Low Cardiorespiratory Fitness Research Articles

Associations of physical condition with lung function and asthma in adolescents from the general population.

BackgroundThe relation of physical condition with respiratory outcomes in adolescents is unclear. We examined the hypothesis that adolescents with a lower physical condition represented by a lower cardiorespiratory fitness and physical activity, and a higher screen time have a lower lung function and higher risk of asthma.MethodsIn a population‐based prospective cohort study on 4854 children aged 13 years, we assessed cardiorespiratory fitness by using the peak work rate measured by the steep ramp test. Information on physical activity and screen time was obtained by self‐reported questionnaires. Lung function was measured by spirometry and current asthma was assessed by a parental‐reported questionnaire.ResultsTaking sociodemographic, lifestyle, and growth‐related confounders and multiple hypothesis testing into account, a 1 SD lower cardiorespiratory fitness was associated with a lower FEV1, FVC, and FEF75 (Z‐score difference (95% CI): −0.31 (−0.35, −0.28), −0.30 (−0.33, −0.26), −0.13 (−0.17, −0.10), respectively), and a higher risk of asthma (Odds Ratio (95% CI) 1.25 (1.06, 1.46)). A 1 SD higher screen time was associated with a lower FVC (Z‐score difference (95% CI): −0.06 (−0.10, −0.03)). Physical activity and screen time were not related to asthma. Results did not materially change after additional adjustment for respiratory outcomes at an earlier age.ConclusionAdolescents with a lower cardiorespiratory fitness had a lower lung function and a higher risk of asthma. Those with a higher screen time had a lower FVC. Further studies are needed to explore the effect of improvements in physical condition on long‐term respiratory outcomes.

Sleep behaviour and cardiorespiratory fitness in patients after percutaneous coronary intervention during cardiac rehabilitation: protocol for a longitudinal study

IntroductionMost patients with coronary heart disease experience sleep disturbances and low cardiorespiratory fitness (CRF), but their relationship during cardiac rehabilitation (CR) is still unclear. This article details a protocol for...

245-OR: Age and Diabetes Interact to Decrease Muscle Mitochondrial Function

People with T2D have lower cardiorespiratory fitness (CRF) than those without diabetes contributing to increased cardiovascular morbidity and mortality. People with T2D have impaired oxidative flux associated with lower CRF. Yet, reports on muscle mitochondrial dysfunction in T2D are mixed. As diabetes duration and age are predictors of poor outcomes, we hypothesized that T2D and increased age associate with impaired mitochondrial function. We assessed post-exercise calf mitochondrial function in overweight sedentary participants (45 with and 54 without T2D) ages 30-50 and 51-70y. Mitochondrial function was measured in vivo by 31Phosphorous magnetic resonance spectroscopy (31P-MRS) before, during and after 90 seconds of isotonic calf press at 70% maximal force and ex vivo by mitochondrial respiration in muscle fibers using the Oroboros Oxygraph-2k. There was no significant effect of age or T2D on ex vivo measures. MRS-measured phosphocreatine synthesis, apparent maximum rate of oxidative ATP synthesis and ADP time constant were worse in those with T2D or age >50 (Figure) . Age and T2D interact to significantly decrease apparent maximum rate of oxidative ATP synthesis. These data suggest that age and T2D decrease in vivo oxidative capacity. Given that impairment is only found in in vivo mitochondrial measures, factors such as micro- and macrovascular function and blood flow, combined with cardiac function, are likely implicated. Disclosure L.Abushamat: None. J.G.Regensteiner: None. R.L.Scalzo: None. D.Ramirez: None. I.E.Schauer: None. L.Knaub: None. E.Clark: None. Y.Garcia reyes: None. M.Cree-green: None. J.Reusch: Advisory Panel; Medtronic. Funding American Diabetes Association (1-21-CMF-003) (1-12-CT-64) ; Department of Veterans Affairs (BX002046, CX001532)

Associations of Plasma Bioactive Adrenomedullin Levels with Cardiovascular Risk Factors in BRCA1/2 Mutation Carriers

Background Cardiovascular disease (CVD) is an important cause of morbidity and mortality in breast cancer survivors. Effective screening modalities to identify CVD risk are lacking in this population. Adrenomedullin (ADM) has been suggested as a biomarker for subclinical cardiac dysfunction in the general population. Levels of ADM have been proven to be responsive to lifestyle changes that lead to improved cardiovascular health. As BRCA1/2 mutation carriers are deemed to be at an increased risk for CVD, the aim of this study was to examine plasma ADM levels in a cohort of BRCA mutation carriers and to assess their association with cardiovascular risk factors. Methods Plasma ADM concentrations were measured in 292 female BRCA1/2 mutation carriers with and without a history of breast cancer. Subjects were classified into high versus low ADM levels based on the median ADM level in the entire cohort (13.8 pg/mL). Logistic regression models were used to estimate the odds ratios (OR) of having elevated ADM levels by several cardiovascular risk factors. Results Of all women (median age: 43 years), 57.5% had a previous diagnosis of breast cancer. The median time between diagnosis and study entry was three years (range: 0 – 32 years). Women presenting with metabolic syndrome had 22-fold increased odds of having elevated ADM levels (p < 0.001). Elevated ADM levels were associated with lower cardiorespiratory fitness (OR = 0.88, p < 0.001) and several parameters of obesity (p < 0.001). ADM levels were higher in women who have ever smoked (OR = 1.72, p = 0.02). ADM levels were not associated with a previous diagnosis of breast cancer (p = 0.28). Conclusions This is the first study in BRCA mutation carriers that has linked circulating ADM levels to traditional cardiovascular risk factors. The long-term clinical implications of these findings are yet to be determined.

Mid-Life Cardiorespiratory Fitness, Obesity, and Risk of Atrial Fibrillation: The Cooper Center Longitudinal Study

BackgroundLower cardiorespiratory fitness (CRF) and higher body mass index (BMI) are associated with a higher risk of myocardial infarction and heart failure. However, the independent contribution of these lifestyle factors to the risk of atrial fibrillation (AF) is less well established. ObjectivesThe purpose of this study was to evaluation the association between midlife CRF, BMI, and risk of AF in older age. MethodsThis study included 18,493 participants without AF who underwent assessment of CRF (estimated using the maximal treadmill time) and BMI in middle age and had Medicare coverage after the age of 65 years. The association among midlife CRF, BMI, and risk of AF was assessed by fitting a proportional hazards intensity model to the failure time data with adjustment for potential confounders. The association between changes in CRF and BMI in middle age and the risk of AF was also assessed in the subset of participants with repeat CRF assessments. ResultsAmong 18,493 participants (79% men), a higher midlife BMI was significantly associated with a higher risk of AF independent of CRF levels and other potential confounders (hazard ratio per 1-kg/m2: 1.05; 95% confidence interval: 1.03-1.06). Lower midlife CRF was also associated with higher risk of AF (hazard ratio per 1 MET higher CRF: 0.98; 95% confidence interval: 0.96-0.99). However, this association was attenuated and not significant after further adjustment for BMI. Change in CRF on follow-up was also not associated with the risk of AF after adjustment for other confounders. ConclusionsThe association between low fitness and AF was primarily driven by differences in BMI. In contrast, obesity was independently associated with excess AF risk.

Correlation between nutritional status and physical activity Vo2max at employess of Aisyah University of Pringsewu in 2021

Introduction: VO 2 max is one of ways to measured cardiorespiratory fitness. Low cardiorespiratory fitness becomes one of the factors that cause heart disease. There are factors related to fitness, including nutritional status and physical activity. Objective : The aim of this study was to determine the correlation between nutritional status and physical activity with VO2max at employess of Aisyah University of Pringsewu in 2021 . M etho d: The design of this study used Cross Sectional. The number of samples was 78 consist of 30 men and 48 women with an average age of 30.81 ± 6.58 years . Cardiorespiratory fitness was measured by using 20-M eters Shuttle Run Test . R esult : The results of statistical analysis showed that there was a significant correlation between nutritional status and VO 2 max (p&lt;0.05) and other test results showed that there was a significant correlation between physical activity and VOmax (p&lt;0.05 ). C onclusion : In conclusion, both nutritional status and physical activity have a significant correlation with the vo2max in employees. Employees with lower B ody M ass I ndex (Nutritional Status) and higher physical activity have better

Interactions Between Statins, Exercise, and Health: A Clinical Update

Interactions Between Statins, Exercise, and Health: A Clinical Update

Cardiorespiratory fitness, genetic susceptibility, inflammation and risk of incident type 2 diabetes: A population-based longitudinal study

ObjectiveTo examine whether the association between cardiorespiratory fitness (CRF) and type 2 diabetes (T2D) is modified by genetic susceptibility and inflammation. ParticipantsThe prospective study included 57,185 participants (40–70 years) who were free from T2D and received the CRF assessment at enrollment (2006–2010) in the UK biobank. CRF was examined through a submaximal cycle ergometer test and expressed in metabolic equivalent of tasks (METs), genetic susceptibility was quantified using a genetic risk score, and inflammation was assessed according to the concentration of C-reactive protein. All these three factors were categorized into tertiles. ResultsDuring a median follow-up of 10.4 years, 5477 (7.0%) cases of T2D were ascertained. CRF was inversely associated with the risk of T2D in a dose-response manner. The hazard ratio (HR) was 0.85 (95% confidence interval [CI]: 0.79–0.92) per 1 MET increment of CRF. There was a significant interaction between CRF and genetic susceptibility to T2D in relation to the risk of T2D (P for interaction = 0.03). Compared with participants with high CRF and low genetic susceptibility, the HR was 4.98 (95% CI: 3.17–7.82) for those with low CRF and high genetic susceptibility. A similar pattern was observed in participants with low CRF and high inflammation compared with those who had high CRF and low inflammation (HR = 2.53; 95% CI: 1.83–3.48), though the interaction between CRF and inflammation did not reach statistical significance. T2D risk declined progressively with increased CRF among different inflammation categories. ConclusionOur study reveals that genetic susceptibility may modify the association between CRF and T2D, highlighting that risk of T2D associated with genetics could benefit most from interventions on improving CRF.

Screening for QTc prolongation during acute exercise in childhood acute lymphoblastic leukemia survivors

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Institute of Cancer Research (ICR) of the Canadian Institutes ofHealth Research (CIHR), C17 Council Background Anthracycline-related cardiotoxicity is a major cause of mortality and morbidity in childhood acute lymphoblastic leukaemia (ALL) survivors. Electrophysiologic complications and cardiac autonomic dysfunction are both known to be developed by childhood ALL survivors. Current methods for detection of cardiotoxicity have limitations, particularly due to their lack of sensitivity for early detection of subclinical cardiac dysfunction. Early detection of cardiac dysfunction remains a cardiologist’s challenge and is essential to allow optimal therapeutic intervention. Purpose This study aimed to observe ventricular repolarization during a maximal cardiopulmonary exercise test (CPET) in childhood ALL survivors. We hypothesized that cancer treatments lead to changes in ventricular repolarization that persist over time, and that the use of CPET allows the unmasking of electrophysiological abnormalities. Methods A total of 250 childhood ALL survivors underwent a maximal CPET on an ergocycle, and their direct oxygen uptake was measured. All survivors were monitored continuously during the test using a 12-lead electrocardiogram. Measurements of the QT interval were completed at rest, at the end of each stage of the CPET, and during recovery. The QT interval was defined as the period from the onset of the Q-wave to the end of the T-wave, measured linearly. Values were corrected (QTc) using a specific group equation. To compare the effect of cardiorespiratory fitness on QTc during CPET, participants were divided in two groups according to the median of survivors’ cardiorespiratory fitness (group A: &amp;lt;32.0 mL.kg-1.min-1; group B: ≥32.0 mL.kg-1.min-1). Results All survivors (median age: 21 years, 51.5% male) included in the final analysis (n=200) performed a validated maximal CPET. At rest, the QTc interval was 379.1±32.2ms. None of the participants had a prolonged QTc during exercise (371.5±16.1ms, range 310.7-416.1ms). The mean QTc interval during CPET was not different between groups A and B (370.1±17.6ms and 373.0±14.4ms, p=0.218). Group A had a longer QT interval at low to moderate exercise intensities. During recovery, the QTc interval was 373.4.1±16.2ms. Conclusions Cancer and anthracycline treatments have an impact on the cardiorespiratory system. Low cardiorespiratory fitness in childhood ALL survivors is associated with longer ventricular repolarization during exercise. These differences may be an indicator of altered cardiac function. This shows the importance of studying the response to exercise to improve early cardiac dysfunction detection, as well as documenting the autonomic nervous system response to exercise between survivors with lower and higher physical fitness.

Identifying new genetic markers for maximal oxygen uptake

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Central Norway Regional Health AuthorityNorwegian Health Association Introduction Cardiovascular disease (CVD) is the leading cause of death worldwide. Several studies have shown that low cardiorespiratory fitness (CRF) is a major risk factor for CVD. Low CRF is suggested to be a stronger predictor of CVD morbidity and mortality than established cardiovascular risk factors like obesity, diabetes, and cholesterol. Several studies suggest that CRF quantified as maximal oxygen uptake (VO2max) has a strong genetic component, estimated to be ~50%. Unfortunately, current studies on genetic markers for CRF are limited by small sample sizes. In addition, there are few studies on directly measured VO2max, as most of the previous studies are based on estimated CRF. Directly measured VO2max is considered as the gold standard for measuring CRF. Thus, a large-scale systematic screening for genetic variants associated with VO2max may provide awaited insight to this complex trait and discover possible links between VO2max and CVD. Purpose To identify and validate genetic factors associated with VO2max. Methods The genotypes of 70.000 participants from the Trøndelag Health study (HUNT) were imputed providing information on 25 million SNPs. We conducted a genome-wide association study (GWAS) including 4525 participants with directly measured VO2max from the HUNT3 Fitness study. The GWAS was performed using BOLT-LMM, adjusted for age, gender, physical activity, principal components, and genotyping batch. In addition, we ran a GWAS with the same covariates except physical activity. Further, gender specific analyses were conducted. For validation, similar analyses were performed in the United Kingdom Biobank (UKBB). In the UKBB, CRF was assessed through a submaximal bicycle test. The analyses of UKBB included ~60.000 participants and over 90 million SNPs. Results Two GWAS-significant (p &amp;lt; 5x10-8) SNPs associated with VO2max were identified in the total population in HUNT. Further, 24 GWAS-significant SNPs associated with VO2max in females, and two GWAS-significant SNPs associated with VO2max in males were discovered. Two of the 24 SNPs found in the female population were nominally significant in the UKBB. The validated SNPs are rs376927175, an intergenic SNP downstream of APBA1, and rs551942830 (proxy for rs190675254 with LD = 1.0), a 3 Prime UTR variant inside PIK3R5. PIK3R5 encodes the regulatory subunit of one class of PI3Ks, that is shown to be of importance in cardiac function and CVD. None of the SNPs found in the total population nor the male population were validated in UKBB. Conclusions We have identified 28 novel SNPs associated with VO2max in the HUNT cohort. Two of these SNPs were nominally validated in females in UKBB. One of the validated SNPs resides within a gene previously reported to be related to heart function and CVD. Further functional analyses using bioinformatic approaches may provide more information on the physiological importance of these findings and their relation to CVD.

The Association of Obesity and Cardiorespiratory Fitness in Relation to Cognitive Flexibility: An Event-Related Potential Study.

This study investigates an association between obesity and cardiorespiratory fitness concerning their potential effects on cognitive flexibility in young adults from behavioral and neuroelectrical perspectives. Eligible young adults (N = 140, 18–25 years) were assigned into one of four groups, according to their status of obesity (i.e., body mass index) and cardiorespiratory fitness levels (i.e., estimated maximal oxygen uptake), namely, normal weight with high cardiorespiratory fitness (NH), obese with high cardiorespiratory fitness (OH), normal weight with low cardiorespiratory fitness (NL), and obese with low cardiorespiratory fitness (OL). The task-switching test was utilized, and its induced endogenous (P3) and exogenous (N1) event-related potential components were recorded. Concerning behavioral indices, the NH demonstrated superior behavioral performance across global switching and local switching of the task-switching test compared to individuals with lower cardiorespiratory fitness and obesity (i.e., NL, OH, and OL). Additionally, the OH demonstrated better performance than the OL during the heterogeneous condition. For neuroelectrical indices, the NH had larger mean P3 amplitudes during global and local switching than the other three groups. A larger N1 amplitude was also observed in the NH during local switching than in the OH group. The findings suggest that cardiorespiratory fitness has beneficial effects on cognitive flexibility, attentional resource allocation, and sensory evaluation in young adults. Furthermore, our research provided novel evidence showing that cardiorespiratory fitness might potentially alleviate the adverse effects of obesity on cognitive flexibility in young adults.

A Non‐Invasive Method to Estimate Pulmonary Oxygen Transfer Rate

ObjectiveIneffective transfer of oxygen from the atmospheric air to the circulation is associated with low cardiorespiratory fitness and increased disease risk. Unfortunately, measuring the efficiency of gas exchange requires invasive and expensive procedures. We first sought to develop a parameter (Do) that reflects the capacity to move oxygen from air to the arterial circulation using non‐invasive methods. We then tested the utility of Do to detect changes in pulmonary oxygen transfer rate under differing conditions of oxygen supply and demand. Last, we compared Do with the Oxygen Deficit (OD) method, a non‐invasive way to estimate gas‐exchange impairment.MethodsHeart rate (ECG), tidal volume (pneumotachometer), respiratory rate (pneumobelt), and oxygen saturation (finger pulse oximeter) were measured in 25 young healthy adult participants (13 males, 12 females; 25 ± 4 years of age). Participants completed 4 trials: 1) Resting normoxia, 2) Steady‐state hypoxia (80% SpO2, SSH), 3) Cold pressor test (CPT, to increase oxygen demand), and 4) SSH + CPT. Do was derived by engineering analysis considering the biophysics of the 3 major process essential for effective oxygen transfer (i.e., ventilation, alveolar gas exchange, hemoglobin binding). Do was estimated for each condition and results were compared with the OD method.ResultsDoincreased during SSH (5.13±1.07×10‐2L/min/kPa) and CPT (2.91±1.03 ×10‐2L/min/kPa) when compared to resting normoxia (2.24±0.66×10‐2 L/min/kPa, p&lt;0.05). Dowas further increased during SSH+CPT (5.71±1.52×10‐2L/min/kPa) when compared to SSH alone (p&lt;0.05). Applicability of the OD method was limited to SpO2&lt;95%; thus OD could only be calculated in 40% of participants (n=10). OD was lower during SSH (2.18±0.63 kPa) and CPT (2.48±1.56 kPa) versus normoxia (3.15±1.3 kPa, p&lt;0.05). In contrast, OD increased during SSH+CPT (2.42±0.59 kPa) when compared to SSH alone (p&lt;0.05).ConclusionApplication of the novel parameter, Donot only showed the ability to respond to changes in supply and demand of oxygen but exhibited advantages over a conventional measure (OD). Specifically, Do showed consistent effect of CPT under normoxic and hypoxic conditions, whereas: 1) OD could only be determined in 40% of study participants, and 2) OD exhibited a paradoxical increase during SSH+CPT, despite a decrease during SSH and/or CPT alone. Future studies seek to test the utility of Do in cardiopulmonary patients.

Cardiorespiratory Fitness, Inflammation, and Risk of Sudden Cardiac Death in Middle-Aged Men

Inflammation and cardiorespiratory fitness (CRF) are each independently related to the risk of sudden cardiac death (SCD). The interplay between CRF, inflammation and SCD is not well understood. We aimed to study the separate and joint associations of inflammation (high-sensitivity C-reactive protein [hsCRP]) and CRF with SCD risk in a cohort of Caucasian men. In 1,749 men aged 42 to 61 years without a history of coronary heart disease at baseline, serum hsCRP was measured using an immunometric assay, and CRF was assessed using a respiratory gas exchange analyzer during exercise testing. hsCRP was categorized as normal and high (≤3 and >3 mg/L, respectively) and CRF as low and high (median cutoff). A total of 148 SCD events occurred during a median follow-up of 28.9 years. Comparing high versus normal hsCRP, the multivariable-adjusted hazard ratio (95% confidence interval) for SCD was 1.65 (1.11 to 2.45), which remained similar on further adjustment for CRF 1.62 (1.09 to 2.40). Comparing high versus low CRF, the multivariable-adjusted hazard ratio for SCD was 0.61 (0.42 to 0.89), which remained persistent after adjustment for hsCRP 0.64 (0.44 to 0.93). Compared with normal hsCRP-low CRF, normal hsCRP-high CRF was associated with a decreased SCD risk of 0.65 (0.43 to 0.99), high hsCRP-low CRF was associated with an increased SCD risk of 1.72 (1.10 to 2.69), with no evidence of a relationship between high hsCRP-high CRF and SCD risk 0.86 (0.39 to 1.88). Positive additive and multiplicative interactions were found between hsCRP and CRF. In a middle-aged Finnish male population, both hsCRP and CRF are independently associated with SCD risk. However, high CRF levels appear to offset the increased SCD risk related to high hsCRP levels.

Genome-Wide Association Study Identifies New Genetic Determinants of Cardiorespiratory Fitness: The Trøndelag Health Study.

Low cardiorespiratory fitness (CRF) is a major risk factor for cardiovascular disease (CVD) and a stronger predictor of CVD morbidity and mortality than established risk factors. The genetic component of CRF, quantified as peak oxygen uptake (V̇O 2peak ), is estimated to be ~60%. Unfortunately, current studies on genetic markers for CRF have been limited by small sample sizes and using estimated CRF. To overcome these limitations, we performed a large-scale systematic screening for genetic variants associated with V̇O 2peak . A genome-wide association study was performed with BOLT-LMM including directly measured V̇O 2peak from 4525 participants in the HUNT3 Fitness study and 14 million single-nucleotide polymorphisms (SNP). For validation, similar analyses were performed in the United Kingdom Biobank (UKB), where CRF was assessed through a submaximal bicycle test, including ~60,000 participants and ~60 million SNP. Functional mapping and annotation of the genome-wide association study results was conducted using FUMA. In HUNT, two genome-wide significant SNP associated with V̇O 2peak were identified in the total population, two in males, and 35 in females. Two SNP in the female population showed nominally significant association in the UKB. One of the replicated SNP is located in PIK3R5 , shown to be of importance for cardiac function and CVD. Bioinformatic analyses of the total and male population revealed candidate SNP in PPP3CA , previously associated with CRF. We identified 38 novel SNP associated with V̇O 2peak in HUNT. Two SNP were nominally replicated in UKB. Several interesting genes emerged from the functional analyses, among them one previously reported to be associated with CVD and another with CRF.

Associations Between Fitness, Physical Activity, and Fatness in Preschool Children With Typical and Atypical Motor Coordination.

PurposeIncreased adiposity in children confers a higher risk of cardiovascular disease in later life, with low cardiorespiratory fitness strongly linked to poorer metabolic health. Children with motor coordination problems are likely to be less physically fit and at a higher risk of obesity. In this study, we examined the associations between aerobic and anaerobic fitness, device-measured physical activity, and body adiposity in children (aged 4–5 years) with typical and atypical motor coordination.MethodsBaseline data from the Coordination and Activity Tracking in CHildren (CATCH) cohort study were utilised. The assessments included aerobic and anaerobic fitness via time-to-exhaustion on Bruce treadmill test and normalised mean power on Wingate cycling test, respectively; light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and sedentary time via accelerometry; and body adiposity (%) via bioelectrical impedance analysis (BIA). The Movement Assessment Battery for Children-Second Edition (MABC-2) was used to assess motor coordination and classify children as typically developing (TD, >16th percentile) or at risk of developmental coordination disorder (DCD, ≤16th percentile). General linear regression models were fitted to examine associations.ResultsThe analyses included 495 participants (5.0 ± 0.6 years, 56% male, and body adiposity 22.7 ± 4.2%). Aerobic fitness (β = −0.006, p < 0.001) and MVPA (β = −0.018, p = 0.045) were negatively associated with body adiposity when adjusted for age, sex, and MABC-2 score. There was no relationship between sedentary time and body adiposity. There were no interactions of sex or MABC-2 score with any variable.ConclusionLower aerobic fitness and MVPA were associated with higher body adiposity in preschoolers, regardless of motor coordination. Interventions targetting improved aerobic fitness and MVPA are therefore warranted in both TD and atypically developing preschoolers. Whether maintaining high aerobic fitness in children with possible DCD confers protection against obesity requires longitudinal investigation.

Age-Related Differences for Cardiorespiratory Fitness Improvement in Patients Undergoing Cardiac Rehabilitation.

ObjectiveWe investigated age-related differences for peak oxygen uptake (peak VO2) improvement with exercise training during cardiac rehabilitation (CR).Patients and MethodsThis was a retrospective cohort study of the Mayo Clinic Rochester CR program including adult patients who attended CR (≥1 session) for any eligible indication between 1999 and 2017 and who had a cardiopulmonary exercise test pre and post CR with VO2 data (peak respiratory exchange ratio ≥1.0). Younger (20–49 yrs), midlife (50–64 yrs), and older adults (≥65 yrs) were compared using ANOVA for delta and percent change in peak VO2; and percentage of peak VO2 responders (>0% change).Results708 patients (age: 60.8 ± 12.1 years; 24% female) met inclusion criteria. Delta and percent change in peak VO2 was lower for older adults (1.6 ± 3.2 mL.kg.min−1; 12 ± 27%) compared with younger (3.7 ± 4.0 mL.kg.min−1, p < 0.001; 23 ± 28%, p = 0.002) and midlife adults (2.8 ± 3.8 mL.kg.min−1, p < 0.001; 17 ± 28%, p = 0.04). For midlife, delta change, but not percent change in peak VO2 was significantly lower (p = 0.02) compared with younger. Percentage of responders was only different between older and younger (72 vs. 86%; p = 0.008). Sensitivity analyses in non-surgical patients showed similar differences for delta change, and differences in percent change remained significant between older and younger adults (10 ± 20% vs. 16 ± 18%; p = 0.04).ConclusionsIn CR patients, older adults had lower improvement in cardiorespiratory fitness than younger and midlife adults. While excluding surgical patients reduced age-related differences, older adults still had lower cardiorespiratory fitness improvement during CR. These findings may have implications for individualizing CR programming in aging populations to reduce future cardiovascular risk.

The combination of cardiorespiratory fitness and muscular fitness, and prevalence of diabetes mellitus in middle-aged and older men: WASEDA\u2019S Health Study

BackgroundAlthough the negative relationship between cardiorespiratory fitness (CRF) or muscular fitness and diabetes mellitus were respectively observed in many previous studies, there is still a lack of studies that include CRF and muscular fitness simultaneously. Therefore, this study aimed to investigate the relationship between the combination of CRF and muscular fitness and diabetes through a cross-sectional study. MethodsThis study was part of WASEDA'S Health Study, a cohort study launched in 2014. We used a part of the baseline data collected for this study. Maximal exercise test using a cycle ergometer and leg extension power (LEP) test were respectively used to evaluate CRF and muscular fitness. Since LEP is affected by body weight, relative LEP (rLEP) which is LEP per body weight, was used as an index of muscular fitness. 796 men (56.5 ± 10.4 years old) who completed a medical examination and fitness tests, were divided into two groups based on CRF and rLEP, respectively. The prevalence of diabetes was collected based on a self-reported questionnaire or blood test. Odds ratios and 95% confidence intervals (CIs) for the prevalence of diabetes were obtained using logistic regression models while adjusting for age, body mass index, exercise habits, family history of diabetes, smoking habits, and drinking habits.Results55 (7%) participants had diabetes. Compared to participants with lower CRF or rLEP, the odds ratio (95% CIs) of diabetes in those with higher CRF or rLEP was 0.46 (0.21–0.98) or 0.34 (0.16–0.74), respectively. Furthermore, using the lower CRF and lower rLEP group as the reference, the odds ratio (95% CIs) for the lower CRF and higher rLEP group was 0.32 (0.12–0.88), and higher CRF and higher rLEP group was 0.21 (0.07–0.63), after adjusting for potential confounding factors.ConclusionsCRF and rLEP have independent and joint inverse associations with diabetes prevalence. In addition, participants with high CRF and high rLEP had a lower prevalence of diabetes compared to those with only high CRF or only high rLEP.

Cardiorespiratory physiology, exertional symptoms, and psychological burden in post-COVID-19 fatigue

Fatigue is a common, debilitating, and poorly understood symptom post-COVID-19. We sought to better characterize differences in those with and without post-COVID-19 fatigue using cardiopulmonary exercise testing. Despite elevated dyspnoea intensity ratings, V̇O2peak (ml/kg/min) was the only significant difference in the physiological responses to exercise (19.9 ± 7.1 fatigue vs. 24.4 ± 6.7 ml/kg/min non-fatigue, p = 0.04). Consistent with previous findings, we also observed a higher psychological burden in those with fatigue in the context of similar resting cardiopulmonary function. Our findings suggest that lower cardiorespiratory fitness and/or psychological factors may contribute to post-COVID-19 fatigue symptomology. Further research is needed for rehabilitation and symptom management following SARS-CoV-2 infection.

Cardiorespiratory Fitness Cut-Points Related to Body Adiposity Parameters in Macedonian Children

Background and Objectives: There is a shortage of criteria referent standards for tests of logistic application meant to estimate the cardiorespiratory fitness (CRF) of children and adolescents in the Republic of North Macedonia. The goal of the research was twofold: (1) To identify the ability of CRF estimated by the 20-m shuttle-run test (20mSRT) to discriminate between “healthy” and “unhealthy” phenotypes (by adiposity measures such as WC and WHR) in children; (2) To determine the correlation between obesity and relatively maximum oxygen consumption (VO2 peak) tested on a relatively large respondents’ sample of Macedonian children. The research was conducted on a sample of 1,863 respondents, 957 (51.4%) of whom were boys, and 906 (48.6%) were girls at the age of 7 to 10 years. All of them were from 19 primary schools in the central and eastern parts of the Republic of North Macedonia. &#x0D; Materials and Methods: The waist circumference (WC) and waist-to-height ratio (WHtR) were used to identify body adiposity markers. CRF was measured using the 20mSRT (VO2 peak). Receiver operating characteristic curves and logistic regression were applied in order to establish the discriminative power of CRF in anticipating the parameters of body adiposity markers. &#x0D; Results: With regard both to the boys and girls, VO2 peak showed considerable predictive power of identifying the body adiposity (area under the curve [AUC] &gt; 0.66). In boys, when considering the full sample (7-10 years), the best cut-point for VO2 peak to detect body fat by WC were 48.8 to mL•kg−1•min−1 and WHtR were 47.4 to mL•kg−1•min−1. For girls, when considering the full sample (7-10 years), the best cut-point to detect body fat by WC were 47.4 to mL•kg−1•min−1 and WHtR were 47.1 to mL•kg−1•min−1. &#x0D; Conclusions: According to these cut-points, adolescents with low CRF were more likely to be obese either by WC or WHtR. The border values (cut-points) of CRF can be used as quantitative markers of children of healthier body characteristics from the Republic of North Macedonia.

Effects of sodium intake and cardiorespiratory fitness on body composition and genetic susceptibility to obesity: results from the Quebec Family Study.

The main aim of this study was to evaluate the effects of Na intake and cardiorespiratory fitness (CRF) on body composition. The study was also intended to assess whether Na intake and/or CRF mediate the genetic susceptibility to obesity. Analyses were performed on a sample of 526 adult participants from the Quebec Family Study for whom a complete data set was available for nutrient and energy intake, CRF and body composition variables. The effects of Na, CRF and their interaction were analysed by comparing sex-specific tertiles using general linear mixed models. In both males and females, we observed a significant effect of Na intake and CRF on all body composition variables. However, in females only, we found that the effect of Na intake on body composition variables varies according to CRF level such that high Na intake was associated with increased body fatness, but only in females with low CRF. This interaction effect remained significant after statistical adjustment for total sugar, fat and energy intake. Using mediation analysis, we also found Na intake and CRF to be significant mediators of the relationship between a polygenic risk score of obesity based on > 500000 genetic variants and BMI or waist circumference. In conclusion, the current study shows that Na intake influences body composition via mechanisms that interact with aerobic fitness, especially in females. Furthermore, both Na intake and CRF seem to be involved in the expression of the genetic susceptibility to obesity.