Unsupervised Exercise Intervention vs. Adherence to a Mediterranean Diet Alone: The Role of Bioelectrical Impedance Vector Analysis and Cardiovascular Performance in Liver-Transplanted Recipients.

(1) Background: Cardiovascular disease is one of the leading causes of mortality after liver transplantation. Body composition and cardiovascular performance assessment represent a potential approach for modulating lifestyle correction and proper follow-up in chronic disease patients. This study aimed to verify the additional role of an unsupervised physical activity program in a sample of male liver transplant recipients who follow the Mediterranean diet. (2) Methods: Thirty-three male liver transplant recipients were enrolled. Sixteen subjects followed a moderate-intensity home exercise program in addition to nutritional support, and seventeen received advice on the Mediterranean diet. After six months, bioelectrical vector impedance analysis (BIVA) and cardiopulmonary exercise testing (CPET) were performed. (3) Results: No differences in CPET (VO2 peak: exercise 21.4 ± 4.1 vs. diet 23.5 ± 6.5 mL/kg/min; p = 0.283) and BIVA (Z/H: exercise 288.3 ± 33.9 vs. diet 310.5 ± 34.2 Ω/m; p = 0.071) were found. Furthermore, the BIVA values of resistance correlate with the submaximal performance of the Ve/VCO2 slope (R = 0.509; p < 0.05) and phase angle with the maximal effort of the VO2 peak (R = 0.557; p < 0.05). (4) Conclusions: Unsupervised physical exercise alone for six months does not substantially modify liver transplant recipients' cardiovascular performance and hydration status, despite their adherence to a Mediterranean diet. The body composition analysis is useful to stratify the risk profile, and it is potentially associated with better outcomes in transplanted subjects.

Side Bioimpedance Analysis in Menopausal Post-Oncological Breast Cancer.

BACKGROUND: Post-oncological BC (breast cancer) has an increased cardiovascular risk due to the variation of some anthropometric parameters. This study investigates the differences between a quadrantectomy and a mastectomy on the body composition over time in presence of a breast prothesis. METHODS: A group of BC patients (n = 41 aged 56.6 ± 9.5 years; 15 mastectomy patients; and 26 quadrantectomy patients) were compared to controls (C) (n = 22 aged 46.5 ± 13.44 years). Through bioimpedance analysis (Akern-BIA 101), the body mass index (BMI), total body water (TBW), extracellular water (ECW), body cell mass (BCM), fat mass (FM), free fat mass (FFM), and angle phase (PA) were compared within each group and between different groups using the Student's Test T. RESULTS: The BC group showed lower values of FFM and TBW compared to C. The FFM was significantly (p = 0.04) lower in those with quadrantectomy. The right hemisome of the quadrantectomy has increased values of FFM, BCM (p = 0.04) and TBW compared to the counter-lateral hemisome, and FM values (p = 0.0008) lower than the counter-lateral. The hemisome with intervention has increased values of FM and ECW compared to the counter lateral, as well the FFM, BCM, TBW, and PA. CONCLUSIONS: The results support the hypothesis that non-conservative surgical treatment (mastectomy) is associated with a better BIA profile without any substantial impact of breast implants in the body composition analysis. The awareness of a severe diseases could play a role to ameliorate lifestyle; however, further studies will be necessary to support this theory.

Coronary Inflammation by Computed Tomography Pericoronary Fat Attenuation in MINOCA and Tako-Tsubo Syndrome.

Background The pericoronary fat attenuation index (pFAI) has emerged as a marker of coronary inflammation, which is measurable from standard coronary computed tomography angiography (CCTA). It compares well with gold-standard methods for the assessment of coronary inflammation and can predict future cardiovascular events. pFAI could prove invaluable to differentiate an inflammatory from a noninflammatory coronary artery status, helping unravel the mechanisms subtending an event classified as myocardial infarction with nonobstructive coronary arteries (MINOCA) or Tako-Tsubo syndrome (TTS). Methods and Results Patients admitted with MINOCA and TTS between 2011 and 2018, who had both CCTA and cardiac magnetic resonance during or shortly after the acute phase, were selected and pFAI measured in their CCTA; pFAI was also measured in control subjects who had CCTA for atypical chest pain workup, no obstructive coronary artery disease found in their CCTA, and no cardiac events at 2-year follow-up. In the n=106 MINOCA/TTS patients, mean pFAI was -68.37±8.29 versus -78.03±6.20 in the n=106 controls (P<0.0001), and the difference was confirmed also when comparing mean pFAI in each coronary artery between MINOCA/TTS and controls (P<0.0001). Nonobstructive coronary plaques at CCTA, high-risk plaques in particular, were more frequently found (P<0.01) in the MINOCA/TTS group compared with controls. Conclusions In MINOCA and TTS patients, CCTA is not only able to detect angiographically invisible atherosclerotic plaques, but its diagnostic yield can be expanded using the simple measurement of pFAI to characterize pericoronary fat tissue; in MINOCA/TTS mean pFAI demonstrates higher values compared with controls, a finding that has been associated with coronary artery inflammation.