{"title":"Every activity and intensity count in cardiovascular prevention in individuals with cardiovascular disease.","authors":"Esmée A Bakker, Henner Hanssen","doi":"10.1093/eurjpc/zwae299","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae299","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nicholas A Koemel, Matthew N Ahmadi, Raaj Kishore Biswas, Annemarie Koster, Andrew J Atkin, Angelo Sabag, Emmanuel Stamatakis
{"title":"Can incidental physical activity offset the deleterious associations of sedentary behaviour with major adverse cardiovascular events?","authors":"Nicholas A Koemel, Matthew N Ahmadi, Raaj Kishore Biswas, Annemarie Koster, Andrew J Atkin, Angelo Sabag, Emmanuel Stamatakis","doi":"10.1093/eurjpc/zwae316","DOIUrl":"10.1093/eurjpc/zwae316","url":null,"abstract":"<p><strong>Aims: </strong>Incidental physical activity as part of daily living may offer feasibility advantages over traditional exercise. We examined the joint associations of incidental physical activity and sedentary behaviour with major adverse cardiovascular events (MACE) risk.</p><p><strong>Methods: </strong>Analyses included 22,368 non-exercising adults from the UK Biobank accelerometry sub-study (Median age [IQR]: 62.9 [11.6] years; 41.8% male). Physical activity and sedentary behaviour exposures were derived using a machine learning-based intensity and posture classification schema. We assessed the tertile-based joint associations of sedentary behaviour and: a) incidental vigorous (VPA), b) incidental moderate to vigorous (MVPA), c) vigorous intermittent lifestyle physical activity (VILPA; bouts lasting up to 1 minute), and d) moderate to vigorous intermittent lifestyle physical activity (MV-ILPA; bouts lasting up to 3 minutes) with MACE risk.</p><p><strong>Results: </strong>Over an 8.0-year median follow-up, 819 MACE events occurred. Compared to the highest physical activity and lowest sedentary time, high sedentary behaviour (>11.4 hours/day) with low incidental VPA (<2.1 minutes/day) had an HR of 1.34 (95% CI: 0.98, 1.84) and low incidental MVPA (<21.8 minutes/day) had a 1.89 HR (95% CI: 1.42, 2.52) for MACE. Sedentary behaviour was not associated with MACE at medium and high levels of VPA or VILPA. Completing 4.1 minutes/day of VPA or VILPA may offset the MACE risk associated with high sedentary behaviour. Conversely, 31-65 minutes of incidental MVPA or 26-52 minutes of MV-ILPA per day largely attenuated the associations with MACE.</p><p><strong>Conclusion: </strong>Brief intermittent bursts of vigorous incidental physical activity may offset cardiovascular risks from high sedentary behaviour.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jordi Jou, Xingwu Zhou, Thomas Lindow, Lars Brudin, Kristofer Hedman, Magnus Ekström, Andrei Malinovschi
{"title":"Heart rate response and recovery in cycle exercise testing - normal values and association with mortality.","authors":"Jordi Jou, Xingwu Zhou, Thomas Lindow, Lars Brudin, Kristofer Hedman, Magnus Ekström, Andrei Malinovschi","doi":"10.1093/eurjpc/zwae308","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae308","url":null,"abstract":"<p><strong>Aim: </strong>Chronotropic incompetence and impaired heart rate (HR) recovery are related to mortality. Guidelines lack specific reference values for HR recovery. We defined normal values and studied blunted HR response and recovery, and mortality risk.</p><p><strong>Methods: </strong>We included 9,917 subjects (45% females) aged 18-85 years who performed a cycle exercise test. We defined normal values for peak HR, HR reserve, and HR recovery at 1 and 2 minutes (HRR1 and HRR2) based on individuals apparently healthy (N=2,242). Associations between blunted HR indices (<5th percentile) and mortality over a median follow-up of 8.6 years were analysed using Cox regression and competing risk analysis.</p><p><strong>Results: </strong>All HR indices were age-dependent and independent predictors of all-cause and CV mortality. The 5th percentiles of HR reserve, HRR1, and HRR2 correlated weakly with existing reference values. HR recovery variables were the strongest predictors of all-cause mortality (HRR1, hazard ratio 1.70 [95% confidence interval, 1.49-1.94] and HRR2, 1.57 [1.37-1.79]), including in subjects with normal exercise capacity (HRR1, 1.96 [1.61-2.39] and HRR2, 1.76 [1.46-2.12]). Combining HR indices appeared to increase the risk of all-cause (HRR1 and HRR2, 1.96 [1.68-2.29] and peak HR and HRR1, 1.87 [1.56-2.23]) and CV mortality, although no specific combination was superior for predicting CV mortality.</p><p><strong>Conclusions: </strong>All HR variables were age-dependent and associated with all-cause and CV mortality. Blunted HR recovery variables were the strongest predictors of all-cause mortality, even in subjects with normal exercise capacity. Combined blunted HR indices appeared to add prognostic value.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lorenzo Nesti, Martina Chiriacò, Luca Sacchetta, Diego Moriconi, Lorenza Santoni, Nicola Riccardo Pugliese, Simone Gallo, Noemi Cimbalo, Giovanna Forotti, Giuliano Chiriacò, Simone Leonetti, Andrea Natali, Anna Solini, Domenico Tricò
{"title":"Circadian heart rate fluctuations predict cardiovascular and all-cause mortality in type 2 and type 1 diabetes: a 21-year retrospective longitudinal study.","authors":"Lorenzo Nesti, Martina Chiriacò, Luca Sacchetta, Diego Moriconi, Lorenza Santoni, Nicola Riccardo Pugliese, Simone Gallo, Noemi Cimbalo, Giovanna Forotti, Giuliano Chiriacò, Simone Leonetti, Andrea Natali, Anna Solini, Domenico Tricò","doi":"10.1093/eurjpc/zwae305","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae305","url":null,"abstract":"<p><strong>Background: </strong>Circadian heart rate (HR) fluctuations are associated with cardiovascular health. We examined their relationship with microvascular disease and long-term survival in patients with diabetes.</p><p><strong>Methods: </strong>In this secondary analysis from the CHAMP1ON cohort of 497 adults with metabolic disease, 349 participants who had type 1 or type 2 diabetes, baseline 24h ambulatory blood pressure and HR monitoring (ABPM), and survival data over a 21-year observational follow-up were included. Clinical features, microvascular complications, and mortality rates were examined in participants with low circadian HR fluctuations (24h-HR SD below the median of 30.4) and blunted nocturnal HR dip (<10%).</p><p><strong>Results: </strong>Low 24h-HR SD and blunted nocturnal HR dip were associated with an adverse cardiometabolic risk profile and 12-23% higher prevalence of cardiac autonomic neuropathy and nephropathy. After 6,251 person-years follow-up (21.0 [14.0-21.0] years), a total of 136 (39%) deaths occurred, of which 100 (68%) of cardiovascular cause. The low 24h-HR SD group had a higher risk for both cardiovascular (adjusted hazard ratio [aHR] 2.00, 95%CI 1.30-3.08, p=0.002) and all-cause mortality (aHR 1.61, 95%CI 1.13-2.29, p=0.009), compared with high 24h-HR SD. Similarly, patients with blunted nocturnal HR dip had a higher risk for cardiovascular (aHR 1.63, 95%CI 1.08-2.46, p=0.019) and all-cause mortality (aHR 1.69, 95%CI 1.20-2.38, p=0.003), compared with those with preserved nocturnal HR dip.</p><p><strong>Conclusions: </strong>Impaired circadian HR fluctuations are associated with microvascular disease and long-term cardiovascular and all-cause mortality in diabetes. ABPM-derived HR measures may provide a widely available and inexpensive risk stratification tool in this high-risk population.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ali Wahab, Ramesh Nadarajah, Catherine Reynolds, Sheena Bennett, Edisemi Ambakederemo, Mohammad Harris, Tanina Younsi, Tobin Joesph, Keerthenan Raveendera, Adam Smith, Asad Bhatty, Gregory Y H Lip, Peter P Swoboda, Jianhua Wu, Chris P Gale
{"title":"Phenotypic characterisation of people at risk of atrial fibrillation: Protocol for the FIND-AF longitudinal cohort study.","authors":"Ali Wahab, Ramesh Nadarajah, Catherine Reynolds, Sheena Bennett, Edisemi Ambakederemo, Mohammad Harris, Tanina Younsi, Tobin Joesph, Keerthenan Raveendera, Adam Smith, Asad Bhatty, Gregory Y H Lip, Peter P Swoboda, Jianhua Wu, Chris P Gale","doi":"10.1093/eurjpc/zwae303","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae303","url":null,"abstract":"<p><strong>Aims: </strong>The Future Innovations in Novel Detection of Atrial Fibrillation (FIND-AF) longitudinal cohort study is a multi-centre prospective cohort study of patients identified at risk of atrial fibrillation (AF). The aim of the FIND-AF longitudinal cohort study is to provide multi-modal phenotypic characterisation of these patients.</p><p><strong>Methods and results: </strong>1955 participants identified as at risk of AF by the FIND-AF algorithm from primary care electronic health (EHR) data, aged 30 years and above and eligible for oral anticoagulation, will be be recruited between October 2023 and November 2024 to receive home-based intermittent ECG monitoring. About 500 participants without diagnosed AF will then undergo cross-sectional phenotypic characterisation including physical examination, symptoms assessment, serum blood biomarkers and echocardiography, and non-stress cardiac magnetic resonance imaging. Longitudinal information about cardio-renal-metabolic-pulmonary outcomes will be ascertained from linkages to EHR data. The study is funded by the British Heart Foundation (CC/22/250026). The study has ethical approval (North West - Greater Manchester South Research Ethics Committee reference 23/NW/0180). Findings will be announced at relevant conferences and published in peer-reviewed journals in line with the Funder's open access policy.</p><p><strong>Conclusions: </strong>The FIND-AF multi-centre prospective longitudinal cohort study aims to (i) provide evidence for the impact of comorbidities on AF genesis (ii) uncover actionable targets to prevent AF, and (iii) act as a platform for cohort randomised clinical trials that investigate enhanced detection and prevention of AF.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kam Cheong Wong, Tu N Nguyen, Simone Marschner, Samual Turnbull, Anupama Balasuriya Indrawansa, Rose White, Mason Jenner Burns, Vishal Gopal, Haeri Min, Desi Quintans, Amy von Huben, Steven A Trankle, Tim Usherwood, Richard I Lindley, Saurabh Kumar, Clara K Chow
{"title":"A randomised controlled implementation study integrating patient self-screening with a remote central monitoring system to screen community-dwellers aged 75 years and older for atrial fibrillation.","authors":"Kam Cheong Wong, Tu N Nguyen, Simone Marschner, Samual Turnbull, Anupama Balasuriya Indrawansa, Rose White, Mason Jenner Burns, Vishal Gopal, Haeri Min, Desi Quintans, Amy von Huben, Steven A Trankle, Tim Usherwood, Richard I Lindley, Saurabh Kumar, Clara K Chow","doi":"10.1093/eurjpc/zwae312","DOIUrl":"10.1093/eurjpc/zwae312","url":null,"abstract":"<p><strong>Aims: </strong>Diagnosis of atrial fibrillation (AF) provides opportunities to reduce stroke risk. This study aimed to compare AF diagnosis rates, participant satisfaction and feasibility of an electrocardiogram (ECG) self-screening virtual care system with usual care.</p><p><strong>Methods: </strong>This randomised controlled implementation study involving community-dwelling people aged ≥75 years was conducted from May 2021 to June 2023. Participants were given a handheld single-lead ECG device and trained to self-record ECGs once daily on weekdays for 12 months. The control group received usual care with their general practitioners in the first 6 months and participated in the subsequent 6 months. AF diagnosis and participant satisfaction were assessed at 6 months.</p><p><strong>Results: </strong>200 participants (mean age 79.0±3.4 years; 54.0% female; 72.5% urban). AF was diagnosed in 10/97 (10.3%) intervention participants and 2/100 (2.0%) in the control group (Odds Ratio 5.6, 95% CI 1.4-37.3, p=0.03). In the intervention, 80% of AF cases were diagnosed within 3 months. 91/93 (97.9%) intervention participants and 55/93 (59.1%) control-waitlisted participants (p<0.001) were satisfied with AF screening. Of the expected 20 days per month, the overall monthly median number of days participants self-recorded ECGs was 20 (interquartile range 17-22). Participants were confident using the device (93%), reported it was easy to use (98%) and found screening efficient (96%).</p><p><strong>Conclusions: </strong>Patient-led AF self-screening using single-lead ECG devices with a remote central monitoring system was feasible, acceptable, and effective in diagnosing AF among older people. This screening model could be adapted for implementation, interfacing with integrated care models within existing health systems.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Coronary Artery Calcification, Fitness, and Outcomes from the CARDIA Cohort \"Stones in the Heart, Not Hearts of Stone\".","authors":"Simon Oestreicher, Aaron L Baggish","doi":"10.1093/eurjpc/zwae302","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae302","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francesco Gentile, Alberto Giannoni, Alberto Aimo, Vincenzo Castiglione, Francesca Bramanti, Giovanni Iudice, Eleonora Degl'Innocenti, Michele Emdin, Giuseppe Vergaro, Claudio Passino
{"title":"Clinical and prognostic significance of central and obstructive apneas in patients with transthyretin cardiac amyloidosis.","authors":"Francesco Gentile, Alberto Giannoni, Alberto Aimo, Vincenzo Castiglione, Francesca Bramanti, Giovanni Iudice, Eleonora Degl'Innocenti, Michele Emdin, Giuseppe Vergaro, Claudio Passino","doi":"10.1093/eurjpc/zwae297","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae297","url":null,"abstract":"<p><strong>Aims: </strong>Central (CA) and obstructive apneas (OA) are highly prevalent in patients with chronic heart failure (HF) and transthyretin cardiac amyloidosis (ATTR-CA) is an increasingly recognized HF etiology. This study aimed to investigate the prevalence and impact of CA and OA in patients with ATTR-CA.</p><p><strong>Methods: </strong>Consecutive patients with ATTR-CA underwent a 24-hour ambulatory cardiorespiratory monitoring to evaluate the prevalence and severity of breathing disorders. The severity of these disorders was quantified using the apnea-hypopnea index (AHI). Accordingly, patients were categorized as having normal breathing (NB, AHI <5 events/hour), obstructive apnea (OA, AHI ≥5 events/hour with >50% being obstructive), or central apnea (CA, AHI >5 events/hour with ≥50% being central). The primary endpoint at follow-up was all-cause mortality.</p><p><strong>Results: </strong>Out of 142 patients enrolled (n=142, aged 77±7 years, 91% males, 96% wild-type ATTR-CA), considering the 24 hours, 20% had NB (39% at daytime, 8% at nighttime), while 35% had CA (45% at daytime, 39% at nighttime) and 45% had OA (25% at daytime, 54% at nighttime). After a median 2.3 (1.4-3.3) years follow-up, 24-hour, daytime, and nighttime AHI were higher in non-survivors vs. survivors (all p<0.05), independently of the prevalent apnea type (p=0.64). At multivariable regression analysis (adjusted for the possible clinical, echocardiographic, and biohumoral confounders), nighttime AHI ≥30 events/hour (hazard ratio 2.37 [95%CI 1.07-5.23], p=0.033) and hs-troponin T (hazard ratio 2.43 [95%CI 1.42-4.17], p=0.001) were predictors of mortality.</p><p><strong>Conclusion: </strong>CA and OA are highly prevalent both at daytime and nighttime in patients with ATTR-CA and are associated with higher mortality.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emanuele Monda, Martina Caiazza, Alfredo Mauriello, Natale Guarnaccia, Annapaola Cirillo, Marta Rubino, Gaetano Diana, Federica Verillo, Adelaide Fusco, Chiara Cirillo, Carolina Putotto, Giuseppe Pacileo, Eduardo Bossone, Maria Giovanna Russo, Giuseppe Limongelli
{"title":"Prevalence and Cardiovascular Outcomes of Left Ventricular Hypertrabeculation in Children.","authors":"Emanuele Monda, Martina Caiazza, Alfredo Mauriello, Natale Guarnaccia, Annapaola Cirillo, Marta Rubino, Gaetano Diana, Federica Verillo, Adelaide Fusco, Chiara Cirillo, Carolina Putotto, Giuseppe Pacileo, Eduardo Bossone, Maria Giovanna Russo, Giuseppe Limongelli","doi":"10.1093/eurjpc/zwae309","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae309","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reply to letter to the editor regarding article 'exposure to workplace sexual harassment and risk of cardiometabolic disease: a prospective cohort study of 88904 Swedish men and women'.","authors":"Linda L Magnusson Hanson","doi":"10.1093/eurjpc/zwae300","DOIUrl":"https://doi.org/10.1093/eurjpc/zwae300","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":null,"pages":null},"PeriodicalIF":8.4,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}