6-min Walk Test Research Articles

A WeChat platform program (WCPP) for full-process management of patients with cardiac valve interventional surgery based on psycho-cardiology: protocol of a mixed-method study

BackgroundValvular heart disease is the third most common cardiovascular disease; it significantly diminishes patients’ quality of life and imposes burdens on individuals, families, and healthcare systems. In recent years, psycho-cardiology has emerged as a prominent field in which to explore the link between mental illness and heart disease. This mixed-method study aims to assess the effectiveness of the WCPP, which includes hospital-to-home transitional care, remote intelligent monitoring, and decision aids, in improving the physical and mental health of patients.MethodsA mixed-method study was conducted at a cardiac valve interventional surgery (CVIS) center in Southwest China. A total of 154 CVIS patients participated, with the intervention group receiving the WCPP and the control group following the traditional CVIS management program. Both groups were followed up at 1, 3, 6, and 12 months. The primary outcome is measured via the Chinese version of the 36-item Short Form Health Survey (SF-36). The Secondary outcomes included the 6-min walk test (6MWT), modified Barthel index (MBI), major adverse cardiovascular events (MACE), patient satisfaction, and length of hospital stay (LOS). Additionally, qualitative research will assess the psychological state and experiences of the patients.DiscussionOur study is one of the few involving patients with CVIS and the first to apply psycho-cardiology through a full-process management platform. The study population is predominantly from Southwest China and includes a diverse range of demographic and socioeconomic backgrounds. Upon completion, this study will provide valuable insights into the use of a remote, full-process management platform for CVIS patients.Trial registrationChinese Clinical Trial Registry ChiCTR2400081052. Registered on 21 February 2024. The trial complies with the SPIRIT and CONSORT guidelines.

Clinical development and proof of principle testing of new regenerative vascular endothelial growth factor-D therapy for refractory angina: rationale and design of the phase 2 ReGenHeart trial

BackgroundDespite tremendous therapeutic advancements, a significant proportion of coronary artery disease patients suffer from refractory angina pectoris, that is, quality-of-life-compromising angina that is non-manageable with established pharmacological and interventional treatment...

Effects of Resistance Training Volume on Physical Function, Lean Body Mass and Lower-Body Muscle Hypertrophy and Strength in Older Adults: A Systematic Review and Network Meta-analysis of 151 Randomised Trials.

The optimal prescription and precise recommendations of resistance training volume for older adults is unclear in the current literature. In addition, the interactions between resistance training volume and program duration as well as physical health status remain to be determined when assessing physical function, muscle size and hypertrophy and muscle strength adaptations in older adults. This study aimed to determine which resistance training volume is the most effective in improving physical function, lean body mass, lower-limb muscle hypertrophy and strength in older adults. Additionally, we examined whether effects were moderated by intervention duration (i.e. short term, < 20weeks; medium-to-long term, ≥ 20weeks) and physical health status (i.e. physically healthy, physically impaired, mixed physically healthy and physically impaired; PROSPERO identifier: CRD42023413209). CINAHL, Embase, LILACS, PubMed, Scielo, SPORTDiscus and Web of Science databases were searched up to April 2023. Eligible randomised trials examined the effects of supervised resistance training in older adults (i.e. ≥ 60years). Resistance training programs were categorised as low (LVRT), moderate (MVRT) and high volume (HVRT) on the basis of terciles of prescribed weekly resistance training volume (i.e. product of frequency, number of exercises and number of sets) for full- and lower-body training. The primary outcomes for this review were physical function measured by fast walking speed, timed up and go and 6-min walking tests; lean body mass and lower-body muscle hypertrophy; and lower-body muscle strength measured by knee extension and leg press one-repetition maximum (1-RM), isometric muscle strength and isokinetic torque. A random-effects network meta-analysis was undertaken to examine the effects of different resistance training volumes on the outcomes of interest. We included a total of 161 articles describing 151 trials (n = 6306). LVRT was the most effective for improving timed up and go [- 1.20 standardised mean difference (SMD), 95% confidence interval (95% CI): - 1.57 to - 0.82], 6-min walk test (1.03 SMD, 95% CI: 0.33-1.73), lean body mass (0.25 SMD, 95% CI: 0.10-0.40) and muscle hypertrophy (0.40 SMD, 95% CI: 0.25-0.54). Both MVRT and HVRT were the most effective for improving lower-limb strength, while only HVRT was effective in increasing fast walking speed (0.40 SMD, 95% CI: - 0.57 to 0.14). Regarding the moderators, our results were independent of program duration and mainly observed for healthy older adults, while evidence was limited for those who were physically impaired. A low resistance training volume can substantially improve healthy older adults' physical function and benefits lean mass and muscle size independently of program duration, while a higher volume seems to be necessary for achieving greater improvements in muscle strength. A low volume of resistance training should be recommended in future exercise guidelines, particularly for physically healthy older adults targeting healthy ageing.

Real-World Experience in the Clinical Use of Pirfenidone in Patients with Idiopathic Pulmonary Fibrosis in Taiwan: A Post-Marketing Surveillance Study.

Idiopathic pulmonary fibrosis (IPF) is a serious, progressive lung disease for which treatments are scarce. Pirfenidone has been approved for the treatment of IPF in Taiwan since 2016. This study aimed to gain a better insight into pirfenidone's real-world safety and effectiveness in adult IPF patients in Taiwan. We conducted a prospective, multicenter, post-marketing surveillance study, and analyzed data from a small sample of 50 IPF patients treated with pirfenidone. Most patients were men, with a mean age of 72.8 years (±10.3). They were in physiology stage I or II with a baseline mean forced vital capacity (FVC) of 2.236 L (73.8% of predicted value). After treatment with pirfenidone, the mean FVC decreased by 0.088 L at week 24 and 0.127 L at week 52. The mean 6 min walk test was 325.5 m at baseline, increased by 8.1 m at week 24, but then decreased by 23.0 m at week 52. These changes from baseline did not reach statistical significance. Pirfenidone prevented worsening of cough but did not stabilize dyspnea. During 52 weeks of treatment, the incidence of total adverse drug reactions was 62.0%, with decreased appetite (32.0%) and pruritis (10.0%) being the most common. The adverse events leading to treatment discontinuation were decreased appetite (8.0%), nausea (4.0%), and respiratory failure (4.0%). No safety concern was raised by the study. Treatment with pirfenidone stabilized both FVC and the subjective symptom of cough in most patients. This post-marketing surveillance study demonstrated that pirfenidone is an effective, safe, and well-tolerated treatment in patients with IPF in Taiwan.

Impact of Multi-Professional Intervention on Health-Related Physical Fitness and Biomarkers in Overweight COVID-19 Survivors for 8 and 16 Weeks: A Non-Randomized Clinical Trial.

Considering the diverse symptomatology of COVID-19-ranging from mild to severe cases-multi-professional interventions are crucial for enhancing physical recovery, nutritional status, and mental health outcomes in affected patients. Thus, this study aimed to investigate the effects of such an intervention on health-related physical fitness and biomarkers in overweight COVID-19 survivors with varying degrees of symptom severity after 8 weeks and 16 weeks. This non-randomized clinical trial included 59 overweight COVID-19 survivors (32 males and 27 females) divided into three groups: mild (n = 31), moderate (n = 13), and severe/critical (n = 15). The participants underwent a multi-professional program and were assessed for anthropometric and body composition (primary outcome), as well as physical fitness and biochemical markers (secondary outcome) 8 and 16 weeks before the intervention. After 8 weeks, time effects were observed for the maximum isometric handgrip strength (p < 0.001), maximum isometric lumbar-traction strength (p = 0.01), flexibility (p < 0.001), abdominal strength-endurance (p < 0.001), the sit-and-stand test (p < 0.001), maximum oxygen consumption (p < 0.001), and distance covered in the 6 min walk test (p < 0.001). Additionally, time effects were also observed for fat mass (p = 0.03), body fat percentage (p = 0.02), abdominal circumference (p = 0.01), total cholesterol (p < 0.001), low-density lipoproteins (p < 0.001), and glycated hemoglobin (p < 0.001), with lower values after multi-professional interventions. After 16 weeks, the systolic and diastolic blood pressure showed significant reductions independently of the intervention group (p < 0.001). These findings suggest that multi-professional interventions can provide substantial benefits for post-COVID-19 patients, regardless of the severity of their initial symptoms.

Heart rate recovery after the 6-min walk test in people with bronchiectasis

BackgroundThe cardiac autonomic response to exercise and during recovery has been poorly explored in bronchiectasis.MethodsA longitudinal study was conducted in adults with bronchiectasis. Sociodemograhic and clinical data were collected at baseline and after 12 months of follow-up. The heart rate recovery after the first (HRR1) and second minute (HRR2) of recovery in the six-minute walk test (6MWT) was estimated in both assessments. Adjusted regression models were used to identify predictors of a delayed HRR1(HRR1≤ 14).Results104 participants with a mean (sd) age of 64 (13) years and mostly woman (67%) were included. A delayed HRR1after the baseline 6MWT was identified in 36% of participants. These participants presented a higher proportion of males, increased body mass index, higher disease severity, more likely to required hospitalisation, more impact on quality of life, lower exercise capacity, lower HR at the end of the 6MWT and lower HRR2. Disease severity (ß, 95%CI) (moderate and severeversusmild, −0.47 (−0.94 to −0.01)) and distance walked (0.34 (0.11 to 0.56)) were the independent variables associated with HRR1. Of the 45 participants who completed the entire follow-up period, 24% exhibited delayed HRR1. The presence of at least two exacerbations during the follow-up period (OR, 95%CI) (16.89 (1.44 to 197.48)) was the only predictor of a delayed HRR1in the assessment completed at the end of the study.ConclusionHRR1is related to disease severity and mainly affected by having severe exacerbations in people with bronchiectasis.

Multimodal prehabilitation improves functional capacity in patients with advanced ovarian cancer undergoing cytoreductive surgery

ObjectivePrehabilitation, defined as the preparatory intervention to increase patient preparedness in the lead-up to surgery, has shown a decrease in post-operative complications in various types of surgery. However, there is...

Body compositions phenotypes of older adults with COPD.

Changes in nutritional status are important extrapulmonary manifestations of the chronic obstructive pulmonary disease (COPD). The study aimed to assess the prevalence of different body composition phenotypes in older patients with COPD and to investigate the relationship between these phenotypes and the severity of the disease, as well as physical performance of the subjects. The study included 124 subjects aged ≥60 with COPD. In all of them body composition analysis and muscle strength measurement were performed. Additionally, data from patients' medical records were analyzed. Study sample was divided into four groups based on the phenotypic body composition: normal phenotype (N), sarcopenia, obesity and sarcopenic obesity (SO). Incidence of sarcopenia was significantly higher in patients with severe or very severe COPD based on GOLD in comparison with subjects with mild or moderate obstruction (p = 0.043). Participants with sarcopenia, obesity and SO had lower results of the 6-min walk test than subjects with N (225.77 m, 275.33 m, 350.67 m, 403.56 m, respectively). Moreover, sarcopenia and SO had lower results than obesity (p = 0.001, p = 0.041, respectively). Sarcopenia is common in patients with advanced COPD. Sarcopenia and SO are associated with poorer physical performance. All older people with COPD should routinely have their body composition assessed, instead of simply measuring of body weight or body mass index (BMI).

The Relation between Parameters of Physical Performance and Depression in Consecutive Hospitalized Geriatric Patients with Heart Failure.

In the geriatric population, the risk of cardiometabolic diseases is strongly influenced by comorbidities. The aim of the study was to estimate the prevalence of depression among hospitalized patients with heart failure (HF) and to assess the relation between physical performance and depression in this population. We included consecutive hospitalized patients with HF aged >65 years. The depression symptoms were evaluated using the Geriatric Depression Scale (GDS), the physical performance was assessed using the grip strength measurements, the Back Scratch Test, the Timed Up and Go Test (TUGT), the Five Times Sit to Stand Test (5 × SST), and the 6 min walk test. We included 206 patients (134 females and 72 males, median age 82 years (77-86) years). Altogether, 33% of participants had signs of depression. The association was found between depression severity and economic status (p = 0.001), stressful events (p = 0.005), self-reported general health status (p = 0.001), and heart failure severity assessed by the New York Heart Association class (NYHA), p = 0.003. The Back Scratch Test, the TUGT, and the 5xSST were associated with depression severity in a univariable regression analysis (β coefficient 0.04 [95% CI 0.00-0.08], 0.20 [95% CI 0.12-0.27], 0.18 [95% CI 0.07-0.27], respectively); however, when adjusted for co-factors, the TUGT and the 5xSST (0.17 [95% CI 0.08-0.26] and 0.14 [95% CI 0.02-0.26], respectively) were significantly related to the GDS score. Grip strength and the 6 min walk test were not related to the GDS score in the univariable nor multivariable analysis. These findings were confirmed in the logistic analyses. Our study indicated a high incidence of depression among elderly hospitalized patients with heart failure. Depression severity in older patients with HF is related to physical performance decline as assessed by the Timed Up and Go Test and the Five Times Sit to Stand Test. Grip strength and the 6 min walk test are not related to the GDS score in this population.

Handgrip strength is associated with functioning in patients with mental disorders: A two-center cross-sectional study

Physical and mental health are intricated, however, there is a paucity of studies investigating the association between self-reported global functioning and handgrip strength and functional capacity in people with mental disorders. This study investigated the association between functioning, handgrip strength, and functional capacity in outpatients with a range of mental disorders. This was a two-center, cross-sectional study. Functioning was assessed with the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Handgrip strength was assessed with a hand dynamometer, and functional exercise capacity through the 2-min walk test (2 MW T). Multiple linear regression analysis was used to identify the association between WHODAS 2.0, handgrip strength, and functional capacity, adjusted for study site, age, educational level, and severity of psychiatric symptoms. A total of 91 outpatients (mean age = 40.16 ± 13.49, 63.7% females) participated in the study. The mean functioning score was 26.77 (±8.74) out of 60 points, while the mean distance walked was 142.20 ± 34.40 m and the mean handgrip strength was 30.62 ± 11.17 kgf. The adjusted multiple linear regression analysis revealed that only handgrip strength (p = 0.008, 95%CI = −0.327 to −0.050) was associated with functioning. Thus, our results revealed that muscular strength is associated with functioning in patients with mental disorders. This study suggests the importance of incorporating physical health assessment into mental health care for a comprehensive assessment of functioning levels, which is usually restricted to mental symptoms.

8352 Association Between Sleep and Physical Activity Among Women with Obesity and Infertility

Abstract Disclosure: K. Brûlé: None. F. Jean-Denis: None. M. Belan: None. M. Langlois: None. S. Ruchat: None. J. Baillargeon: Grant Recipient; Self; Ferring Pharmaceuticals. BACKGROUND: Infertility affects up to 15% of couples and a major modifiable risk factor is obesity. Thus, it has been recommended that women with obesity should be assisted to adopt healthy lifestyle behaviors prior to conception. Also, individuals with obesity often present reduced sleep quantity and quality, which could affect their physical activity (PA) practice. On the other hand, PA seems to improve sleep quality. Regular practice of PA could also improve an individual’s functional capacity, and thus could be an objective measure of a person's level of PA. Hence, our study aimed to: 1) compare the sleep quantity of women with obesity and infertility to the Canadian population; and 2) determine the relationship between their PA practice, functional capacity and sleep quantity and quality. Methods: This cross-sectional study is nested within a multicenter randomized controlled trial recruiting women of 18-40 years old with obesity and infertility in Canadian fertility clinics. At their initial research visit, they were assessed for body mass index (BMI), functional capacity (distance at 6-min walk test); total energy expenditure (EE, kcal/day), total PA (steps/day) and time spent in light (min/day) or moderate-to-vigorous physical activity (MVPA, min/day) or sedentarity (min/day) (Fitbit monitor); as well as sleep quality and duration (Pittsburgh Sleep Quality Index questionnaire and Fitbit monitor), and total time asleep per night (Fitbit monitor). For the Canadian population, we used the mean sleep duration of women aged 18-60 years reported in the Canadian Community Health Survey of 2020. Associations were tested using Pearson’s correlations (some measures were made normally distributed by square root transformation). Results: A total of 98 women (mean age = 31.5 years and mean BMI = 39.2 kg/m2) from 5 centers were included, 48% of whom were recruited in Sherbrooke (Qc). Their sleep duration was significantly lower than that of Canadian women (7.2±1.1 vs 8.1 h; p&amp;lt;0.001). Poor perceived sleep quality was negatively associated with EE (r=-0.271; p=0.020) and steps (r=-0.280; p=0.026), but directly with sedentary time (r=0.277; p=0.033). Light PA was negatively associated with measured sleep duration (r=-0.241; p=0.016), but positively associated with measured sleep efficiency (r=0.237; p=0.036). Functional capacity is positively associated with measures of EE, steps and MVPA (r=0.239 to 0.347; p=0.005 to 0.031), and there is a tendency with total time asleep (r=0.238, p=0.061). Conclusion: Canadian women with obesity and infertility have, on average, less sleep time than women in the general Canadian population. Their PA practice is associated with better perceived sleep quality but does not improve their sleep quantity per se. Furthermore, the association between their functional capacity and PA practice suggests that it is a valid objective indirect measure of PA practice. Presentation: 6/1/2024

Ferric carboxymaltose and exercise capacity in heart failure with preserved ejection fraction and iron deficiency: the FAIR-HFpEF trial.

Evidence is lacking that correcting iron deficiency (ID) has clinically important benefits for patients with heart failure with preserved ejection fraction (HFpEF). FAIR-HFpEF was a multicentre, randomized, double-blind trial designed to compare intravenous ferric carboxymaltose (FCM) with placebo (saline) in 200 patients with symptomatic HFpEF and ID (serum ferritin < 100 ng/mL or ferritin 100-299 ng/mL with transferrin saturation < 20%). The primary endpoint was change in 6-min walking test distance (6MWTD) from baseline to week 24. Secondary endpoints included changes in New York Heart Association class, patient global assessment, and health-related quality of life (QoL). The trial was stopped because of slow recruitment after 39 patients had been included (median age 80 years, 62% women). The change in 6MWTD from baseline to week 24 was greater for those assigned to FCM compared to placebo [least square mean difference 49 m, 95% confidence interval (CI) 5-93; P = .029]. Changes in secondary endpoints were not significantly different between groups. The total number of adverse events (76 vs. 114) and serious adverse events (5 vs. 19; rate ratio 0.27, 95% CI 0.07-0.96; P = .043) was lower with FCM than placebo. In patients with HFpEF and markers of ID, intravenous FCM improved 6MWTD and was associated with fewer serious adverse events. However, the trial lacked sufficient power to identify or refute effects on symptoms or QoL. The potential benefits of intravenous iron in HFpEF with ID should be investigated further in a larger cohort.

Low-field MRI lung opacity severity associated with decreased DLCO in post-acute Covid-19 patients

ObjectivesTo evaluate the clinical significance of low-field MRI lung opacity severity. MethodsRetrospective cross-sectional analysis of post-acute Covid-19 patients imaged with low-field MRI from 9/2020 through 9/2022, and within 1 month of pulmonary function tests (PFTs), 6-min walk test (6mWT), and symptom inventory (SI), and/or within 3 months of St. George Respiratory Questionnaire (SGRQ) was performed.Univariate and correlative analyses were performed with Wilcoxon, Chi-square, and Spearman tests. The association between disease and demographic factors and MR opacity severity, PFTs, 6mWT, SI, and SGRQ, and association between MR opacity severity with functional and patient-reported outcomes (PROs), was evaluated with mixed model analysis of variance, covariance and generalized estimating equations. Two-sided 5 % significance level was used, with Bonferroni multiple comparison correction. Results81 MRI exams in 62 post-acute Covid-19 patients (median age 57, IQR 41–64; 25 women) were included. Exams were a median of 8 months from initial illness. Univariate analysis showed lung opacity severity was associated with decreased %DLCO (ρ = −0.55, P = .0125), and lung opacity severity quartile was associated with decreased %DLCO, predicted TLC, FVC, and increased FEV1/FVC.Multivariable analysis adjusting for sex, initial disease severity, and interval from Covid-19 diagnosis showed MR lung opacity severity was associated with decreased %DLCO (P < .001). Lung opacity severity was not associated with PROs. ConclusionLow-field MRI lung opacity severity correlated with decreased %DLCO in post-acute Covid-19 patients, but was not associated with PROs.

Accuracy of smartwatches for the remote assessment of exercise capacity

Exercise capacity is a strong independent predictor of cardiovascular and all-cause mortality. The utilization of well-established submaximal tests of exercise capacity such as the 6-min walk test (6MWT), 3-min step test (3MST) and 10-chair rise test (10CRT) in the community would improve patient care but requires remote monitoring technology. Consumer grade smartwatches provide such an opportunity, however, their accuracy in measuring physiological responses to these tests is unclear. The aim of this study was to determine the accuracy of consumer grade smartwatches in assessing exercise capacity to develop a framework for remote, unsupervised testing. 16 healthy adults (7 male (44%), age median 27 [interquartile range (IQR) 26,29] years) performed 6MWTs using two protocols: (1) standard—straight 30 m laps (6MWT-standard) and 2) continuous lap—circular 240 m laps around a park (6MWT-continuous lap), 3MSTs and 10CRTs. Each one of these four tests was performed three times across two clinic visits. Each participant was fitted with a Garmin Vivoactive4 and Fitbit Sense smartwatch to measure three parameters: distance, step counts and heart rate (HR) response. Reference measures were a meter-wheel, hand tally counter and ECG, respectively. Mean HR was measured at rest, peak exercise and recovery. Agreement was measured using Bland–Altman analysis for repeated measures and summarized as median absolute percentage errors (MAPE). Distance during 6MWT-continuous lap had better agreement than during 6MWT-standard for both Garmin (MAPE: 6.4% [3.0, 10.4%] versus 20.1% [13.9, 28.4%], p < 0.001) and Fitbit (8.0% [2.9, 10.1% versus 18.8% [15.2, 28.1%], p < 0.001). Garmin measured step count more accurately than Fitbit (MAPE: 1.8% [0.9, 2.9%] versus 8.0% [2.6, 12.3%], p < 0.001). Irrespective of test, both devices showed excellent accuracy in measuring HR at rest and recovery (≤ 3%), while accuracy decreased during peak exercise (Fitbit: ~ 12% and Garmin: ~ 7%). In young adults without mobility difficulties, exercise capacity can be measured remotely using standardized tests and consumer grade smartwatches.

Comparison of Gait in Women with Degenerative Changes of the Hip Joint and Healthy Women Using the MoKA System-A Pilot Study.

Osteoarthritis (OA) is a global problem. There are few reports in the literature regarding the temporal and spatial parameters of gait in people with OA. The aim of this study was to determine spatiotemporal parameters for the pelvis and lower limbs during walking in women with OA and to compare these parameters with healthy people. For this purpose, a 6 min walking test (6MWT) was carried out. OA subjects had worse outcomes compared to the control group (p < 0.05). Data were collected using IMU sensors integrated into the MoKA system and mounted on indicator points on the body. Limited mobility of the pelvis in the frontal plane was observed in the study group, which influenced walking strategy. For the comparison with the control group at each minute, p < 0.05. IMU sensors attached to the body and integrated in one application provide extensive research and diagnostic capabilities.

A single-center, double-blind, randomized, placebo-controlled, two-arm study to evaluate the safety and efficacy of once-weekly sirolimus (rapamycin) on muscle strength and endurance in older adults following a 13-week exercise program

BackgroundAging leads to a decline in muscle mass and strength, contributing to frailty and decreased quality of life. Sirolimus (rapamycin) , an mTOR inhibitor, has shown potential in preclinical studies to extend lifespan and improve health span. This study evaluates the safety and efficacy of once-weekly sirolimus (rapamycin) administration on muscle strength and endurance in older adults engaged in a 13-week exercise program.MethodsThis randomized, double-blind, placebo-controlled trial will enroll 40 participants aged 65–85. Participants will be randomly assigned to receive either sirolimus (rapamycin) 6 mg/week or placebo for 13 weeks, in conjunction with an at-home exercise program. The primary outcome measure is the change in muscle strength and endurance, assessed by the 30-Second Chair-Stand Test. Secondary outcome measures include adverse events, changes in muscle strength and endurance as measured by the 6-min walk test, handgrip strength, and participant-reported outcomes using the SF-36 survey. Assessments will be conducted at baseline, mid-intervention (week 6), and post-intervention (week 13). Blood samples will be collected for hematology and biochemistry analyses, including full blood count, urea and electrolytes, liver function tests, HbA1c, lipids, serum IGF-1, and hs-CRP. DNA methylation will be analyzed using TruDiagnostic™ to explore changes in biological age.DiscussionThis study aims to provide insights into the potential benefits of intermittent sirolimus (rapamycin) administration on muscle performance in older adults. By alternating periods of mTOR inhibition through rapamycin and activation via exercise, this study will explore a novel approach to enhancing muscle strength and endurance in the aging population. The results could have significant implications for developing interventions to improve physical function and overall health outcomes in older adults. Safety and tolerability will also be closely monitored to ensure the feasibility of this regimen for wider application.Trial registrationAustralia New Zealand Clinical Trials Registry, ACTRN12624000790549. Registered on 26 June 2024 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12624000790549.

Associations of physical activity, sedentary time, and fitness with cardiovascular risk and atherosclerosis over 3 years in women with systemic lupus erythematosus

IntroductionCardiovascular (CV) diseases are among the main causes of death in systemic lupus erythematosus (SLE). Physical activity (PA) and fitness are potential protective factors against the progression of CV risk factors and atherosclerosis. AimTo analyze trends over time in PA, sedentary time (ST) and physical fitness and their associations of with traditional and novel markers of CV risk and subclinical atherosclerosis in women with SLE over a 3-year follow-up period. MethodsIn this exploratory study, 77 White Hispanic women with SLE (43.3±13.8 years) with mild disease activity were followed after 3 years (n=44). HDL and LDL cholesterol (blood samples), BMI and muscle mass (stadiometer and bioimpedance device), blood pressure (BP), pulse wave velocity (PWV, Mobil-O-Graph® monitor), carotid plaques and intima–media thickness (General Electric Medical Systems, LOGQ-6 model) were assessed. PA and ST were measured using triaxial accelerometers. Physical fitness was assessed with the back-scratch, handgrip strength, 30-s chair stand, and 6-min walk, tests. ResultsAfter 3 years, LDL-c (estimated mean change [est]=13.77mg/dL) and PWV (0.13m/s) increased while diastolic BP (−2.80mmHG) decreased (all, p<0.05). In mixed models, 6-min walk test was positively associated with HDL-c (est=0.07); back scratch (est=0.33) and chair-stand (est=1.19) tests were positively associated with systolic BP (all, p<0.05). No other trends or associations over time were identified (all, p>0.05). ConclusionsPA, ST, fitness, and most studied CV risk factors remained stable over time, with only marginal changes in LDL-c, PWV, and diastolic BP. Overall, PA and ST were not longitudinally associated with CV risk factors and subclinical atherosclerosis and contradictory weak associations were found for physical fitness.

Contextualizing the results of HELIOS-B in the broader landscape of clinical trials for the treatment of transthyretin cardiac amyloidosis.

This focused review will highlight the results of HELIOS-B, the first randomized outcomes trial evaluating a gene silencing treatment for transthyretin cardiac amyloidosis (ATTR-CM). In HELIOS-B, vutrisiran was tested against placebo and demonstrated a 28% reduction in the composite of all-cause mortality and recurrent cardiovascular events. Additionally, there were clinically significant benefits on the 6-min walk test, Kansas City Cardiomyopathy Questionnaire, and NYHA class. Discontinuation rates and adverse events were similar between treatment and control arms, suggesting that vutrisiran is well tolerated. In this review, these promising results are explored and compared with other treatment trials in ATTR-CM.

3-year quality of life, functional performance, and long-term survival after acute pulmonary embolism; A prospective study.

Our prospective study investigates the 3-year trajectory of disease-specific quality of life (QoL) using the PEmb-QoL questionnaire, functional performance via 6-min walk tests, and the 5-year survival following acute pulmonary embolism (PE) and explores their association with patient demographics and clinical characteristics. We highlight that PE-specific QoL improves over time despite no significant changes in cardiopulmonary performance.

Fitness, Gray Matter Volume, and Executive Function in Cognitively Normal Older Adults: Cross-Sectional Findings From the AGUEDA Trial.

The aim of the study is to investigate the association of cardiorespiratory fitness (CRF) and muscular strength indicators with gray matter volume (GMV) and to study whether fitness-related regions of GMV are associated to executive function (EF) in cognitively normal older adults. Ninety-one cognitively normal older adults (71.69 ± 3.91 years; 57.14% females) participated in this study from the AGUEDA trial. CRF was measured by a 2-km walking test and a 6-min walking test. Muscular strength was measured by handgrip, biceps curl, squats, and isokinetic strength tests. T1-weigthed images were obtained through a magnetic resonance scan. GMV was determined by voxel-based morphometric analysis. Standardized EF tests were performed. CRF did not show any positive association with GMV. Handgrip strength was positively associated with GMV (p < 0.001) in nine regions (β from 0.6 to 0.8 and k from 106 to 1927) and knee extension strength in three regions (β from 0.4 to 0.5 and k from 76 to 2776). Squats strength was negatively associated with GMV (p < 0.001) in two regions (β = -0.3, k = 1102 and k = 152) and the 2-km walking test in one region (β = -0.4, k = 99). Only handgrip strength-related GMV was associated with cognitive flexibility (p = 0.039, β = 0.215) and spatial working memory (p < 0.03, β 0.247-0.317), but not with EF score (p > 0.05). Muscular strength, but no CRF, may be positively related to GMV in cortical and subcortical regions, with implications for specific cognitive domains rather than the overall EF score. Specifically, handgrip strength was the indicator most associated with higher GMV, while squats strength and CRF were negatively related to GMV. ClinicalTrials.gov identifier: NCT05186090.