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ABSTRACT: We compared, head-to-head, the old generation Actigraph model 7164 with the new generation Actigraph GT1M accelerometer. A total of 15 randomly selected teenagers (eight girls and seven boys) were investigated. They performed a treadmill test wearing the two kinds of accelerometers around the waist simultaneously. The treadmill test consisted of three different levels of speed 4, 6 and 8 km h(-1) for four consecutive minutes. Accelerometer counts per 1 sec epoch for the Actigraph GT1M versus the Actigraph 7164 were at 4 km h(-1) 21·6 ± 12·9 versus 26·5 ± 11·5 counts, at 6 km h(-1) 56·0 ± 23·2 versus 62·9 ± 25·6 counts and at 8 km h(-1) 142·6 ± 37·2 versus 156·4 ± 34·9 counts (P<0·01 for all levels of speed). Data from the old generation Actigraph 7164 and the new generation Actigraph GT1M accelerometers differ, where the Actigraph GT1M generates 10-23% lower values. Correction equation for Actigraph GT1M was Actigraph 7164 = 5·2484 + Actigraph GT1M counts × 1·0448. These results need to be taken into consideration when using these devices.
Clinical Physiology and Functional Imaging 03/2013; 33(2):162-5. · 1.33 Impact Factor
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ABSTRACT: Limited data exist of tracking and changes in accelerometer-measured physical activity in children.
Physical activity was assessed by accelerometers for 4 days in 167 children (boys, n = 90; girls n = 77) age 9.8 ± 0.6 years. Follow-up measurement was made 2.0 ± 0.1 yrs later (range 1.9-2.1 yrs). General physical activity (GPA) was defined as mean count/minute. Minutes of inactivity; light, moderate, and vigorous physical activity (LMVPA); moderate and vigorous physical activity (MVPA); and vigorous physical activity (VPA) per day were calculated both as absolute values and as percentage of total registration time.
Spearman rank order correlation indicated low tracking of MVPA and VPA in girls (r = .25-0.33, P < .05), and low-moderate tracking of GPA, inactivity, LMVPA, MVPA and VPA in boys (r = .23-0.40, P < .05). Time in inactivity increased at follow-up by 5%-14%. Most of the assessed physical activity variables were decreased at follow-up by 6% to 30%.
Physical activity tracks at a low-moderate degree from age 10-12 years, which confirm previous investigations that have used self-report assessments. The low-moderate tracking of physical activity variables indicate that those who were most active initially remained most active. Increasing inactive behavior was observed and that several other physical activity variables were decreased at follow-up.
Journal of Physical Activity and Health 02/2013; 10(2):241-8.
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ABSTRACT: We studied the effect in children of an exercise intervention program on fracture rates and skeletal traits. Fractures were registered for 5 years in a population-based prospective controlled exercise intervention study that included children aged 6-9 years at study start, 446 boys and 362 girls in the intervention group and 807 boys and 780 girls in the control group. Intervention subjects received 40 min/school day of physical education and controls, 60 min/week. In 73 boys and 48 girls in the intervention group and 52 boys and 48 girls in the control group, bone mineral density (BMD, g/cm(2)) and bone area (mm(2)) were followed annually by dual-energy X-ray absorptiometry, after which annual changes were calculated. At follow-up we also assessed trabecular and cortical volumetric BMD (g/cm(3)) and bone structure by peripheral computed tomography in the tibia and radius. There were 20.0 fractures/1,000 person-years in the intervention group and 18.5 fractures/1,000 person-years in the control group, resulting in a rate ratio of 1.08 (0.79-1.47) (mean and 95 % CI). The gain in spine BMD was higher in both girls (difference 0.01 g/cm(2), 0.005-0.019) and boys (difference 0.01 g/cm(2), 0.001-0.008) in the intervention group. Intervention girls also had higher gain in femoral neck area (difference 0.04 mm(2), 0.005-0.083) and at follow-up larger tibial bone mineral content (difference 0.18 g, 0.015-0.35), larger tibial cortical area (difference 17 mm(2), 2.4-31.3), and larger radial cross-sectional area (difference 11.0 mm(2), 0.63-21.40). As increased exercise improves bone mass and in girls bone size without affecting fracture risk, society ought to encourage exercise during growth.
Calcified Tissue International 01/2013; · 2.38 Impact Factor
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ABSTRACT: INTRODUCTION: Children and adolescents are encouraged to maintain a habitually active lifestyle because of the known health benefits associated with regular physical activity, but there are some reports that a high level of activity may be associated with increased fracture risk. This prospective controlled exercise intervention study in pre-pubertal children evaluated if a school-based exercise intervention could enhance growth related gains in muscle strength and muscular function without affecting fracture risk. METHODS: Fractures were registered in 417 girls and 500 boys aged 7-9 years in the intervention and in 836 age-matched girls and 872 boys. The intervention included 40 minutes/day of school physical education for two years whereas the controls achieved 60 minutes/week. In a subsample consisting of 49 girls and 80 boys in the intervention and 50 girls and 53 boys in the control group, body composition was measured by dual X-ray absorptiometry (DXA), muscle strength by isokinetic Peak Torque (PT) of the knee extensors and flexors at 60 and 180 °/seconds by a computerized dynamometer and neuromuscular performance by Vertical Jump Height (VJH). RESULTS: The rate ratio [RR (95% confidence interval)] for children in the intervention group to sustain a fracture was 1.07 (0.66, 1.68). The annual gain in knee extensor PT at 180°/seconds was significantly higher for both girls (p<0.001) and boys (p<0.01) in the intervention compared to the control group. Boys in the intervention group also had a greater annual gain in knee flexion PT at 180 °/seconds (p<0.001) and girls a greater gain in VJH (p<0.05). CONCLUSIONS: An increase in school-based physical education from 60 to 200 min/week enhanced muscle strength in pre-pubertal children without affecting fracture risk.
Medicine and science in sports and exercise 11/2012; · 3.71 Impact Factor
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ABSTRACT: Vacuum-assisted wound closure (VAC®) therapy is considered to be superior to conventional dressings in the treatment of peri-vascular groin infections after vascular surgery at our department. Therefore, we wanted to perform an early interim analysis of clinical outcome in these seriously ill patients at risk for amputation and death. Patients were randomised to either VAC® (n = 5) or Sorbalgon® (n = 5; best other treatment) therapy after surgical debridement. Non-invasive laser Doppler perfusion imaging (LDPI) studies of the skin adjacent to the undressed wound were performed after 14 days of wound treatment. There were no difference in LDPI values in VAC® versus Sorbalgon® treated patients (P = 0·46). One patient in the VAC® group suffered from two re-bleeding episodes, leading to vascular resection and transfemoral amputation and in the Sorbalgon® group two had a complete wound healing time of more than 4 months and one had a visible interposition bypass graft in the groin after 1 month of treatment. No patient died due to the groin infection. Although not statistically proven, fewer wound treatment failures were recorded in the VAC® group, justifying this early interim analysis. LDPI studies were feasible.
International Wound Journal 06/2012; · 1.46 Impact Factor
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ABSTRACT: Most prospective pediatric exercise intervention studies cover <1 year and use bone traits as surrogate end points for fractures. This prospective controlled exercise intervention study therefore followed not only skeletal development but also fracture incidence for 4 years.
Fractures were prospectively registered in a cohort of children aged 7 to 9 years, 446 boys and 362 girls in the intervention group (2675 person-years) and 807 boys and 780 girls in the control group (5661 person-years). The intervention included 40 minutes per day of school physical education for 4 years whereas the controls had 60 minutes per week. In a subsample, 73 boys and 48 girls in the intervention and 52 boys and 48 girls in the control group, bone mineral content (g) and bone width (cm) were followed by means of dual-energy radiograph absorptiometry.
The rate ratio for fractures was 1.11. In the dual-energy radiograph absorptiometry-measured children, there were no group differences at baseline in age, anthropometrics, or bone traits. The mean annual gain in lumbar spine bone mineral content was 7.0% higher in girls and 3.3% higher in boys and in femoral neck width 1.7% higher in girls and 0.6% higher in boys in the intervention than in the control group.
A population-based moderately intense 4-year exercise program in 7- to 9-year-old children increased bone mass and size without affecting the fracture risk.
PEDIATRICS 05/2012; 129(6):e1468-76. · 4.47 Impact Factor
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ABSTRACT: We analysed whether total body fat (TBF), abdominal fat and body fat distribution are associated with higher composite risk factor scores for cardiovascular disease (CVD) in young children.
Cross-sectional study of 238 children aged 8-11 years. TBF and abdominal fat mass (AFM) were measured by Dual-Energy X-Ray Absorptiometry. TBF was expressed as a percentage of body weight (BF%). Body fat distribution was calculated as AFM/TBF. Maximal oxygen uptake (VO(2PEAK) ), systolic and diastolic blood pressure (SBP, DBP), and resting heart rate (RHR) were measured. Mean arterial pressure (MAP) and pulse pressure (PP) were calculated. Left atrial diameter (LA) was measured, and left ventricular mass (LVM) and relative wall thickness (RWT) were calculated. Z-scores were calculated. Sum of z-scores for SBP, DBP, MAP, PP, RHR, LVM, LA, RWT and -VO(2PEAK) was calculated in boys and girls, separately, and used as composite risk factor score.
Pearson correlations between ln BF%, ln AFM and AFM/TBF versus composite risk factor score for boys were r = 0.56, r = 0.59 and r = 0.48, all p < 0.001, and for girls r = 0.45, r = 0.50 and r = 0.48, all p < 0.001.
Total body fat, abdominal fat and body fat distribution were all associated with higher composite risk factor scores for CVD in young children.
Acta Paediatrica 03/2012; 101(8):852-7. · 2.07 Impact Factor
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ABSTRACT: Previous studies on associations between reduced lung function and cardiovascular disease (CVD) have mainly been based on forced expiratory volume in 1-s (FEV(1) ) and vital capacity (VC). This study examined potential associations between five different lung function variables and plaques in the internal carotid artery (ICA).
Subjects (n = 450) from a previous population-based respiratory questionnaire survey [current smokers without lower respiratory symptoms, subjects with a self-reported diagnosis of chronic obstructive pulmonary disease (COPD) and never-smokers without lower respiratory symptoms] were examined using spirometry, body plethysmography and measurements of diffusing capacity for CO (D(L,CO) ). Plaques in the ICA were assessed by ultrasonography.
Two hundred and twenty subjects were current smokers, 139 ex-smokers and 89 never-smokers. COPD was diagnosed in 130 subjects (GOLD criteria). Plaques in the ICA were present in 231 subjects (52%). General linear analysis with adjustment for established risk factors for atherosclerosis, including C-reactive protein, showed that D(L,CO) was lower [77.4% versus 83.7% of predicted normal (PN), P = 0.014] and residual volume (RV) was higher (110.3% versus 104.8% of PN, P = 0.020) in subjects with than without plaques in the ICA. This analysis did not show any statistically significant association between plaques and FEV(1) or VC.
The occurrence of plaques in the ICA was associated with low D(L,CO) and high RV, but not significantly with FEV(1) or COPD status. The results suggest that the relationships between reduced lung function, COPD and CVD are complex and not only linked to bronchial obstruction and low-grade systemic inflammation.
Clinical Physiology and Functional Imaging 03/2012; 32(2):120-5. · 1.33 Impact Factor
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ABSTRACT: BACKGROUND: Limited data exists of tracking and changes in accelerometer measured physical activity in children. METHODS: Physical activity was assessed by accelerometers for four days in 167 children (boys n=90, girls n=77), aged 9.8±0.6 years. Follow-up measurement was made 2.0±0.1 yrs later (range 1.9-2.1 yrs). General physical activity (GPA) was defined as mean count/minute. Minutes of inactivity, light- moderate- and vigorous physical activity (LMVPA), moderate and vigorous physical activity (MVPA) and vigorous physical activity (VPA) per day were calculated both as absolute values and as percentage of total registration time. RESULTS: Spearman rank order correlation indicated low tracking of MVPA and VPA in girls (r=0.25-0.33, P<0.05), and low-moderate tracking of GPA, inactivity, LMVPA, MVPA and VPA in boys (r=0.23-0.40, P<0.05). Time in inactivity increased at follow-up by 5-14%. Most of the assessed physical activity variables were decreased at follow-up by 6-30%. CONCLUSIONS: Physical activity tracks at a low-moderate degree from age 10 to age 12 years, which confirm previous investigations that have used self-report assessments. The low-moderate tracking of physical activity variables indicate that those who were most active initially remained most active. Increasing inactive behaviour was observed and that several other physical activity variables were decreased at follow-up.
Journal of Physical Activity and Health 02/2012;
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ABSTRACT: This study assessed short-term and long-term effects of a 3-yr controlled school-based physical activity (PA) intervention on fatness, cardiorespiratory fitness (VO(2peak)) and CVD risk factors in children.
The study involved 18 schools (10 intervention and 8 controls) and included a follow-up 4 yr after the end of intervention. The analyses included 696, 6- to 7-yr-old children at baseline, 612 postintervention (age 9.5 yr) and 441 at follow-up (age 13.4 yr). The intervention consisted of a doubling of the amount of physical education (PE; from 90 to 180 min·wk(-1)), training of PE teachers, and upgrading of PE and playing facilities. Anthropometrics and systolic blood pressure (SBP) were measured. VO(2peak) was directly measured, and PA was assessed using accelerometry. Fasting blood samples were analyzed for CVD risk factors. A composite risk score was computed from z-scores of SBP, triglycerides, total cholesterol-to-HDL cholesterol ratio, homeostatic model assessment (HOMA score), skinfolds, and inverse VO(2peak).
The HOMA score of the intervention group boys had a smaller increase from baseline to postintervention compared with control boys (P = 0.004). From baseline to follow-up intervention group boys had a smaller increase in SBP compared with control boys (P = 0.010). There were no other significant differences between groups.
This 3-yr school-based PA intervention caused positive changes in SBP and HOMA score in boys but not in girls, and no effects were seen in PA, VO(2peak), fatness, and the other measured CVD risk factors. Our results indicate that a doubling of PE and providing training and equipment may not be sufficient to induce major improvements in CVD risk factors in a normal population.
Medicine and science in sports and exercise 01/2012; 44(7):1310-7. · 3.71 Impact Factor
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ABSTRACT: Ingestion of a meal increases the blood flow to the gastrointestinal organs and affects the heart rate (HR), blood pressure and cardiac output (CO), although the mechanisms are not known. The aim of this study was to evaluate the effect of endogenously released glucose, insulin, glucagon-like peptide 1 (GLP-1), ghrelin on CO, HR, stroke volume (SV), and blood pressure.
Eleven healthy men and twelve healthy women ((mean ± SEM) aged: 26 ± 0.2 y; body mass index: 21.8 ± 0.1 kg/m(2))) were included in this study. The CO, HR, SV, systolic and diastolic blood pressure, antral area, gastric emptying rate, and glucose, insulin, GLP-1 and ghrelin levels were measured.
The CO and SV at 30 min were significantly higher, and the diastolic blood pressure was significantly lower, than the fasting in both men and women (P < 0.05). In men, significant correlations were found between GLP-1 level at 30 min and SV at 30 min (P = 0.015, r = 0.946), and between ghrelin levels and HR (P = 0.013, r = 0.951) at 110 min. Significant correlations were also found between the change in glucose level at 30 min and the change in systolic blood pressure (P = 0.021, r = -0.681), and the change in SV (P = 0.008, r = -0.748) relative to the fasting in men. The insulin 0-30 min AUC was significantly correlated to the CO 0-30 min AUC (P = 0.002, r = 0.814) in men. Significant correlations were also found between the 0-120 min ghrelin and HR AUCs (P = 0.007, r = 0.966) in men. No statistically significant correlations were seen in women.
Physiological changes in the levels of glucose, insulin, GLP-1 and ghrelin may influence the activity of the heart and the blood pressure. There may also be gender-related differences in the haemodynamic responses to postprandial changes in hormone levels. The results of this study show that subjects should not eat immediately prior to, or during, the evaluation of cardiovascular interventions as postprandial affects may affect the results, leading to erroneous interpretation of the cardiovascular effects of the primary intervention.
NCT01027507.
Cardiovascular Ultrasound 12/2011; 9:43. · 1.26 Impact Factor
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ABSTRACT: Low aerobic fitness (maximum oxygen uptake (VO(2 PEAK))) is predictive for poor health in adults. In a cross-sectional study, we assessed if VO(2 PEAK) is related to a composite risk factor score for cardiovascular disease (CVD) in 243 children (136 boys and 107 girls) aged 8 to 11 years. VO(2 PEAK) was assessed by indirect calorimetry during a maximal exercise test and scaled by body mass (milliliters per minute per kilogram). Total body fat mass (TBF) and abdominal fat mass (AFM) were measured by Dual-energy X-ray absorptiometry. Total body fat was expressed as a percentage of total body mass (BF%) and body fat distribution as AFM/TBF. Systolic and diastolic blood pressure (SDP and DBP) and resting heart rate (RHR) were measured. The mean artery pressure (MAP) and pulse pressure (PP) were calculated. Echocardiography, 2D-guided M-mode, was performed. Left atrial diameter (LA) was measured and left ventricular mass (LVM) and relative wall thickness (RWT) were calculated. Z scores (value for the individual - mean value for group)/SD were calculated by sex. The sum of z scores for DBP, SDP, PP, MAP, RHR, LVM, LA, RWT, BF%, AFM and AFM/TBF were calculated in boys and girls, separately, and used as composite risk factor score for CVD. Pearson correlation revealed significant associations between VO(2 PEAK) and composite risk factor score in both boys (r = -0.48 P < 0.05) and in girls (r = -0.42, P < 0.05). One-way ANOVA analysis indicated significant differences in composite risk factor score between the different quartiles of VO(2 PEAK) (P < 0.001); thus, higher VO(2 PEAK) was associated with lower composite risk factor score for CVD. In conclusion, low VO(2 PEAK) is associated with an elevated composite risk factor score for CVD in both young boys and girls.
European Journal of Pediatrics 12/2011; 171(4):705-10. · 1.88 Impact Factor
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ABSTRACT: The aim of this study was to assess cardiovascular predictors for all-cause long-term mortality in patients undergoing standard endovascular aneurysm repair (EVAR) for infrarenal abdominal aortic aneurysm (AAA). Consecutive patients treated with EVAR (Zenith(®) stent grafts; Cook) between May 1998 and February 2006 were prospectively enrolled in a computerized database, together with retrospectively collected data on medication, and electrocardiographic and echocardiographic variables. Mortality was assessed on 1 December 2010. The median follow-up time was 68 months and the median age was 74 years (range 53-89) for the 304 patients. Mortality at the end of follow-up was 54.3% (165/304). The proportion of deaths caused by vascular diseases was 61% (101/165). In the univariate analysis, low preoperative ejection fraction (EF) (p = 0.004), absence of statin medication (p = 0.007), and medication with diuretics (p = 0.028) or digitalis (p = 0.016) were associated with an increased long-term mortality rate. Myocardial ischemia on electrocardiogram (ECG) (hazard ratio (HR) 1.6 [95% CI 1.1-2.4]) and anemia (HR 1.5 [95% CI 1.0-2.1]) were found to be independent predictors for long-term mortality after Cox regression analysis. There was a trend that chronic kidney disease, stage ≥ 3 (HR 1.5 [95% CI 1.0-2.2]), and age 80 years and above (HR 1.5 [95% CI 1.0-2.4]) were independently associated with long-term mortality. In conclusion, ischemia on ECG and anemia were independently related to an increased long-term mortality rate after EVAR, and these predictive factors seem to be most important for critical assessment in the preoperative medical work-up.
Vascular Medicine 12/2011; 16(6):422-7. · 1.46 Impact Factor
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ABSTRACT: Lipid embolizations from retransfused shed blood during cardiac surgery have been shown to enter the circulation and end up in different organs. The purpose of this investigation was to evaluate differences in the kinetics and deposition between emulsified and non-emulsified lipid emboli in a porcine model.
Twelve animals were anesthetized and put on cardiopulmonary bypass. A shed-blood phantom (6 animals given emulsified and 6 given non-emulsified lipids) was produced from arterial blood, saline, and tritium-labeled triolein. The phantom was infused into the cardiopulmonary bypass circuit. Arterial and venous blood samples were taken at short intervals. Tissue samples were taken post-mortem from examined organs and prepared for scintillation counting. Levels of radioactivity were used to measure lipid emboli content in blood and tissue.
Emulsified lipid emboli generated a 5-fold higher embolic load in the arterial and a 12-fold higher in the venous circulation, compared with non-emulsified lipid emboli. Emulsified lipid micro emboli resulted in a 2-15-fold higher tissue deposition in investigated organs compared with non-emulsified lipid micro emboli.
This study shows that the state of emulsion significantly alter the kinetics and tissue deposition of lipid emboli. Emulsified lipid emboli give higher embolic load in the arterial and venous circulation, and higher tissue deposition versus non-emulsified lipid emboli. In both groups, the embolic load was higher in the arterial circulation than on the venous side.
Scandinavian cardiovascular journal: SCJ 11/2011; 46(1):51-6. · 1.07 Impact Factor
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ABSTRACT: Cardiovascular (CVD) risk factors have been shown to cluster in some children. This has been shown in children from the age of nine years, but recently we found no clustering in six-year old children. It is uncertain when clustering develops and which parameters are related to the development of clustered CVD risk.
A longitudinal study including 484 children aged six years. Three years later, 434 children participated in a follow-up. The main outcome was clustering of five CVD risk factors: homeostasis assessment insulin resistance (HOMA), total cholesterol:HDL ratio, triglyceride (TG), systolic blood pressure and sum of four skinfolds. Independent variables were physical activity and cardiorespiratory fitness.
CVD risk factors were independently distributed in the six-year-olds, and there was no association between composite risk factor score and physical fitness or activity even if there were obese and unfit children in the population. Clustering of CVD risk factors was found at the age of nine years, and the observed number with three or more CVD risk factors was 3.33 (95% CI: 1.41-7.87) times higher than expected if risk factors had been independently distributed. At the age of nine years, the lowest quartile of fitness had 34.9 (95% CI: 8.0-152.5) times higher risk of having clustered risk than the most fit quartile.
Clustering of CVD risk factors developed between the age of six and nine years. At nine years of age clustered CVD risk was highly associated with low fitness level.
International journal of pediatric obesity: IJPO: an official journal of the International Association for the Study of Obesity 09/2011; 6 Suppl 1:29-34. · 2.00 Impact Factor
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ABSTRACT: This study evaluates the effect of food intake on commonly used pulsed Doppler and tissue Doppler measurements.
Twenty-three healthy subjects aged 25.6 ± 4.5 years were investigated. A wide selection of pulsed Doppler and tissue Doppler variables were measured before a standardized meal as well as and 30 and 110 minutes afterwards.
The following variables increased significantly (P < 0.05) 30 minutes after food intake: left ventricular stroke volume, left ventricular cardiac output, left ventricular outflow velocity-time integral, peak of early diastolic (E) and late diastolic (A) mitral flow velocities, pulmonary vein peak velocities in systole (S) and in diastole (D), S/D, pulsed tissue Doppler peak systolic velocities, and late diastolic velocities. Deceleration time of E-wave decreased significantly (P < 0.05). The change in measured variables between fasting and 30 minutes after the food intake ranged from 7% to 28%. There were no significant (P > 0.05) changes in E/A, early diastolic tissue Doppler velocities (e'), and E/e'. Most, but not all variables returned to baseline values 110 minutes after food intake.
This study shows that food intake affects several echocardiographic variables used to routinely assess diastolic function and hemodynamics. Further studies are warranted in older healthy subjects and in patients with various cardiac diseases to determine whether the findings are reproducible in such populations.
Echocardiography 08/2011; 28(8):843-7. · 1.24 Impact Factor
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ABSTRACT: In adults, the size of the left atria (LA) has important prognostic information. In obese adults, adolescents and children enlargement of LA have been observed. This has not been investigated on a population-based level in young children. We therefore assessed if total body fat mass (TBF), abdominal fat, and body fat distribution were related to LA diameter. Cross-sectional study of 244 children (boys = 137 and girls n = 107) aged 8-11 years, recruited from an urban population-based cohort. Dual-energy X-ray absorptiometry (DXA) measured total lean body mass, TBF, and abdominal fat mass (AFM). Body fat was also calculated as a percentage of body mass (BF%). Body fat distribution (AFM/TBF) was calculated. Echocardiography was performed with two-dimensional guided M-mode. LA diameter was measured and left ventricular mass (LVM) was calculated. Systolic blood pressure and diastolic blood pressure were measured and maturity assessed according to Tanner. There were significant (P < 0.05) univariate correlations for all children between TBF (r = 0.40), BF% (r = 0.32), AFM (r = 0.41), and AFM/TBF (r = 0.41) vs. LA diameter. Multiple regression analyses with the inclusion of possible confounders such as lean body mass, blood pressure, gender, age, and Tanner stage revealed that TBF, AFM, and AFM/TBF were all independently related to LA diameter. Differences in the different body fat measurements explained 6-9% of the variance in LA size. These results demonstrated that both total body fat, AFM, and body fat distribution are already at a young age negatively and independently associated to LA diameter.
Obesity 08/2011; 20(5):1104-8. · 4.28 Impact Factor
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ABSTRACT: This study was designed to assess aorto-iliac morphological characteristics in relation to reintervention and all-cause long-term mortality in patients undergoing standard EVAR for infrarenal AAA.
Patients treated with EVAR (Zenith(®) Stentgrafts, Cook) between May 1998 and February 2006 were prospectively enrolled in a computerized database where comorbidities and preoperative aneurysm morphology were entered. Reinterventions and mortality were checked until December 1, 2010. Median follow-up time was 68 months.
A total of 304 patients were included, of which 86% were men. Median age was 74 years. The reintervention rate was 23.4% (71/304). A greater diameter of the common iliac artery (p = 0.037; hazard ratio (HR) 1.037 [1.002-1.073]) was an independent factor for an increased number of reinterventions. The 30-day mortality rate was 3.0% (9/304). Aneurysm-related deaths due to AAA occurred in 4.9% (15/304). Five patients died due to a concomitant ruptured thoracic aortic aneurysm. The mortality until end of follow-up was 54.3% (165/304). The proportion of deaths caused by vascular diseases was 61.6%. The severity of angulation of the iliac arteries (p = 0.014; HR 1.018 [95% confidence interval (CI) 1.004-1.033]) and anemia (p = 0.044; HR 2.79 [95% CI 1.029-7.556]) remained as independent factors associated with all-cause long-term mortality. The crude reintervention-free survival rate at 1, 3, and 5 years was 84.5%, 64.8%, and 51.6%, respectively.
The initial aorto-iliac morphological state in patients scheduled for standard EVAR for AAA seems to be strongly related to the need for reinterventions and long-term mortality.
CardioVascular and Interventional Radiology 07/2011; 35(5):1009-15. · 2.09 Impact Factor
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ABSTRACT: Maximum oxygen uptake (VO(2PEAK)) is generally considered to be the best single marker for aerobic fitness. While a positive relationship between daily physical activity and aerobic fitness has been established in adults, the relationship appears less clear in children and adolescents. The purpose of this paper is to summarise recently published data on the relationship between daily physical activity, as measured by accelerometers, and VO(2PEAK) in children and adolescents. A PubMed search was performed on 29 October 2010 to identify relevant articles. Studies were considered relevant if they included measurement of daily physical activity by accelerometry and related to a VO(2PEAK) either measured directly at a maximal exercise test or estimated from maximal power output. A total of nine studies were identified, with a total number of 6116 children and adolescents investigated. Most studies reported a low-to-moderate relationship (r = 0.10-0.45) between objectively measured daily physical activity and VO(2PEAK). No conclusive evidence exists that physical activity of higher intensities are more closely related to VO(2PEAK), than lower intensities.
Journal of Sports Sciences 06/2011; 29(9):887-95. · 1.93 Impact Factor
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ABSTRACT: The digestion of food is known to alter the hemodynamics of the body significantly. The purpose of this study was to study the postprandial changes in stroke volume (SV), cardiac output (CO) and left ventricular (LV) longitudinal systolic and diastolic functions measured with tissue Doppler imaging, in relation to gastric emptying rate (GER), satiety, and glucose and insulin concentrations in healthy subjects.
Twenty-three healthy subjects were included in this study. The fasting and postprandial changes at 30 min and 110 min in CO, heart rate (HR) and blood pressure were measured. Moreover, tissue Doppler imaging systolic (S'), early (E') and late (A') mitral annular diastolic velocities were measured in the septal (s) and lateral (l) walls. Glucose and insulin concentrations, and satiety were measured before and 15, 30, 45, 60, 90, and 120 min after the start of the meal. The GER was calculated as the percentage change in the antral cross-sectional area 15-90 min after ingestion of the meal.
This study show that both CO, systolic longitudinal ventricular velocity of the septum (S's) and lateral wall (S'l), the early diastolic longitudinal ventricular velocity of the lateral wall (E'l), the late diastolic longitudinal ventricular velocity of the septum (A's) and lateral wall (A'l) increase significantly, and were concomitant with increased satiety, antral area, glucose and insulin levels. The CO, HR and SV at 30 min were significantly higher, and the diastolic blood pressure was significantly lower, than the fasting. The satiety was correlated to HR and diastolic blood pressure. The insulin level was correlated to HR.
This study shows that postprandial CO, HR, SV and LV longitudinal systolic and diastolic functions increase concomitantly with increased satiety, antral area, and glucose and insulin levels. Therefore, patients should not eat prior to, or during, cardiac evaluation as the effects of a meal may affect the results and their interpretation.
Nutrition Journal 03/2011; 10:26. · 2.48 Impact Factor
