Canadian Journal of Cardiology最新文献

{"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}

{"title":"The Acquisition of Cardiovascular Adaptation to Aerobic Exercise: When Does It Begin and How Does It Evolve Depending on Intrinsic and Extrinsic Factors?","authors":"Fabian Sanchis-Gomar MD, PhD ,&nbsp;Marco V. Perez MD ,&nbsp;Carme Perez-Quilis MD, PhD ,&nbsp;Giuseppe Lippi MD ,&nbsp;Carl J. Lavie MD ,&nbsp;François Haddad MD ,&nbsp;Jeffrey W. Christle PhD ,&nbsp;Jonathan Myers PhD","doi":"10.1016/j.cjca.2024.12.023","DOIUrl":"10.1016/j.cjca.2024.12.023","url":null,"abstract":"<div><div>The acquisition and evolution of cardiovascular (CV) adaptation to physical activity or exercise training are critical in enhancing cardiorespiratory fitness and reducing CV disease (CVD) risk. CV adaptations to exercise occur through structural, functional, and molecular changes that enhance cardiac efficiency. These adaptations, such as increased stroke volume, improved blood pressure regulation, and enhanced endothelial function, collectively reduce CVD morbidity and mortality. In this review we explore how CV adaptations vary across different demographic characteristics, and highlight the importance of exercise timing, intensity, and recovery periods. We delve into the immediate physiological responses to physical activity, such as increased heart rate and cardiac output, and the longer-term adaptations, including cardiac hypertrophy and improved vascular function. The influence of age, sex, and preexisting health conditions on CV responses to exercise is also discussed, emphasizing the need for tailored exercise interventions. Finally, the review highlights the significance of recovery periods in optimizing CV adaptations and how insufficient recovery might lead to adverse outcomes. Overall, understanding the timing and evolution of CV adaptations can inform exercise prescriptions to improve CV health across populations for the primary and secondary prevention of CVD.</div></div>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 3","pages":"Pages 386-397"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871576","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":"Invited Commentary: Health Benefits Associated With an Active Lifestyle in the Elderly Population: Unique Opportunities Associated With Light-Intensity Physical Activity","authors":"Carl J. Lavie MD ,&nbsp;Gen-Min Lin MD ,&nbsp;Robert Ross PhD","doi":"10.1016/j.cjca.2024.07.017","DOIUrl":"10.1016/j.cjca.2024.07.017","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 3","pages":"Pages 478-480"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141747533","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":"Considerations for Assessing Physical Activity in Those at Risk of and Living With Cardiovascular Disease","authors":"Carley D. O’Neill PhD ,&nbsp;Stephanie A. Prince PhD ,&nbsp;Marina Mitra MSc ,&nbsp;Jennifer L. Reed PhD, RKin","doi":"10.1016/j.cjca.2024.12.011","DOIUrl":"10.1016/j.cjca.2024.12.011","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 3","pages":"Pages 553-557"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821939","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":"Is the Time Right for Preventive Cardiology Guidelines on Sedentary Behaviours and Sitting Time?","authors":"Julie Riopel-Meunier RD, MSc ,&nbsp;Paul Poirier MD, PhD ,&nbsp;Jean-Pierre Després PhD ,&nbsp;Marie-Eve Piché MD, PhD","doi":"10.1016/j.cjca.2024.12.024","DOIUrl":"10.1016/j.cjca.2024.12.024","url":null,"abstract":"<div><div>In this review sedentary behaviour (SB) is considered beyond its simplistic definition of “sitting” and also includes sedentary activities. We explore the definition, physiological characteristics, prevalence, and guidelines of SB, contrasting it with physical activity (PA). The discussion encompasses: (1) the association between SB and mortality, with a specific focus on cardiovascular (CV) outcomes; (2) biological mechanisms that link SB to CV health, additionally differentiating between the effects of acute and chronic sitting; (3) sex and gender differences in SB; and (4) SB as an independent CV risk factor is explored. The review concludes with an examination of the potential beneficial effects of PA on mitigating the detrimental effects of SB and an analysis of evidence that supports the use of break-up strategies in preventive cardiology. This analysis sheds light on the significant deleterious consequences of SB on CV health. It highlights the potential of incorporating strategies to reduce and interrupt prolonged sitting alongside existing guidelines that promote PA. These findings suggest considering SB as a major CV risk factor, and emphasize the importance of targeting SB reduction and interruption as a valuable approach for preventing and managing CV disease. However, further research is needed to determine the long-term effectiveness of SB interventions, to inform the development of optimal guidelines for CV health management.</div></div>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 3","pages":"Pages 412-426"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871575","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":"Prescribed Fitness for Overtraining Syndrome in an Amateur Bodybuilder With Obsessive Compulsive Disorder and Athletic Heart","authors":"David S. Younger MD, DPh, MPH, MS (Epidemiology)","doi":"10.1016/j.cjca.2025.01.004","DOIUrl":"10.1016/j.cjca.2025.01.004","url":null,"abstract":"","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 3","pages":"Page 558"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969599","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":"Age-Dependent Relationship of Physical Inactivity With Incident Cardiovascular Disease: Analysis of a Large Japanese Cohort","authors":"Kensuke Ueno MSc ,&nbsp;Hidehiro Kaneko MD ,&nbsp;Kentaro Kamiya PhD ,&nbsp;Yuta Suzuki PhD ,&nbsp;Akira Okada MD ,&nbsp;Norifumi Takeda MD ,&nbsp;Katsuhito Fujiu MD ,&nbsp;Hiroyuki Morita MD ,&nbsp;Junya Ako MD ,&nbsp;Koichi Node MD ,&nbsp;Hideo Yasunaga MD ,&nbsp;Issei Komuro MD","doi":"10.1016/j.cjca.2024.06.012","DOIUrl":"10.1016/j.cjca.2024.06.012","url":null,"abstract":"<div><h3>Background</h3><div>There have been limited studies examining age-dependent associations between physical inactivity and cardiovascular disease (CVD). We aimed to clarify the age-dependent relationship of physical inactivity with incident CVD.</div></div><div><h3>Methods</h3><div>We analyzed 1,097,424 participants, aged 18 to 105 years, without histories of CVD, enrolled in the DeSC database (median age, 63 years; 46.4% men). We categorized participants into the following 4 groups based on age: ≤ 44 years (n = 203,835); 45 to 64 years (n = 403,619); 65 to 79 years (n = 437,236); and ≥ 80 years (n = 52,734). We used 3 physical inactivity components gained from the self-reported questionnaire during a health checkup. The outcomes were composite CVD events including myocardial infarction, stroke, heart failure, and each CVD event.</div></div><div><h3>Results</h3><div>During a mean follow-up of 3.2 ± 1.9 years, 81,649 CVD events were observed. The hazard ratios of 3 physical inactivity components for CVD events increased with age category (<em>P</em> for interaction &lt; 0.001). For example, the hazard ratio (95% confidence interval) of physical inactivity defined as not doing light sweaty exercise for 30 minutes at least twice a week for incident CVD in the groups aged ≤ 44 years, 45 to 64 years, 65 to 79 years, and ≥ 80 years were 0.97 (0.88-1.05), 1.08 (1.05-1.12), 1.12 (1.10-1.15), and 1.17 (1.12-1.21), respectively (<em>P</em> for interaction &lt; 0.001). This association was consistent across subtypes of CVD including heart failure, myocardial infarction, and stroke.</div></div><div><h3>Conclusions</h3><div>The association of physical inactivity with a higher risk of developing CVD increased with age. Preventive efforts for physical activity optimization may be more valuable in older people.</div></div>","PeriodicalId":9555,"journal":{"name":"Canadian Journal of Cardiology","volume":"41 3","pages":"Pages 470-477"},"PeriodicalIF":5.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141436402","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}