Alterations in the autonomic and haemodynamic response to prolonged high-intensity endurance exercise in individuals with coronary artery calcification.

Endurance exercise is associated with increased life duration and improved life quality. Paradoxically, high exercise intensity is also associated with increased coronary artery calcification (CAC) and a small but significant increased risk of adverse cardiac events during exercise. The mechanisms underlying the development of CAC during prolonged high-intensity endurance exercise are unknown.

Stent-in-Stent Intervention for Pulmonary Vein in Stent Restenosis: A Long-Term Follow-Up Case Report.

Introduction: Pulmonary vein (PV) restenosis develops with reported incidence rates of up to 50%. Balloon angioplasty seems to be the widely preferred treatment of choice.

Method And Results: A 54-year-old man with long history of atrial fibrillations developed PVS secondary to multiple radiofrequency ablation procedures.

Changes in 6-min walk test is an independent predictor of death in chronic heart failure with reduced ejection fraction.

Aims: Functional capacity provides important clinical information in patients with heart failure (HF) and reduced ejection fraction (HFrEF). The 6-min walk test (6MWT) is a simple and inexpensive tool for assessing functional capacity and risk. Although change in 6MWT is frequently used as a surrogate outcome in HF trials, the association with mortality is unclear.

The relationship between workload and exercise-induced cardiac troponin elevations is influenced by non-obstructive coronary atherosclerosis.

The relationship between exercise-induced troponin elevation and non-obstructive coronary artery disease (CAD) is unclear. This observational study assessed non-obstructive CAD's impact on exercise-induced cardiac Troponin I (cTnI) elevation in middle-aged recreational athletes. cTnI levels of 40 well-trained recreational athletes (73% males, 50 ± 9 years old) were assessed by a high-sensitive cTnI assay 24 h before, and at 3 and 24 h following two high-intensity exercises of different durations; a cardiopulmonary exercise test (CPET), and a 91-km mountain bike race.

Optimizing support vector machines and autoregressive integrated moving average methods for heart rate variability data correction.

Heart rate variability (HRV) is the variation in time between successive heartbeats and can be used as an indirect measure of autonomic nervous system (ANS) activity. During physical exercise, movement of the measuring device can cause artifacts in the HRV data, severely affecting the analysis of the HRV data. Current methods used for data artifact correction perform insufficiently when HRV is measured during exercise.

Circulating trimethylamine N-oxide levels do not predict 10-year survival in patients with or without coronary heart disease.

Background: Trimethylamine N-oxide (TMAO) is an amine oxide generated by gut microbial metabolism. TMAO may contribute to atherothrombosis and systemic inflammation. However, the prognostic value of circulating TMAO for risk stratification is uncertain.

Cardiac Structure and Function in Epilepsy Patients with Drug-Resistant Convulsive Seizures.

High frequency of convulsive seizures and long-lasting epilepsy are associated with an increased risk of sudden unexpected death in epilepsy (SUDEP). Structural changes in the myocardium have been described in SUDEP victims. It is speculated that these changes are secondary to frequent convulsive seizures and may predispose to SUDEP.

The Association of Smoking with Hospitalization and Mortality Differs According to Sex in Patients with Heart Failure Following Myocardial Infarction.

Smoking has been associated with higher morbidity and mortality following myocardial infarction (MI), but reports of the impact on morbidity and mortality for females and elderly patients experiencing MI complicated with left ventricular dysfunction or overt heart failure are limited. In an individual patient data meta-analysis of high-risk MI patients, the association of smoking with hospitalizations and death were investigated. Weighted Cox proportional hazard modeling were used to study the risks of smoking on adjudicated endpoints among different sex and age categories.

Texture-based probability mapping for automatic scar assessment in late gadolinium-enhanced cardiovascular magnetic resonance images.

Purpose: To evaluate a novel texture-based probability mapping (TPM) method for scar size estimation in LGE-CMRI.

Methods: This retrospective proof-of-concept study included chronic myocardial scars from 52 patients. The TPM was compared with three signal intensity-based methods: manual segmentation, full-width-half-maximum (FWHM), and 5-standard deviation (5-SD).

Exercise-Induced Cardiac Troponin Elevations: From Underlying Mechanisms to Clinical Relevance.

Serological assessment of cardiac troponins (cTn) is the gold standard to assess myocardial injury in clinical practice. A greater magnitude of acutely or chronically elevated cTn concentrations is associated with lower event-free survival in patients and the general population. Exercise training is known to improve cardiovascular function and promote longevity, but exercise can produce an acute rise in cTn concentrations, which may exceed the upper reference limit in a substantial number of individuals.

Determinants of Interindividual Variation in Exercise-Induced Cardiac Troponin I Levels.

Background Postexercise cardiac troponin levels show considerable interindividual variations. This study aimed to identify the major determinants of this postexercise variation in cardiac troponin I (cTnI) following 3 episodes of prolonged high-intensity endurance exercise. Methods and Results Study subjects were recruited among prior participants in a study of recreational cyclists completing a 91-km mountain bike race in either 2013 or 2014 (first race).

Regular consumption of cod liver oil is associated with reduced basal and exercise-induced C-reactive protein levels; a prospective observational trial : A NEEDED (The North Sea Race Endurance Exercise Study) 2014 sub-study.

Background: Dietary supplement use among recreational athletes is common, with the intention of reducing inflammation and improving recovery. We aimed to describe the relationship between omega-3 fatty acid supplement use and inflammation induced by strenuous exercise.

Methods: C-reactive protein (CRP) concentrations were measured in 1002 healthy recreational athletes before and 24 h after a 91-km bicycle race.

The relationship between Fibroblast Growth Factor 23 (FGF23) and cardiac MRI findings following primary PCI in patients with acute first time STEMI.

Background: Fibroblast growth factor 23 (FGF23) is a regulator of mineral metabolism, that has been linked to myocardial remodeling including development of left ventricular (LV) hypertrophy and myocardial fibrosis. The aim of this study was to investigate the relationship between intact FGF23 (iFGF23), myocardial infarct size and LV remodeling following a first acute ST-elevation myocardial infarction (STEMI).

Methods And Results: Forty-two consecutive patients with first-time STEMI, single vessel disease, successfully treated with primary percutaneous coronary intervention were included.

Artifact Correction in Short-Term HRV during Strenuous Physical Exercise.

Heart rate variability (HRV) analysis can be a useful tool to detect underlying heart or even general health problems. Currently, such analysis is usually performed in controlled or semi-controlled conditions. Since many of the typical HRV measures are sensitive to data quality, manual artifact correction is common in literature, both as an exclusive method or in addition to various filters.

High-Sensitivity Cardiac Troponin I and T Response Following Strenuous Activity is Attenuated by Smokeless Tobacco: NEEDED (North Sea Race Endurance Exercise Study) 2014.

Background Use of snus, a smokeless tobacco product, is increasing in Scandinavia. Strenuous physical activity is associated with an acute increase in high-sensitivity cardiac troponin (swhs-cTn) concentrations. Current smoking is associated with lower hs-cTn, but whether this also holds true for smokeless tobacco and whether tobacco affects the hs-cTn response to exercise remain unknown.

6 min walk test is a strong independent predictor of death in outpatients with heart failure.

Aims: The aim of this study was to examine the prognostic value of the 6 min walk test (6MWT) in a large cohort of outpatients with heart failure.

Methods And Results: A total of 5519 outpatients with heart failure from the National Norwegian Heart Failure Registry (NNHFR), which is part of the Norwegian Cardiovascular Disease Registry, were included in this analysis. The NNHFR recommended the use of the 6MWT for prognostic assessment of all patients included in the registry.

Methods for preprocessing time and distance series data from personal monitoring devices.

There is a need to develop more advanced tools to improve guidance on physical exercise to reduce risk of adverse events and improve benefits of exercise. Vast amounts of data are generated continuously by Personal Monitoring Devices (PMDs) from sports events, biomedical experiments, and fitness self-monitoring that may be used to guide physical exercise. Most of these data are sampled as time- or distance-series.

Endurance exercise training volume is not associated with progression of coronary artery calcification.

Background: Recent cross-sectional studies have suggested a dose-dependent relationship between lifelong exposure to physical activity and the burden of calcified coronary artery disease (CAD). No longitudinal studies have addressed this concern.

Hypothesis: Exercise volume is associated with progression of coronary artery calcium (CAC), defined as ≥10 units increase in CAC score.