Pub Date : 2026-01-01DOI: 10.1016/j.cjco.2025.09.009
Thibaut Moulin MD, MSc , Nicolas Lellouche MD, PhD , Estelle Gandjbakhch MD, PhD , Mikael Laredo MD, PhD
Background
Electrocardiogram (ECG) interpretation is a critical skill for medical students that requires regular practice to achieve competency. Microlearning is an emerging pedagogical trend that offers students repetitive, short, and focused e-learning sessions. This study aimed to assess the feasibility of a 6-week, daily, digital ECG training program based on microlearning principles among undergraduate medical students.
Methods
We conducted a bicentric noncontrolled pilot study. Volunteer medical students received a daily (from Monday to Friday) ECG quiz via commonly used digital platforms, followed by immediate feedback, for 6 weeks. The primary endpoint was the daily participation rate. Skill improvement was evaluated through a baseline test and a final test (20 questions, score ranging from 0-20). Student satisfaction and self-assessment of progression were measured.
Results
A total of 47 students were included. The median daily participation rate was high, at 80.9% (iinterquartile range 73.9-86.2), but it tended to decrease over time (weeks 1-2, 87.2%; weeks 3-4, 81.2%; weeks 5-6, 70.2%). A comparison of baseline and final test scores showed a significant improvement, of 1.1 points (95% confidence interval 0.15-2.1; P = 0.03), after the program. No significant correlation was found between individual participation rate and score improvement. Overall, 93% of students subjectively perceived progression, and 93% were satisfied with the training program.
Conclusions
Daily quiz-based microlearning is a feasible method to support ECG training, with high initial adherence. Future controlled studies are required to evaluate the impact of integrating this approach with traditional teaching methods and assess its long-term efficacy and sustainability.
{"title":"Daily Quiz-Based Microlearning Program to Support Electrocardiogram Interpretation Training for Medical Students: A Feasibility Study","authors":"Thibaut Moulin MD, MSc , Nicolas Lellouche MD, PhD , Estelle Gandjbakhch MD, PhD , Mikael Laredo MD, PhD","doi":"10.1016/j.cjco.2025.09.009","DOIUrl":"10.1016/j.cjco.2025.09.009","url":null,"abstract":"<div><h3>Background</h3><div>Electrocardiogram (ECG) interpretation is a critical skill for medical students that requires regular practice to achieve competency. Microlearning is an emerging pedagogical trend that offers students repetitive, short, and focused e-learning sessions. This study aimed to assess the feasibility of a 6-week, daily, digital ECG training program based on microlearning principles among undergraduate medical students.</div></div><div><h3>Methods</h3><div>We conducted a bicentric noncontrolled pilot study. Volunteer medical students received a daily (from Monday to Friday) ECG quiz via commonly used digital platforms, followed by immediate feedback, for 6 weeks. The primary endpoint was the daily participation rate. Skill improvement was evaluated through a baseline test and a final test (20 questions, score ranging from 0-20). Student satisfaction and self-assessment of progression were measured.</div></div><div><h3>Results</h3><div>A total of 47 students were included. The median daily participation rate was high, at 80.9% (iinterquartile range 73.9-86.2), but it tended to decrease over time (weeks 1-2, 87.2%; weeks 3-4, 81.2%; weeks 5-6, 70.2%). A comparison of baseline and final test scores showed a significant improvement, of 1.1 points (95% confidence interval 0.15-2.1; <em>P</em> = 0.03), after the program. No significant correlation was found between individual participation rate and score improvement. Overall, 93% of students subjectively perceived progression, and 93% were satisfied with the training program.</div></div><div><h3>Conclusions</h3><div>Daily quiz-based microlearning is a feasible method to support ECG training, with high initial adherence. Future controlled studies are required to evaluate the impact of integrating this approach with traditional teaching methods and assess its long-term efficacy and sustainability.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 1","pages":"Pages 43-50"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patients with hereditary transthyretin amyloid cardiomyopathy (hATTR-CM), can show neurologic signs that lead to the eventual onset of polyneuropathy (PN). Detection of PN among patients with hATTR-CM can identify candidates for disease-modifying therapies that could significantly reduce the incidence of mortality and morbidity for these complex patients. The purpose of this study is to determine the prevalence of PN among patients with hATTR-CM.
Methods
Sixty patients with hATTR-CM were enrolled in this prospective study, from the Amyloidosis Clinic at the University Health Network in Toronto, Ontario, Canada. All patients (average age: 69.12 ± 11.82 years; 51.7% male; 48.3% female) were referred to neurology programs specialized in hATTR PN. Comprehensive neurologic assessments were conducted, including a physical examination and nerve conduction studies (NCSs). NCSs were performed on the upper and lower extremities.
Results
Thirty patients (50.0%) displayed clinical and NCS abnormalities. Six patients (10.0%) did not display any neurologic abnormalities on the physical examination, but did have abnormalities on the NCSs, suggesting the presence of transthyretin-PN. The abnormalities on the NCSs were more indicative of sensory PN than of motor polyneuropathy. Twenty-four patients (40.0%) did not display any clinical or NCS abnormalities. Based on the systematic neurologic assessment, 36 patients in our study were identified as having a mixed hATTR phenotype, and they are to receive specific disease-modifying therapies, either patisiran or inotersen.
Conclusion
Patients with hATTR-CM should be systematically referred to a specialized neurologist for routine assessment, especially patients who report neurologic symptoms (ie, numbness and burning sensation in extremities).
{"title":"Detecting Polyneuropathy in Patients with Hereditary Transthyretin Amyloid Cardiomyopathy","authors":"Priya Arivalagan MSc , Rodrigo Carrasco Loza MD, PhD , Natalia Nugaeva MSc, PhD , Hans Katzberg MD, MSc , Jamsheed Desai MD , Vincenzo Santo Basile MD , Vera Bril MD , Diego Delgado MD, MSc","doi":"10.1016/j.cjco.2025.09.015","DOIUrl":"10.1016/j.cjco.2025.09.015","url":null,"abstract":"<div><h3>Background</h3><div>Patients with hereditary transthyretin amyloid cardiomyopathy (hATTR-CM), can show neurologic signs that lead to the eventual onset of polyneuropathy (PN). Detection of PN among patients with hATTR-CM can identify candidates for disease-modifying therapies that could significantly reduce the incidence of mortality and morbidity for these complex patients. The purpose of this study is to determine the prevalence of PN among patients with hATTR-CM.</div></div><div><h3>Methods</h3><div>Sixty patients with hATTR-CM were enrolled in this prospective study, from the Amyloidosis Clinic at the University Health Network in Toronto, Ontario, Canada. All patients (average age: 69.12 ± 11.82 years; 51.7% male; 48.3% female) were referred to neurology programs specialized in hATTR PN. Comprehensive neurologic assessments were conducted, including a physical examination and nerve conduction studies (NCSs). NCSs were performed on the upper and lower extremities.</div></div><div><h3>Results</h3><div>Thirty patients (50.0%) displayed clinical and NCS abnormalities. Six patients (10.0%) did not display any neurologic abnormalities on the physical examination, but did have abnormalities on the NCSs, suggesting the presence of transthyretin-PN. The abnormalities on the NCSs were more indicative of sensory PN than of motor polyneuropathy. Twenty-four patients (40.0%) did not display any clinical or NCS abnormalities. Based on the systematic neurologic assessment, 36 patients in our study were identified as having a mixed hATTR phenotype, and they are to receive specific disease-modifying therapies, either patisiran or inotersen.</div></div><div><h3>Conclusion</h3><div>Patients with hATTR-CM should be systematically referred to a specialized neurologist for routine assessment, especially patients who report neurologic symptoms (ie, numbness and burning sensation in extremities).</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 1","pages":"Pages 9-15"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.cjco.2025.09.007
Katherine L. Mason BSc , Katherine S. Allan PhD , June Carroll MD , Arnon Adler MD , Julie Rutberg MSc, CGC , Sheldon Cheskes MD , Steve Lin MSc, MDCM , Erik K. Mont MD , Joel A. Kirsh MSc, MD, MHCM, LLM , Lindsay J. Denis BScN, RN , Kris Cunningham MD, PhD , Jodi Garner MSc , Liz Siydock MEd, MACP , Katie N. Dainty PhD , Matthew Bowes MD , Karolyn Yee RN , Paul Dorian MSc, MD , Krystina B. Lewis RN, MN, PhD
Background
Sudden cardiac death (SCD) is a leading global cause of mortality and is often attributable to heritable cardiac conditions in the young (aged 2-45 years). Death investigators are responsible for determining the cause of death and communicating the risk of heritable conditions with the families of victims. Families often struggle to comprehend this information. This study explores how death investigators communicate with families of young SCD victims who die from suspected heritable causes about the cause of death and their risk for SCD.
Methods
We conducted an explanatory sequential mixed-methods study, collecting quantitative data, via a web-based survey, and qualitative data, via telephone interviews, to investigate how death investigators in Ontario and Nova Scotia, Canada, communicate with family members of SCD victims. We used descriptive statistics to analyze quantitative data, and thematic analysis to analyze qualitative data. We triangulated the data at multiple levels.
Results
Between October 2022 and July 2023, we surveyed 78 death investigators and interviewed a subset of these (n = 20). Participants (40%; n = 31) reported that SCDs due to heritable cardiac conditions were more difficult to investigate, requiring a higher frequency of communication with families. Participants (96.1%; n = 75) reported contacting family members via phone. Strategies to achieve their communication goals were influenced by family characteristics; involvement of other professionals; characteristics of the investigation, access to resources, and system-level barriers.
Conclusions
SCD investigations in the young who die due to suspected heritable cardiac conditions are challenging and require a high frequency of communication. Further research should examine how systematic changes can improve communication among death investigators and families.
{"title":"“I Am a Quarterback”: A Mixed-Methods Study of Death Investigators’ Communication with Family Members of Young Sudden Cardiac Death Victims","authors":"Katherine L. Mason BSc , Katherine S. Allan PhD , June Carroll MD , Arnon Adler MD , Julie Rutberg MSc, CGC , Sheldon Cheskes MD , Steve Lin MSc, MDCM , Erik K. Mont MD , Joel A. Kirsh MSc, MD, MHCM, LLM , Lindsay J. Denis BScN, RN , Kris Cunningham MD, PhD , Jodi Garner MSc , Liz Siydock MEd, MACP , Katie N. Dainty PhD , Matthew Bowes MD , Karolyn Yee RN , Paul Dorian MSc, MD , Krystina B. Lewis RN, MN, PhD","doi":"10.1016/j.cjco.2025.09.007","DOIUrl":"10.1016/j.cjco.2025.09.007","url":null,"abstract":"<div><h3>Background</h3><div>Sudden cardiac death (SCD) is a leading global cause of mortality and is often attributable to heritable cardiac conditions in the young (aged 2-45 years). Death investigators are responsible for determining the cause of death and communicating the risk of heritable conditions with the families of victims. Families often struggle to comprehend this information. This study explores how death investigators communicate with families of young SCD victims who die from suspected heritable causes about the cause of death and their risk for SCD.</div></div><div><h3>Methods</h3><div>We conducted an explanatory sequential mixed-methods study, collecting quantitative data, via a web-based survey, and qualitative data, via telephone interviews, to investigate how death investigators in Ontario and Nova Scotia, Canada, communicate with family members of SCD victims. We used descriptive statistics to analyze quantitative data, and thematic analysis to analyze qualitative data. We triangulated the data at multiple levels.</div></div><div><h3>Results</h3><div>Between October 2022 and July 2023, we surveyed 78 death investigators and interviewed a subset of these (n = 20). Participants (40%; n = 31) reported that SCDs due to heritable cardiac conditions were more difficult to investigate, requiring a higher frequency of communication with families. Participants (96.1%; n = 75) reported contacting family members via phone. Strategies to achieve their communication goals were influenced by family characteristics; involvement of other professionals; characteristics of the investigation, access to resources, and system-level barriers.</div></div><div><h3>Conclusions</h3><div>SCD investigations in the young who die due to suspected heritable cardiac conditions are challenging and require a high frequency of communication. Further research should examine how systematic changes can improve communication among death investigators and families.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 1","pages":"Pages 35-42"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.cjco.2025.09.011
Valdano Manuel MD, PhD , Ana Olga Mocumbi MD, PhD , Liesl Zühlke MD, PhD
Rheumatic heart disease (RHD) remains a major cause of preventable morbidity and premature death, affecting over 40 million people worldwide and causing more than 300,000 deaths annually, predominantly in low- and middle-income countries. Children and adolescents bear a substantial burden, with 1-year mortality rates up to 17%, primarily from heart failure, especially among those with poor adherence to benzathine penicillin prophylaxis. RHD is entirely preventable through timely diagnosis and secondary prophylaxis, yet access to prevention, medical therapy, and surgical care remains inconsistent. Girls and women face delayed diagnosis, high maternal mortality, and inequitable access to gender-sensitive care. Fewer than 10 African countries have implemented national or pilot RHD programs, and despite the 2018 World Health Assembly Resolution 71.14, progress remains slow. Sustainable, African-led programs integrated into national healthcare systems are urgently needed to reduce RHD-related mortality and achieve its long-term elimination.
{"title":"Rheumatic Heart Disease: Global Failure in Tackling a Common Killer","authors":"Valdano Manuel MD, PhD , Ana Olga Mocumbi MD, PhD , Liesl Zühlke MD, PhD","doi":"10.1016/j.cjco.2025.09.011","DOIUrl":"10.1016/j.cjco.2025.09.011","url":null,"abstract":"<div><div>Rheumatic heart disease (RHD) remains a major cause of preventable morbidity and premature death, affecting over 40 million people worldwide and causing more than 300,000 deaths annually, predominantly in low- and middle-income countries. Children and adolescents bear a substantial burden, with 1-year mortality rates up to 17%, primarily from heart failure, especially among those with poor adherence to benzathine penicillin prophylaxis. RHD is entirely preventable through timely diagnosis and secondary prophylaxis, yet access to prevention, medical therapy, and surgical care remains inconsistent. Girls and women face delayed diagnosis, high maternal mortality, and inequitable access to gender-sensitive care. Fewer than 10 African countries have implemented national or pilot RHD programs, and despite the 2018 World Health Assembly Resolution 71.14, progress remains slow. Sustainable, African-led programs integrated into national healthcare systems are urgently needed to reduce RHD-related mortality and achieve its long-term elimination.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 1","pages":"Pages 59-64"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Early identification of coronary artery disease (CAD) in patients newly diagnosed with heart failure (HF) has prognostic and therapeutic implications. We evaluated frequency and predictors of CAD testing in Alberta between April 1, 2004 and March 31, 2023.
Methods
Population-level retrospective cohort study using linked administrative health datasets and previously validated case definitions.
Results
Of 166,447 adults with newly diagnosed HF, 64.2% first presented in the outpatient setting. Within the first month of diagnosis, patients were most likely to be seen by a primary care physician only (PCP, 41.8%); co-management with PCP and a specialist was the second most common management strategy (31.6%). Within 6-months of diagnosis, 46,143 (27.7%) patients had at least one diagnostic evaluation for CAD; coronary catheterization was more common in patients diagnosed in hospital while non-invasive imaging was more common in non-hospitalized patients. Testing was strongly associated with specialist involvement: 54.4% if co-managed with PCP [aOR 5.19, 95% confidence interval 4.96-5.43], 39.6% if saw specialist alone [aOR 2.86, 2.75- 2.97], and 13.8% if managed by PCP alone [referent]). Although frequency of echocardiography and CAD non-invasive imaging rose sharply in 2017, the majority of patients with new HF in all years were not tested for CAD.
Conclusion
Despite its prognostic importance, CAD testing is performed in a minority of patients with newly diagnosed heart failure and is heavily influenced by specialist involvement. Optimizing CAD testing patterns for all patients newly diagnosed with HF should be a priority for clinicians and policy makers.
{"title":"Testing for Coronary Artery Disease in Patients Newly Diagnosed with Heart Failure in Alberta, Canada","authors":"Amlish Munir MD, MSc , Luan Manh Chu PhD , Padma Kaul PhD , Justin Ezekowitz MB, BCh, MSc , Finlay A. McAlister MD, MSc","doi":"10.1016/j.cjco.2025.09.008","DOIUrl":"10.1016/j.cjco.2025.09.008","url":null,"abstract":"<div><h3>Background</h3><div>Early identification of coronary artery disease (CAD) in patients newly diagnosed with heart failure (HF) has prognostic and therapeutic implications. We evaluated frequency and predictors of CAD testing in Alberta between April 1, 2004 and March 31, 2023.</div></div><div><h3>Methods</h3><div>Population-level retrospective cohort study using linked administrative health datasets and previously validated case definitions.</div></div><div><h3>Results</h3><div>Of 166,447 adults with newly diagnosed HF, 64.2% first presented in the outpatient setting. Within the first month of diagnosis, patients were most likely to be seen by a primary care physician only (PCP, 41.8%); co-management with PCP and a specialist was the second most common management strategy (31.6%). Within 6-months of diagnosis, 46,143 (27.7%) patients had at least one diagnostic evaluation for CAD; coronary catheterization was more common in patients diagnosed in hospital while non-invasive imaging was more common in non-hospitalized patients. Testing was strongly associated with specialist involvement: 54.4% if co-managed with PCP [aOR 5.19, 95% confidence interval 4.96-5.43], 39.6% if saw specialist alone [aOR 2.86, 2.75- 2.97], and 13.8% if managed by PCP alone [referent]). Although frequency of echocardiography and CAD non-invasive imaging rose sharply in 2017, the majority of patients with new HF in all years were not tested for CAD.</div></div><div><h3>Conclusion</h3><div>Despite its prognostic importance, CAD testing is performed in a minority of patients with newly diagnosed heart failure and is heavily influenced by specialist involvement. Optimizing CAD testing patterns for all patients newly diagnosed with HF should be a priority for clinicians and policy makers.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 1","pages":"Pages 1-8"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.cjco.2025.09.005
Jooa Norha PhD, MHSc , Maria Saarenhovi MD, PhD , Petri Kallio MD , Tanja Sjöros PhD , Taru Garthwaite PhD , Saara Laine PhD , Noora Houttu PhD , Kirsi Laitinen (PhD) , Henri Vähä-Ypyä MSc (Tech) , Harri Sievänen PhD , Eliisa Löyttyniemi MSc , Tommi Vasankari (MD, PhD) , Juhani Knuuti (MD, PhD) , Kari K. Kalliokoski PhD , Ilkka H.A. Heinonen PhD
Background
Interventional studies on sedentary behaviour (SB) and cardiac health are missing. Therefore, this study investigates the effects of reducing SB on cardiac structure and function in inactive and sedentary adults with metabolic syndrome.
Methods
In this randomized controlled trial, the intervention group (n = 33) aimed at reducing SB by 1 h/d for 6 months. The control group (n = 31) continued their SB and physical activity (PA) as usual. All participants wore accelerometers throughout the study. Echocardiography was performed at rest and during incremental exercise tests before and after the intervention.
Results
No intervention effects were observed in any echocardiographic variables between the randomized groups. However, when participants were regrouped into a less sedentary (mean SB reduction 60 min/d) or a continuously sedentary group, based on their actual measured behaviour change, left ventricular (LV) mass index and end-diastolic diameter decreased more in the less sedentary than in the continuously sedentary group (group x time P = 0.045 and 0.020, respectively). Moreover, LV global longitudinal strain during exercise improved in the less sedentary group compared to the continuously sedentary group. Among all participants, the change in light PA was correlated inversely with the change in LV mass index (r = –0.32, P = 0.026), and the change in standing time was correlated with the change in the early diastolic flow velocity / lateral mitral annular velocity (E/e’) ratio (r = 0.28, P = 0.048).
Conclusions
A 6-month intervention aimed at reducing SB did not affect cardiac structure or function. However, in participants with successful SB reduction and increased light PA regardless of original randomization, LV mass index may have decreased, and LV function during exercise may have improved.
Clinical Trial Registration
NCT03101228.
背景：关于久坐行为（SB）和心脏健康的介入性研究尚缺乏。因此，本研究旨在探讨减少SB对不活动和久坐代谢综合征成人心脏结构和功能的影响。方法在随机对照试验中，干预组（n = 33）以降低SB 1 h/d为目标，持续6个月。对照组（n = 31）照常进行SB和体力活动（PA）。在整个研究过程中，所有参与者都佩戴了加速度计。在干预前后分别在休息和增量运动试验期间进行超声心动图检查。结果两组间超声心动图指标均无干预效果。然而，根据实际测量的行为变化，当参与者被重新分组为少坐组（平均SB减少60分钟/天）或连续久坐组时，少坐组的左心室（LV）质量指数和舒张末期直径比连续久坐组下降得更多（组x时间P分别= 0.045和0.020）。此外，与持续久坐组相比，少坐组运动时左心室整体纵向应变有所改善。在所有受试者中，轻PA的变化与左室质量指数的变化呈负相关（r = -0.32, P = 0.026），站立时间的变化与舒张早期血流速度/侧二尖瓣环速度（E/ E’）比值的变化呈相关（r = 0.28, P = 0.048）。结论6个月降低SB干预对心脏结构和功能无影响。然而，无论最初的随机分组如何，在成功减少SB和增加光PA的参与者中，左室质量指数可能下降，运动时左室功能可能改善。临床试验注册编号nct03101228。
{"title":"Effects of Reducing Sedentary Behaviour on Cardiac Structure and Function at Rest and During Exercise: A 6-Month Randomized Controlled Trial","authors":"Jooa Norha PhD, MHSc , Maria Saarenhovi MD, PhD , Petri Kallio MD , Tanja Sjöros PhD , Taru Garthwaite PhD , Saara Laine PhD , Noora Houttu PhD , Kirsi Laitinen (PhD) , Henri Vähä-Ypyä MSc (Tech) , Harri Sievänen PhD , Eliisa Löyttyniemi MSc , Tommi Vasankari (MD, PhD) , Juhani Knuuti (MD, PhD) , Kari K. Kalliokoski PhD , Ilkka H.A. Heinonen PhD","doi":"10.1016/j.cjco.2025.09.005","DOIUrl":"10.1016/j.cjco.2025.09.005","url":null,"abstract":"<div><h3>Background</h3><div>Interventional studies on sedentary behaviour (SB) and cardiac health are missing. Therefore, this study investigates the effects of reducing SB on cardiac structure and function in inactive and sedentary adults with metabolic syndrome.</div></div><div><h3>Methods</h3><div>In this randomized controlled trial, the intervention group (n = 33) aimed at reducing SB by 1 h/d for 6 months. The control group (n = 31) continued their SB and physical activity (PA) as usual. All participants wore accelerometers throughout the study. Echocardiography was performed at rest and during incremental exercise tests before and after the intervention.</div></div><div><h3>Results</h3><div>No intervention effects were observed in any echocardiographic variables between the randomized groups. However, when participants were regrouped into a less sedentary (mean SB reduction 60 min/d) or a continuously sedentary group, based on their actual measured behaviour change, left ventricular (LV) mass index and end-diastolic diameter decreased more in the less sedentary than in the continuously sedentary group (group x time <em>P</em> = 0.045 and 0.020, respectively). Moreover, LV global longitudinal strain during exercise improved in the less sedentary group compared to the continuously sedentary group. Among all participants, the change in light PA was correlated inversely with the change in LV mass index (<em>r</em> = –0.32, <em>P</em> = 0.026), and the change in standing time was correlated with the change in the early diastolic flow velocity / lateral mitral annular velocity (E/e’) ratio (<em>r</em> = 0.28, <em>P</em> = 0.048).</div></div><div><h3>Conclusions</h3><div>A 6-month intervention aimed at reducing SB did not affect cardiac structure or function. However, in participants with successful SB reduction and increased light PA regardless of original randomization, LV mass index may have decreased, and LV function during exercise may have improved.</div></div><div><h3>Clinical Trial Registration</h3><div>NCT03101228.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"8 1","pages":"Pages 69-81"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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