresented in randomized clinical trials testing lipid-lowering therapies (i.e. statins, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, ezetimibe, bile acid sequestrants, fibrates, niacin, and omega-3 polyunsaturated fatty acids).

Purpose
We sought to investigate presence of disparities in trials testing the new emergent lipid-lowering drug bempedoic acid (BA).

Methods
Several databases were searched with the use of a purposedly developed search strategy. To minimize the chances of missing data, the identified clinical trials were subsequently searched on http://www.clinicaltrials.gov. Original studies were included in the analysis if they met the following inclusion criteria: (i) being a clinical trial with either multicentre or single-centre design and (ii) having an appropriate controlled design for BA.

Results
Considering together, the overall participation rate and the mean participation rate across the clinical studies, men, whites and non-Hispanic/Latinos were sufficiently represented compared with their proportion in the disease population. Non-whites and Asians were underrepresented. Women, blacks and Hispanic/Latinos were from adequately to over-represented across clinical trials, though in the pooled population their portion was lower than their share of the disease population.

Conclusions
Further efforts are needed to enhance the representativeness of clinical trials according to race and sex and ensure complete information about efficacy and safety of treatment with BA.
Short-term trajectories of exercise-induced plasma lipid changes in overweight females, with a focus on HDL cholesterol
Authors: Hubacek J , Suchanek P , Lanska V 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministry of Health, Czech Republic

Background
Increased levels of plasma lipoproteins are among the modifiable risk factors of cardiovascular disease. Dietary changes and increased physical activity are the most powerful non-pharmacological interventions for the optimisation of plasma lipid levels.

Objectives
The aim of our study was to investigate the effect of an intensive short-term lifestyle intervention on plasma lipid trajectories in overweight non-diabetic females.

Materials and Methods
Two hundred and two healthy overweight (BMI &gt; 27.5 kg/m2) females underwent an intensive short-term (10-week) intervention (at least four units of 1-hour exercise activity weekly at optimal energetic intake) aimed at lowering body weight. Plasma lipid (TC, LDL-C, HDL-C, TG) levels were examined at baseline and every two weeks over the course of the 10-week intervention.

Results
There was a significant decrease in BMI (Δ -4.7%, P&lt;0.001) and body weight (Δ -4.9%, P&lt;0.001) after the intervention. Positive changes (decreases) in TC (Δ -8%, P&lt;0.001), TG (Δ -9%, P&lt;0.001) and LDL-C (Δ -11%, P&lt;0.001) were observed immediately after two weeks, but levels did not decrease further. In contrast, HDL-C did not increase as expected: after two weeks of intervention, we observed a significant decrease of about 6% (P&lt;0.001) followed by a slow return to baseline values. But even after ten weeks of intervention, HDL-C values had not reached the values detected at baseline.

Conclusion
In overweight females, HDL-C decreased after short-term intensive lifestyle intervention. To confirm the protective effect of increased physical activity, plasma lipids need to be examined over a longer time period.
Impact of COVID-19 infection on a physically active population: evaluation functional using the Cardiopulmonar Exercise Test (CPET)
Authors: Berenguel Senen A , Borrego Rodriguez J , Godoy Lopez JR , Gadella Fernandez A , De Cabo Porras C , Serrano Blanco A , Gallango Brejano M , Gigante Miravalles E , Morante Perea MC , Cepas-Guillen PL , Lazaro Salvador M , Villasante Felix ME , Fernandez-Vazquez F , Rodriguez Padial L 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
An increase it is being seen in patients who are referred for consultation due to dyspnea persistent after having overcome COVID19. The cause for this sequel is still not entirely clear, but our group has observed -in another study- that the consumption of oxygen (VO2) determined by cardiopulmonar exercise test (CPET) in these patients is low with respect to its predicted (p50). The objective of the present work was to demonstrate this hypothesis against to a control group with similar characteristics, who have not suffered from COVID19.

Methods
We conducted a prospective study with military personnel who are part of a corps of army elite. All subjects have performed the same training daily during the last 2 years. They were divided into 3 groups: the first (G1) made up of those who had not suffered from the COVID19 disease; a second group (G2) that had suffered from it, but did not report impairment of functional class (CF); and a third group (G3) who maintained dyspnea persistent 3 months after suffering from the disease. Analytical with NT-proBNP, echocardiogram, basal spirometry, and CPET were performed. None required hospital admission.

Results
36 subjects were included, distributed as follows: G1 (n = 14), G2 (n = 15), G3 (n = 7). The 3 groups had a similar age and BMI. None of the subjects presented alterations in baseline spirometry, neither structural heart disease in the echo, and nor relevant analytical alterations, being NT-proBNP less than 125 pg/ml in all of them. In relation to the response variables cardiovascular, statistical differences (p = 0.03) were observed in peak oxygen consumption predicted among the three groups (% predicted peak VO2), being significantly lower in the G3 subjects. In addition, a trend was observed -in absolute values- of peak VO2 to be lower in G3 -not significant probably due to the small sample size-. They were not objectified significant differences in PulseO2, nor in OUES. No patient presented alterations in the ventilatory efficiency parameters, or in final BR.

Conclusions
In our sample, patients who remained with persistent dyspnea after COVID-19, have a lower functional capacity compared to healthy subjects of the same characteristics, and with respect to subjects who after COVID19 do not present any symptoms. This subjective deterioration of the FC can be objectively quantified using CPET, thus reaffirming its value in this context.
Would be the minute ventilation variability an alternative to the dichotomous diagnosis of exercise oscillatory ventilation?
Authors: Karsten M , Ribeiro GS , Deresz LF , Salvioni E , Silveira LS , Hansen D , Agostoni P 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): CAPES and FAPERGS.

Background
Exercise oscillatory ventilation (EOV) is an abnormal ventilatory phenomenon observed in chronic heart failure (HF) patients usually defined as EOV-positive or EOV-negative based on a dichotomous diagnosis. Minute ventilation variability (vVE) can quantify the presence of these oscillations and assist the prognosis of patients.

Purpose
To analyse the sensitivity and specificity of vVE to predict 2-year all-causes of death in HF patients.

Methods
Data from 233 cardiopulmonary exercise tests from HF patients performed between 2011 and 2014 at an Italian heart centre were analysed. The vVE was defined by the standard deviation (SD) of VE normalized by the number of respiratory cycles (SD/n) during the exercise tests. The cut-off to predict 2-year mortality was determined by the receiver-operating characteristic (ROC) curve.

Results
Thirty-five deaths were registered at 2-years. The ROC curve indicated ≤ 54.9 as the better cut-off for vVE (32 deaths were registered in follow-up; Figure 1). The relative risk was 3.9 (1.3 to 12.4) with a hazard ratio of 2.7 (1.3 to 5.6) for 2-year mortality.

Conclusion
The vVE appears to be a sensitive alternative to quantify EOV and stratify high-risk cases from 2-year all-cause mortality.
Long-term effects of high-intensity interval training, moderate-to-vigorous intensity continuous training and Nordic walking on physical and mental health in patients with coronary artery disease
Authors: Terada T , Cotie L , Tulloch H , Mistura M , Vidal-Almela S , O'neill C , Reid R , Pipe A , Reed J 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Canadian Institutes of Health Research (CIHR) Postdoctoral Fellowship

Background/Introduction
Twelve weeks of high-intensity interval training (HIIT), moderate-to-vigorous intensity continuous training (MICT) and Nordic walking (NW) have been shown to improve functional capacity, quality of life (QoL) and depression in patients with coronary artery disease (CAD). However, their long-term effects are unknown.

Purpose
The primary purpose was to compare the long-term effects and sustainability of 12 weeks of HIIT, MICT and NW on functional capacity. The secondary purpose was to assess the long-term effects and sustainability of 12 weeks of HIIT, MICT and NW on QoL and depression severity.

Methods
Patients with CAD were randomized to a 12-week HIIT, MICT or NW program. Functional capacity, QoL and depression severity were measured at baseline, at the end of 12 weeks of intervention, and following 14 weeks of observation phase (week 26). Functional capacity was measured with a 6-minute walk test (6MWT); QoL was assessed by the HeartQoL and Short-Form-36; and depression severity by the Beck Depression Inventory-II (BDI-II). The long-term effects (changes between baseline and week 26) and sustainability (changes between week 12 and week 26) were assessed by linear mixed models for repeated measures.

Results
Of 130 participants randomized, 86 (HIIT: n=29, MICT: n=27, NW: n=30) completed week 26 assessments. There were significant improvements in 6MWT distance (F=149.657, p&lt;0.001), QoL and depression severity (both p&lt;0.05) from baseline to week 26; the increase in 6MWT distance was greater for NW when compared to MICT (F=7.021, p=0.010) and HIIT (F=5.279, p=0.025, Figure). Between week 12 and week 26, 6MWT distance (F=10.863, p=0.001) and physical QoL (physical component summary [PCS]; F=4.084, p=0.047) increased significantly, whereas mental QoL significantly decreased (mental component summary [MCS]; F=4.052, p=0.047).

Conclusion
HIIT, MICT and NW have positive long-term impacts on functional capacity, QoL and depression severity. However, NW was shown to confer additional benefits in increasing long-term functional capacity. The positive effects of the 12-week exercise programs were sustained at week 26 except for mental QoL.
The relation between Phase Angle as muscle function by BIA and physical function and nutrition states in cardiac patients
Authors: Kawazu T , Kurose S , Kimura Y 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
[Purpose] Phase angle (PhA) by BIA was studied as muscle function in various diseases. However the effects of nutrition states to phase angle is unclear especially in cardiac patients. This study examined the relationship between PhA, physical function and nutritional index in patients with heart disease.

Methods
PhA was measured using InBody770 for 33 heart disease patients (age: 71.6 ± 13.4 years, EF: 58.6 + 11.0%) who underwent cardiac rehabilitation during hospitalization. Short Physical Performance Battery (SPPB) was performed for physical function evaluation, and ALB, eGFR, and NT-ProBNP were evaluated for blood tests. calorie intake and GNRI were calculated as nutritional assessments.

Results
PhA was 4.1 ± 0.9 °. PhA has a positive correlation with SMI (r = 0.62), chair rise time (r = 0.62), dietary calorie intake (r = 0.49), GNRI (r = 0.50), NT-ProBNP (r = -0.631), ECW A negative correlation was found with / TBW (r = -0.91). As a result of multiple regression analysis with PhA as the dependent variable, ECW / TBW (β = -0.73), SMI (β = 0.33), and chair rise time (β = 0.10) were extracted as significant independent factors (β = -0.13). r² = 0.96).
[Conclusion] PhA in patients with heart disease was correlated with physical function and nutritional index, and a significant independent factor was physical function. In particular, lower limb muscle strength was extracted independently of extracellular water ratio and muscle mass. These results suggest that PhA may be a comprehensive index of physical function in cardiac patients.
Patients with Minor Non-Disabling Stroke (MiNDS): results of a structured cardiovascular rehabilitation program
Authors: Palermi S , Brugin E , Compagno S , Pescatore V , Tegon G , Sarto M , Marin R , Masato M , Panico A , Biffi A , Giada F 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Ischemic cerebral and cardiac events are the leading causes of mortality and morbidity in Minor non-Disabling Stroke (MiNDS) patients. Control of cardiovascular risk factors, including physical activity levels, is a key strategy in secondary prevention of MiNDS. However, there is a gap between recommendations and real achieved physical activity levels in these patients. Clinical benefits obtained with cardiovascular rehabilitation in cardiac ischemic patients could be obtained with similar programs also in patients with MiNDS, given the common pathophysiological substrate of these two diseases.

Purpose
To evaluate safety, effectiveness and feasibility of a cardiovascular rehabilitation program based on structured physical exercise (SPE) in patients with MiNDS.

Methods
39 MiNDS patients (26 males, mean age 66 years) underwent an accurate medical screening process, body composition evaluation, cardiopulmonary exercise test (CPET) and muscular strength assessment, before and after a 12-sessions in-hospital SPE program, and after 6- and 12-months follow-up during which they could continue their training schedule on their own.

Results
After in-hospital rehabilitation program, a significant improvement in CPET parameters, body composition and muscular strength was observed. These modifications persisted in the 32 patients who continued 6- and 12- months follow-up training, while regressed in the 7 patients who stopped training.

Conclusions
Results of the present study show that a SPE-based cardiovascular rehabilitation program provides clinical benefit in patients with MiNDS.
Role of Integrated yoga like posture, breathing exercise, music, sattvic diet and bhagwad geeta for quit smoking and cardiovascular prevention as compare to still active smokers
Authors: Sen N , Tanwar SONAL , Jain ASHOK , Kumar DEEPAK , Sen NARESH 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Coronary heart disease (CHD) is increasing in young individuals and female also in India due to smoking .The possible effect of smoking on endothelial function has long been revealed and also cause oxidative distress, negatively affects platelet function, fibrinolysis, inflammation and vasomotor function.

Purpose
Smoking cessation program by integrated yoga to quit smoking for better cardiovascular prevention .

Methods
17655 pre-hypertensive and prediabetic enrolled during 2009- 2011 at different medical centers, male versus female 4: 1 (age 18-50 years), 10660 non-smokers and 6995 smokers at same smoking index. We categorized group A for Integrated yoga like posture, breathing exercise (Pranayama), music, sattvic diet and bhagwad geeta for quit smoking and Group B who were denied for spiritual vedic program. Session were perform with three cycles for 3 months and taken follow up after 5 & 10 years.

Results
Data suggest that quit smoking samples were found in integrated yoga group A, 88 % versus 15 % in normal group B. We compared data and found significant BP, HR, HRV reduction around 2.5 fold higher reduction in integrated yoga group quit smokers as compare to still smokers in normal group B with P value ( 0.002, 0.004, 0.003), 1.5 fold reduction of BMI in group A (p&lt;0.005). Significant two fold decrease of incidence of diabetes type 2 and left ventricular diastolic dysfunction, improvement of treadmill METs value, 6 min walk and pulmonary vital capacity in integrated yoga group after 10 years of follow up. 38% risk reduction of acute myocardial injury and stroke found in integrated yoga quit smoking group A.

Conclusion
Smoking cessation is mandatory to reduce cardiovascular events. Integrated yoga is a master life style intervention for quit smoking without medical side effects in future.
Shorter cardiac rehabilitation programs: taking time is taking effectiveness?
Authors: Alves Da Silva P , Brito J , Aguiar-Ricardo I , Cunha N , Abrantes A , Fonseca J , Pinto R , Caldeira E , Sousa P , Pinto FJ , Abreu A , Miguel S 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Due to the covid-19 outbreak, cardiac rehabilitation programs (CRP) underwent most needed adaptions to stay operative. To face all the requests and guarantee sanitary measures, we reduced the duration of the program from about 12 weeks to about 8 weeks, so we could have smaller groups but still respond to all patients who had been referred. However, it is still unclear whether less hours of contact and exercise sessions can achieve the same results as traditional CRP.

Objective
To analyse the effectiveness of shorter duration CRP on risk factor control and exercise tolerance after concluding the program.

Methods
Observational single center study including two groups of patients who underwent CRP: one group who had been in 12 weeks-CRP before the pandemic sprout and another group enrolled in an 8-week program after April 2021. Albeit differences in their duration, both CRP had the same structure: observation by cardiologist, physiatrist, specialist nurse, exercise (aerobic and strength exercises) and educational sessions, as well as nutrition and psychologist consultation.

Results
A total of 114 pts were analysed (mean age 62,4±11,6 years, 85.1% men, 86% with ischemic heart disease). Main comorbidities were hypertension (68,4%), dyslipidaemia (70%) and diabetes (30,7%). 78 pts completed a longer programme with 12 weeks duration while 36 underwent a shorter CRP with 8 weeks. There were no statistically significant differences between both groups regarding population demographics, aetiology, LVEF and co-morbidities.
After CRP, there was significant improvement in risk factor control (mainly lipidic profile and weight) and echocardiographic parameters in both groups. We noted an important reduction in LDL levels (85±42.6mg/dL before CRP and 67.68±28.45mg/dL after), approaching the guideline recommended levels (&lt;55mg/dL): 29.8% before vs 42.6% after (p=0.079), with no difference between the two groups (p=0,65). Significant improvement of LVEF was also observed (53% to 57%, p &lt;0.001) without difference between the two groups (p=0.112).
Exercise tolerance improved similarly in both groups, assessed by the time of exercise stress test: we registered a global increase of 65 ± 1.38s after CRP, with no difference between the two groups (p = 0.157).

Conclusion
Shorter duration CRP showed similar results concerning risk factor control, echocardiographic LVEF and exercise tolerance improvement, suggesting that they can be an effective alternative when needed.
Centres of sports cardiology in Czechia - first experiences
Authors: Tuka V , Jenisova A , Jiravska-Godula B , Jiravsky O 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background/Introduction
Sports cardiology is a subspeciality of cardiology. It differs from general cardiology practice; the presence of an athlete’s heart can be challenging to differentiate from incipient cardiac pathologies, and athletes often present with atypical symptoms and expectations. In Czechia, three Centres of Sports Cardiology (CSC) for athletes older than 15 years and one for children were founded 2020 and endorsed by the Czech Society of Cardiology and the Czech Society of Sports medicine.

Purpose
The present study aims to share our experience from the first two years of functioning two tertiary sport cardiology centres (Centre 1 and Centre 2)

Methods
Only athletes registered for the examination from 1st January 2020 till 7th November 2021 were included.

Results
We included 149 athletes (79 from Centre 1 and 71 from Centre 2). The mean age was 29 ± 13 years. The majority of sports were mixed (n= 83) than endurance (n=58) and very few power (n=3) and skill sports (n=1). The main reason for examination was abnormal preparticipation screening results (n=46), symptoms (n=45) and abnormal findings on complementary examination (n=31). Only two athletes were indicated from cascade screening and one athlete after sudden cardiac arrest.
In CSC we performed electrocardiograms (n=101), echocardiography (n=77), HolterECG (n=39), 24-hour ambulatory blood pressure monitoring (n=3), cardiac magnetic resonance (n=13) one CT-coronary angiography, cardiopulmonary exercise stress test (n=41), invasive coronary angiography (n=3), other examination (n=15). We were able to ascertain a diagnosis in 113 athletes; a suspected diagnosis was in 14 athletes, and in 20, we were unable to set any diagnosis. The main conclusions were that 79 (53%) of athletes were eligible to sport participation, in 34 (23%) of athletes, the eligibility had a condition, and only 10 (6.7 %) athletes were ineligible to sport participation. (However, the main conclusions were that 79 (53%) of athletes were eligible to sport participation, in 34 (23%) of athletes, the eligibility had a condition, and only 10 (6.7 %) athletes were ineligible to sport participation. ) The ineligibility was due to cardiomyopathy (n=5), long QT syndrome (n=2), valvular heart disease (n=1), Marfan syndrome (n=1), preexcitation syndrome (n=1). Only six athletes were lost to follow-up, and in 13 (8.7 %), the examination process was not yet closed.

Conclusion(s)
The establishment of sports cardiology centres in Czechia respects the global trend in cardiovascular care for athletes. The first 22 months of their work confirm the importance of their existence with the centralization of subspecialty cardiology care. Confirmation of the trend is the establishment of full eligibility in 76% of examined athletes. Similarly, the non-recommendation of further sports activity in less than 7% of examined athletes again confirms the correctness of the existence of sports cardiology centres.