Immunomodulatory effects of aerobic training in obesity.

Introduction: Physical inactivity and obesity are independent risk factors for atherosclerosis. We analyzed the immunomodulatory capacity of 10-week intensified exercise training (ET) in obese and lean athletes. Markers of the innate immune response were investigated in obese (ONE: ET≤40 km/week) and lean athletes (LNE: ET≤40 km/week and LE: ET≥55 km/week).

Controlled study of myocardial recovery after interval training in heart failure: SMARTEX-HF--rationale and design.

Background: The large randomized controlled multicentre clinical trial, HF-ACTION, recently demonstrated that a programme of recommendation of regular exercise training at moderate intensity is safe, improves quality of life, and reduces the combined endpoint of all-cause death and hospitalization in patients with chronic heart failure. However, the size of beneficial effects was modest compared to results published in smaller single studies and meta-analyses.

Objective: Based on results of a pilot study, the objective of the present investigation is to test the hypothesis that a programme comprising interval training at high relative intensity would yield significantly larger effects in terms of left ventricular remodelling compared to moderate continuous exercise training.

Cardiovascular evaluation of middle-aged/ senior individuals engaged in leisure-time sport activities: position stand from the sections of exercise physiology and sports cardiology of the European Association of Cardiovascular Prevention and Rehabilitation.

Regular aerobic exercise at moderate intensities and an increased physical fitness are associated with a reduced risk of fatal and nonfatal coronary events in middle-aged individuals. In contrast, moderate and vigorous physical exertion is associated with an increased risk for cardiac events, including sudden cardiac death in individuals harbouring cardiovascular disease. The risk-benefit ratio may differ in relation to the individual’s age, fitness level, and presence of cardiovascular disease; sedentary individuals with underlying coronary artery disease are at greatest risk.

72-h kinetics of high-sensitive troponin T and inflammatory markers after marathon.

Introduction: Strenuous exercise induces significant increases in cardiac biomarkers. However, it is still unclear whether this is caused by cardiomyocyte necrosis or secondary mechanisms such as ischemia, cardiac energy deficiency, increased inflammation, or renal dysfunction.

Methods: Therefore, we investigated cardiac biomarkers (high-sensitive cardiac troponin T (hs-cTnT), N-terminal pro-brain natriuretic peptide (NT-proBNP), heart-type fatty acid-binding protein (h-FABP)), inflammation markers (high-sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-10, tumor necrosis factor-α), and renal function (cystatin C) in 102 healthy men age 42 ± 9 yr before and 0, 24, and 72 h after a marathon.

Multivariable analysis of heart rate recovery after cycle ergometry in heart failure: exercise in heart failure.

Purpose: The purpose of this study was to investigate the association between impairment in heart rate recovery (HR(rec)) after cycle ergometry and prognostic markers in patients with heart failure (HF) compared with healthy controls.

Methods: Fifty patients with chronic HF (systolic HF, N = 30; diastolic HF, N = 20; mean age = 62 ± 12 years) and 50 healthy controls (N = 50; mean age = 66 ± 13 years) underwent 2-dimensional and M-mode echocardiography followed by cardiopulmonary exercise testing. Independent predictors of HR(rec) at 1 and 2 minutes after exercise were analyzed by univariable and multivariable regression analyses, and receiver operating characteristics were performed to obtain area under the curve.

Left ventricular remodeling with intensive exercise after aortic valve replacement.

The influence of regular exercise on cardiac remodeling after aortic valve replacement (AVR) is virtually unknown. The case is reported of a 49-year-old male patient who had undergone biological valve replacement for severe aortic regurgitation with reduced left ventricular ejection fraction (LVEF; 45%) and massive left ventricular dilation (left ventricular end-diastolic diameter (LVEDD) 96 mm), which had been recognized for at least three years before surgery. Starting with the normal postoperative cardiac rehabilitation, the patient subsequently intensified his regular endurance training, reaching a total of 9,500 km of cycling within one year.

Exercise-induced alterations of retinal vessel diameters and cardiovascular risk reduction in obesity.

Background: The retinal microcirculation is affected early in the process of atherosclerosis and retinal vessel caliber is an emerging cardiovascular risk factor. Obesity is associated with vascular dysfunction. Here, we investigate the effect of regular exercise on retinal vessel diameters in lean and obese runners.

An interdisciplinary intervention to prevent falls in community-dwelling elderly persons: protocol of a cluster-randomized trial [PreFalls].

Background: Prevention of falls in the elderly is a public health target in many countries around the world. While a large number of trials have investigated the effectiveness of fall prevention programs, few focussed on interventions embedded in the general practice setting and its related network. In the Prevent Falls (PreFalls) trial we aim to investigate the effectiveness of a pre-tested multi-modal intervention compared to usual care in this setting.

Association of physical activity and prognostic parameters in elderly patients with heart failure.

Objective: Assessment of habitual physical activity (PA) in patients with heart failure.

Methods: This study included 50 patients with heart failure (61.9 ± 4.

Cardiovascular disease associated with radiotherapy: activation of nuclear factor kappa-B.

There have been several recent reports of an increased risk of cardiovascular disease after radiotherapy. Hence, with an increasing number of cancer survivors, the incidence of cardiovascular disease caused by radiotherapy will increase. The existence of a type of vascular disease, or vasculopathy, induced by radiotherapy has been known for decades.

Boxing-acute complications and late sequelae: from concussion to dementia.

Background: Boxing has received increased public attention and acceptance in recent years. However, this development has not been accompanied by a critical discussion of the early and late health complications.

Methods: We selectively review recent studies on the acute, subacute, and chronic neuropsychiatric consequences of boxing.

The daughter-mother relationship in the presence of aphasia: how daughters view changes over the first year poststroke.

In this study we explored daughters' perceptions of changes in their relationship with their mother who became aphasic as a result of stroke. Four daughters of aphasic women were each interviewed qualitatively at three different times over the course of a year, and their discourse was transcribed and analyzed. A conceptual model of dynamic relationship changes was drawn, showing how the daughters' perceptions of maternal fragility, problems and/or abilities motivated protective and/or trusting behaviors that resulted in maternal reactions of satisfaction and/or dissatisfaction that, in turn, reinforced the daughters' initial perceptions.

Dynamic retinal vessel response to flicker in obesity: A methodological approach.

Obesity and related metabolic disorders affect vascular endothelial function. The use of the Dynamic Vessel Analyzer (DVA) represents a modern methodological approach to analyze vascular function in the retinal microcirculation. Whether the dynamic reaction to flicker stimulation in retinal vessels is altered in obese subjects is investigated.

Association of a MTNR1B gene variant with fasting glucose and HOMA-B in children and adolescents with high BMI-SDS.

Context: Genome-wide association studies have shown that the melatonin receptor 1B (MTNR1B) gene locus is strongly associated with fasting glucose and β-cell function. However, data are rather limited to the adult population and normal-weight children. So far, little is known whether similar associations are present in overweight and obese children and adolescents.

Psychological predictors of injuries in circus artists: an exploratory study.

Objectives: To explore the relationship between potential psychological risk factors and injury risk in circus artists.

Design: Historical cohort study.

Setting: Cirque du Soleil training programme.

[Inflammation-related cardiovascular morbidity : Pathophysiology and therapy].

Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are associated with increased mortality, largely as a consequence of cardiovascular (CV) disease. Studies found relative risk ratios of 2 for myocardial infarction in RA and up to 7 for myocardial infarction in SLE patients.Beyond the traditional CV risk factors, chronic systemic inflammation has been shown to be a crucial factor in atherosclerosis development and progression from endothelial dysfunction to plaque rupture and thrombosis.

[Therapy of dyslipidemia in rheumatic diseases].

Cardiovascular diseases are the main cause of death worldwide and dyslipidemia constitutes a substantial risk factor. Patients with rheumatic diseases, especially active inflammatory arthritis and systemic lupus erythematosus, show unfavorable lipid profiles, which, however, do not account for the total excess cardiovascular morbidity. Effective disease management, life-style changes and cholesterol-lowering agents can ameliorate the lipid profile and lower cardiovascular mortality.

Magnetic resonance imaging of myocardial injury and ventricular torsion after marathon running.

Recent reports provide indirect evidence of myocardial injury and ventricular dysfunction after prolonged exercise. However, existing data is conflicting and lacks direct verification of functional myocardial alterations by CMR [cardiac MR (magnetic resonance)]. The present study sought to examine structural myocardial damage and modification of LV (left ventricular) wall motion by CMR imaging directly after a marathon.

An internet-delivered exercise intervention for workplace health promotion in overweight sedentary employees: a randomized trial.

Objective: To evaluate the effect of structured vs. non-structured internet-delivered exercise recommendations on aerobic exercise capacity and cardiovascular risk profile in overweight sedentary employees.

Methods: 140 employees of an automobile company (11% female, median age 48 years (range 25-60), BMI 29.

Rationale and design of the 'aldosterone receptor blockade in diastolic heart failure' trial: a double-blind, randomized, placebo-controlled, parallel group study to determine the effects of spironolactone on exercise capacity and diastolic function in patients with symptomatic diastolic heart failure (Aldo-DHF).

Aims: Increasing evidence suggests that enhanced aldosterone signalling plays a key role in the onset and progression of diastolic heart failure (DHF). Aldo-DHF will test the hypothesis that aldosterone receptor blockade by spironolactone will improve exercise capacity and diastolic function in patients with DHF.

Methods: Aldo-DHF is a randomized, placebo-controlled, double-blinded, two-armed, multicentre, parallel group study.

Systemic inflammation activates the nuclear factor-kappaB regulatory pathway in adipose tissue.

Adipose tissue (AT) is a store of energy but also an endocrine organ with the capacity to produce and release proinflammatory mediators into the circulation. The mechanism that may trigger human AT inflammation on a cellular level still remains largely unknown. The aim of this study was to investigate whether an acute systemic inflammation increases AT inflammatory activity, focused on innate immunity.

Sustained inflammation due to nuclear factor-kappa B activation in irradiated human arteries.

Objectives: The aim of this study was to investigate gene expression networks related to cardiovascular disease in radiated human arteries.

Background: Recent epidemiological studies have shown that radiotherapy is associated with cardiovascular disease years after treatment. However, the molecular mechanisms underlying late effects of radiation are poorly described.

Structural alterations of retinal arterioles in adults late after repair of aortic isthmic coarctation.

Patients after coarctation repair still have an increased risk of cardiovascular or cerebrovascular events. This has been explained by the persisting hypertension and alterations in the peripheral vessels. However, involvement of the central vessels such as the retinal arteries is virtually unknown.

Pedometer accuracy in patients with chronic heart failure.

This study assesses the accuracy of the Omron HJ-720ITC pedometer at low walking intensities in patients with chronic heart failure. Step accuracy was assessed by visual observation on the treadmill and during free walking at 40, 50, 60, 70, 80 m/min, as well as during self paced walking using the 6 min walk test. A total of ninety-seven patients with heart failure (mean age: 61+/-13, NYHA I, N=30; NYHA II, N=32; NYHA III, N=35) participated in the study.