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Advances in Clinical Practice and Research of Cardiovascular Disease: The...
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Advances in Clinical Practice and Research of Cardiovascular Disease: The Role of Physical Activity

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Sports Medicine".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 11778

Special Issue Editors

Prof. Dr. Xuemei Sui

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Guest Editor
Department of Exercise Science, University of South Carolina, Columbia, SC, USA
Interests: physical activity epidemiology; impact of cardiorespiratory fitness on health outcomes; cardiometabolic disease
Prof. Dr. Carl J. Lavie

grade E-Mail Website
Guest Editor
Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, LA, USA
Interests: cardiac rehabilitation and preventive cardiology; impact of physical activity and fitness on obesity and obesity paradox; COVID-19

Special Issue Information

Dear Colleagues,

The World Health Organization and many countries have developed physical activity guidelines due to the overwhelming evidence supporting the health benefits not only in apparently healthy individuals but also in patients with documented cardiovascular disease. In this Special Issue, we aim to gather manuscripts including reviews, original research, and meta-analyses on the role of physical activity in clinical practice and research of cardiovascular disease—a group of heart and blood vessel disorders that contribute to the majority of mortality globally. We welcome articles providing new insights into:

The impact of physical fitness on cardiovascular diseases;

The impact of resistance activity or aerobic activity on cardiovascular diseases;

New tools for clinical assessment of cardiorespiratory fitness;

Incorporating physical activity into patients’ electronic health records;

Exercise experimental studies in populations with cardiovascular diseases;

Impact of physical activity, exercise, and fitness on COVID-19 and its outcomes;

Mechanisms for the potential benefits of physical activity and fitness, as well as other related topics.

Prof. Dr. Xuemei Sui
Prof. Dr. Carl Lavie
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • physical fitness
  • aerobic activity
  • resistance exercise
  • cardiovascular disease
  • stroke
  • hypertension
  • diabetes mellitus
  • dyslipidemia
  • obesity

Published Papers (6 papers)

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Research

12 pages, 521 KiB  
Article
Personal Activity Intelligence and Ischemic Heart Disease in a Healthy Population: China Kadoorie Biobank Study
by Pål Hammer, Atefe R. Tari, Barry A. Franklin, Chi-Pang Wen, Ulrik Wisløff and Javaid Nauman
J. Clin. Med. 2022, 11(21), 6552; https://doi.org/10.3390/jcm11216552 - 04 Nov 2022
Viewed by 1848
Abstract
Background: Personal Activity Intelligence (PAI) is a physical activity metric that translates heart rate during physical activity into a simple score, where a weekly score of 100 or greater is associated with a lower risk of cardiovascular disease and mortality. Here, we prospectively [...] Read more.
Background: Personal Activity Intelligence (PAI) is a physical activity metric that translates heart rate during physical activity into a simple score, where a weekly score of 100 or greater is associated with a lower risk of cardiovascular disease and mortality. Here, we prospectively investigated the association between PAI and ischemic heart disease (IHD) mortality in a large healthy population from China. Methods: Using data from the China Kadoorie Biobank, we studied 443,792 healthy adults (60% women). The weekly PAI score of each participant was estimated based on the questionnaire data and divided into four groups (PAI scores of 0, ≤50, 51–99, or ≥100). Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for fatal IHD and nonfatal myocardial infraction (MI) related to PAI were estimated using Cox proportional hazard regression analyses. Results: There were 3050 IHD deaths and 1808 MI events during a median follow-up of 8.2 years (interquartile range, 7.3–9.1; 3.6 million person-years). After adjustments for multiple confounders, a weekly PAI score ≥ 100 was associated with a lower risk of IHD (aHR: 0.91 (95% CI: 0.83–1.00)), compared with the inactive group (0 PAI). The corresponding aHR for MI was 0.94 (95% CI: 0.83–1.05). In participants aged 60 years or older at baseline, the aHR associated with a weekly PAI score ≥ 100 was 0.84 (95% CI, 0.75–0.93) for IHD and 0.84 (95% CI, 0.73–0.98) for MI. Conclusion: Among healthy Chinese adults, a weekly PAI score of 100 or greater was associated with a lower risk of IHD mortality across all age groups; moreover, a high PAI score significantly lowered the risk of MI but only in those 60 years and older at baseline. The present findings extend the scientific evidence that PAI may have prognostic significance in diverse settings for IHD outcomes and suggest that the PAI metric may be useful in delineating the magnitude of weekly physical activity needed to reduce the risk of IHD mortality. Full article
(This article belongs to the Special Issue Advances in Clinical Practice and Research of Cardiovascular Disease: The Role of Physical Activity)
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10 pages, 702 KiB  
Article
Leisure-Time Physical Activity Has a More Favourable Impact on Carotid Artery Stiffness Than Vigorous Physical Activity in Hypertensive Human Beings
by Olga Vriz, Lucio Mos and Paolo Palatini
J. Clin. Med. 2022, 11(18), 5303; https://doi.org/10.3390/jcm11185303 - 08 Sep 2022
Cited by 3 | Viewed by 1286
Abstract
Aim. To assess the effect of leisure time versus vigorous long-term dynamic physical activity (PA) on carotid stiffness in normotensive versus hypertensive subjects. Methods. The study was conducted on 120 leisure-time exercisers and 120 competitive athletes. One hundred and twenty sedentary subjects served [...] Read more.
Aim. To assess the effect of leisure time versus vigorous long-term dynamic physical activity (PA) on carotid stiffness in normotensive versus hypertensive subjects. Methods. The study was conducted on 120 leisure-time exercisers and 120 competitive athletes. One hundred and twenty sedentary subjects served as controls. In addition, participants were classified according to whether their systolic blood pressure was ≥130 mmHg (hypertensives, n = 120) or normal (normotensives, n = 240) according to the ACC/AHA 2017 definition. Carotid artery stiffness was assessed with an echo-tracking ultrasound system, using the pressure-strain elastic modulus (EP) and one-point pulse wave velocity (PWVβ) as parameters of stiffness. Results. The effect of the two levels of PA differed in the normotensives and the hypertensives. Among the normotensives, there was an ongoing, graded reduction in EP and PWVβ from the sedentary subjects to the athletes. By contrast, among the hypertensives, the lowest levels of EP and PWVβ were found among the leisure-time PA participants. EP and PWVβ did not differ between the hypertensive sedentary subjects and the athletes. A significant interaction was found between PA and BP status on EP (p = 0.03) and a borderline interaction on PWVβ (p = 0.06). In multiple regression analyses, PA was a negative predictor of EP (p = 0.001) and PWVβ (p = 0.0001). The strength of the association was weakened after the inclusion of heart rate in the models (p = 0.04 and 0.007, respectively). Conclusions. These data indicate that in people with hypertension, leisure-time PA has beneficial effects on carotid artery stiffness, whereas high-intensity chronic PA provides no benefit to vascular functions. Full article
(This article belongs to the Special Issue Advances in Clinical Practice and Research of Cardiovascular Disease: The Role of Physical Activity)
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11 pages, 494 KiB  
Article
Cardiorespiratory Fitness and the Risk of All-Cause, Cardiovascular and Cancer Mortality in Men with Hypercholesterolemia
by Xuemei Sui, Mark A. Sarzynski, Nicole Gribben, Jiajia Zhang and Carl J. Lavie
J. Clin. Med. 2022, 11(17), 5211; https://doi.org/10.3390/jcm11175211 - 03 Sep 2022
Cited by 4 | Viewed by 1426
Abstract
Background: Whether higher cardiorespiratory fitness (CRF) confers protection against cardiovascular disease (CVD) in individuals with manifest hypercholesterolemia is poorly understood. Methods: Participants were 8920 men aged 20–82 years with hypercholesterolemia but no history of CVD and/or cancer and who received a preventive examination [...] Read more.
Background: Whether higher cardiorespiratory fitness (CRF) confers protection against cardiovascular disease (CVD) in individuals with manifest hypercholesterolemia is poorly understood. Methods: Participants were 8920 men aged 20–82 years with hypercholesterolemia but no history of CVD and/or cancer and who received a preventive examination at the Cooper Clinic in Dallas, TX, USA, during 1974–2001. CRF was quantified as maximal treadmill test duration and was grouped for analysis as low, moderate, or high based on the traditional Aerobics Center Longitudinal Study cutpoints. Using Cox regression analyses, we computed hazard ratios and 95% confidence intervals for risk of mortality based on CRF. Results: During an average of 17 years of follow-up, 329 CVD and 290 cancer deaths occurred. After control for baseline age, examination year, body mass index, total cholesterol, smoking, alcohol intake, physical activity, hypertension, diabetes, and parental history of CVD, hazard ratios (95% confidence interval) for CVD deaths across moderate and high categories of CRF (with low fit as referent) were: 0.66 (0.50–0.87) and 0.55 (0.39–0.79), respectively. There was an inverse association between CRF and CVD death among normal-weight (trend p < 0.0001), younger (<60 y, trend p = 0.01), and inactive men (trend p = 0.002). However, no significant association was found between CRF and cancer mortality. Conclusions: Among men with hypercholesterolemia, higher CRF was associated with a lower risk of dying from CVD independent of other clinical risk factors. Our findings underscored the importance of promoting CRF in the primary prevention of CVD in patients with hypercholesterolemia. Full article
(This article belongs to the Special Issue Advances in Clinical Practice and Research of Cardiovascular Disease: The Role of Physical Activity)
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9 pages, 621 KiB  
Article
Normal References of Peak Oxygen Uptake for Cardiorespiratory Fitness Measured with Cardiopulmonary Exercise Testing in Chinese Adults
by Yan Wang, Huijuan Li, Juan Wang, Wei Zhao, Zhipeng Zeng, Li Hao, Yifang Yuan, Yuwei Lin, Yangfeng Wu and Zhengzhen Wang
J. Clin. Med. 2022, 11(16), 4904; https://doi.org/10.3390/jcm11164904 - 21 Aug 2022
Cited by 1 | Viewed by 1684
Abstract
Introduction: This study aims to establish normal reference values of peak oxygen uptake (VO2peak) for cardiorespiratory fitness (CRF) in Chinese adults using cardiorespiratory exercise testing (CPET). Methods: A cross-sectional study was done in four communities, two in the North (Beijing) and [...] Read more.
Introduction: This study aims to establish normal reference values of peak oxygen uptake (VO2peak) for cardiorespiratory fitness (CRF) in Chinese adults using cardiorespiratory exercise testing (CPET). Methods: A cross-sectional study was done in four communities, two in the North (Beijing) and two in the South (Hezhou, Guangxi) of China from 1 January 2017 to 31 December 2018, with one urban and one rural in each region. Out of 1642 participants screened, 1114 were eligible and completed CPET using a cycle ergometer (Ergosana320F) without abnormal ECG and were included in the analysis. The 2nd and 98th percentiles of V·O2peak were used as the lower and upper limits of the normal reference values. Results: Significant difference in mean V·O2peak was shown between men (27.0 mL·min−1·kg−1) and women (23.7 mL·min−1·kg−1). The mean V·O2peak decreased with age in both sexes, from 35.8 mL·min−1·kg−1 in age 20–29 years to 20.5 mL·min−1·kg−1 in 70–79 years in men and from 29.2 mL·min−1·kg−1 to 17.0 mL·min−1·kg−1 in women. Thus, the age- and sex-specific normal reference values of V·O2peak were presented for each 10-year age group by men and women separately. Conclusions: This first community-based study in China provides age- and sex-specific normal references of V·O2peak as a measure of CRF in Chinese adults, which differed significantly from those established in Western populations. Future studies with national representative samples should be warranted. Full article
(This article belongs to the Special Issue Advances in Clinical Practice and Research of Cardiovascular Disease: The Role of Physical Activity)
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14 pages, 1017 KiB  
Article
Effect of the COVID-19 Pandemic on Physical Activity and Sedentary Behavior in Older Adults
by Elizabeth C. Lefferts, Joseph M. Saavedra, Bong Kil Song and Duck-chul Lee
J. Clin. Med. 2022, 11(6), 1568; https://doi.org/10.3390/jcm11061568 - 12 Mar 2022
Cited by 17 | Viewed by 2920
Abstract
Whether the COVID-19 pandemic has long-lasting effects on physical activity (PA) and sedentary behavior in the vulnerable older adult population is uncertain. A total of 387 older adults (75 ± 6 years) completed a retrospective questionnaire on time spent sitting, walking, and performing [...] Read more.
Whether the COVID-19 pandemic has long-lasting effects on physical activity (PA) and sedentary behavior in the vulnerable older adult population is uncertain. A total of 387 older adults (75 ± 6 years) completed a retrospective questionnaire on time spent sitting, walking, and performing aerobic and muscle-strengthening PA before, during the first three months, and one year into the COVID-19 pandemic. Whether the participants met the aerobic and muscle-strengthening PA guidelines was then determined. Of the 387 older adults, 376 (97%) were vaccinated. The participants completed 361 ± 426, 293 ± 400, and 454 ± 501 min/week of moderate-to-vigorous aerobic PA before, during the first three months, and one year into the pandemic, respectively. During the same time periods, the participants performed muscle-strengthening PA 87 ± 157, 68 ± 163, and 90 ± 176 min/week, walked 2.4 ± 1.7, 2.3 ± 1.7, and 2.6 ± 1.9 h/day, and sat 6.2 ± 2.9, 7.4 ± 3.1, and 6.1 ± 2.9 h/day, respectively. Aerobic PA, muscle-strengthening PA, and walking time decreased, whereas sitting time increased, during the first three months of the pandemic (p < 0.05), and then returned to pre-pandemic levels after one year (p < 0.05). The percentage of participants meeting both aerobic and muscle-strengthening PA guidelines decreased during the first three months of the pandemic (48.9% to 33.5%, p < 0.001), but returned to pre-pandemic levels one year later (p < 0.001). In conclusion, the COVID-19 pandemic significantly decreased PA and increased sitting time in older adults; however, both PA and sitting time returned to pre-pandemic levels after one year. Full article
(This article belongs to the Special Issue Advances in Clinical Practice and Research of Cardiovascular Disease: The Role of Physical Activity)
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10 pages, 964 KiB  
Article
High Levels of Sedentary Time in Patients with COVID-19 after Hospitalisation
by Bram M. A. van Bakel, Frederik M. A. van den Heuvel, Jacqueline L. Vos, Hajar Rotbi, Esmée A. Bakker, Robin Nijveldt, Dick H. J. Thijssen and Thijs M. H. Eijsvogels
J. Clin. Med. 2022, 11(4), 1110; https://doi.org/10.3390/jcm11041110 - 19 Feb 2022
Cited by 4 | Viewed by 1692
Abstract
Many patients with COVID-19 experience severe and even fatal disease. Survivors may have long-term health consequences, but data on physical activity and sedentary behaviour are scarce. Therefore, we objectively assessed physical activity (PA) patterns among post-hospitalised patients with COVID-19 and explored associations with [...] Read more.
Many patients with COVID-19 experience severe and even fatal disease. Survivors may have long-term health consequences, but data on physical activity and sedentary behaviour are scarce. Therefore, we objectively assessed physical activity (PA) patterns among post-hospitalised patients with COVID-19 and explored associations with patient characteristics, disease severity and cardiac dysfunction. We objectively assessed PA, sedentary behaviour and sleep duration for 24 h/day during 8 days at 3-6 months after COVID-19 hospitalisation. PA and sedentary time were compared across pre-defined subgroups based on patient and disease characteristics, cardiac biomarker release during hospitalisation, abnormal transthoracic echocardiogram at 3-6 months post-hospitalisation and persistence of symptoms post-discharge. PA and sedentary behaviour were assessed in 37 patients (60 ± 10 years old; 78% male). Patients spent 4.2 [3.2; 5.3] h/day light-intensity PA and 1.0 [0.8; 1.4] h/day moderate-to-vigorous intensity PA. Time spent sitting was 9.8 [8.7; 11.2] h/day, which was accumulated in 6 [5; 7] prolonged sitting bouts (≥30 min) and 41 [32; 48] short sitting bouts (<30 min). No differences in PA and sedentary behaviour were found across subgroups, but sleep duration was higher in patients with versus without persistent symptoms (9.1 vs. 8.3 h/day, p = 0.02). Taken together, high levels of sedentary time are common at 3–6 months after COVID-19 hospitalisation, whilst PA and sedentary behaviour are not impacted by patient or disease characteristics. Full article
(This article belongs to the Special Issue Advances in Clinical Practice and Research of Cardiovascular Disease: The Role of Physical Activity)
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