Timo H Mäkikallio

University of Eastern Finland, Yoensu, North Karelia, Finland

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Publications (144)752.03 Total impact

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    ABSTRACT: Background: Little is known about the relationship between metabolic syndrome and sudden cardiac death (SCD). We examined the association of metabolic syndrome, as defined by World Health Organization (WHO), International Diabetes Federation (IDF), National Cholesterol Education Program (NCEP) and American Heart Association (AHA) - IDF interim criteria, with incident SCD. We also assessed the association of a continuous metabolic risk score with SCD. Methods: A total of 1466 middle-aged men participating in a prospective population-based cohort study from eastern Finland with no history of coronary heart disease or diabetes at baseline were included. Results: During the average follow-up of 21years 85 SCDs occurred. Men with the metabolic syndrome as defined by the WHO, NCEP, IDF and interim criteria had a 2.2-2.6 fold, increased risk for SCD, after adjusting for lifestyle and traditional cardiovascular risk factors not included in the metabolic syndrome definition (P<0.001-0.011). A one-standard deviation increase in the metabolic risk score (composed of the sum of Z-scores for waist circumference, insulin, glucose, high-density lipoprotein (HDL) cholesterol, triglycerides, and blood pressure) was associated with a 1.68-fold higher (95% CI 1.33-2.11) risk of SCD. Even when adjusting further for systolic blood pressure, HDL cholesterol and body mass index, the association remained significant for the interim criteria and the metabolic risk score, but not for WHO, NCEP, or IDF definitions. Conclusions: Men with metabolic syndrome are at increased risk for SCD. Incident SCD associated with the IDF/AHA interim criteria and metabolic risk clustering estimated by a score is not explained by obesity or traditional cardiovascular risk factors. Key messages: Men with metabolic syndrome are at increased risk for sudden cardiac death. Incident sudden cardiac death associated with metabolic risk clustering estimated by a score in not explained by obesity or traditional cardiovascular risk factors. Prevention of the metabolic syndrome may help reduce the health burden of SCD.
    No preview · Article · Oct 2015 · International journal of cardiology
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    ABSTRACT: This study aimed to describe the incidence and periprocedural predictors of permanent work disability (PWD) pension among patients ≤50 years old who underwent percutaneous coronary intervention (PCI). Patient records of 910 consecutive patients undergoing PCI at four Finnish hospitals in 2002-2012 were reviewed for baseline and procedural data and late adverse events. Data on permanent work disability (PWD) pension allocation were acquired from the Finnish Centre for Pensions, which governs the statutory pension security in Finland. Mean follow-up was 41 [standard deviation (SD) 31] months. Altogether 103/910 (11.3%) of patients were on PWD by the end of follow-up, 60 (58.3%) for cardiac diagnoses (cumulative freedom from PWD 81% at 7 years). Independent predictors of PWD were post procedural stroke [hazard ratio (HR) 4.7, 95% confidence interval (95% CI) 1.8-11.9], post procedural myocardial infarction (MI) (HR 3.3, 95% CI 1.8-6.0), diabetes (HR 2.0, 95% CI 1.1-3.7), discharge diuretics (HR 3.5, 95% CI 2.1-5.9), and increasing age (HR 1.2, 95% CI 1.1-1.3). Predictors of PWD for cardiac diagnoses were post procedural stroke and MI, discharge diuretics, and use of calcium-channel blockers, diabetes and older age. Patients ≤50 years old undergoing PCI are at a high risk for subsequent permanent disability for cardiac diagnoses. This finding underscores the need for reinforcing adherence to secondary prevention by cardiac rehabilitation and early collaboration with occupational health care professionals.
    No preview · Article · Jun 2015 · Scandinavian Journal of Work, Environment & Health
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    ABSTRACT: Increased risk of arrhythmic events occurs at certain times during the circadian cycle with the highest risk being in the second and fourth quarter of the day. Exercise improves treatment outcome in individuals with cardiovascular disease. How different exercise protocols affect the circadian rhythm and the associated decrease in adverse cardiovascular risk over the circadian cycle has not been shown. Fifty sedentary male participants were randomized into an 8-week high volume and moderate volume training and a control group. Heart rate was recorded using Polar Electronics and investigated with Cosinor analysis and by Poincaré plot derived features of SD1, SD2 and the complex correlation measure (CCM) at 1-h intervals over the 24-h period. Moderate exercise significantly increased vagal modulation and the temporal dynamics of the heart rate in the second quarter of the circadian cycle (p = 0.004 and p = 0.007 respectively). High volume exercise had a similar effect on vagal output (p = 0.003) and temporal dynamics (p = 0.003). Cosinor analysis confirms that the circadian heart rate displays a shift in the acrophage following moderate and high volume exercise from before waking (1st quarter) to after waking (2nd quarter of day). Our results suggest that exercise shifts vagal influence and increases temporal dynamics of the heart rate to the 2nd quarter of the day and suggest that this may be the underlying physiological change leading to a decrease in adverse arrhythmic events during this otherwise high-risk period.
    Full-text · Article · May 2015 · Arbeitsphysiologie

  • No preview · Article · May 2015 · International Journal of Cardiology

  • No preview · Article · May 2015 · Physiotherapy
  • Sudhir Kurl · Timo H Mäkikallio · Jari A Laukkanen
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    ABSTRACT: Objective: To investigate the predictive value of T-wave inversion (TWI) on routine electrocardiogram (ECG) for mortality in the general population with various risk groups in a prospective population-based follow-up study. Subjects. ECGs of a random population-based sample of 1814 men aged 42-60 years without coronary heart disease (CHD) at baseline. Results: During an average follow-up of 21 years, 685 deaths occurred. Of these deaths 174 were due to CHD and 278 to cardiovascular disease (CVD). There were 57 subjects with TWI. After adjusting for age, TWI was associated with an increased CHD mortality (relative risk (RR) 4.10, 95% CI 2.26-7.41), CVD mortality (RR 3.47, 95% CI 2.09-5.78), and all-cause mortality (RR 2.07, 95% CI 1.37-3.12). After further adjustment for conventional risk factors, TWI remained statistically significant, predicting CHD mortality (RR 2.62, 95% CI 1.57-4.36), CVD mortality (RR 2.18, 95% CI 1.40-3.38), and all-cause mortality (RR 1.41, 95% CI 1.00-2.01), respectively. Conclusion: TWI is a strong predictor for CHD, CVD, and all-cause mortality in the general population. The respective risks of CHD and CVD among men with TWI were also increased among men with high blood pressure, LDL cholesterol, and obesity.
    No preview · Article · Jan 2015 · Annals of Medicine
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    ABSTRACT: Data on the outcome of young patients after coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) are scarce. Data on 2,209 consecutive patients aged ≤50 years who underwent CABG or PCI were retrospectively collected from 15 European institutions. PCI and CABG had similar 30-day mortality rates (0.8% vs 1.4%, p = 0.27), late survival (at 5 years, 97.8% vs 94.9%, p = 0.082), and freedom from stroke (at 5 years, 98.0% and 98.0%, p = 0.731). PCI was associated with significantly lower freedom from major adverse cardiac and cerebrovascular events (at 5 years, 73.9% vs 85.0%, p <0.0001), repeat revascularization (at 5 years, 77.6% vs 92.5%, p <0.0001), and myocardial infarction (at 5 years, 89.9% vs 96.6%, p <0.0001) compared with CABG. These findings were confirmed in propensity score-adjusted and matched analyses. Freedom from major adverse cardiac and cerebrovascular events after PCI was particularly low in diabetics (at 5 years, 58.0% vs 75.9%, p <0.0001) and in patients with multivessel disease (at 5 years, 63.6% vs 85.1%, p <0.0001). PCI in patients with ST elevation myocardial infarction was associated with significantly better 5-year survival (97.5% vs 88.8%, p = 0.001), which was driven by its lower 30-day mortality rate (1.5% vs 6.0%, p = 0.017). In conclusion, patients aged ≤50 years have an excellent immediate outcome after either PCI or CABG with similar long-term survival when used according to the current clinical practice. PCI was associated with significantly lower freedom from myocardial infarction and repeat revascularization.
    Full-text · Article · May 2014 · The American Journal of Cardiology
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    ABSTRACT: The value of SBP during exercise and recovery period as a risk marker for sudden cardiac death (SCD) is not known. Thus, we assessed the association of SBP during recovery from exercise testing with the risk of SCD. SBP was measured every 2 min during and at 2 min after a progressive cycle ergometer exercise in a representative sample of 2366 men (aged 42-61 years). During an average follow-up period of 18.9 years, a total of 180 SCDs occurred. SBP during recovery from exercise was associated with the risk of SCD (hazard ratio 1.24, 95% confidence interval 1.06-1.45, P = 0.007 for 1 SD increment), after adjustment for age, risk factors and exercise test findings. Men with elevated SBP of over 195 mmHg at 2 min recovery from exercise had a 1.74-fold (95% confidence interval 1.18-2.54, P = 0.005) risk of an SCD as compared to those with SBP less than 170 mmHg, after adjustment for age, risk factors and other exercise test findings. However, after further adjustment for resting SBP, the association between SBP at 2 min recovery from exercise and the risk of SCD became non-significant. This study shows that SBP during recovery phase from exercise is related to the risk of SCD, although its prognostic value is limited in conjunction with the assessment of resting SBP in the general male population.
    No preview · Article · Dec 2013 · Journal of Hypertension
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    ABSTRACT: The purpose of this study was to determine whether a rating of perceived exertion scale (RPE) obtained during submaximal exercise could be used to predict peak exercise capacity (METpeak) in coronary artery disease (CAD) patients. Angiographically documented CAD patients (n = 124, 87% on β blockade) completed a symptom-limited peak exercise test on a bicycle ergometer, reporting RPE values at every second load on a scale of 6-20. Regression analysis was used to develop equations for predicting METpeak. We found that submaximal METs at a workload of 60/75 W (for women and men, respectively) and the corresponding RPE (METs/RPE ratio) was the most powerful predictor of METpeak (r = 0.67, p < 0.0001). The final model included the submaximal METs/RPE ratio, body mass index (BMI), sex, resting heart rate, smoking history, age, and use of a β blockade (r = 0.86, p < 0.0001, SEE 0.98 METs). These data suggest that RPE at submaximal exercise intensity is related to METpeak in CAD patients. The model based on easily measured variables at rest and during "warm-up" exercise can reasonably predict absolute METpeak in patients with CAD.
    Full-text · Article · Sep 2013 · Frontiers in Physiology
  • Jouni Karppi · Sudhir Kurl · Timo H Mäkikallio · Kimmo Ronkainen · Jari A Laukkanen
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    ABSTRACT: Background: Fruit and vegetable intake has been associated with lower risk for cardiovascular diseases, but data on congestive heart failure (CHF) are inconsistent. The association of serum carotenoids, biomarkers reflecting fruit and vegetable intake, with the risk of CHF has not been well documented in previous studies. We therefore examined the association between carotenoid levels and the risk of CHF. Methods: Data were available for 1031 males aged 46 to 65 years participating in the Kuopio Ischaemic Heart Disease Risk Factor Study (Finland). Baseline data for the present study were collected between 1991 and 1993. The association between serum concentrations of carotenoids and the risk of CHF was examined by using Cox proportional hazard models. Results: During the median of 17.8 follow-up years, CHF occurred in 72 patients. Age and examination year adjusted risk (hazard ratio, HR) for CHF among men within the lowest quartile of serum β-carotene was 4.08 (95% CI, 1.90-8.78, p<0.001) as compared to men in the highest quartile of serum β-carotene. After further adjustment for many potential confounders, men with the lowest quartile of β-carotene had almost 3-fold increased risk of CHF (HR=2.78, 95% CI, 1.23-6.25, p=0.014). However, serum concentrations of lycopene and α-carotene were not related to the risk of CHF. Conclusions: The present study suggests that low concentrations of serum β-carotene may be associated with an increased risk of CHF.
    No preview · Article · Jan 2013 · International journal of cardiology
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    Jari A Laukkanen · Timo H Mäkikallio · Kimmo Ronkainen · Jouni Karppi · Sudhir Kurl
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    ABSTRACT: OBJECTIVE The aim of the study was to determine whether impaired fasting plasma glucose (FPG) and type 2 diabetes may be risk factors for sudden cardiac death (SCD).RESEARCH DESIGN AND METHODS This prospective study was based on 2,641 middle-aged men 42-60 years of age at baseline. Impaired FPG level (≥5.6 mmol/L) among nondiabetic subjects (501 men) was defined according to the established guidelines, and the group with type 2 diabetes included subjects (159 men) who were treated with oral hypoglycemic agents, insulin therapy, and/or diet.RESULTSDuring the 19-year follow-up, a total of 190 SCDs occurred. The relative risk (RR) for SCD was 1.51-fold (95% CI 1.07-2.14, P = 0.020) for nondiabetic men with impaired FPG and 2.86-fold (1.87-4.38, P < 0.001) for men with type 2 diabetes as compared with men with normal FPG levels, after adjustment for age, BMI, systolic blood pressure, serum LDL cholesterol, smoking, prevalent coronary heart disease (CHD), and family history of CHD. The respective RRs for out-of-hospital SCDs (157 deaths) were 1.79-fold (1.24-2.58, P = 0.001) for nondiabetic men with impaired FPG and 2.26-fold (1.34-3.77, P < 0.001) for men with type 2 diabetes. Impaired FPG and type 2 diabetes were associated with the risk of all-cause death. As a continuous variable, a 1 mmol/L increment in FPG was related to an increase of 10% in the risk of SCD (1.10 [1.04-1.20], P = 0.001).CONCLUSIONS Impaired FPG and type 2 diabetes represent risk factors for SCD.
    Full-text · Article · Dec 2012 · Diabetes care
  • Jouni Karppi · Sudhir Kurl · Timo Heikki Mäkikallio · Kimmo Ronkainen · Jari Antero Laukkanen
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    ABSTRACT: Systemic inflammation, oxidative stress, and atrial fibrosis are identified as the main mechanisms for atrial fibrillation (AF). Antioxidant micronutrients may have antiarrhythmic benefit in humans. We studied whether plasma carotenoids are related to the risk of AF in elderly subjects. The study population consisted of 1,847 Finnish subjects (620 women and 1,227 men) aged 61-82 years from the Kuopio Ischaemic Heart Disease Risk Factor study cohort. Plasma concentrations of carotenoids were measured by high-performance liquid chromatography. The multivariable-adjusted hazard ratios (HRs) and 95 % confidence intervals (CIs) of plasma carotenoids were analyzed using the Cox proportional hazard's model. During a median follow-up of 2.8 years a total of 105 subjects developed incident AF. The HRs of AF among subjects with levels in the highest through the lowest tertile after adjustment for age, examination year, gender, systolic blood pressure, smoking, alcohol consumption, education, diabetes, use of antihypertensive medication, congestive heart failure, recurrent AF, prevalent coronary heart disease and baseline prevalence of myocardial infarction were 1.70 (95 % CI: 1.01-2.86, p = 0.047) for lutein, 1.99 (95 % CI: 1.14-3.48, p = 0.016) for zeaxanthin. Risk of AF was borderline significant for β-carotene (HR = 1.69, 95 % CI: 1.00-2.87, p = 0.050). Results remained unchanged, when season was added to the multivariable model. Lycopene, β-cryptoxanthin, α-carotene and total carotenoids were not associated with the risk of AF. Results of the present study suggest that low plasma concentrations of lutein and zeaxanthin were associated with an increased risk of AF in elderly population.
    No preview · Article · Dec 2012 · European Journal of Epidemiology
  • Jouni Karppi · Jari A Laukkanen · Timo H Mäkikallio · Kimmo Ronkainen · Sudhir Kurl
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    ABSTRACT: Objectives: To examine whether serum concentrations of carotenoids are related to the risk of sudden cardiac death (SCD) in middle-aged men. Methods: The study population consisted of 1031 Finnish men aged 46-65 years of the Kuopio Ischemic Heart Disease Risk Factor (KIHD) cohort. Serum concentrations of carotenoids were measured by high-performance liquid chromatography. The hazard ratios (HR) of serum β-carotene, lycopene and α-carotene were estimated by using the Cox proportional hazard model after adjusting for age and other potential confounding factors. Results: During a median follow-up of 15.9 years a total of 59 incidents of SCD occurred. After controlling for age, systolic blood pressure, waist circumference, smoking, alcohol consumption, years of education, serum LDL cholesterol, serum hs-CRP, diabetes, prevalent coronary heart disease (CHD) and congestive heart failure (CHF), men in the lowest tertile of serum concentrations of β-carotene had a 2-fold increased risk of SCD (HR=2.15, 95% CI: 1.02-4.51; p=0.044) as compared to those in the highest tertile. The risk of SCD was borderline significant for lycopene. In addition, low serum β-carotene concentrations increased the risk of cardiovascular disease (CVD) and total mortality. Lycopene and α-carotene were not related to the risk of SCD. Conclusions: Our findings suggest that low serum β-carotene concentrations may increase the risk of SCD in middle-aged Finnish men. Furthermore, low serum β-carotene concentrations may be related to the risk of CVD and total mortality.
    No preview · Article · Nov 2012 · Atherosclerosis
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    ABSTRACT: Cardiovascular autonomic dysfunction, which is a common complication of diabetes, is associated with increased mortality in patients with coronary artery disease (CAD). However, the reasons of autonomic dysfunction in CAD patients with or without diabetes are not well known. We examine the association between heart rate recovery (HRR) and other potential factors among CAD patients with and without type 2 diabetes (T2D). Correlations between HRR 60 s after exercise (HRR60), characteristics, laboratory and echocardiographic variables, exercise capacity and physical activity were assessed in 50 CAD patients with T2D and 55 patients with CAD alone. HRR60 had the closest univariate correlation with physical activity and exercise capacity in patients with T2D (r = 0.38, p = 0.006 and r = 0.37, p = 0.008, respectively). Age, exercise capacity and high-density lipoprotein cholesterol level explained 30% of the HRR60 in patients with T2D (p = 0.001), while the high intensity physical activity was the only predictor of HRR60 in CAD patients (12%, p = 0.010). HRR60 was reduced in patients with T2D as compared with those without (34 ± 9 vs. 39 ± 9 bpm, p = 0.005), but the difference was no longer significant after adjustments for physical activity, exercise capacity, body mass index and the use of calcium antagonists and nitrates (p = 0.273). In conclusion, blunted HRR is more common among CAD patients with T2D than in those without, and this is more closely related to physical activity and obesity than to the duration of T2D or associated co-morbidities.
    Full-text · Article · Nov 2012 · Autonomic neuroscience: basic & clinical
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    ABSTRACT: Promotion of and adherence to increased physical activity (PA) is an important part of the prevention and treatment of coronary artery disease (CAD). We hypothesized that individually tailored home-based exercise prescriptions will increase long-term PA and maximal exercise capacity among CAD patients without and with type 2 diabetes (CAD+T2D). Physical activity of patients with CAD (n = 44) and CAD+T2D (n = 39), matched by age, sex and ejection fraction, was measured over 5 days with an accelerometer pre- and postexercise prescription. PA was assessed as the average time per day of moderate (METs = 2-5) and high (METs > 5) intensities. Six-month exercise prescriptions were introduced based on individual maximal heart rate reserve. At the baseline, patients with CAD+T2D engaged in less moderate-intensity PA (2:40 ± 1:23 versus 3:24 ± 1:17 h, P = 0·014) and exhibited a non-significant trend to reduced high-intensity PA (2:08 ± 2:57 versus 5:02 ± 9:19 min, P = 0·091) compared with patients with CAD. High-intensity PA increased markedly in CAD (5:02 ± 9:19 versus 9:59 ± 15:03 min) and patients with CAD+T2D (2:08 ± 2:57 versus 6:14 ± 10:18 min) after exercise prescription (main effect for time P = 0·001). Also maximal exercise capacity increased in both groups (main effect for time P<0·001). Patients with CAD with T2D are physically less active than CAD patients without diabetes in their daily life. Individually tailored home-based exercise prescriptions are an effective way to promote more active lifestyles and improve fitness in both patient groups.
    Full-text · Article · Nov 2012 · Clinical Physiology and Functional Imaging
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    ABSTRACT: Previous studies indicate that increased QRS duration in ECG is related to the risk of all-cause death. However, the association of QRS duration with the risk of sudden cardiac death (SCD) is not well documented in large population-based studies. Our aim was to examine the relation of QRS duration with SCD in a population-based sample of men. This prospective study was based on a cohort of 2049 men aged 42 to 60 years at baseline with a 19-year follow-up, during which a total of 156 SCDs occurred. As a continuous variable, each 10-ms increase in QRS duration was associated with a 27% higher risk for SCD (relative risk, 1.27; 95% confidence interval, 1.14-1.40; P<0.001). Subjects with QRS duration of >110 ms (highest quintile) had a 2.50-fold risk for SCD (relative risk, 2.50; 95% confidence interval, 1.38-4.55; P=0.002) compared with those with QRS duration of <96 ms (lowest quintile), after adjustment for established key demographic and clinical risk factors (age, alcohol consumption, previous myocardial infarction, smoking, serum low- and high-density lipoprotein cholesterol, C-reactive protein, type 2 diabetes mellitus, body mass index, systolic blood pressure, and cardiorespiratory fitness). In addition to QRS duration, smoking, previous myocardial infarction, type 2 diabetes mellitus, cardiorespiratory fitness, body mass index, systolic blood pressure, and C-reactive protein were independently associated with the risk of SCD. QRS duration is an independent predictor of the risk of SCD and may have utility in estimating SCD risk in the general population.
    Full-text · Article · May 2012 · Circulation
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    ABSTRACT: The role of systolic blood pressure (SBP) as an independent risk factor for sudden cardiac death (SCD) is not well defined in a general population. Thus, we assessed the association between BP at rest and risk of SCD. BP and other risk factors were measured in a representative population-based sample of 2,666 Finnish men (42 to 61 years of age). During an average follow-up period of 18.9 years (interquartile range 17.9 to 22.6), 213 SCDs occurred. Each increment 10-mm Hg of SBP at rest was associated with an increased risk of SCD (relative hazard 1.15, 95% confidence interval 1.07 to 1.25, p <0.001) after adjustment for age, alcohol consumption, cigarette smoking, serum low-density lipoprotein cholesterol, type 2 diabetes, body mass index, left ventricular hypertrophy, previous myocardial infarction, family history of coronary heart disease, and use of antihypertensive medications. Men with increased SBP of >145 mm Hg had a 2.04-fold (95% confidence interval 1.23 to 2.52, p = 0.003) adjusted risk for SCD compared to those with SBP <123 mm Hg. In conclusion, this study emphasizes the importance of the definition of SBP at rest because it provides a valuable prognostic measurement for SCD.
    No preview · Article · Apr 2012 · The American journal of cardiology
  • J Karppi · J.A. Laukkanen · T.H. Mäkikallio · K Ronkainen · S Kurl
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    ABSTRACT: Healthy diet rich in fruits and vegetables is an important factor in prevention of cardiovascular diseases (CVD). Some previous epidemiological studies have suggested that dietary and serum carotenoids are associated with decreased CVD mortality, but the results have been inconsistent. We assessed relations between the concentrations of serum carotenoids and CVD mortality among Eastern Finnish men. The study population consisted of 1031 Eastern Finnish men aged 46-65 years in the Kuopio Ischaemic Heart Disease Risk Factor (KIHD) cohort. Subjects were classified quartiles according to concentrations of carotenoids and subgroups according to risk factors. Hazard ratios of serum lycopene, α-carotene and β-carotene were estimated by the Cox proportional hazard model after adjusting for potential confounding factors. During the median 15.9-year follow-up, 122 deaths from CVDs, were identified among the cohort subjects. Low serum concentrations of β-carotene were strongly related to an increased CVD mortality risk after adjustment for confounders. For β-carotene, the hazard ratio (95% confidence interval) for the lowest versus highest quartile was 2.23 (1.26-3.93; P=0.006). However, the strongest risk of CVD mortality was observed among smokers with lowest levels of β-carotene (HR=3.15, 95%, CI: 1.19-8.33; P=0.020). Other carotenoids and the sum of carotenoids were not significantly related to increased risk of CVD mortality. Low concentrations of serum β-carotene concentrations may increase the risk for CVD mortality among Eastern Finnish men; thus elevated serum concentrations of β-carotene may have clinical and public health relevance.
    No preview · Article · Apr 2012 · Nutrition, metabolism, and cardiovascular diseases: NMCD
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    ABSTRACT: Treatment of acute myocardial infarction with stem cell transplantation has achieved beneficial effects in many clinical trials. The bone marrow microenvironment of ST-elevation myocardial infarction (STEMI) patients has never been studied even though myocardial infarction is known to cause an imbalance in the acid-base status of these patients. The aim of this study was to assess if the blood gas levels in the bone marrow of STEMI patients affect the characteristics of the bone marrow cells (BMCs) and, furthermore, do they influence the change in cardiac function after autologous BMC transplantation. The arterial, venous and bone marrow blood gas concentrations were also compared. Blood gas analysis of the bone marrow aspirate and peripheral blood was performed for 27 STEMI patients receiving autologous stem cell therapy after percutaneous coronary intervention. Cells from the bone marrow aspirate were further cultured and the bone marrow mesenchymal stem cell (MSC) proliferation rate was determined by MTT assay and the MSC osteogenic differentiation capacity by alkaline phosphatase (ALP) activity assay. All the patients underwent a 2D-echocardiography at baseline and 4 months after STEMI. As expected, the levels of pO(2), pCO(2), base excess and HCO(3) were similar in venous blood and bone marrow. Surprisingly, bone marrow showed significantly lower pH and Na(+) and elevated K(+) levels compared to arterial and venous blood. There was a positive correlation between the bone marrow pCO(2) and HCO(3) levels and MSC osteogenic differentiation capacity. In contrast, bone marrow pCO(2) and HCO(3) levels displayed a negative correlation with the proliferation rate of MSCs. Patients with the HCO(3) level below the median value exhibited a more marked change in LVEF after BMC treatment than patients with HCO(3) level above the median (11.13 ± 8.07% vs. 2.67 ± 11.89%, P = 0.014). Low bone marrow pCO(2) and HCO(3) levels may represent the optimal environment for BMCs in terms of their efficacy in autologous stem cell therapy in STEMI patients.
    Full-text · Article · Apr 2012 · Journal of Translational Medicine
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    ABSTRACT: Purpose: Individual responses to aerobic training vary from almost none to a 40% increase in aerobic fitness in healthy subjects. We hypothesized that the baseline self-rated mental stress may influence to the training response. Methods: The study population included 44 healthy sedentary subjects (22 women) and 14 controls. The laboratory controlled training period was 2 weeks, including five sessions a week at an intensity of 75% of the maximum heart rate for 40 min/session. Self-rated mental stress was assessed by inquiry prior to the training period from 1 (low psychological resources and a lot of stressors in my life) to 10 (high psychological resources and no stressors in my life), respectively. Results: Mean peak oxygen uptake [Formula: see text] increased from 34 ± 7 to 37 ± 7 ml kg(-1) min(-1) in training group (p < 0.001) and did not change in control group (from 34 ± 7 to 34 ± 7 ml kg(-1) min(-1)). Among the training group, the self-rated stress at the baseline condition correlated with the change in fitness after training intervention, e.g., with the change in maximal power (r = 0.45, p = 0.002, W/kg) and with the change in [Formula: see text] (r = 0.32, p = 0.039, ml kg(-1) min(-1)). The self-rated stress at the baseline correlated with the change in fitness in both female and male, e.g., r = 0.44, p = 0.039 and r = 0.43, p = 0.045 for ΔW/kg in female and male, respectively. Conclusion: As a novel finding the baseline self-rated mental stress is associated with the individual training response among healthy females and males after highly controlled aerobic training intervention. The changes in fitness were very low or absent in the subjects who experience their psychological resources low and a lot of stressors in their life at the beginning of aerobic training intervention.
    Full-text · Article · Mar 2012 · Frontiers in Physiology

Publication Stats

7k Citations
752.03 Total Impact Points


  • 2015
    • University of Eastern Finland
      • Institute of Biomedicine
      Yoensu, North Karelia, Finland
  • 2001-2015
    • Oulu University Hospital
      • Department of Internal Medicine
      Uleoborg, Northern Ostrobothnia, Finland
    • Virginia Commonwealth University
      Richmond, Virginia, United States
  • 1996-2015
    • University of Oulu
      • • Institute of Clinical Medicine
      • • Department of Internal Medicine
      • • Department of Electrical and Information Engineering
      • • Department of Neurology
      Uleoborg, Northern Ostrobothnia, Finland
  • 2011
    • Kainuu Central Hospital
      Kjana, Kainuu, Finland
  • 2008
    • Satakunta Hospital District
      Björneborg, Province of Western Finland, Finland
  • 2006-2008
    • Lapland Central Hospital
      Rovanieni, Lapland, Finland
  • 2004
    • University of Turku
      Turku, Varsinais-Suomi, Finland
  • 2003
    • University of Waterloo
      Ватерлоо, Ontario, Canada
  • 2002
    • University of Miami Miller School of Medicine
      • Cardiology
      Miami, Florida, United States
  • 2000
    • Turku University Hospital
      • Turku PET Centre
      Turku, Varsinais-Suomi, Finland