Canadian Journal of Cardiology最新文献

{"title":"Are the Cardiovascular Benefits and Potential Risks of Physical Activity and Exercise Dependent on Race, Ethnicity, or Sex?","authors":"Daniel T. Tardo BAppSc(Ex&SpSc)(Hons), MBBS(Hons), MMed, FRACP ,&nbsp;Michael Papadakis MBBS, MD(Res), FRCP, FESC","doi":"10.1016/j.cjca.2024.11.013","DOIUrl":"10.1016/j.cjca.2024.11.013","url":null,"abstract":"<div><div>Physical activity (PA) is established as a cornerstone of cardiovascular health, however, disparities in participation exist across sociocultural groups, which in turn affect cardiovascular outcomes. Evidence suggests that although the positive cardiovascular effects of exercise are consistent across populations, notable differences in the magnitude of these benefits exist for racial and ethnic minorities and the female sex. Women derive greater protection from PA compared with men, with reduced rates of sudden cardiac death. In this review we examine the complex interplay of race and/or ethnicity and sex on the cardiovascular benefits associated with PA and exercise, cardiovascular adaptations to exercise, risks of sudden cardiac death, and “excessive” volume of exercise. Understanding these factors is crucial for developing targeted interventions to promote cardiovascular health and offset disparities.</div></div>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 3","pages":"Pages 456-469"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Surviving to Thriving: A Roadmap for Reinventing Cardiac Rehabilitation in Pediatric Congenital Heart Disease","authors":"Katherine Hansen MD","doi":"10.1016/j.cjca.2024.11.020","DOIUrl":"10.1016/j.cjca.2024.11.020","url":null,"abstract":"<div><div>Exercise is an essential component of the cardiac care of children with congenital heart disease (CHD), and safe and effective exercise counselling by the medical team is important early in life to develop positive physical activity and exercise habits. Without it, children are at risk for sedentariness and related comorbidities in childhood and adulthood. Pediatric cardiologists can guide patients to a cycle of positive fitness through exercise counselling, promotion, prescription, and/or supervised exercise training similar to adult cardiac rehabilitation (ACR). ACR has improved exercise capacity, mortality, and quality of life in adults with acquired heart disease. Similar outcomes have been shown in exercise training for adult and pediatric CHD. Exercise training specific to pediatric CHD is not widely available but is expanding in response to growing need and increasing demand. Although ACR provides a framework for structured exercise training, approaches to pediatric exercise training must be individualized and innovated upon to be successful for children. I propose that the ACR model must be reinvented for children with CHD by integrating 6 missing pieces. First, the underlying goal should be to optimize fitness, not rehabilitate to a previous state of health. Second and third are training mental skills and motor skills. Fourth, play-based exercise training is needed to foster a positive relationship with exercise. Fifth, family-focused exercise interventions can address root causes of sedentariness. Finally, building communities in which positive fitness is a priority will be essential to long-term sustainability.</div></div>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 3","pages":"Pages 375-385"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738496","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":"The Many Roads Toward Sports Cardiology—How to Become A Sports Cardiologist and the Importance of Specialised Training","authors":"Ryan Quinn MD ,&nbsp;David Dorian MD","doi":"10.1016/j.cjca.2024.11.026","DOIUrl":"10.1016/j.cjca.2024.11.026","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 3","pages":"Pages 542-544"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766550","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":"Your Heart Can’t See What Sneakers You Are Wearing: Exercise Training Load in Endurance Athletes Is Inadequately Quantified in Sports Cardiology","authors":"Christophe Dausin MSc ,&nbsp;Rafael Machado Tironi MD ,&nbsp;Véronique Cornelissen PhD ,&nbsp;Peter Hespel PhD ,&nbsp;Rik Willems MD, PhD ,&nbsp;Mark Haykowsky PhD ,&nbsp;André La Gerche MBBS, PhD ,&nbsp;Guido Claessen MD, PhD ,&nbsp;Stephen Foulkes PhD","doi":"10.1016/j.cjca.2024.12.009","DOIUrl":"10.1016/j.cjca.2024.12.009","url":null,"abstract":"<div><h3>Background</h3><div>Training load may be an important factor underlying the (patho-)physiologic cardiovascular adaptations from endurance exercise. Yet, quantifying training load remains challenging due to the complexity of its components (Frequency, Intensity, Time, and Type [FITT]). In this systematic review we evaluate how training load has been quantified in sports cardiology studies and provide recommendations for how this can be improved.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted across PubMed and EMBASE up to October 2024. Studies involving \"sports cardiology,\" \"training load,\" and \"endurance sport\" were included. Data extraction included study characteristics, training load assessment methods, cardiovascular outcomes, and athlete profiles.</div></div><div><h3>Results</h3><div>A total of 62 studies with 1,060,700 participants were included in our review. The majority of studies (59.7%) focused on exercise-induced cardiac remodelling, with other topics being cardiac arrhythmias (12.9%), cardiac autonomic adaptation (3.2%), exercise dose-response (6.5%), and coronary heart disease (17.7%). Training load was primarily quantified by questionnaires (58.1%), whereas heart rate monitoring, a more objective measure, was used in only 1.6% of the studies. All studies reported exercise type, but only 19.4% measured all FITT components.</div></div><div><h3>Conclusions</h3><div>There is a lack of uniformity in the assessment of key FITT variables to quantify training load within the field of sports cardiology, with many studies relying on subjective or incomplete methods. As cardiology moves into the precision medicine era, researchers and clinicians should seek to obtain objective training load information from their athletes according to the FITT framework, and data from use of objective wearable devices represent the optimal way to do this.</div></div>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 3","pages":"Pages 354-363"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invited Commentary: Problems Using the Cardiopulmonary Exercise Test in Cardiac Rehabilitation: It Is Time to Retire Outdated Protocols and Replace Them With Better Ones","authors":"Daniel A. Keir PhD","doi":"10.1016/j.cjca.2024.12.026","DOIUrl":"10.1016/j.cjca.2024.12.026","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 3","pages":"Pages 491-493"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892380","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":"Call for Original Papers: Transplantation","authors":"","doi":"10.1016/S0828-282X(25)00166-7","DOIUrl":"10.1016/S0828-282X(25)00166-7","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 3","pages":"Pages A9-A10"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143592271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Rehabilitation and Heart Failure with Reduced Ejection Fraction: Pathophysiology, Benefits, and Precautions","authors":"Alexandra Barriault MD, FRCPC ,&nbsp;Umair Iftikhar MD, FRCPC, FACC ,&nbsp;James A. Stone BPHE, BA, MSc, MD, PhD, FRCPC, FAACVPR, FACC","doi":"10.1016/j.cjca.2024.10.014","DOIUrl":"10.1016/j.cjca.2024.10.014","url":null,"abstract":"<div><div>Heart failure (HF) is a highly comorbid condition associated with significant mortality, despite advances in current medical management. Patients who suffer from HF represent a high needs disease care population in whom structured, long-term chronic disease care delivery models, such as cardiac rehabilitation (CR), have been shown to be highly cost effective in reducing hospitalizations and improving quality of life. HF with reduced ejection fraction affects a growing number of Canadians and health care costs secondary to this condition are increasing, with further increases over the next decade to be expected. CR is a guideline-directed medical therapy for patients living with HF with reduced ejection fraction, and with increasing numbers of HF patients across the world, there is a prescient need to revisit the benefits, safety, and the prescription of this intervention for the health care professionals who treat this condition. Certainly, there is a clinical need for HF practitioners to better understand the pathophysiological benefits of CR with respect to exercise training, as well as the prudent precautions required to facilitate the safe delivery of this highly cost-effective patient intervention.</div></div>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 3","pages":"Pages 443-455"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Different Prognostic Values of Quadriceps Muscle Thickness at Rest and During Isometric Contraction in Heart Failure","authors":"Yudai Fujimoto MD,&nbsp;Yuya Matsue MD, PhD","doi":"10.1016/j.cjca.2024.10.001","DOIUrl":"10.1016/j.cjca.2024.10.001","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 3","pages":"Page 559"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399500","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":"Sex Differences and Correlates of the Utility of the Cardiopulmonary Exercise Test for Prescribing Exercise at Entry to Cardiac Rehabilitation","authors":"Susan Marzolini PhD, RKin ,&nbsp;Paul Oh MD ,&nbsp;James E. Peterman PhD ,&nbsp;Phillip Wallace PhD, RKin ,&nbsp;Azadeh Yadollahi PhD ,&nbsp;Fernando Rivera-Theurel MD ,&nbsp;Carolina Carvalho PhD, MD, MScCH (HPTE) ,&nbsp;Leonard A. Kaminsky PhD","doi":"10.1016/j.cjca.2024.11.022","DOIUrl":"10.1016/j.cjca.2024.11.022","url":null,"abstract":"<div><h3>Background</h3><div>Despite the importance of objective measures for prescribing aerobic exercise for mitigating cardiovascular risk in people with coronary artery disease (CAD), no study has examined sex differences in the utility of the cardiopulmonary exercise test (CPET) for developing the exercise prescription.</div></div><div><h3>Methods</h3><div>CPET results from 1352 females and 5875 males with CAD were analysed to determine if there was a sex difference in achieving maximal oxygen uptake (<span><math><mrow><mover><mi>V</mi><mo>˙</mo></mover></mrow></math></span>O_2max) or an identifiable first ventilatory threshold (VT₁). Secondary outcomes were to determine correlates of not achieving <span><math><mrow><mover><mi>V</mi><mo>˙</mo></mover></mrow></math></span>O_2max or VT₁ in all patients and in males and females separately.</div></div><div><h3>Results</h3><div>A greater proportion of males than females achieved <span><math><mrow><mover><mi>V</mi><mo>˙</mo></mover></mrow></math></span>O_2max or VT₁ (89.7% vs 71.3%; <em>P</em> &lt; 0.001) as well as specifically achieving <span><math><mrow><mover><mi>V</mi><mo>˙</mo></mover></mrow></math></span>O_2max (40.2% vs 26.7%; <em>P</em> &lt; 0.001) and VT₁ (88.0% vs 69.2%; <em>P</em> &lt; 0.001). The most influential correlates of not achieving <span><math><mrow><mover><mi>V</mi><mo>˙</mo></mover></mrow></math></span>O_2max or VT₁ were female sex (odds ratio 3.1, 95% confidence interval 2.6-3.7), age &gt; 60 years, tested on treadmill vs cycle, depressive symptoms, and a secondary heart failure diagnosis. At entry to cardiac rehabilitation, these correlates were more prevalent in females than in males. Correlates differed by sex. The threshold for when age affected achieving <span><math><mrow><mover><mi>V</mi><mo>˙</mo></mover></mrow></math></span>O_2max or VT₁ on the cycle CPET was earlier for females (&gt; 50 years of age) than for males (&gt; 70 years of age) with no difference on treadmill (&gt; 80 years of age for both).</div></div><div><h3>Conclusions</h3><div>Although most patients achieved <span><math><mrow><mover><mi>V</mi><mo>˙</mo></mover></mrow></math></span>O_2max or VT₁ on the CPET, females were 3 times less likely than males to achieve <span><math><mrow><mover><mi>V</mi><mo>˙</mo></mover></mrow></math></span>O_2max or VT₁. Strategies to improve utility of CPETs for females, such as alternative exercise test protocols and investigation into underlying mechanisms for effects of depressive symptoms, should be conducted.</div></div>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 3","pages":"Pages 481-490"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Does the Dose and Type of Exercise Impact Acute Cardiovascular Function in Healthy Individuals?","authors":"Robert F. Bentley PhD,&nbsp;Nino Nikolovski BKin,&nbsp;Jack M. Goodman PhD","doi":"10.1016/j.cjca.2024.12.016","DOIUrl":"10.1016/j.cjca.2024.12.016","url":null,"abstract":"<div><div>During aerobic exercise, the cardiovascular system is tasked with delivering oxygen to active skeletal muscle via muscle blood flow while regulating mean arterial blood pressure. The impact of aerobic exercise on acute cardiovascular function may be modulated by the dose and type of exercise. Acutely, dose is the product of exercise intensity and time, whereas exercise type may refer to common aerobic modalities like cycling, running, swimming, or rowing. Each modality is unique for its medium of completion as well as the implications on blood flow arising from the position of active muscle mass relative to heart level. The purpose of this review was to address how an acute exercise dose influences cardiovascular function between prominent aerobic exercise modalities in healthy individuals. Across all modalities, all doses may transiently reduce both left and right ventricular systolic and diastolic function as well as both macro- and microvascular function. However, accurately quantifying and comparing exercise dose across the literature is challenging due to methodologic differences in exercise prescription and the cardiovascular demands imposed by differing modalities of exercise. Furthermore, the potential confounding influence of cardiovascular drift alongside variations in age, the composition of cohorts with respect to biological sex, and timing of cardiovascular measures further complicates interpretation. Future work should focus on exercise intensity prescription according to modality-specific physiologic thresholds to provide comparable doses. This approach may serve to standardize the physiologic stimulus and allow for objective assessments to be compared with confidence.</div></div>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 3","pages":"Pages 398-411"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852929","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}