Metabolic Equivalents Research Articles

The impact of physical activity on the prevalence of edentulism: an analysis of the relationships between active lifestyle and dental health.

Edentulism is considered the ultimate sign of oral health disease burden. It is a common and frequent clinical disease, mostly seen in the elderly, which has been reported to be closely associated with many diseases. While physical activity is known to benefit many chronic diseases, the relationship between the volume of physical activity and edentulism remains unclear. The CHARLS provided the data for this study. A total of 6,480 participants were enrolled in this study, of whom 46.02% were male and 53.98% were female. The edentulism was defined according to self-report and physical activity volume can be represented by metabolic equivalents. Multiple logistic regression, smooth curve fitting, threshold effects analysis, and Cox regression models were used to explore the relationship between physical activity volume and edentulism. In the fully adjusted model, physically active participants had a 24% lower risk of edentulism compared to those who were physically inactive. Then, we subdivided participants with adequate physical activity into four levels: 600 ≤ PAV < 1200; 1200 ≤ PAV < 1800; 1800 ≤ PAV < 3000; and PAV ≥ 3000. We found that the risk of developing edentulism was lowest and statistically significant at the level of 1,800-3,000 MET-minutes/week physical activity volume (OR = 0.41; 95% CI, 0.24-0.69, p < 0.001). A U-shaped relationship between physical activity volume and edentulism with an inflection point of 2514 (MET-minutes/week) was observed. The results of the longitudinal study also confirm the benefits of physical activity volume with edentulism, participants with adequate physical activity volume had a 21% lower risk of developing edentulism than participants with inadequate physical activity volume (HR = 0.79; 95% CI, 0.67-0.94, p = 0.008). This study reveals a U-shaped relationship between physical activity volume and edentulism. Physical activity reduces the risk of developing edentulism in middle-aged and older populations, but it is important to control the appropriate volume of physical activity.

Physical activity before and after cancer diagnosis and mortality risk in three large prospective cohorts.

Physical activity (PA) can improve cancer survival; however, whether the timing of PA differentially affects mortality risk is unclear. We evaluated the association between PA levels pre- and post-diagnosis and mortality risk in the Women's Health Study (WHS), Physicians' Health Study (PHS)-I, and PHS-II prospective cohorts. We categorized PA pre- and post-diagnosis as active (WHS: ≥ 7.5 metabolic equivalent (MET)-h/week; PHS: vigorous PA ≥ 2-4 times/week) or inactive. We analyzed changes in pre- and post-diagnosis PA levels as four joint categories: (1) Inactive → Inactive, (2) Active → Inactive, (3) Inactive → Active, and (4) Active → Active, on mortality risk using multivariable Cox proportional hazards regression. We identified 10,541 participants with incident cancer and 3,696 deaths during follow-up. Compared to maintaining inactivity in both periods, remaining active pre- and post-diagnosis observed lower all-cause (Hazard Ratio [95% confidence interval]: WHS: 0.55 [0.47-0.64]; PHS-I: 0.77 [0.67-0.88]), cancer (WHS: 0.55 [0.45-0.67]; PHS-I: 0.75; [0.61-0.92]) and non-cancer/cardiovascular disease (CVD) mortality risks (WHS: 0.49 [0.38-0.65]). Similarly, becoming active post-diagnosis was associated with lower all-cause (WHS: 0.60 (0.48-0.75]; PHS-I: 0.72 [0.61-0.88]), cancer (WHS: 0.65 [0.49-0.86]; PHS-I: 0.64 [0.49-0.84]), and non-cancer/CVD mortality risk (WHS: 0.49 [0.33-0.75]). Being active pre- and post-diagnosis was associated with lower mortality risks in separate analyses, although significance differed by cohort and outcome. Remaining active pre- and post-diagnosis and becoming active post-diagnosis may be associated with improvements in cancer survival, however, research is needed across diverse cancer populations.

The association of mental health with physical activity and its dimensions in Chinese adults: A cross-sectional study.

Selecting the most efficient type of physical activity that improves mental health can assist in choosing appropriate interventions. Hence, the objective of this study was to evaluate the associations between physical activity and its various aspects, including weekly physical activity, weekly walking and exercise sessions, and the frequency of walking and exercise per week, with the mental health of Chinese adults. This cross-sectional study was carried out in Hangzhou (2023) involving 512 adults aged 18 and 64. Each participant received a self-completed questionnaire comprising three sections. The initial section focused on gathering basic information about the participants, such as gender, age, annual income, and marital status. The second section consisted of the 12-item General Health Questionnaire (GHQ-12), which aimed to evaluate the mental health status of the participants. Lastly, the third section included the International Physical Activity Questionnaire-Short Version (IPAQ-SV), which assessed the metabolic equivalent (MET) of activities like walking, moderate-intensity exercises, and high-intensity exercises. The study found that mental health problems affected 25.74% of adults, while physical inactivity was prevalent in 49.63% of adults. The statistical model was highly significant (F = 25.143, p < 0.001), suggesting that at least one predictor has a significant impact on mental health. The model accounted for 39% of the variance in mental health, with all variables showing predictive value. Notably, the number of walking days per week emerged as the most influential predictor of mental health (β = -0.392), followed by level of weekly physical activity in MET, the number of exercise training sessions per week, weekly exercise training in MET, and weekly walking in MET (β = -0.312, -0.301, -0.212, and -0.202, respectively). Adults can allocate more days per week to walking and their usual physical activity to improve their mental health.

Use of the ECG-Controlled Six-Minute Walk Test to Assess Exercise Capacity: a Comparative Cohort Study

INTRODUCTION. In clinical practice, stress tests are carried out to draw up an individual patient rehabilitation plan, assess tolerance and optimize the load, and evaluate its clinical effectiveness. The Six-minute walk test (6MWT), in the presence of contraindications to the bicycle ergometer test or the impossibility of performing it, is a tool for assessing the response of the cardiovascular and respiratory systems to the load being performed. There is no description in the literature of the relationship between the distance traveled during 6MWT and the peak metabolic equivalent (MET) assessed during the bicycle ergometer test. AIM. Study the relationship between 6MWT indicators and the results of bicycle ergometer test in patients who have suffered a myocardial infarction. MATERIALS AND METHODS. During the examination, 56 patients underwent a symptom limited bicycle ergometer test and 6MWT, the peak MET and the distance traveled during 6MWT, as well as changes in the ECG during both tests were assessed. RESULTS AND DISCUSSION. The average values of maximum heart rate during the bicycle ergometer test and ECG-controlled 6MWT did not differ significantly. The distance in meters during 6MWT and the power of the exercise performed during bicycle ergometer test in MET have a significant relationship, which indicates the comparability of the data from these tests as a criterion of exercise tolerance. CONCLUSION. The use of 6MWT and bicycle ergometer test allows us to assess various aspects of cardiorespiratory function and physical fitness in patients undergoing a cardiac rehabilitation program. Further study of the possibility of using ECG-controlled 6MWT in the early stages of rehabilitation is necessary to create the most effective and safe physical training for patients who have suffered a myocardial infarction.

The Relationship Between Metabolic Syndrome with Physical Activity and Eating Habits: The Result of the Tabari Cohort Study

Background: Metabolic syndrome (MetS) is a group of metabolic issues that increase the risk of type 2 diabetes and heart disease. Objectives: To reduce deaths from type 2 diabetes and heart disease, this study was conducted to determine the relationship between metabolic syndrome, physical activity, and eating habits in participants of the Tabari cohort study. Methods: In this descriptive cross-sectional study, data from the Tabari cohort in an urban and mountain area in Sari, Mazandaran, was utilized from June 2015 to November 2017. Background information of participants was documented, and their eating habits were assessed using a food habit questionnaire. Additionally, the physical activity levels of the participants were recorded. All individuals were assessed for metabolic syndrome according to the third Adult Treatment Panel (ATP III) guidelines. The gathered data was then inputted into SPSS V.23 software for analysis. Qualitative variables, such as demographic and epidemiological data, were compared between the two groups using the chi-square test, while quantitative variables were compared using an independent t-test. Results: A total of 10,255 adults between the ages of 35 and 70 participated in this study, and after applying entry and exit criteria, 9,976 people, including 4,083 with metabolic syndrome and 5,893 healthy individuals, were included in the final analysis. There was no significant difference in the average Body Mass Index (BMI) between individuals with metabolic syndrome (30.6 ± 4.5 kg/m²) and healthy individuals (26.8 ± 4.4 kg/m²). However, individuals with metabolic syndrome exhibited significantly higher values for height, weight, waist circumference, abdominal circumference, and wrist circumference compared to the control group (P = 0.001). The average Metabolic Equivalent of Task (MET) for the entire population was 43.03 ± 9.27, with a median of 40.68 (range: Twenty-four-one hundred three) hours/day. A greater percentage of individuals with metabolic syndrome (57.0%) and healthy individuals (45.2%) had MET values below the average (P = 0.001). Regarding energy intake, individuals with metabolic syndrome consumed an average of 2189.74 ± 721.90 calories, while healthy individuals consumed 2354.92 ± 4.04 calories, showing a significant difference (P = 0.006). Moreover, healthy individuals demonstrated significantly higher consumption of added salt in food, fried foods, fried potatoes, fried onions, fried vegetables, and various types of cooking oils compared to those with metabolic syndrome (P = 0.001). Conclusions: Based on the results of the Tabari cohort study, the prevalence of metabolic syndrome in Mazandaran was 41.10%, highlighting the need for prevention and screening programs. In this study, individuals with metabolic syndrome consumed fewer fried foods, trans fats, and daily calories compared to the healthy group. Considering that this study is cross-sectional and utilized data from the Tabari cohort, it is assumed that the difference is due to dietary compliance and lifestyle changes in patients with metabolic syndrome. It is recommended that prospective studies be designed to evaluate the causes of differences in metabolic syndrome components between the two groups.

Modification of SMWT for remote heart’s functional capacity determination from oxygen consumption rate

Cardiovascular disease (CVD) is series of diseases affects blood circulation and heart which are fatal to human being. CVD patients recorded that every each of them must have at least one among the following behavioural risks: smoking, diabetes, obesity, hypertension, high cholesterol, and sedentary lifestyle. The diagnosis for CVD is commonly through cardiac stress test. It is a test where electrocardiogram will be used to monitor heart activity under induced stress such as walking on treadmill. However, the facilities for the cardiac stress test are very limited and increasing number of patients with potential CVD caused a long queue for an appointment. This situation makes it hard for healthy people living with behavioral risk wanting for their heart to be checked. Therefore, in this paper, we proposed to determine heart functional capacity which can be done anywhere and sufficient to access heart condition. For this proposal, despite using treadmill-test, Six-Minutes Walking Test (SMWT) is utilized. SMWT induces stress while the heart’s endurance parameters such as heart rate is extracted. This study developed an integrated sensor device which comprises of a sensor to detect step count calculate distance, and a pulse sensor that detect heart rate. Then, oxygen consumption rate during the SMWT, is computed. Metabolic equivalent of task (MET) is equal to the oxygen consumption rate during activity over resting oxygen consumption rate. Heart functional capacity classification is about exercise intensity and the MET of SMWT can be compared to the classification which allows this paper to determine heart functional capacity remotely using SMWT. Based on the results, the heart’s functional capacity classification after performing SMWT using sensor device is Class 1, the same when using manual calculation for distance and heart rate. The device sensor somehow produce error at 20.63% when calculating oxygen uptake. Nevertheless, this paper is identified that the SMWT is able to classify the heart’s functional capacity.

Effects of cardiac telerehabilitation during COVID-19 on cardiac hemodynamic &amp; functional responses and quality of life: A randomized controlled trial

Purpose: This study aimed to assess the effects of a home-based cardiac telerehabilitation (HBCT) on cardiac hemodynamic &amp; functional responses and health-related quality (HRQOL) of the patients undergoing percutaneous coronary intervention (PCI). Materials and methods: In this randomized controlled clinical trial, single-blinded. One hundred-fifty five patients (mean age: 50.41 ± 7.3 years, 41 women and 39 men) who underwent PCI were randomized into the two groups of intervention and control. The HBCT program included supervised exercise training, walking, phone calls and a pedometer for eight weeks. Hemodynamic changes, including systolic blood pressure (SBP) and diastolic blood pressure (DBP), resting heart rate (HRrest), maximum heart rate (HRmax), ejection fraction (EF), and rate pressure product (RPP), and functional parameters including the distance walked and metabolic equivalents (METS), also HRQOL were measured in all patients before and after the 8-week HBCT program. Results: Our results showed significant reductions in SBPrest (126.82±9.17 vs. 131.27±10.24; P =0.044), DBPrest (87.4±5.39 vs. 89.17±7.33; P =0.027), HRrest (76.15±3.01 vs. 77.65±4.16; P =0.041), HRmax (143.1±5.24 vs. 147.57±8.63; P =0.011), and RPP (9.64±0.81 vs. 10.07±0.99; P =0.007) and significant elevations in (45.75±4.31 vs. 43.5±5.21; P=0.039), distance walked (514.95±214.5 vs. 368.04±221.43; P=0.019), Mets (7.41±0.84 vs. 6.89±1.28; P =0.018), as well as HRQOL in the MCS (50.62±10.45 vs. 46.25±7.74; P=0.037), and HRQOL in the PCS (46.75±8.73 vs. 42.37±9.99; P =0.040) in the intervention group compared to the control group. Conclusion: An HBCT program consisting of supervised exercise training significantly improved hemodynamic response, exercise performance capacity and HRQOL in patients following PCI.

Prognostic value of exercise tolerance and exercise-induced diastolic dysfunction in elderly patients referred for exercise stress echocardiography

BackgroundWe studied the prognostic value of exercise tolerance and exercise-associated diastolic dysfunction (Ex-DD) in elderly patients referred for exercise stress echocardiography (ExE). MethodsA total of 674 patients ≥60 years who underwent ExE using the Bruce protocol between January 2017 and December 2020 were included in this study. The prognostic factors examined were exercise tolerance, quantified in metabolic equivalents of tasks (METs), and Ex-DD. Patients were followed for a composite endpoint of all-cause death and cardiovascular hospitalization. Results122 (18 %) patients had Ex-DD and had a higher incidence of the combined outcome (23 [19 %] vs. 47 [9 %], p = 0.001) compared to patients without Ex-DD. Patients were classified into the following groups: group A (no Ex-DD and METs≥8.5), group B (either Ex-DD or METs<8.5), and group C (both Ex-DD and METs<8.5). Group B did not show higher mortality (HR: 1.6, p = 0.475) or cardiovascular hospitalization (HR: 1.8, p = 0.08) compared to group A, but showed an increased risk for the combined outcome (HR: 1.9, p = 0.038). Group C was associated with higher mortality (HR: 4.8, p = 0.032), cardiovascular hospitalization (HR: 3.9, p < 0.001), and the combined outcome (HR: 4.0, p < 0.001) compared to group A. ConclusionsDecreased exercise capacity and Ex-DD were associated with poor outcomes, especially when both findings were present.

Intergenerational and genetic influences on physical activity: family data from the HUNT study, Norway

ObjectivesThe objectives of this study are to examine the association of physical activity in parents with physical activity in their adult offspring and explore if the offspring’s genetic liability (ie,...

A randomized controlled trial evaluation of a smoking cessation and physical activity intervention delivered via telemedicine in the Norton Sound region of Alaska

ObjectivesTobacco use disproportionately affects Alaska Native people. Physical activity may aid quitting smoking and provides health benefits. We tested telemedicine-delivered heart health interventions in Alaska’s Norton Sound region. MethodsAlaska Native adults (N = 299, 51.5 % male, 60.5 % Inupiaq) with hypertension and/or hypercholesterolemia who smoked daily were randomized to intervention on smoking and physical activity (group 1) or traditional diet and medication adherence (group 2). Intention to change was not required for participation. Stage-tailored mailed workbooks and personalized reports were supported by telehealth counseling at baseline, 3, 6, and 12 months. Study outcomes were assessed at baseline, 3-, 6-, 12-, and 18-months (i.e., 6-months after the final counseling session). Smoking outcomes were self-reported 7-day point prevalence abstinence (7d-PPA),11Abbreviations:7d-PPA: 7-day point prevalence abstinenceMET: Metabolic equivalent of taskMVPA: Moderate-to-vigorous physical activityNRT: Nicotine replacement therapy. bioconfirmed with urine anabasine; 24-hour quit attempts; and 50 % reduction in smoking. Self-reported physical activity outcomes were metabolic equivalent of task (MET) minutes and meeting moderate-to-vigorous physical activity (MVPA) guidelines. ResultsAt baseline, participants averaged 12.4 (SD = 10.0) cigarettes/day, with 19.4 % prepared to quit smoking, and 81.6 % meeting MVPA guidelines. During the study, most (70.2 % group 1; 63.5 % group 2) reported a 24-hr quit attempt (p = 0.219), and Group 1 (53.6 %) was more likely than Group 2 (28.4 %) to use nicotine replacement therapy (NRT), OR = 2.92, p < 0.001. At 18-months, 40.5 % (group 1) and 32.5 % (group 2) had reduced their smoking by half or more (p = 0.343), and 10.8 % vs. 7.9 % (group 1 vs. 2) reported 7d-PPA with 4 % vs. 6 % (group 1 vs. 2) bioconfirmed. Time and baseline stage of change predicted 7d-PPA (p’s≤.015), with no group effect (p = 0.325). Activity levels did not significantly differ by group or time. ConclusionsTelemedicine counseling supported NRT use but did not significantly affect behavioral outcomes.

Subjective fitness relates to performance and can be improved by exercise in children and young adults with heart disease.

The Duke Activity Status Index is used to assess an individual patient's perception of their fitness abilities. It has been validated and shown to predict actual fitness in adults but has been studied less in the paediatric population, specifically those with heart disease. This study aims to assess if the Duke Activity Status Index is associated with measured markers of physical fitness in adolescents and young adults with heart disease. This retrospective single-centre cohort study includes patients who completed a minimum of 12 weeks of cardiac rehabilitation between 2016 and 2022. Cardiac rehabilitation outcomes included physical, performance, and psychosocial measures. A comparison between serial testing was performed using a paired t-test. Univariable and multivariable analyses for Duke Activity Status Index were performed. Data are reported as median [interquartile range]. Of the 118 participants (20 years-old [13.9-22.5], 53% male), 33 (28%) completed at least 12 weeks of cardiac rehabilitation. Median peak oxygen consumption was 60.1% predicted [49-72.8%], and Duke Activity Status Index was 32.6 [21.5-48.8]. On Pearson's correlation assessing the Duke Activity Status Index, there were significant associations with % predicted peak oxygen consumption (r = 0.49, p < 0.0001), 6-minute walk distance (r = 0.45, p < 0.0001), Duke Activity Status Index metabolic equivalents (r = 0.45, p < 0.0001), and dominant hand grip (r = 0.48, p < 0.0001). In multivariable analysis, the % predicted peak oxygen consumption (r = 0.40, p = 0.005) and dominant hand grip (r = 0.37, p = 0.005) remained statistically significant. Duke Activity Status Index is associated with measures of physical fitness in paediatric and young adults with heart disease who complete a cardiac rehabilitation program.

Relationship between Physical Activity Levels and Academic Performance in Adolescents from Serbia.

Today's high school students often engage in sedentary behavior by choosing passive activities during leisure time. Increasing research shows that regular physical activity (PA) provides benefits beyond physical health, especially important during childhood and adolescence. Our study investigated the association between physical activity levels and academic performance (AP) in Serbian adolescents. We selected a sample of 836 fourth-grade high school students (avg. 17.9 ± 0.7 years old) who completed the IPAQ (short-version) and the Academic Performance Scale. Data analysis was conducted using IBM SPSS 21.0. Due to non-normal data distribution, Spearman's correlation was used and hierarchical regression analysis to assess the association between PA and AP. The findings revealed significant correlations between vigorous, moderate and light PA, as well as overall units of metabolic equivalent of task (METs), with AP (p-values: 0.000, 0.005, 0.021, 0.004, respectively), although with weak correlation coefficients (0.127, 0.098, 0.080, 0.181, respectively). Vigorous PA influenced AP by 10.1%, moderate PA by 8.2%, and light PA by 11.4%. These results suggest that adolescents engaging in higher PA levels tend to have better AP. This finding indicates a substantial association between PA levels and AP, with both moderate and vigorous PA showing a positive correlation and influence. Further investigation is necessary to comprehensively grasp the link between light PA and AP.

Dietary patterns and cardiorespiratory fitness in midlife and subsequent all-cause dementia: findings from the Cooper Center Longitudinal Study

BackgroundIdentifying lifestyle factors that independently or jointly lower dementia risk is a public health priority given the limited treatment options available to patients. In this cohort study, we examined the associations between Mediterranean or Dietary Approaches to Stop Hypertension (DASH) diet adherence and cardiorespiratory fitness (CRF) with later-life dementia, and assessed whether the associations between dietary pattern and dementia are modified by CRF.MethodsData are from 9,095 adults seeking preventive care at the Cooper Clinic (1987–1999) who completed a 3-day dietary record and a maximal exercise test. Alzheimer’s disease and related disorders or senile dementia (i.e., all-cause dementia) was identified from Medicare administrative claims (1999–2019). Illness-death models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between Mediterranean or DASH diet adherence (primary exposure), CRF (secondary exposure), and all-cause dementia, adjusted for demographic and clinical factors. An interaction term was included between diet score and CRF to assess effect modification by CRF.ResultsThe mean age at baseline was 50.6 (standard deviation [SD]: 8.4) years, and a majority of the study sample were men (77.5%) and White (96.4%). 1449 cases of all-cause dementia were identified over a mean follow-up of 9.2 (SD: 5.8) years. Neither Mediterranean nor DASH diet adherence was associated with dementia risk in fully adjusted models (HR per SD of Mediterranean diet score: 1.00, 95% CI: 0.94, 1.05; HR per SD of DASH diet score: 1.02, 95% CI: 0.96, 1.08). However, participants with higher CRF had a decreased hazard of dementia (HR, per metabolic equivalent of task [MET] increase, Mediterranean model: 0.95, 95% CI: 0.92, 0.98; HR, per MET increase, DASH model: 0.96, 95% CI: 0.92, 0.97). No effect modification by CRF was observed in the association between diet and dementia.ConclusionsIn this sample of apparently healthy middle-aged adults seeking preventive care, higher CRF at midlife was associated with a lower risk of all-cause dementia, though adherence to a Mediterranean or DASH diet was not, and CRF did not modify the diet-dementia association. CRF should be emphasized in multimodal interventions for dementia prevention and investigated among diverse samples.

Effect of physical activity on risk reduction of infective endocarditis among patients with diabetes: a nationwide cohort study.

Patients with diabetes mellitus (DM) are at a higher risk of infectious diseases, and exercise is an important treatment modality for DM. Despite their susceptibility to infection in diabetic patients, the association between the amount of physical activity and the incidence of infective endocarditis (IE) is unclear. We attempted to demonstrate risk reduction by physical activity in diabetic patients with IE. From the National Health Insurance database, patients with DM were verified, and the incidence of IE was investigated. The level of physical activity was categorized into < 500, 500-999, 1,000-1,499, and ≥ 1,500 metabolic equivalent task (METs) minutes/week. Cox proportional hazard models were used to analyze the relationship between incident IE and physical activity. A total of 2,603,012 patients were included in this study. The incidence rate of IE was 10.06, 9.45, 7.78, and 8.84 in < 500, 500-999, 1,000-1,499, and ≥ 1,500 METs-minutes/week groups, respectively (100,000 person/year). A significant risk reduction of incident IE was observed in the 1,000-1499 and ≥ 1,500 METs-min/week groups compared to the < 500 METs-min/week group (Hazard ratio = 0.82, 95% confidence interval [0.690-0.976], HR = 0.831, 95% CI [0.704-0.981]). An analysis of a large national cohort database demonstrated that physical exercise reduced the risk of IE in patients with DM.

Lung function decline in people with serious mental illness: A call to action

This prospective observational study aimed to evaluate the rate of change in forced expiratory volume in the first second (FEV1) and to explore the factors associated with changes in FEV1 in people with serious mental illness (SMI). Sixty subjects diagnosed with schizophrenia or bipolar disorder who were smokers and without history of respiratory illness agreed to participate. The mean (range) follow-up period was 3.54 (3.00–4.98) years. The mean (standard deviation) annual rate of change in FEV1 decreased by 39.1 (105.2) mL/year. Thirty-one (51.7 %) patients experienced a decrease in the FEV1 ≥40 mL/year (i.e. a rapid decline). The factors associated with the absolute change in FEV1 were the baseline International Physical Activity Questionnaire activity score in metabolic equivalents of tasks (β 0.145, 95 % confidence interval [CI] 0.043 to 0.246; p = 0.005), baseline FEV1 (β -0.025, 95 % CI -0.076 to 0.027; p = 0.352), and the interaction term of both variables (β -3.172e-05, 95 % CI -6.025e-05 to -0.319e-05; p = 0.029). The factors associated with rapid FEV1 decline were income (odds ratio [OR] 0.999, 95 % CI 0.995 to 1.003; p = 0.572), the rate of change in abdominal circumference (OR 0.000, 95 % CI 0.000 to 0.890; p = 0.081), and the interaction term of both variables (OR 1.038, 95 % CI 1.010 to 1.082; p = 0.026). In conclusion, a substantial proportion of people with SMI experienced a rapid decrease in FEV1. If our results are confirmed in larger samples, the routine evaluation of lung function in people with SMI would be an opportunity to identify individuals at greater risk of morbidity and mortality.

The Effect of Trimetazidine Combined with Cardiac Rehabilitation on the Prognosis of Patients with Acute Myocardial Infarction

Objective: To investigate the effects of Trimetazidine (TMZ) combined with Cardiac Rehabilitation (CR) on acute myocardial infarction (AMI). A Acute Myocardial Infarction (AMI) patients who underwent PCI, the effects of ventricular remodeling and quality of life at different times after PCI; to observe the changes in the expression of Nod-Like Receptor Protein 3 (NLRP3) in peripheral blood mononuclear cells at different times after the onset of AMI and the effects of TMZ combined with CR therapy on it. Methods: The study population was selected from 89 AMI patients admitted to the Second Hospital of Dalian Medical University from October 2018 to January 2020. All of them underwent PCI in emergency or within 2 days of admission, and they were all treated with double antibiotics, heparin and statins, and β-receptor antagonists or CCB or RAS system antagonists according to the patients' blood pressure and heart rate. The patients were divided into a control group and a rehabilitation group according to their willingness and adherence to rehabilitation. The control group consisted of 44 patients (n=44), who were treated only with the above treatments and no other treatments. The rehabilitation group consisted of 45 patients (n=45) who were treated with TMZ and CR in combination with the above treatments. In the rehabilitation group, the cardiac rehabilitation program was initiated as appropriate from day 2 after PCI, and trimetazidine hydrochloride treatment (35 mg bid po) was given on day 7 after PCI for a total of 1 year (52±2 weeks). Blood was collected in the morning of the 2nd day of admission for routine blood tests, cTnI, lipids, blood glucose, liver and kidney function, and glycosylated hemoglobin. Cardiac ultrasound was performed at weeks 1, 4, 12, and 52±2, and left ventricular end-diastolic diameter (LVEDd) and left ventricular ejection fraction (LVEF) were measured. The Quality of Life Scale (SF-12) and Generalized Anxiety Disorder Scale (GAD-7) were assessed at week 1 and week 52±2. Cardiopulmonary exercise test was performed at week 1 and week 52±2 of onset, and maximum kilogram oxygen uptake (peakVO2/kg), kilogram oxygen uptake at anaerobic threshold (VO2/kg@AT), and metabolic equivalents at anaerobic threshold (Mets@AT) were recorded. The expression of NLRP3 in peripheral blood mononuclear cells of patients at 24-36 hours of onset, week 1, week 4, week 12 and week 52±2 was detected. All the above data were analyzed by SPSS 24.0 software. Results: At 1 year of onset, LVEDd was less in the rehabilitation group than in the control group. At weeks 4 and 12 of onset, LVEF was higher in the rehabilitation group than in the control group. At 1 year after the onset of the disease, the quality of life and anxiety and depression status of the rehabilitation group were significantly improved, the SF-12 score was higher than that of the control group, and the GAD-7 score was lower than that of the control group. And the cardiopulmonary exercise experiment indexes of the two groups were compared, and the peakVO2/kg, VO2/kg@AT and Mets@AT of the rehabilitation group were significantly higher than those of the control group. During the 1-year follow-up, peripheral blood mononuclear cell NLRP3 levels tended to decrease in both groups and were at their highest values at 24-36 hours after onset. At weeks 4 and 12, peripheral blood mononuclear cell NLRP3 levels were significantly lower in the rehabilitation group than in the control group. Conclusion: TMZ combined with CR therapy showed significant improvement in ventricular remodeling, exercise tolerance, and quality of life in patients with AMI, and it was most effective and beneficial to patients at 1 year after PCI. TMZ combined with CR therapy significantly reduced peripheral blood mononuclear cell NLRP3 levels in AMI patients, and the effect was most pronounced at 3 months after PCI.

Relationship between cardiopulmonary exercise testing and the prognosis of cardiovascular disease in coronary heart disease patients

Objective: To investigate the predictive value of cardiopulmonary exercise test (CPET) indexes for major adverse cardiovascular events (MACE) in patients with coronary heart disease (CHD). Methods: This study was a retrospective cohort study. CHD patients were consecutively enrolled who procedure CPET before discharge from the Department of Cardiology, General Hospital of Northern Theater Command from November 2015 to September 2021 were enrolled. Demographic information, past medical history, CPET indexes and other baseline data were collected and the patients were followed up. Patients were divided into a MACE group and a control group according to the presence or absence of MACE. A multivariate Cox proportional hazard regression model was used to analyze the CPET indexes with predictive value for MACE in CHD patients. Results: A total of 3 800 patients were eligible for the criterion, age (57.2±8.8) years, 2 920 (76.84%) males. During a follow-up of 1 237 (695, 1 596) days, 390 (10.26%) patients were in MACE group, and 3 410 (89.74%) patients were in control group. In adjusted multivariable analysis, higher metabolic equivalent of tasks (MET) at anaerobic threshold (AT) is an independent protective factor for MACE in patients with CHD (HR=0.75, 95%CI 0.62-0.90, P=0.002), higher VE/VCO2 is an independent risk factor for MACE in CHD patients (HR=1.05, 95%CI 1.02-1.07, P=0.001). Conclusion: In CPET, high MET at AT is an independent protective factor for MACE in patients with CHD, and high VE/VCO2 is an independent risk factor for MACE in CHD patients.

Impact of cardiac rehabilitation exercise frequency on exercise capacity in patients with coronary artery disease: a retrospective study

ABSTRACT Cardiac rehabilitation (CR) significantly improves cardiovascular outcomes in patients with coronary artery disease (CAD). International guidelines vary in the minimum recommended frequency of supervised exercise from 1 to 3 sessions per week. This is the first study in the Middle East and North African regions assessing the impact of 2 versus 3 days/week of supervised exercise on peak exercise capacity in patients with CAD. Single-center retrospective cohort study involving 362 patients enrolled in the only CR center in the State of Qatar. Only high-quality data was included by strict evaluation of compliance to the exercise intervention. Fifty patients who underwent a symptom-limited exercise test before and after CR were included (31 patients on 2 days/week, 19 on 3 days/week). No significant differences were observed in baseline characteristics between groups. Exercise intervention differed significantly between groups in exercise training frequency (2 days/week: 1.97 ± 0.2 vs. 3 days/week: 2.7 ± 0.3; p < 0.00). Peak exercise capacity as peak metabolic equivalents of task (MET) significantly increased in both groups (2 days/week: Pre 8.3 ± 2.4 vs. Post 9.4 ± 2.9, p-value 0.00; 3 days/week: Pre 7.4 ± 1.6 vs. Post 8.4 ± 2.0, p-value 0.00). No significant difference was observed between groups for change in Peak Exercise Capacity (2 days/week 1.1 ± 1.1 vs. 3 days/week 1.0 ± 0.9, p = 0.87). When the total number of exercise sessions is equal, supervised exercise frequencies of 2 and 3 days/week may significantly and equally improve peak exercise capacity in patients with CAD.

Smartphone-Based Digital Peer Support for a Walking Intervention Among Public Officers in Kanagawa Prefecture: Single-Arm Pre- and Postintervention Evaluation.

Digital peer support, defined as peer support delivered through technology such as smartphone apps, may be promising to promote activity in the form of step counts. Interactions among users have a positive impact on retention rates, and apps with social elements show significant improvements in daily step count. However, the feasibility of digital peer support in promoting physical activity (PA) is unknown; therefore, its effectiveness on step count and the clinical implications remain unconfirmed. This study aimed to assess the feasibility of digital peer support over a 3-month intervention period using the retention rate as the outcome. Moreover, changes in daily step count and physical measurements were compared between pre- and postintervention. The study design was a 3-month 1-arm intervention with participants from local government offices in Kanagawa, Japan. We used an available smartphone app, Minchalle, as the tool for the group intervention. Participants were required to report their daily step count to a maximum of 5 members composed exclusively of study participants. The primary outcome was the retention rate. Secondary outcomes included daily step count, the rate of achieving daily step goals, physical measurements, and lifestyle characteristics. Descriptive statistics and the Pearson coefficient were used to examine the relationship between goal achievement and step count, as well as changes in step count and various variables including physical measurements. Of the 63 participants, 62 completed the intervention. The retention rate was 98% (62/63). The average daily step count during the intervention was 6993 (SD 2328) steps, an 1182-step increase compared with the count observed 1 week before the intervention began. The rate of achieving the daily step count during the intervention was 53.5% (SD 26.2%). There was a significant correlation (r=0.27, P=.05) between achieving daily step goals and increasing daily step count. Comparative analyses showed that changes in weight (68.56, SD 16.97 kg vs 67.30, SD 16.86 kg; P<.001), BMI (24.82, SD 4.80 kg/m2 vs 24.35, SD 4.73 kg/m2; P<.001), somatic fat rate (28.50%, SD 7.44% vs 26.58%, SD 7.90%; P=.005), systolic blood pressure (130.42, SD 17.92 mm Hg vs 122.00, SD 15.06 mm Hg; P<.001), and diastolic blood pressure (83.24, SD 13.27 mm Hg vs 77.92, SD 11.71 mm Hg; P=.002) were significantly different before and after the intervention. Similarly, the daily amount of PA significantly improved from 5.77 (SD 3.81) metabolic equivalent (MET)-hours per day to 9.85 (SD 7.84) MET-hours per day (P<.001). This study demonstrated that digital peer support is feasible for maintaining a high retention rate and can, therefore, effectively promote PA. It can be a promising tool to improve daily step count, subjective PA, and clinical outcomes, such as weight and somatic fat rate. UMIN Clinical Trials Registry UMIN000042520; https://tinyurl.com/46c4nm8z.

Exploring the characteristics changes of cardiopulmonary exercise testing in patients with acute coronary syndrome after PCI before and during the COVID-19 pandemic

Objective: To investigate the changes in cardiopulmonary exercise testing (CPET) characteristics before and after the outbreak of COVID-19 in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI). Methods: This is a cross-sectional study that included ACS patients who underwent PCI at the General Hospital of the Northern Theater Command from July 2018 to February 2023. Based on the timeline of the COVID-19 pandemic, patients were divided into two groups: the pre-pandemic group and the during-pandemic group, with January 2020 as the dividing line. Clinical data were collected from both groups, and a comparative analysis was performed on their postoperative CPET outcomes, including peak oxygen uptake (peak VO2), peak metabolic equivalents (peak MET), and other indicators. Weber's classification was used to assess cardiac function. In addition, the 7-tiem generalized anxiety disorder scale (GAD-7) and the patient health questionnaire-9 (PHQ-9) were used to assess the patients' psychological anxiety and depression states, respectively. Multivariate logistic regression was used to analyze the influencing factors of CPET after PCI. Results: A total of 4 310 post-PCI ACS patients were included, with an average age of (58.7±9.1) years, and 3 464 (80.37%) were male. There were 1 698 patients in the pre-pandemic group and 2 612 patients in the during-pandemic group. The main indicator of the CPET, peak VO2 (15.04±3.93) ml·min-1·kg-1 in the during-pandemic group, was lower than that in the pre-pandemic group (15.52±3.68) ml·min-1·kg-1, and the difference was statistically significant (P<0.001). Multivariate logistic regression analysis showed that advanced age, female gender, high body mass index, elevated high-sensitivity C-reactive protein, reduced high-density lipoprotein cholesterol, smoking history, history of myocardial infarction, more severe ACS classification, and mild to moderate degree of depression were related to poor cardiopulmonary outcomes (P<0.05). Conclusion: The COVID-19 pandemic had a negative impact on the cardiopulmonary outcomes of ACS patients after PCI. Reduced physical activity, and increased psychological stress should be given consideration and attention regarding their impact on patients' cardiopulmonary function.