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1.
Am J Transl Res ; 12(8): 4582-4593, 2020.
Article in English | MEDLINE | ID: mdl-32913532

ABSTRACT

This study examined the effectiveness, suitability, and safety of a mixed interval-type aerobic and strength training program (MIAST) on physical fitness in patients with stable coronary artery disease (CAD) without history of myocardial infarction (MI). Twenty-three patients with stable CAD were randomly assigned to a MIAST (n = 12; mean age 58.6 years) or control (n = 11; 63.3 years) group. The MIAST group participated in the progressive training program twice a week for 21 weeks. Peak oxygen uptake (VO2peak), workload, and exercise time were measured as were maximal muscle strength, serum lipids, glucose concentration, and the cross-sectional area (CSA) of knee extensors. The safety and suitability of the program were assessed by wireless electrocardiogram (ECG) monitoring and exercise diaries. VO2peak (6.9%; P < 0.05) and exercise time (11.2%; P < 0.05) improved significantly after 12 weeks of training in the MIAST group compared to the control group. Muscle strength (19.9%; P < 0.05) and CSA (2.2%; P < 0.05) increased, and serum lipids and blood glucose tended to decrease after the training. The successful training program (increase in maximal oxygen uptake) increased the gene expression of oxygen metabolism and decreased the gene expression of inflammation pathways in lymphomonocytes. The MIAST program, including interval-type aerobic and strength training, was safe, did not cause any adverse effects, and led to significant improvements in physical fitness in patients with stable CAD.

2.
Acta Odontol Scand ; 75(8): 577-583, 2017 Nov.
Article in English | MEDLINE | ID: mdl-28789581

ABSTRACT

OBJECTIVE: The purpose of this study was to get new information from several sources about the background factors of Finnish smokers, snuffers, and dual users. Profiles of young smokers and snuffers were investigated in association with restorative treatment need, oral hygiene, eating habits, physical activity, body mass index (BMI), psychological and socioeconomic factors. MATERIAL AND METHODS: The study group comprised 3420 conscripts. The data were collected from four different sources: a health examination including an oral health screening, a computer-based questionnaire for investigating individual background factors, a psychological test assessing cognitive skills, and the Cooper test. Statistical analyses comprised cross tabulation and binary logistic regression modelling. RESULTS: The odds for smoking were the greatest among those who had DT (Decayed teeth) > 0, used energy drinks or alcohol regularly, or whose parents were divorced. A score of ≥2900 m in the Cooper test, a higher physical exercise level, a higher own education level, and using sports drinks decreased the odds for smoking. The odds for snuffing were higher among those who ran >2500 m in the Cooper test, had a BMI of ≥25, used sports/energy drinks, or exercised regularly, and lower among those who achieved good results in the cognitive test. Using energy/sports drinks or alcohol was positively and a higher education level was negatively associated with dual use. CONCLUSIONS: Along with increasing prevalence of snuffing, heterogeneity is likely among snuffers. Good cognitive skills may prevent from smoking and snuffing.


Subject(s)
Dental Caries/epidemiology , Oral Health/statistics & numerical data , Smokers/statistics & numerical data , Smoking/epidemiology , Tobacco, Smokeless/statistics & numerical data , Adult , Body Mass Index , Cross-Sectional Studies , Energy Drinks , Female , Finland/epidemiology , Humans , Logistic Models , Male , Prevalence , Socioeconomic Factors , Surveys and Questionnaires , Young Adult
3.
Appl Physiol Nutr Metab ; 41(12): 1285-1294, 2016 Dec.
Article in English | MEDLINE | ID: mdl-27863207

ABSTRACT

This study investigated the effects of 24 weeks of morning versus evening same-session combined strength (S) and endurance (E) training on physical performance, muscle hypertrophy, and resting serum testosterone and cortisol diurnal concentrations. Forty-two young men were matched and assigned to a morning (m) or evening (e) E + S or S + E group (mE + S, n = 9; mS + E, n = 9; eE + S, n = 12; and eS + E, n = 12). Participants were tested for dynamic leg press 1-repetition maximum (1RM) and time to exhaustion (Texh) during an incremental cycle ergometer test both in the morning and evening, cross-sectional area (CSA) of vastus lateralis and diurnal serum testosterone and cortisol concentrations (0730 h; 0930 h; 1630 h; 1830 h). All groups similarly increased 1RM in the morning (14%-19%; p < 0.001) and evening (18%-24%; p < 0.001). CSA increased in all groups by week 24 (12%-20%, p < 0.01); however, during the training weeks 13-24 the evening groups gained more muscle mass (time-of-day main effect; p < 0.05). Texh increased in all groups in the morning (16%-28%; p < 0.01) and evening (18%-27%; p < 0.001), however, a main effect for the exercise order, in favor of E + S, was observed on both testing times (p < 0.051). Diurnal rhythms in testosterone and cortisol remained statistically unaltered by the training order or time. The present results indicate that combined strength and endurance training in the evening may lead to larger gains in muscle mass, while the E + S training order might be more beneficial for endurance performance development. However, training order and time seem to influence the magnitude of adaptations only when the training period exceeded 12 weeks.


Subject(s)
Athletic Performance , Exercise , Muscle Development , Muscle Strength , Muscle, Skeletal/physiology , Physical Endurance , Resistance Training , Adult , Bicycling , Circadian Rhythm , Exercise Test , Fatigue/blood , Fatigue/etiology , Fatigue/prevention & control , Humans , Hydrocortisone/blood , Hypertrophy/prevention & control , Male , Muscle, Skeletal/growth & development , Patient Dropouts , Quadriceps Muscle/growth & development , Quadriceps Muscle/physiology , Resistance Training/adverse effects , Testosterone/blood , Time Factors , Weight Lifting
4.
Appl Physiol Nutr Metab ; 41(7): 767-74, 2016 Jul.
Article in English | MEDLINE | ID: mdl-27351384

ABSTRACT

This study investigated changes in physical fitness, body composition, and blood lipid profile following 24 weeks of 3 volume-equated concurrent strength and endurance training protocols. Physically active, healthy male and female participants (aged 18-40 years) performed strength and endurance sessions on different days (DD; men, n = 21; women, n = 18) or in the same session with endurance preceding strength (ES; men, n = 16; women, n = 15) or vice versa (SE; men, n = 18; women, n = 14). The training volume was matched in all groups. Maximal leg press strength (1-repetition maximum (1RM)) and endurance performance (maximal oxygen consumption during cycling), body composition (dual-energy X-ray absorptiometry), and blood lipids were measured. 1RM and maximal oxygen consumption increased in all groups in men (12%-17%, p < 0.001; and 7%-18%, p < 0.05-0.001, respectively) and women (13%-21%, p < 0.01-0.001; and 10%-25%, p < 0.01-0.001, respectively). Maximal oxygen consumption increased more in DD vs. ES and SE both in men (p = 0.003-0.008) and women (p = 0.008-0.009). Total body lean mass increased in all groups (3%-5%, p < 0.01-0.001). Only DD led to decreased total body fat (men, -14% ± 15%, p < 0.001; women, -13% ± 14%, p = 0.009) and abdominal-region fat (men, -18% ± 14%, p = 0.003; women, -17% ± 15%, p = 0.003). Changes in blood lipids were correlated with changes in abdominal-region fat in the entire group (r = 0.283, p = 0.005) and in DD (r = 0.550, p = 0.001). In conclusion, all modes resulted in increased physical fitness and lean mass, while only DD led to decreases in fat mass. Same-session SE and ES combined training is effective in improving physical fitness while volume-equated, but more frequent DD training may be more suitable for optimizing body composition and may be possibly useful in early prevention of cardiovascular and metabolic diseases.


Subject(s)
Body Composition , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Physical Conditioning, Human/methods , Physical Endurance , Physical Fitness , Resistance Training , Triglycerides/blood , Absorptiometry, Photon , Adolescent , Adult , Body Mass Index , Energy Intake , Female , Humans , Male , Oxygen Consumption , Young Adult
5.
Eur J Sport Sci ; 16(8): 1055-63, 2016 Nov.
Article in English | MEDLINE | ID: mdl-27231807

ABSTRACT

Insulin-like growth factor-I (IGF-I) and its splice variants Insulin-like growth factor-I isoform Ea (IGF-IEa) and mechano growth factor (MGF) may play an important role in muscular adaptations to resistance training (RT) that may be modulated by ageing. It has been suggested that IGF-I induces cellular responses via AKT8 virus oncogene cellular homolog (Akt) and Extracellular signal-regulated kinase (Erk) signalling pathways. Therefore, resistance exercise-induced changes in skeletal muscle IGF-IEa and MGF messenger ribonucleic acid (mRNA), and MGF, Erk1/2, Akt and p70S6K protein expression were investigated before and after 21 weeks of RT in younger (YM, 20-34 yrs., n = 7) and older men (OM, 51-71 yrs., n = 10). Experimental resistance exercises (RE) of 5 × 10 repetition maximum leg presses were performed pre- and post-RT. Muscle biopsies were obtained before and 48 h after REs, to study the late response to muscle loading. The muscle proteins or mRNAs of interest were not systematically influenced by the REs or RT, except for MGF mRNA expression which was increased (p < .01) following RE before RT in OM. No differences were observed between YM and OM in any variables. This study demonstrated that basal levels or RE-induced responses in skeletal muscle MGF, Erk1/2, Akt and p70S6K protein levels or IGF-IEa and MGF mRNA expression did not differ between YM and OM, nor change systematically due to RT. Thus, ageing appears not to effect expression of the present signalling molecules involved in skeletal muscle hypertrophy.


Subject(s)
Insulin-Like Growth Factor I/metabolism , Muscle, Skeletal/physiology , Protein Isoforms/metabolism , Resistance Training , Aged , Aging/physiology , Humans , Insulin-Like Growth Factor I/chemistry , Insulin-Like Growth Factor I/genetics , Male , Middle Aged , Protein Isoforms/chemistry , Protein Isoforms/genetics , RNA, Messenger/analysis , RNA, Messenger/genetics , RNA, Messenger/metabolism , Signal Transduction/physiology
6.
Front Physiol ; 7: 689, 2016.
Article in English | MEDLINE | ID: mdl-28119632

ABSTRACT

Worries about the potential negative consequences of popular fat loss regimens for aesthetic purposes in normal weight females have been surfacing in the media. However, longitudinal studies investigating these kinds of diets are lacking. The purpose of the present study was to investigate the effects of a 4-month fat-loss diet in normal weight females competing in fitness-sport. In total 50 participants finished the study with 27 females (27.2 ± 4.1 years) dieting for a competition and 23 (27.7 ± 3.7 years) acting as weight-stable controls. The energy deficit of the diet group was achieved by reducing carbohydrate intake and increasing aerobic exercise while maintaining a high level of protein intake and resistance training in addition to moderate fat intake. The diet led to a ~12% decrease in body weight (P < 0.001) and a ~35-50% decrease in fat mass (DXA, bioimpedance, skinfolds, P < 0.001) whereas the control group maintained their body and fat mass (diet × group interaction P < 0.001). A small decrease in lean mass (bioimpedance and skinfolds) and in vastus lateralis muscle cross-sectional area (ultrasound) were observed in diet (P < 0.05), whereas other results were unaltered (DXA: lean mass, ultrasound: triceps brachii thickness). The hormonal system was altered during the diet with decreased serum concentrations of leptin, triiodothyronine (T3), testosterone (P < 0.001), and estradiol (P < 0.01) coinciding with an increased incidence of menstrual irregularities (P < 0.05). Body weight and all hormones except T3 and testosterone returned to baseline during a 3-4 month recovery period including increased energy intake and decreased levels aerobic exercise. This study shows for the first time that most of the hormonal changes after a 35-50% decrease in body fat in previously normal-weight females can recover within 3-4 months of increased energy intake.

7.
Exp Gerontol ; 69: 148-58, 2015 Sep.
Article in English | MEDLINE | ID: mdl-26079649

ABSTRACT

This study investigated the effects of resistance training (RT) on the metabolism of testosterone (T) in younger (n=5, 28±3yrs.) and older (n=8, 70±2yrs.) men. Experimental heavy resistance exercises (5×10RM leg presses) were performed before and after a 12-month of RT. No age differences were found in the production or metabolic clearance rate of T (determined by stable isotope dilution method), skeletal muscle androgen receptor content or serum LH concentrations due to acute or chronic RT. The T production capacity response to gonadotropin stimulation and the concentrations of the urinary T metabolites (androsterone and etiocholanolone) were lower in the older compared to younger men (p<0.05-0.01). This study further showed that RT may have acute effect on T production and clearance rates, while the exercise-induced increases in serum T appeared to be induced by decreased metabolic clearance rate of T. Attenuated T production capacity and urinary excretion of T metabolites in older men may reflect the known reduction in testicular steroidogenesis upon aging. No changes were observed in T metabolism due to RT indicating a homeostatic stability for this hormone in men of different ages.


Subject(s)
Aging/physiology , Exercise/physiology , Muscle, Skeletal/metabolism , Receptors, Androgen/blood , Resistance Training/methods , Testosterone , Adult , Age Factors , Aged , Androsterone/urine , Etiocholanolone/urine , Humans , Isotope Labeling/methods , Male , Patient Outcome Assessment , Renal Elimination/physiology , Testosterone/blood , Testosterone/metabolism
8.
Eur J Appl Physiol ; 115(9): 1835-45, 2015 Sep.
Article in English | MEDLINE | ID: mdl-25861013

ABSTRACT

PURPOSE: The aim of this study was to compare activation of cellular signaling pathways regulating protein synthesis and glucose uptake in skeletal muscle between resistance and endurance exercise. Moreover, the effect of resistance exercise volume was examined. METHODS: Three groups of male volunteers (26 ± 3 years) were examined: 5 × 10 repetition maximum (RM) resistance exercise (RE) with leg press device (5 × 10 RE; n = 8), 10 × 10 RE (n = 11), and endurance exercise (strenuous 50-min walking with extra load on a treadmill; EE; n = 8). Muscle biopsies were obtained from m.vastus lateralis 30 min pre- and post-exercise. RESULTS: Downstream markers of mTORC1, p-p70S6K(Thr421/Ser424) and p-rpS6(Ser240/244), increased more after 10 × 10 RE than after 5 × 10 RE (p < 0.05) and EE (p < 0.01-0.001). Exercise-induced changes in p-IRS-I(Ser636/639) that inhibit IRS-I signaling via negative feedback from hyperactivated mTORC1 signaling were greater (p < 0.05) after 10 × 10 RE compared with 5 × 10 RE and EE. The changes in energy sensor p-AMPKα(Thr172) were greater after 10 × 10 RE and EE (p < 0.05-0.01) than after 5 × 10 RE. A major regulator of glucose uptake in muscle, p-AS160(Thr642), increased more after 10 × 10 RE than after 5 × 10 RE (p < 0.01) and EE (p < 0.05). CONCLUSION: 10 × 10 RE induced greater activation of important signaling proteins regulating glucose uptake (p-AS160) and protein synthesis (p-p70S6K, p-rpS6) than 5 × 10 RE and EE. The present findings further suggest that, especially after 10 × 10 RE, IRS-I signaling is downregulated and that AS160 is activated through AMPK signaling pathway.


Subject(s)
Exercise/physiology , Glucose/metabolism , Muscle Proteins/biosynthesis , Muscle, Skeletal/physiology , Physical Endurance/physiology , Resistance Training/methods , Adaptation, Physiological/physiology , Adult , Humans , Male , Metabolic Clearance Rate , Physical Exertion/physiology , Protein Biosynthesis/physiology , Signal Transduction/physiology
9.
Appl Physiol Nutr Metab ; 40(1): 28-36, 2015 Jan.
Article in English | MEDLINE | ID: mdl-25494869

ABSTRACT

This study investigated the effects of endurance training only (E, n = 14) and same-session combined training, when strength training is repeatedly preceded by endurance loading (endurance and strength training (E+S), n = 13) on endurance (1000-m running time during incremental field test) and strength performance (1-repetition maximum (1RM) in dynamic leg press), basal serum hormone concentrations, and endurance loading-induced force and hormone responses in recreationally endurance-trained men. E was identical in the 2 groups and consisted of steady-state and interval running, 4-6 times per week for 24 weeks. E+S performed additional mixed-maximal and explosive-strength training (2 times per week) immediately following an incremental running session (35-45 min, 65%-85% maximal heart rate). E and E+S decreased running time at week 12 (-8% ± 5%, p = 0.001 and -7% ± 3%, p < 0.001) and 24 (-13% ± 5%, p < 0.001 and -9% ± 5%, p = 0.001). Strength performance decreased in E at week 24 (-5% ± 5%, p = 0.014) but was maintained in E+S (between-groups at week 12 and 24, p = 0.014 and 0.011, respectively). Basal serum testosterone and cortisol concentrations remained unaltered in E and E+S but testosterone/sex hormone binding globulin ratio decreased in E+S at week 12 (-19% ± 26%, p = 0.006). At week 0 and 24, endurance loading-induced acute force (-5% to -9%, p = 0.032 to 0.001) and testosterone and cortisol responses (18%-47%, p = 0.013 to p < 0.001) were similar between E and E+S. This study showed no endurance performance benefits when strength training was performed repeatedly after endurance training compared with endurance training only. This was supported by similar acute responses in force and hormonal measures immediately post-endurance loading after the training with sustained 1RM strength in E+S.


Subject(s)
Athletic Performance , Muscle Strength , Physical Endurance , Physical Exertion , Resistance Training , Sex Hormone-Binding Globulin/analysis , Testosterone/blood , Adult , Algorithms , Exercise , Humans , Hydrocortisone/blood , Hydrocortisone/metabolism , Leg , Male , Recreation , Resistance Training/adverse effects , Running , Sex Hormone-Binding Globulin/metabolism , Testosterone/metabolism
10.
Circ J ; 79(2): 360-7, 2015.
Article in English | MEDLINE | ID: mdl-25502167

ABSTRACT

BACKGROUND: Patients at high bleeding risk would benefit from a shorter dual antiplatelet therapy after PCI. Compared to first-generation devices, the design of newer generation drug-eluting stents may facilitate more rapid anatomical and functional healing of stented vessel based on thinner stent platforms, biodegradable/biocompatible polymers and rapid drug elution. METHODS AND RESULTS: Forty-four non-diabetic patients with acute coronary syndrome (ACS) and culprit lesion in the LAD were randomized to receive either biodegradable polymer sirolimus-eluting stent (BP-SES) or durable polymer zotarolimus-eluting stent (DP-ZES). Neointimal strut coverage was examined using optical coherence tomography, and vasodilator response on invasive thermodilution-derived coronary flow reserve (CFR) at 3-month follow-up. The primary endpoints were percent uncovered struts and CFR. A total of 425 cross-sections (4,897 struts) were analyzed in the BP-SES group, and 425 cross-sections (5,467 struts) in the DP-ZES group. The percent uncovered struts was lower in the BP-SES group compared with the DP-ZES group, both at strut level (3.9% vs. 8.9%, respectively, P<0.001), and stent level (3.9 ± 3.2% vs. 8.9 ± 6.9%, respectively, P=0.019). No significant difference was found between the 2 groups regarding CFR (3.0 ± 1.3 vs. 3.2 ± 1.0, respectively, P>0.05). CONCLUSIONS: In non-diabetic patients with ACS, BP-SES provided slightly better stent strut coverage at 3 months compared with DP-ZES, but neither stent was fully covered. No difference in vasodilator response was seen.


Subject(s)
Absorbable Implants , Acute Coronary Syndrome , Biodegradable Plastics , Drug-Eluting Stents , Neointima , Sirolimus/analogs & derivatives , Vasodilation/drug effects , Acute Coronary Syndrome/physiopathology , Acute Coronary Syndrome/surgery , Aged , Double-Blind Method , Female , Humans , Male , Middle Aged , Prospective Studies
11.
J Cardiovasc Med (Hagerstown) ; 16(3): 197-203, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25003998

ABSTRACT

AIMS: The randomized comparison of titanium-nitride-oxide-coated bioactive stent with everolimus-eluting stent in acute coronary syndrome (BASE-ACS) trial demonstrated an outcome of the titanium-nitride-oxide coated bioactive stents (BASs) that was statistically noninferior to that of the everolimus-eluting stents (EESs) at 12-month follow-up, in patients presenting with acute coronary syndrome (ACS) who underwent early percutaneous coronary intervention. We performed a post-hoc gender-based analysis of the BASE-ACS trial at 24-month follow-up. METHODS: A total of 827 patients (198 women) with ACS were randomly assigned to receive either BAS or EES. The primary endpoint was a composite of cardiac death, nonfatal myocardial infarction (MI), or ischemia-driven target lesion revascularization. RESULTS: Women were older, and more likely to have diabetes and hypertension compared with men (P < 0.05 for all). Moreover, women had significantly smaller reference vessel diameter and stent diameter (P < 0.05 for all). At 24-month follow-up, the cumulative incidence of the primary endpoint was similar between the two sex subgroups (15.2 versus 11.0%, for women versus men, respectively, P = 0.13). However, the rate of nonfatal MI was significantly higher in women compared with men (8.6 versus 3.8%, respectively, P = 0.007). After propensity score-adjusted analysis, there was a trend toward more nonfatal MI among women (8.6 versus 4.0%, respectively, P = 0.08). Moreover, among male patients, those assigned to BAS had significantly lower nonfatal MI compared with those assigned to EES (P = 0.027). However, among patients assigned to EES, female patients had a significantly higher rate of nonfatal MI compared with men (P = 0.02). CONCLUSION: In the current post-hoc gender-based analysis of the BASE-ACS trial, the 24-month outcome of patients undergoing percutaneous coronary intervention for ACS was slightly worse in women, compared with men, as reflected by a trend toward more nonfatal MI events after propensity score-adjusted analysis.


Subject(s)
Acute Coronary Syndrome/surgery , Percutaneous Coronary Intervention/instrumentation , Sex Characteristics , Stents/statistics & numerical data , Acute Coronary Syndrome/diagnostic imaging , Aged , Antineoplastic Agents/administration & dosage , Coronary Angiography , Everolimus/administration & dosage , Female , Humans , Male , Middle Aged , Percutaneous Coronary Intervention/statistics & numerical data , Propensity Score , Sex Factors , Titanium , Treatment Outcome
12.
Int J Sports Physiol Perform ; 10(4): 418-25, 2015 May.
Article in English | MEDLINE | ID: mdl-25310023

ABSTRACT

PURPOSE: To examine acute responses of force production and oxygen uptake to combined strength (S) and endurance-running (E) loading sessions in which the order of exercises is reversed (ES vs SE). METHODS: This crossover study design included recreationally endurance-trained men and women (age 21-45 y; n=12 men, 10 women) who performed ES and SE loadings. Force production of the lower extremities including countermovement-jump height (CMJ) and maximal isometric strength (MVC) was measured pre-, mid-, and post-ES and -SE, and ground-reaction forces, ground-reaction times, and running economy were measured during E. RESULTS: A significant decrease in CMJ was observed after combined ES and SE in men (4.5%±7.0% and 6.6%±7.7%, respectively) but not in women (0.2%±8.5% and 1.4%±7.3% in ES and SE). MVC decreased significantly in both men (20.7%±6.1% ES and 19.3%±9.4% SE) and women (12.4%±9.3% ES and 11.6%±12.0% SE). Stride length decreased significantly in ES and SE men, but not in women. No changes were observed in ground-reaction times during running in men or women. Performing S before E caused greater (P<.01) oxygen uptake during running in both men and women than if E was performed before S, although heart rate and blood lactate were similar between ES and SE. CONCLUSIONS: Performing S before E increased oxygen uptake during E, which is explained, in part, by a decrease in MVC in both men and women, decreased CMJ and stride length in men, and/or an increase in postexercise oxygen consumption.


Subject(s)
Exercise Tolerance/physiology , Oxygen Consumption/physiology , Resistance Training/methods , Running/physiology , Adult , Female , Humans , Male , Middle Aged , Muscle Strength/physiology , Young Adult
13.
BMJ Open ; 4(5): e004700, 2014 May 13.
Article in English | MEDLINE | ID: mdl-24823675

ABSTRACT

OBJECTIVES: Anaemia has an adverse impact on the outcome in the general patient population undergoing percutaneous coronary intervention (PCI). The aim of this study was to analyse the impact of anaemia on the 12-month clinical outcome of patients with atrial fibrillation (AF) undergoing PCI and therefore requiring intense antithrombotic treatment. We hypothesised that anaemia might be associated with a worse outcome and more bleeding in these anticoagulated patients. SETTING: Data were collected from 17 secondary care centres in Europe. PARTICIPANTS: Consecutive patients with AF undergoing PCI were enrolled in the prospective, multicenter AFCAS (Atrial Fibrillation undergoing Coronary Artery Stenting) registry. Altogether, 929 patients participated in the study. Preprocedural haemoglobin concentration was available for 861 (92.7%; 30% women). The only exclusion criteria were inability or unwillingness to give informed consent. Anaemia was defined as a haemoglobin concentration of <12 g/dL for women and <13 g/dL for men. OUTCOME MEASURES: The primary endpoint was occurrence of major adverse cardiac and cerebrovascular events (MACCE) or bleeding events. RESULTS: 258/861 (30%) patients had anaemia. Anaemic patients were older, more often had diabetes, higher CHA2DS2-VASc scores, prior history of heart failure, chronic renal impairment and acute coronary syndrome. Anaemic patients had more MACCE than non-anaemic (29.1% vs 19.4%, respectively, p=0.002), and minor bleeding events (7.0% vs 3.3%, respectively, p=0.028), with a trend towards more total bleeding events (25.2% vs 21.7%, respectively, p=0.059). No difference was observed in antithrombotic regimens at discharge. In multivariate analysis, anaemia was an independent predictor of all-cause mortality at 12-month follow-up (hazard ratio 1.62, 95% CI 1.05 to 2.51, p=0.029). CONCLUSIONS: Anaemia was a frequent finding in patients with AF referred for PCI. Anaemic patients had a higher all-cause mortality, more thrombotic events and minor bleeding events. Anaemia seems to be an identification of patients at risk for cardiovascular events and death. TRIAL REGISTRATION: ClinicalTrials.gov number NCT00596570.


Subject(s)
Anemia/complications , Atrial Fibrillation/complications , Percutaneous Coronary Intervention , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Aged , Female , Humans , Male , Prospective Studies , Registries , Treatment Outcome
14.
J Sports Sci ; 32(12): 1155-64, 2014.
Article in English | MEDLINE | ID: mdl-24576212

ABSTRACT

The study examined the acute neuromuscular and metabolic responses and recovery (24 and 48 h) to combined strength and endurance sessions (SEs). Recreationally endurance trained men (n = 12) and women (n = 10) performed: endurance running followed immediately by a strength loading (combined endurance and strength session (ES)) and the reverse order (SE). Maximal strength (MVC), countermovement jump height (CMJ), and creatine kinase activity were measured pre-, mid-, post-loading and at 24 and 48 h of recovery. MVC and CMJ were decreased (P < 0.05) at post-ES and SE sessions in men. Only MVC decreased in ES and SE women (P < 0.05). During recovery, no order differences in MVC were observed between sessions in men, but MVC and CMJ remained decreased. During recovery in women, a delayed decrease in CMJ was observed in ES but not in SE (P < 0.01), while MVC returned to baseline at 24 h. Creatine kinase increased (P < 0.05) during both ES and SE and peaked in all groups at 24 h. The present combined ES and SE sessions induced greater neuromuscular fatigue at post in men than in women. The delayed fatigue response in ES women may be an order effect related to muscle damage.


Subject(s)
Energy Metabolism , Muscle Fatigue/physiology , Muscle Strength/physiology , Physical Education and Training/methods , Physical Endurance/physiology , Running/physiology , Adult , Creatine Kinase/blood , Electromyography , Female , Humans , Lactic Acid/blood , Male , Middle Aged , Resistance Training/methods , Young Adult
15.
Thromb Res ; 133(4): 560-6, 2014 Apr.
Article in English | MEDLINE | ID: mdl-24461143

ABSTRACT

INTRODUCTION: CHADS2 and CHA2DS2-VASc scores are used to estimate thromboembolic risk in atrial fibrillation (AF). HAS-BLED is recommended for bleeding risk prediction. Their value in predicting the outcome of AF patients after percutaneous coronary intervention (PCI) is unknown. Thus, our aim was to assess whether these simple risk scores are useful in predicting outcome in these patients. MATERIALS AND METHODS: AFCAS is an observational, multicenter, prospective registry including patients (n=929) with AF referred for PCI. Primary study endpoints were 1) all cause mortality; 2) major adverse events (all-cause mortality, myocardial infarction, repeat revascularization, stent thrombosis, transient ischemic attack, stroke or other arterial thromboembolism; MACCE); and 3) bleeding at 12 months follow-up. CHADS2 and CHA2DS2-VASc scores and a modified HAS-BLED (mHAS-BLED) score (omitting labile INR and liver function) were calculated. RESULTS: Patients were distributed as follows: CHADS2 low 29.5%, intermediate 55.2%, high 15.3%; CHA2DS2-VASc low 9.6%, intermediate 46.0%, high 44.5%. A high CHA2DS2-VASc score was predictive of all-cause mortality (p=0.02), whereas CHADS2 was not. High CHA2DS2-VASc score predicted MACCE (HR 2.24, 95%CI 1.21-4.17, p=0.01), as did a high CHADS2 score (HR 1.60, 95%CI 1.05-2.45, p=0.029). Their predictive performance was only modest (C indexes 0.56-0.57). CHADS2 or CHA2DS2-VASc scores were not associated with bleeding. High mHAS-BLED scores (≥3) were not associated with any of the study outcomes. CONCLUSIONS: High CHA2DS2-VASc score was the best predictor of thrombotic outcomes after PCI in a high risk AF population. High mHAS-BLED score was not predictive of bleeding events. More accurate, simple risk scores are needed.


Subject(s)
Atrial Fibrillation/physiopathology , Percutaneous Coronary Intervention/methods , Aged , Female , Humans , Male , Prognosis , Risk Assessment , Risk Factors , Stroke/etiology , Thromboembolism/etiology , Treatment Outcome
16.
J Physiol ; 591(21): 5393-400, 2013 Nov 01.
Article in English | MEDLINE | ID: mdl-24000180

ABSTRACT

Recently, contradictory findings have been reported concerning the function of irisin and its precursor gene, skeletal muscle FNDC5, in energy homeostasis, and the associated regulatory role of exercise and PGC-1α. We therefore evaluated whether muscle FNDC5 mRNA and serum irisin are exercise responsive and whether PGC-1α expression is associated with FNDC5 expression. The male subjects in the study performed single exercises: (1) 1 h low-intensity aerobic exercise (AE) (middle-aged, n = 17), (2) a heavy-intensity resistance exercise (RE) bout (young n = 10, older n = 11) (27 vs. 62 years), (3) long-term 21 weeks endurance exercise (EE) training alone (twice a week, middle-aged, n = 9), or (4) combined EE and RE training (both twice a week, middle-aged, n = 9). Skeletal muscle mRNA expression was analysed by quantitative PCR and serum irisin by ELISA. No significant changes were observed in skeletal muscle PGC-1α, FNDC5 and serum irisin after AE, EE training or combined EE + RE training. However, a single RE bout increased PGC-1α by 4-fold in young and by 2-fold in older men, while FNDC5 mRNA only increased in young men post-RE, by 1.4-fold. Changes in PGC-1α or serum irisin were not consistently accompanied by changes in FNDC5. In conclusion, for the most part, neither longer-term nor single exercise markedly increases skeletal muscle FNDC5 expression or serum irisin. Therefore their changes in response to exercise are probably random and not consistent excluding the confirmation of any definitive link between exercise and FNDC5 expression and irisin release in humans. Moreover, irisin and FNDC5 were not associated with glucose tolerance and being overweight, or with metabolic disturbances, respectively. Finally, factor(s) other than PGC-1α and transcription may regulate FNDC5 expression.


Subject(s)
Fibronectins/metabolism , Muscle, Skeletal/metabolism , Physical Endurance , Resistance Training , Transcription, Genetic , Adult , Age Factors , Aged , Case-Control Studies , Fibronectins/blood , Fibronectins/genetics , Humans , Male , Middle Aged , Muscle, Skeletal/physiology , Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha , RNA, Messenger/genetics , RNA, Messenger/metabolism , Transcription Factors/genetics , Transcription Factors/metabolism
17.
PLoS One ; 8(8): e72664, 2013.
Article in English | MEDLINE | ID: mdl-24013586

ABSTRACT

The loss of complexity in physiological systems may be a dynamical biomarker of aging and disease. In this study the effects of combined strength and endurance training compared with those of endurance training or strength training alone on heart rate (HR) complexity and traditional HR variability indices were examined in middle-aged women. 90 previously untrained female volunteers between the age of 40 and 65 years completed a 21 week progressive training period of either strength training, endurance training or their combination, or served as controls. Continuous HR time series were obtained during supine rest and submaximal steady state exercise. The complexity of HR dynamics was assessed using multiscale entropy analysis. In addition, standard time and frequency domain measures were also computed. Endurance training led to increases in HR complexity and selected time and frequency domain measures of HR variability (P<0.01) when measured during exercise. Combined strength and endurance training or strength training alone did not produce significant changes in HR dynamics. Inter-subject heterogeneity of responses was particularly noticeable in the combined training group. At supine rest, no training-induced changes in HR parameters were observed in any of the groups. The present findings emphasize the potential utility of endurance training in increasing the complex variability of HR in middle-aged women. Further studies are needed to explore the combined endurance and strength training adaptations and possible gender and age related factors, as well as other mechanisms, that may mediate the effects of different training regimens on HR dynamics.


Subject(s)
Heart Rate/physiology , Physical Endurance/physiology , Resistance Training , Adult , Aged , Female , Humans , Middle Aged , Time Factors
18.
Eur J Appl Physiol ; 113(9): 2233-44, 2013 Sep.
Article in English | MEDLINE | ID: mdl-23636698

ABSTRACT

Loading using variable resistance devices, where the external resistance changes in line with the force:angle relationship, has been shown to cause greater acute neuromuscular fatigue and larger serum hormone responses. This may indicate a greater potential for adaptation during long-term training. Twelve (constant resistance group) and 11 (variable resistance group) men completed 20 weeks of resistance training with 10 men as non-training controls. Training-induced adaptations were assessed by bilateral leg press one repetition maximum, a repetition to failure test using 75 % 1RM, lower limb lean mass and vastus lateralis cross-sectional area. Only the variable resistance training group improved the total number of repetitions (41 ± 46 %) and volume load (52 ± 37 %) during the repetition to failure test (P < 0.05). Similar improvements in maximum strength and hypertrophy of the lower limbs were observed in both training groups. Also, constant and variable resistance 5 × 10RM leg press loadings were performed before and after training in a crossover design. Acute loading-induced responses were assessed by concentric and isometric force, serum hormone concentrations and phosphorylation of intramuscular signalling proteins (0-30 min post-loading). Greater acute decreases in force (P < 0.05-0.01), and greater increases in serum testosterone and cortisol concentration (P < 0.05) and ERK 1/2 phosphorylation (P < 0.05) were observed following variable resistance loadings before and after training. Greater training-induced improvements in fatigue resistance occurred in the variable resistance training group, which may be due to greater acute fatigue and physiological responses during variable versus constant resistance loadings.


Subject(s)
Exercise/physiology , Fatigue/pathology , Muscle, Skeletal/pathology , Resistance Training/methods , Adaptation, Physiological/physiology , Adult , Cross-Over Studies , Fatigue/blood , Humans , Hydrocortisone/blood , Hypertrophy/blood , Isometric Contraction/physiology , Leg/physiology , MAP Kinase Signaling System/physiology , Male , Muscle, Skeletal/physiology , Quadriceps Muscle/pathology , Testosterone/blood
19.
PLoS One ; 8(1): e54707, 2013.
Article in English | MEDLINE | ID: mdl-23382945

ABSTRACT

OBJECTIVES: To examine whether the adverse effects of slow prenatal and postnatal growth on cognitive function persist to old age and predict age related cognitive decline. DESIGN AND SETTING: A longitudinal birth cohort study of men born in Helsinki, Finland 1934-44. PARTICIPANTS: Nine-hundred-thirty-one men of the Helsinki Birth Cohort Study, with detailed data on growth from birth to adulthood, aged 20.1 (SD = 1.4) at the first and 67.9 (SD = 2.5) years at the second cognitive testing. MAIN OUTCOME MEASURES: The Finnish Defense Forces Basic Intellectual Ability Test assessed twice over nearly five decades apart. RESULTS: Lower weight, length and head circumference at birth were associated with lower cognitive ability at 67.9 years (1.04-1.55 points lower ability per each standard deviation [SD] unit decrease in body size, 95% Confidence Interval [95%CI]: 0.05 to 2.72) and with cognitive decline after 20.1 years (0.07-0.11 SD decline over time per each SD decrease in body size, 95%CI:0.00 to 0.19). Men who were born larger were more likely to perform better in the cognitive ability test over time (1.22-1.43 increase in odds to remain in the top relative to the lower two thirds in ability over time per each SD increase in body size, 95%CI:1.04 to 1.79) and were more resilient to cognitive decline after 20.1 years (0.69 to 0.76 decrease in odds to decline from than remain in the top third of ability over time per each SD increase in body size, 95%CI:0.49 to 0.99). Slower growth between birth and two years in weight, height and body mass index was associated with lower cognitive ability at 67.9 years, but not with cognitive decline. CONCLUSIONS: Poorer lifetime cognitive ability is predicted by slower growth before and after birth. In predicting resilience to age related cognitive decline, the period before birth seems to be more critical.


Subject(s)
Cognition Disorders/etiology , Cognition/physiology , Adolescent , Adult , Age Factors , Aged , Birth Weight , Body Size , Child , Child Development , Child, Preschool , Finland , Humans , Longitudinal Studies , Male , Middle Aged , Risk Factors , Young Adult
20.
J Strength Cond Res ; 27(2): 421-33, 2013 Feb.
Article in English | MEDLINE | ID: mdl-23222087

ABSTRACT

The purpose of this study was to investigate acute neuromuscular and endocrine responses and recovery to a single session of combined endurance and strength loading using 2 loading orders. Forty-two men were demographically matched to perform a single session of combined endurance + strength (E + S) or strength + endurance (S + E) loading. The strength loading was conducted on a leg press and included sets of power, maximal strength, and hypertrophic loads with an overall duration of 30 minutes. The endurance loading was conducted on a bike ergometer and performed by continuous cycling over 30 minutes at 65% of subject's individual maximal watts. Both loading conditions led to significant acute reductions in maximal force production (E + S: -27%, p < 0.001; S + E: -22%, p < 0.001), rapid force produced in 500 milliseconds (E + S: -26%, p < 0.001; S + E: -18%, p < 0.001), and countermovement jump height (E + S: -15%, p < 0.001; S + E: -12%, p < 0.001), whereas no significant differences between the 2 loadings were observed. Maximal and explosive force production recovered after 48 hours after both loading conditions. Whereas no significant acute responses were found in concentrations of serum testosterone (T) and thyroid-stimulating hormone in the 2 loading conditions, concentrations of T were significantly reduced in E + S during recovery at 24 hours (-13%, p < 0.05) and 48 hours (-11%, p = 0.068), but not in S + E, and concentrations of thyroid-stimulating hormone significantly reduced after both loading conditions (24 hours: E + S, -32%, p < 0.001; S + E, -25%, p < 0.01; 48 hours: E + S, -25%, p < 0.001; S + E, -18%, p < 0.01). The loading conditions in this study showed that neuromuscular performance recovered already within 2 days, whereas endocrine function, observed particularly by decreased concentrations in serum T after the E + S loading order, remained altered still after 48 hours of recovery. These results emphasize the different needs for recovery after 2 loading orders.


Subject(s)
Bicycling/physiology , Exercise/physiology , Muscle, Skeletal/physiology , Physical Endurance , Adult , Creatine Kinase/blood , Cross-Sectional Studies , Growth Hormone/blood , Humans , Lactic Acid/blood , Lower Extremity , Male , Movement , Muscle Strength , Resistance Training , Testosterone/blood , Thyrotropin/blood , Time Factors
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