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Real-world experience with mavacamten in obstructive hypertrophic cardiomyopathy: Observations from a tertiary care center 阻塞性肥厚型心肌病患者使用马伐康坦的真实体验:一家三级医疗中心的观察结果。
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-01 DOI: 10.1016/j.pcad.2024.02.001

Background

In symptomatic obstructive hypertrophic cardiomyopathy (oHCM) patients, mavacamten is commercially approved to help improve left ventricular (LV) outflow tract (LVOT) gradients, symptoms, and reduce eligibility for septal reduction therapy (SRT) under the risk evaluation and mitigation strategy (REMS) program. We sought to prospectively report the initial real-world clinical experience with the use of commercially available mavacamten in a multi-hospital tertiary healthcare system.

Methods

We studied the first 150 consecutive oHCM patients (mean age 65 years, 53% women, 83% on betablockers and 61% in New York Heart Association [NYHA] class III) who were initiated on 5 mg of mavacamten with dose titrations using symptom assessment and echocardiographic measurements of LVOT gradient and LV ejection fraction (LVEF) measurements. We measured changes in NYHA class, LVEF, LVOT gradients (resting and Valsalva) at baseline, 4, 8 and 12 weeks.

Results

At 261 ± 143 days (range of 31–571 days), 69 (46%) patients had ≥1 NYHA class, and 27 (18%) additional patients had ≥2 NYHA class improvement. The mean Valsalva LVOT gradient decreased from 72 ± 43 mmHg at baseline to 29 ± 31 mmHg at 4 weeks, 29 ± 28 mmHg at 8 weeks and 30 ± 29 mmHg at 12 weeks (p < 0.001). At baseline, 100% patients had Valsalva LVOT gradients ≥30 mmHg, which reduced to 29% at 4 weeks, 28% at 8 weeks and 30% at 12 weeks. In 40 patients who reported no symptomatic improvement, the mean Valsalva LVOT gradient decreased from 73 ± 39 mmHg at baseline to 34 ± 27 mmHg at 4 weeks, 35 ± 28 mmHg at 8 weeks and 30 ± 24 mmHg at 12 weeks (P < 0.001). The mean LVEF at baseline was 66 ± 6% and changed to 64 ± 5% at 4 weeks, 63 ± 5% at 8 weeks and 62 ± 7% at 12 weeks (p < 0.0001). No patient underwent SRT, developed LVEF ≤30% or developed heart failure requiring admission. Three (2%) patients needed temporary interruption of mavacamten due to LVEF<50%.

Conclusions

In a real-world study in symptomatic oHCM patients at a multi-hospital tertiary care referral center, we demonstrate the efficacy and safety, along with the logistic feasibility of prescribing mavacamten under the REMS program.
背景:对于有症状的梗阻性肥厚型心肌病(oHCM)患者,mavacamten已获得商业批准,有助于改善左心室流出道(LVOT)梯度和症状,并根据风险评估和缓解策略(REMS)计划降低室间隔减容疗法(SRT)的适用性。我们试图前瞻性地报告在一个多医院三级医疗系统中使用市售马伐康坦的初始实际临床经验:我们研究了首批连续使用 5 毫克马伐康坦的 150 名 oHCM 患者(平均年龄 65 岁,53% 为女性,83% 正在使用贝特类受体阻滞剂,61% 属于纽约心脏协会 [NYHA] III 级),他们通过症状评估、左心室出口梯度超声心动图测量和左心室射血分数 (LVEF) 测量进行剂量滴定。我们测量了基线、4周、8周和12周时NYHA分级、LVEF、左心室出口梯度(静息和Valsalva)的变化:在 261 ± 143 天(31-571 天不等)时,69 例(46%)患者的 NYHA 分级≥1 级,另有 27 例(18%)患者的 NYHA 分级提高≥2 级。平均 Valsalva LVOT 梯度从基线时的 72 ± 43 mmHg 降至 4 周时的 29 ± 31 mmHg、8 周时的 29 ± 28 mmHg 和 12 周时的 30 ± 29 mmHg(p 结论:患者的平均 Valsalva LVOT 梯度从基线时的 72 ± 43 mmHg 降至 4 周时的 29 ± 31 mmHg、8 周时的 29 ± 28 mmHg 和 12 周时的 30 ± 29 mmHg:在一项针对多医院三级医疗转诊中心有症状的 oHCM 患者的实际研究中,我们证明了在 REMS 计划下处方马伐康坦的有效性、安全性和后勤可行性。
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引用次数: 0
Anthracyclines, Diastolic Dysfunction and the road to Heart Failure in Cancer survivors: An untold story 蒽环类药物、舒张功能障碍和癌症幸存者的心力衰竭之路:一个不为人知的故事。
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-01 DOI: 10.1016/j.pcad.2024.07.002
Many cardiovascular diseases are characterized by diastolic dysfunction, which associates with worse clinical outcomes like overall mortality and hospitalization for heart failure (HF). Diastolic dysfunction has also been suspected to represent an early manifestation of cardiotoxicity induced by cancer drugs, with most of the information deriving from patients treated with anthracyclines; however, the prognostic implications of diastolic dysfunction in the anthracycline-treated patient have remained poorly explored or neglected. Here the molecular, pathophysiologic and diagnostic aspects of anthracycline-related diastolic dysfunction are reviewed in the light of HF incidence and phenotype in cancer survivors. We describe that the trajectories of diastolic dysfunction toward HF are influenced by a constellation of patient- or treatment- related factors, such as comorbidities and exposure to other cardiotoxic drugs or treatments, but also by prospective novel opportunities to treat diastolic dysfunction. The importance of a research-oriented multidimensional approach to patient surveillance or treatment is discussed within the framework of what appears to be a distinct pathophysiologic entity that develops early during anthracycline treatment and gradually worsens over the years.
许多心血管疾病都以舒张功能障碍为特征,舒张功能障碍与总体死亡率和心力衰竭(HF)住院治疗等较差的临床结果有关。舒张功能障碍也被怀疑是癌症药物诱发心脏毒性的早期表现,其中大部分信息来自接受蒽环类药物治疗的患者;然而,舒张功能障碍对接受蒽环类药物治疗的患者预后的影响仍未得到充分探讨或被忽视。在此,我们根据癌症幸存者的高频发生率和表型,对蒽环类药物相关舒张功能障碍的分子、病理生理学和诊断方面进行了综述。我们描述了舒张功能障碍向心房颤动发展的轨迹受到一系列患者或治疗相关因素的影响,如合并症和接触其他心脏毒性药物或治疗,同时也受到治疗舒张功能障碍的前瞻性新机会的影响。以研究为导向的多维方法对患者进行监测或治疗的重要性将在蒽环类药物治疗期间早期出现并在数年后逐渐恶化的独特病理生理实体的框架内进行讨论。
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引用次数: 0
Can the outlier percentiles from norms increase the sensitivity of the ECG criteria for screening athletes? 超出标准值的百分位数能否提高心电图标准筛选运动员的灵敏度?
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-01 DOI: 10.1016/j.pcad.2024.09.003
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引用次数: 0
Landscape of stroke comorbidities: A disease-wide association study 中风并发症情况。
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-01 DOI: 10.1016/j.pcad.2024.09.005
Stroke is a leading cause of death and disability worldwide, with diverse comorbidities that influence its clinical outcomes. However, a comprehensive understanding of the short- and long-term patterns of stroke-related comorbidities remains limited. To address this gap, we conducted a disease-wide association study (DWAS) to systematically explore the landscape of stroke comorbidities in a population-based cohort. Using data from the FinnGen cohort, which included 337,194 participants and 27,496 ischemic stroke cases, we analyzed 1,757 medical events as potential stroke comorbidities. We employed Cox proportional hazards regression, adjusting for sex and age, to identify significant associations between stroke and these medical events. Comorbidities were classified into pre- and post-stroke categories, and their temporal patterns were analyzed over a 1- to 15-year follow-up period. Our findings revealed that stroke comorbidities span multiple disease taxonomies, with significant enrichment in the circulatory, digestive, and musculoskeletal systems. Notably, the study identified distinct pre-stroke and post-stroke comorbidities that persist or evolve over time, supporting the concept of a disease continuum. These temporal patterns suggest that stroke risk and outcomes are shaped by sequential comorbidities rather than simultaneous occurrences. This study provides the most comprehensive profile of stroke comorbidities to date, highlighting the interconnected nature of diseases. By mapping the progression of comorbidities across time and disease categories, DWAS offers valuable insights for early intervention and long-term treatment. Our findings emphasize the importance of viewing stroke as part of a broader disease continuum, offering new opportunities for prevention, diagnosis, and treatment strategies tailored to individual risk profiles.
脑卒中是导致全球死亡和残疾的主要原因,其多种并发症影响着临床预后。然而,对卒中相关合并症的短期和长期模式的全面了解仍然有限。为了填补这一空白,我们开展了一项全疾病关联研究(DWAS),以系统地探索人群队列中中风合并症的分布情况。芬兰基因队列包括 337,194 名参与者和 27,496 例缺血性中风病例,我们利用该队列的数据分析了作为潜在中风合并症的 1,757 个医疗事件。我们采用 Cox 比例危险度回归,并对性别和年龄进行了调整,以确定中风与这些医疗事件之间的显著关联。合并症分为卒中前和卒中后两类,并对其在 1-15 年随访期内的时间模式进行了分析。我们的研究结果表明,中风合并症涉及多种疾病分类,其中循环系统、消化系统和肌肉骨骼系统的合并症明显增多。值得注意的是,该研究发现了卒中前和卒中后不同的合并症,这些合并症随着时间的推移而持续或演变,支持了疾病连续体的概念。这些时间模式表明,中风风险和预后是由相继发生的合并症而不是同时发生的合并症决定的。这项研究提供了迄今为止最全面的中风合并症概况,突出了疾病的相互关联性。通过描绘合并症在不同时间和不同疾病类别中的进展,DWAS 为早期干预和长期治疗提供了宝贵的见解。我们的研究结果强调了将中风视为更广泛的疾病连续体的一部分的重要性,为针对个体风险特征的预防、诊断和治疗策略提供了新的机会。
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引用次数: 0
Calcified coronary lesions: Imaging, prognosis, preparation and treatment state of the art review 冠状动脉钙化病变:成像、预后、准备和治疗的最新进展回顾。
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-01 DOI: 10.1016/j.pcad.2024.06.007
Calcific coronary artery stenosis is a complex disease associated with adverse outcomes and suboptimal percutaneous treatment. Calcium plaque modification has emerged as a key strategy to tackle the issues that accompany calcific stenosis - namely reduced device deliverability, unpredictable lesion characteristics, and difficult dilatation. Atherectomy has traditionally been the treatment modality of choice for heavily calcified coronary stenoses. Contemporary technologies have emerged to aid with planning, preparation, and treatment of calcified coronary stenosis in an attempt to improve procedural success and long-term outcomes. In this State Of The Art Review, we synthesize the body of data surrounding the diagnosis, imaging, and treatment of calcific coronary disease, with a focus on i) intravascular imaging, ii) calcific lesion preparation, iii) treatment modalities including atherectomy, and iv) updated treatment algorithms for the management of calcified coronary stenosis.
钙化性冠状动脉狭窄是一种复杂的疾病,与不良预后和不理想的经皮治疗有关。钙斑块改造已成为解决钙化狭窄问题的关键策略,即降低设备的可送达性、病变特征不可预测以及难以扩张。对于严重钙化的冠状动脉狭窄,传统上选择的治疗方式是动脉粥样硬化切除术。现代技术的出现有助于钙化冠状动脉狭窄的计划、准备和治疗,以提高手术成功率和长期疗效。在这篇最新技术综述中,我们综合了有关钙化冠状动脉疾病诊断、成像和治疗的大量数据,重点关注 i)血管内成像;ii)钙化病变准备;iii)包括动脉粥样硬化切除术在内的治疗方式;以及 iv)治疗钙化冠状动脉狭窄的最新治疗算法。
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引用次数: 0
List of recent issues 近期期刊清单
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-01 DOI: 10.1016/S0033-0620(24)00133-6
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引用次数: 0
The role of artificial intelligence in cardiovascular magnetic resonance imaging 人工智能在心血管磁共振成像中的作用。
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-01 DOI: 10.1016/j.pcad.2024.06.004
Cardiovascular magnetic resonance (CMR) imaging is the gold standard test for myocardial tissue characterization and chamber volumetric and functional evaluation. However, manual CMR analysis can be time-consuming and is subject to intra- and inter-observer variability. Artificial intelligence (AI) is a field that permits automated task performance through the identification of high-level and complex data relationships. In this review, we review the rapidly growing role of AI in CMR, including image acquisition, sequence prescription, artifact detection, reconstruction, segmentation, and data reporting and analysis including quantification of volumes, function, myocardial infarction (MI) and scar detection, and prediction of outcomes. We conclude with a discussion of the emerging challenges to widespread adoption and solutions that will allow for successful, broader uptake of this powerful technology.
心血管磁共振(CMR)成像是心肌组织特征描述、心腔容积和功能评估的金标准检测方法。然而,手动 CMR 分析可能非常耗时,而且受观察者内部和观察者之间差异的影响。人工智能(AI)是一个通过识别高层次复杂数据关系实现任务自动执行的领域。在这篇综述中,我们回顾了人工智能在 CMR 中迅速发展的作用,包括图像采集、序列处方、伪影检测、重建、分割以及数据报告和分析(包括容量量化、功能、心肌梗死(MI)和瘢痕检测以及预后预测)。最后,我们还讨论了广泛采用这项强大技术所面临的新挑战,以及如何成功、更广泛地采用这项技术的解决方案。
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引用次数: 0
The prevalence, patients' characteristics, and hyper-Lp(a)-emia risk factors in the Polish population. The first results from the PMMHRI-Lp(a) Registry 波兰人口中高脂蛋白(a)血症的发病率、患者特征和高脂蛋白(a)血症风险因素。PMMHRI-Lp(a)登记的首批结果。
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-01 DOI: 10.1016/j.pcad.2024.08.004
<div><h3>Background</h3><div>The knowledge on the prevalence of elevated lipoprotein(a) (Lp(a)), patients' characteristics, and nongenetic risk factors is scarce in some regions including Poland, the largest Central and Eastern European country. Thus, we aimed to present the results from the Lp(a) registry established in Poland's 2nd largest, supra-regional hospital - the Polish Mother's Memorial Hospital Research Institute (PMMHRI).</div></div><div><h3>Methods</h3><div>The PMMHRI-Lp(a)-Registry was established in January 2022. Since that time all consecutive patients of the Departments of Cardiology, Endocrinology, and outpatient cardiology, diabetology and metabolic clinics have been included. The indications for Lp(a) measurement in the registry are based on the 2021 Polish Lipid Guidelines and new Polish recommendations on the management of elevated Lp(a) (2024). Lp(a) was determined using Sentinel's Lp(a) Ultra, an Immunoturbidimetric quantitative test (Sentinel, Milan, Italy), and the results are presented in mg/dL.</div></div><div><h3>Results</h3><div>511 patients were included in the registry between Jan 2022 and 15th May 2024. The mean age of patients was 48.21 years. Female patients represented 53.42 % of the population. Elevated Lp(a) levels above 30 and 50 mg/dL were detected in 142 (27.79 %), and 101 (19.8 %) patients, respectively. The mean Lp(a) level was 30.45 ± 42.50 mg/dL, with no significant sex differences [mean for men: 28.80 mg/dL; women: 31.89 mg/dL]. There were also no significant differences between those with and without: coronary artery disease (CAD), dyslipidemia, stroke, heart failure, cancer, diabetes, chronic kidney disease, and thyroid disease. The significant Lp(a) level difference was observed in those with a history of myocardial infarction (MI) vs those without (51.47 ± 55.16 vs 28.09 ± 37.51 mg/dL, <em>p</em> < 0.001). However, when we divided those with premature vs no premature MI, no significant difference in Lp(a) level was observed (51.43 ± 57.82 vs 51.52 ± 53.18 mg/dL, <em>p</em> = 0.95). Lipid-lowering therapy (LLT) at baseline did not significantly affect Lp(a) level, with only significant differences for the highest doses of rosuvastatin (<em>p</em> < 0.05) and in those treated with ezetimibe (as a part of the combination therapy; 44.73 ± 54.94 vs 26.84 ± 37.11 mg/dL, <em>p</em> < 0.001). For selected patients (<em>n</em> = 43; 8.42 %) with at least two Lp(a) measurements (mean time distance: 7 ± 5 months, range 1–20 months) we did not observe statistically significant visit-to-visit variability (mean difference: 3.25 mg/dL; <em>r</em> = 0.079, <em>p</em> = 0.616). While dividing the whole population into those with Lp(a) ≤30 mg/dL and > 30 mg/dL, the only hyper-Lp(a)-emia prevalence differences were seen for FH diagnosis (12.88 vs 21.43; <em>p</em> = 0.017), MI prevalence (6.52 vs 16.90 %; <em>p</em> < 0.001), thyroid disease diagnosis (18.14 vs 26.76 %; <em>p</em> = 0.033) and ezetimi
背景:在一些地区,包括中东欧最大的国家波兰,有关脂蛋白(a)(Lp(a))升高的患病率、患者特征和非遗传风险因素的知识非常匮乏。因此,我们旨在介绍在波兰第二大地区级医院--波兰母亲纪念医院研究所(PMMHRI)建立的脂蛋白(a)登记册的结果:波兰母亲纪念医院研究所脂蛋白(a)登记处成立于2022年1月。方法:PMMHRI-Lp(a)登记处成立于2022年1月,自此,所有连续就诊于心脏病科、内分泌科、心脏病门诊、糖尿病门诊和代谢门诊的患者都被纳入其中。登记册中的脂蛋白(a)测量指征是根据 2021 年《波兰血脂指南》和波兰关于脂蛋白(a)升高管理的新建议(2024 年)制定的。脂蛋白(a)使用 Sentinel's Lp(a) Ultra 免疫比浊定量检测仪(意大利米兰 Sentinel 公司)进行测定,结果以毫克/分升为单位:2022年1月至2024年5月15日期间,511名患者被纳入登记册。患者平均年龄为 48.21 岁。女性患者占总人数的 53.42%。分别有 142 名(27.79%)和 101 名(19.8%)患者的脂蛋白(a)水平高于 30 毫克/分升和 50 毫克/分升。脂蛋白(a)的平均水平为 30.45 ± 42.50 毫克/分升,无明显性别差异[男性平均:28.80 毫克/分升;女性:31.89 毫克/分升]。患有和未患有冠状动脉疾病(CAD)、血脂异常、中风、心力衰竭、癌症、糖尿病、慢性肾病和甲状腺疾病的人之间也没有明显差异。有心肌梗死(MI)病史者与无心肌梗死病史者的 Lp(a)水平差异明显(51.47 ± 55.16 vs 28.09 ± 37.51 mg/dL,p 30 mg/dL,唯一的高 Lp(a)血症患病率差异见于 FH 诊断(12.88 vs 21.43; p = 0.017)、心肌梗死患病率(6.52 vs 16.90 %; p 50 mg/dL (125 nmol/L),但甲状腺疾病无统计学差异:这些结果有力地强调了应普遍测量脂蛋白(a),因为在一级和二级预防的心血管疾病(CVD)风险患者中,脂蛋白(a)的高水平非常普遍(甚至每三个患者中就有一个),需要重新进行风险分级和优化治疗。这对于心血管疾病高风险地区尤为重要,这些地区包括波兰在内的大多数中欧和东欧国家。
{"title":"The prevalence, patients' characteristics, and hyper-Lp(a)-emia risk factors in the Polish population. The first results from the PMMHRI-Lp(a) Registry","authors":"","doi":"10.1016/j.pcad.2024.08.004","DOIUrl":"10.1016/j.pcad.2024.08.004","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The knowledge on the prevalence of elevated lipoprotein(a) (Lp(a)), patients' characteristics, and nongenetic risk factors is scarce in some regions including Poland, the largest Central and Eastern European country. Thus, we aimed to present the results from the Lp(a) registry established in Poland's 2nd largest, supra-regional hospital - the Polish Mother's Memorial Hospital Research Institute (PMMHRI).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The PMMHRI-Lp(a)-Registry was established in January 2022. Since that time all consecutive patients of the Departments of Cardiology, Endocrinology, and outpatient cardiology, diabetology and metabolic clinics have been included. The indications for Lp(a) measurement in the registry are based on the 2021 Polish Lipid Guidelines and new Polish recommendations on the management of elevated Lp(a) (2024). Lp(a) was determined using Sentinel's Lp(a) Ultra, an Immunoturbidimetric quantitative test (Sentinel, Milan, Italy), and the results are presented in mg/dL.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;511 patients were included in the registry between Jan 2022 and 15th May 2024. The mean age of patients was 48.21 years. Female patients represented 53.42 % of the population. Elevated Lp(a) levels above 30 and 50 mg/dL were detected in 142 (27.79 %), and 101 (19.8 %) patients, respectively. The mean Lp(a) level was 30.45 ± 42.50 mg/dL, with no significant sex differences [mean for men: 28.80 mg/dL; women: 31.89 mg/dL]. There were also no significant differences between those with and without: coronary artery disease (CAD), dyslipidemia, stroke, heart failure, cancer, diabetes, chronic kidney disease, and thyroid disease. The significant Lp(a) level difference was observed in those with a history of myocardial infarction (MI) vs those without (51.47 ± 55.16 vs 28.09 ± 37.51 mg/dL, &lt;em&gt;p&lt;/em&gt; &lt; 0.001). However, when we divided those with premature vs no premature MI, no significant difference in Lp(a) level was observed (51.43 ± 57.82 vs 51.52 ± 53.18 mg/dL, &lt;em&gt;p&lt;/em&gt; = 0.95). Lipid-lowering therapy (LLT) at baseline did not significantly affect Lp(a) level, with only significant differences for the highest doses of rosuvastatin (&lt;em&gt;p&lt;/em&gt; &lt; 0.05) and in those treated with ezetimibe (as a part of the combination therapy; 44.73 ± 54.94 vs 26.84 ± 37.11 mg/dL, &lt;em&gt;p&lt;/em&gt; &lt; 0.001). For selected patients (&lt;em&gt;n&lt;/em&gt; = 43; 8.42 %) with at least two Lp(a) measurements (mean time distance: 7 ± 5 months, range 1–20 months) we did not observe statistically significant visit-to-visit variability (mean difference: 3.25 mg/dL; &lt;em&gt;r&lt;/em&gt; = 0.079, &lt;em&gt;p&lt;/em&gt; = 0.616). While dividing the whole population into those with Lp(a) ≤30 mg/dL and &gt; 30 mg/dL, the only hyper-Lp(a)-emia prevalence differences were seen for FH diagnosis (12.88 vs 21.43; &lt;em&gt;p&lt;/em&gt; = 0.017), MI prevalence (6.52 vs 16.90 %; &lt;em&gt;p&lt;/em&gt; &lt; 0.001), thyroid disease diagnosis (18.14 vs 26.76 %; &lt;em&gt;p&lt;/em&gt; = 0.033) and ezetimi","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":null,"pages":null},"PeriodicalIF":5.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082992","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}
引用次数: 0
Long-term continuous exercise training counteracts the negative impact of the menopause transition on cardiometabolic health in hypertensive women - a 9-year RCT follow-up 长期持续的运动训练可抵消绝经过渡期对高血压妇女心脏代谢健康的负面影响--一项为期 9 年的 RCT 跟踪研究
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-07-01 DOI: 10.1016/j.pcad.2023.12.001

Purpose

The study examined effects of 9-yrs of multicomponent exercise training during the menopause interval on cardiometabolic health in hypertensive women.

Methods

Sedentary, middle-aged women (n = 25) with mild-to-moderate arterial hypertension were randomized into a soccer training (multicomponent exercise; EX; n = 12) or control group (CON; n = 13). EX took part in 1-h football training sessions, 1–3 times weekly, for a consecutive 9-years, totaling ∼800 training sessions, while CON did not take part in regular exercise training. 22 participants entered menopause during the intervention.

Results

A time×group interaction effect (P = 0.04) of 8.5 mmHg in favour of EX was observed for changes in mean arterial pressure (MAP) (EX: −4.8 [−10.7;1.1] mmHg, CON +3.7 [−2.0;9.3] mmHg). Time×group interaction effects in favour of EX were also observed for total body weight (4.6 kg, P = 0.008, EX: +0.7 [−1.7;3.0] kg, CON: +5.3 [3.0;7.6] kg, total fat percentage (5.7%-points, P = 0.02; EX (−1.9 [−4.4;0.6] %-points; P = 0.13), CON +3.8 [1.4;6.2] %-points and for total cholesterol (1.2 mmol/l, P = 0.03, EX: −0.5 [−1.0;-0.1] mmol/l, CON: +0.7 [0.2;1.1] mmol/l. EX reduced (P = 0.02) plasma low-density lipoprotein cholesterol by −0.4 [−0.8;-0.1] mmol/l, whereas an increase (P = 0.01) of 0.4 [0.1;0.8] mmol/l occurred in CON (interaction. P < 0.001). A time×group interaction (P = 0.004) existed for changes in exercise capacity in favour of EX. Fasting glucose remained unchanged in EX and increased (P < 0.001) by 0.7 [0.4;1.0] mmol/l in CON (time×group interaction P = 0.02).

Conclusion

In conclusion, long-term multicomponent exercise training fully counteracts the detrimental effects of the menopause transition on cardiometabolic health in hypertensive women.

方法将患有轻度至中度动脉高血压的中年女性(25 人)随机分为足球训练组(多成分运动;EX;12 人)和对照组(CON;13 人)。EX组参加每周1-3次、每次1小时的足球训练,连续9年,总计约800次训练,而CON组不参加常规运动训练。结果 在平均动脉压(MAP)的变化方面,观察到时间×组的交互效应(P = 0.04)为 8.5 mmHg,EX 更有利(EX:-4.8 [-10.7;1.1] mmHg,CON +3.7 [-2.0;9.3] mmHg)。在总重量(4.6 千克,P = 0.008,EX:+0.7 [-1.7;3.0] 千克,CON:+5.3 [3.0;7.6] 千克,总脂肪百分比(5.7%-点,P = 0.02;EX(-1.9 [-4.4;0.6] %-点;P = 0.13),CON +3.8 [1.4;6.2] %-点;总胆固醇(1.2 mmol/l,P = 0.03,EX:总胆固醇(1.2 毫摩尔/升,P = 0.03,EX:-0.5 [-1.0;-0.1] 毫摩尔/升,CON:+0.7 [0.2;1.1] 毫摩尔/升。EX使血浆低密度脂蛋白胆固醇降低(P = 0.02)-0.4 [-0.8;-0.1] mmol/l,而CON使血浆低密度脂蛋白胆固醇升高(P = 0.01)0.4 [0.1;0.8] mmol/l(交互作用。)在运动能力的变化方面,时间与组别的交互作用(P = 0.004)有利于 EX。EX的空腹血糖保持不变,而CON的空腹血糖增加了0.7 [0.4;1.0] mmol/l(P <0.001)(时间×组的交互作用P = 0.02)。
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引用次数: 0
Predicting life expectancy in the United States: The importance of healthy living behaviors and residential geography 预测美国人的预期寿命:健康生活行为和居住地域的重要性
IF 5.6 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-07-01 DOI: 10.1016/j.pcad.2024.01.021

According to the World Health Organization, 30 countries currently have a life expectancy of ≥80 years: the United States (U.S.) is not among this group of countries. The current analysis assesses the ability of key lifestyle behaviors and characteristics to predict a life expectancy of ≥80 years. Only 577 (19%) of the 3066 U.S. Counties assessed had a life expectancy ≥80 years. These counties had significantly higher life expectancy (81 ± 3 vs. 76 ± 2 years) and lower percent of the population who are physically inactive (20.7 ± 3.9 vs. 27.0 ± 4.7%), actively smoke (15.9 ± 3.1 vs. 21.1 ± 3.6%), obese (31.7 ± 4.7 vs. 37.3 ± 3.9%) and have limited access to healthy food (7.1 ± 6.8 vs. 8.4 ± 6.6%) (all p < 0.001). Binary logistic regression revealed percent adults who currently smoke, percent obese, percent physically inactive, and percent with limited access to healthy food were all significant univariate predictors of </≥80 years life expectancy (p < 0.001) and retained in the multivariate regression (p < 0.05). A better understanding of the driving forces that increase healthy living behaviors should be a primary goal in the effort to increase U.S. life expectancy: an individualized approach recognizing unique regional cultures may significantly improve adoption and maintenance of desirable health behaviors and outcomes.

根据世界卫生组织的数据,目前有 30 个国家的预期寿命≥80 岁:美国不在其中。目前的分析评估了主要生活方式行为和特征预测预期寿命≥80 岁的能力。在接受评估的 3066 个美国县中,只有 577 个(19%)的预期寿命≥80 岁。这些县的预期寿命明显较高(81 ± 3 岁 vs. 76 ± 2 岁),不运动(20.7 ± 3.9 vs. 27.0 ± 4.7%)、经常吸烟(15.9 ± 3.1 vs. 21.1 ± 3.6%)、肥胖(31.7 ± 4.7 vs. 37.3 ± 3.9%)和难以获得健康食品(7.1 ± 6.8 vs. 8.4 ± 6.6%)的人口比例也较低(所有数据均为 0.001)。二元逻辑回归显示,目前吸烟的成人百分比、肥胖百分比、不运动百分比和获得健康食品的机会有限百分比都是</≥80 岁预期寿命的重要单变量预测因素(p <0.001),并在多变量回归中得以保留(p <0.05)。更好地了解增加健康生活行为的驱动力应该是提高美国人预期寿命的首要目标:认识到独特地区文化的个性化方法可能会显著提高采用和维持理想健康行为和结果的能力。
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Progress in cardiovascular diseases
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