Exercise capacity improvement after cardiac rehabilitation following myocardial infarction and its association with long-term cardiovascular events.

AIMS: Cardiovascular rehabilitation (CR) improves aerobic capacity and quality of life in patients after myocardial infarction (MI). The aim was to examine the associations between exercise capacity improvement and different clinically relevant cardiovascular events. METHODS AND RESULTS: This was a registry-based study of post-MI patients, referred to CR. All patients were submitted to exercise testing before and after CR (36 sessions, 2-3 times/week, and combined exercise). Patients were divided into two groups, based on the difference in exercise capacity before and after the CR programme with the cut-off of two metabolic equivalents (METs) improvement. We assessed the correlation between the extent of exercise capacity improvement and the following cardiovascular events: major adverse cardiac events (MACE), cardiovascular-related hospitalizations, and unplanned coronary angiography. A total of 499 patients were included (mean age 56 ± 10 years, 20% women). Both groups significantly improved in terms of exercise capacity, natriuretic peptide levels, resting heart rate, and resting diastolic pressure; however, lipid status significantly improved only in patients with ≥2 METs difference in exercise capacity. A total of 13.4% patients suffered MACE (median follow-up 858 days); 21.8% were hospitalized for cardiovascular reasons (median follow-up 791 days); and 19.8% had at least one unplanned coronary angiography (median follow-up 791 days). Exercise capacity improvement of ≥2 METs was associated with lower rates of MACE, cardiovascular hospitalizations, and unplanned coronary angiography in all examined univariate and multivariate models. CONCLUSION: This study has shown that exercise improvement of ≥2 METs is associated with a significant decrease in MACE, cardiac hospitalizations, and unplanned coronary angiography.

Biofortification with selenium and iodine changes morphological properties of Brassica oleracea L. var. gongylodes) and increases their contents in tubers.

Kohlrabi (Brassica oleracea L. var. gongylodes L.) was biofortified with selenium (Se), as selenite and selenate, and iodine (I), as iodide and iodate, and their combinations through foliar spraying, to study absorption of these elements by the plants, separately and in combination. The effects on selected physiological and morphological traits and optical characteristics were monitored. Treatments with Se positively affected total chlorophylls and carotenoids, and leaf stomata dimensions. Addition of I decreased total chlorophylls and increased anthocyanins. In reflectance spectra of the leaves, specific colour regions differed significantly due to the different treatments. Reflectance in the UV correlated positively with Se and I contents of the leaves, which indicated lower demand for production of phenolic compounds. Differences in reflectance in UV part of the spectra could be a consequence of changes in the cuticle. The Se and I levels increased markedly in leaves and tubers, without loss of biomass or yield. Se had antagonistic effects on accumulation of I in leaves. The similar levels of Se and I in the leaves and tubers suggest that the transport of both elements in these plants occurs from the leaves to the tubers through the phloem. According to the Se and I contents in the kohlrabi tubers, biofortification with both elements simultaneously is feasible for human nutrition.