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Atrial fibrillation and exercise

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https://www.readbyqxmd.com/read/29208632/right-ventricular-exercise-contractile-reserve-and-outcomes-after-early-surgery-for-primary-mitral-regurgitation
#1
Emilie Vitel, Elena Galli, Christophe Leclercq, Maxime Fournet, Christian Bosseau, Hervé Corbineau, Guillame Bouzille, Erwan Donal
OBJECTIVE: To assess if the lack of development of right ventricular (RV) contractile reserve during exercise echocardiography (ex-echo) might be a predictor of postoperative major adverse cardiovascular events (MACEs) in patients with primary mitral regurgitation (pMR) undergoing early surgery. METHODS: Comprehensive resting and ex-echo were performed in 142 asymptomatic patients (58±21 years, 68% men, New York Heart Association functional class ≤2) with isolated severe pMR and preserved left ventricular (LV) function (LV ejection >60%, LV end-systolic diameter <45 mm) undergoing mitral valve replacement (n=20) or repair...
December 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29178512/body-size-and-risk-of-atrial-fibrillation-a-cohort-study-of-1-1-million-young-men
#2
Kasper Andersen, Finn Rasmussen, Martin Neovius, Per Tynelius, Johan Sundström
BACKGROUND: While tall stature has been related to lower risk of vascular disease, it has been proposed as a risk factor for atrial fibrillation. Little is known about other anthropometric measures and their joint effects on risk for atrial fibrillation. OBJECTIVES: We aim to investigate associations and potential joint effects of height, weight, body surface area (BSA) and body mass index (BMI) with risk of atrial fibrillation. METHODS: In a cohort covering 1,153,151 18-years old men participating in the Swedish military conscription (1972-1995) Cox regression was used to investigate associations of height, weight, BSA and BMI with risk of atrial fibrillation...
November 27, 2017: Journal of Internal Medicine
https://www.readbyqxmd.com/read/29161419/incidence-of-postoperative-atrial-fibrillation-recurrence-in-patients-discharged-in-sinus-rhythm-after-cardiac-surgery-a-systematic-review-and-meta-analysis
#3
Nicole Lowres, Georgina Mulcahy, Kai Jin, Robyn Gallagher, Lis Neubeck, Ben Freedman
Postoperative atrial fibrillation (POAF) is associated with increased stroke risk and mortality post-discharge. POAF is often considered transient; however, recurrence is likely under-recognized as symptoms are an unreliable guide. Surveillance post-discharge may identify asymptomatic POAF recurrences in patients discharged in sinus rhythm. Therefore, we performed a systematic review and meta-analysis of studies investigating POAF recurrence post-discharge, in patients with new-onset POAF following cardiac surgery who reverted to sinus rhythm prior to discharge...
November 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29140557/withdrawn-pharmacological-cardioversion-for-atrial-fibrillation-and-flutter
#4
REVIEW
John Cordina, Gillian E Mead
BACKGROUND: Atrial fibrillation is the commonest cardiac dysrhythmia. It is associated with significant morbidity and mortality. There are two approaches to the management of atrial fibrillation: controlling the ventricular rate or converting to sinus rhythm in the expectation that this would abolish its adverse effects. OBJECTIVES: To assess the effects of pharmacological cardioversion of atrial fibrillation in adults on the annual risk of stroke, peripheral embolism, and mortality...
November 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29098615/the-benefits-of-exercise-training-on-aerobic-capacity-in-patients-with-heart-failure-and-preserved-ejection-fraction
#5
Danilo Marcelo Leite do Prado, Enéas Antônio Rocco
Heart failure with preserved ejection fraction (HFpEF) is defined as an inability of the ventricles to optimally accept blood from atria with blunted end- diastolic volume response by limiting the stroke volume and cardiac output. The HEpEF prevalence is higher in elderly and women and may be associated to hypertension, diabetes mellitus and atrial fibrillation. Severe exercise intolerance, manifested by dyspnea and fatigue during physical effort is the important chronic symptom in HFpEF patients, in which is the major determinant of their reduced quality of life...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29094875/heart-failure-with-preserved-ejection-fraction-diagnosis-and-management
#6
REVIEW
John D Gazewood, Patrick L Turner
Heart failure with preserved ejection fraction, also referred to as diastolic heart failure, causes almost one-half of the 5 million cases of heart failure in the United States. It is more common among older patients and women, and results from abnormalities of active ventricular relaxation and passive ventricular compliance, leading to a decline in stroke volume and cardiac output. Heart failure with preserved ejection fraction should be suspected in patients with typical symptoms (e.g., fatigue, weakness, dyspnea, orthopnea, paroxysmal nocturnal dyspnea, edema) and signs (S3 heart sound, displaced apical pulse, and jugular venous distension) of chronic heart failure...
November 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/29089343/impact-of-atrial-fibrillation-on-exercise-capacity-and-mortality-in-heart-failure-with-preserved-ejection-fraction-insights-from-cardiopulmonary-stress-testing
#7
Mohamed B Elshazly, Todd Senn, Yuping Wu, Bruce Lindsay, Walid Saliba, Oussama Wazni, Leslie Cho
BACKGROUND: Atrial fibrillation (AF) has been objectively associated with exercise intolerance in patients with heart failure with reduced ejection fraction; however, its impact in patients with heart failure with preserved ejection fraction has not been fully scrutinized. METHODS AND RESULTS: We identified 1744 patients with heart failure and ejection fraction ≥50% referred for cardiopulmonary stress testing at the Cleveland Clinic (Cleveland, OH), 239 of whom had AF...
October 31, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29049041/the-impact-of-lifestyle-intervention-on-atrial-fibrillation
#8
Kathryn L Hong, Benedict M Glover
PURPOSE OF REVIEW: Atrial fibrillation is the most common sustained cardiac arrhythmia, attributable to several factors that may be amenable through lifestyle modification. There is emerging evidence to suggest that the successful management of several cardiovascular risk factors [obesity, hypertension (HTN), diabetes mellitus, and obstructive sleep apnea (OSA)] can lead to fewer complications and atrial fibrillation prevention. However, the long-term sustainability and reproducibility of these effects have yet to be explored in larger studies...
October 18, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29031455/does-permanent-atrial-fibrillation-modify-response-to-cardiac-resynchronization-therapy-in-heart-failure-patients
#9
Ana Abreu, Mário Oliveira, Pedro Silva Cunha, Helena Santa Clara, Guilherme Portugal, Inês Gonçalves Rodrigues, Vanessa Santos, Luís Morais, Mafalda Selas, Rui Soares, Luísa Branco, Rui Ferreira, Miguel Mota Carmo
INTRODUCTION: The benefits of cardiac resynchronization therapy (CRT) documented in heart failure (HF) may be influenced by atrial fibrillation (AF). We aimed to compare CRT response in patients in AF and in sinus rhythm (SR). METHODS: We prospectively studied 101 HF patients treated by CRT. Rates of clinical, echocardiographic and functional response, baseline NYHA class and variation, left ventricular ejection fraction, volumes and mass, atrial volumes, cardiopulmonary exercise test (CPET) duration (CPET dur), peak oxygen consumption (VO2max) and ventilatory efficiency (VE/VCO2 slope) were compared between AF and SR patients, before and at three and six months after implantation of a CRT device...
October 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29025686/-usefulness-of-spectral-tissue-doppler-e-e-ratio-in-the-management-of-patients-with-atrial-fibrillation
#10
S Arques, E Roux
Atrial fibrillation is the most common cardiac rhythm disorder encountered in daily clinical practice. It carries high morbidity and mortality rates, mainly related to sudden death, heart failure and stroke. Validation of noninvasive markers in the diagnosis of heart failure with preserved ejection fraction and risk stratification is therefore attractive in this clinical setting. The spectral tissue Doppler-derived E/e' ratio is a simple and user-friendly index which has been validated in the assessment of left ventricular diastolic pressures, regardless of rhythm...
November 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29025560/obesity-and-atrial-fibrillation-prevalence-pathogenesis-and-prognosis-effects-of-weight-loss-and-exercise
#11
REVIEW
Carl J Lavie, Ambarish Pandey, Dennis H Lau, Martin A Alpert, Prashanthan Sanders
Both obesity and atrial fibrillation (AF) are increasing in epidemic proportions, and both increase the prevalence of cardiovascular disease events. Obesity has adverse effects on cardiovascular hemodynamics and cardiac structure and function, and increases the prevalence of AF, partly related to electroanatomic remodeling in obese patients. However, numerous studies, including in AF, have demonstrated an obesity paradox, where overweight and obese patients with these disorders have a better prognosis than do leaner patients with the same degree of severity of cardiovascular disease/AF...
October 17, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29024227/impact-of-atrial-fibrillation-on-rest-and-exercise-haemodynamics-in-heart-failure-with-mid-range-and-preserved-ejection-fraction
#12
David M Kaye, Frank E Silvestry, Finn Gustafsson, John G Cleland, Dirk J van Veldhuisen, Piotr Ponikowski, Jan Komtebedde, Shane Nanayakkara, Dan Burkhoff, Sanjiv J Shah
AIMS: Heart failure with preserved (HFpEF) and mid-range ejection fraction (HFmrEF) are becoming the most prevalent forms of heart failure. Patients with HFpEF/HFmrEF in atrial fibrillation (AF) have poorer survival and quality of life, but the mechanism underpinning this is unknown. We sought to investigate the influence of AF on the haemodynamic profile of HFpEF/HFmrEF patients at rest and during exercise. METHODS AND RESULTS: We invasively measured central haemodynamics at rest and during symptom-limited supine bicycle exercise in HFpEF/HFmrEF patients, 35 in sinus rhythm and 20 in AF with matched left ventricular ejection fraction...
October 11, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28986061/adverse-cardiovascular-outcomes-in-atrial-fibrillation-validation-of-the-new-2mace-risk-score
#13
Marija Polovina, Dijana Đikić, Ana Vlajković, Matej Vilotijević, Ivan Milinković, Milika Ašanin, Miodrag Ostojić, Andrew J S Coats, Petar M Seferović
BACKGROUND: In addition to thromboembolism, atrial fibrillation (AF) may also predispose to major adverse cardiovascular events (MACE) attributable to coronary artery disease (CAD), including myocardial infarction (MI). The 2MACE score (2 points - Metabolic syndrome and Age≥75years, 1 point - MI/revascularization, Congestive heart failure/ejection-fraction <40%, and thrombo-Embolism) was recently proposed to help identify AF patients at risk of MACE. We assessed the predictive validity of the 2MACE score for MACE occurrence in AF patients free of CAD at baseline...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28975475/pharmacogenomics-of-bucindolol-in-atrial-fibrillation-and-heart-failure
#14
REVIEW
Kishan S Parikh, Jonathan P Piccini
PURPOSE OF REVIEW: We explore the pharmacogenomics of the beta-blocker bucindolol by discussing relevant beta-1 adrenergic receptor (ADRB1) polymorphisms and recent beta-blocker studies. Through this, we will understand how bucindolol may help patients with atrial fibrillation and heart failure with reduced ejection fraction (AF-HFrEF), which carries poor prognosis. RECENT FINDINGS: Retrospective study of the Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training trial revealed the interaction between the optimal beta-blocker dose and the ADRB1 Arg389 genotype for HFrEF clinical outcomes...
December 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28948451/a-diagnostic-approach-to-stroke-in-young-adults
#15
REVIEW
Christopher A Stack, John W Cole
Optimal diagnosis and management of stroke in young adults benefit from a multidisciplinary team, including a vascular neurology specialist. In addition to the "standard" vascular risk factors including smoking, hypertension, diabetes, and hyperlipidemia, one needs to consider alternative etiologies including substance abuse, carotid/vertebral artery dissections, and rare genetic conditions among others. Once a young patient is determined to have had a stroke, the next question a clinician should ask is why did this patient have a stroke? A "heart to head" diagnostic approach is recommended...
September 25, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28913725/exercise-and-competitive-sport-physiology-adaptations-and-uncertain-long-term-risks
#16
REVIEW
Patrick T Gleason, Jonathan H Kim
The benefits of regular and moderate exercise training on cardiovascular outcomes have been well established. In addition, strenuous exercise training leads to corollary cardiac structural and functional adaptations that are sport-specific and facilitate athletic performance. In this review, the normal physiologic and hemodynamic changes that occur during exercise and the subsequent differential exercise-induced cardiac remodeling patterns that develop will be discussed. Paradoxically, recent data have raised concern about the long-term impact of higher doses of physical activity and exercise on mortality and cardiovascular health outcomes...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28904878/the-effects-of-different-physical-activities-on-atrial-fibrillation-in-patients-with-hypertension-and-chronic-kidney-disease
#17
Márcio Galindo Kiuchi, Shaojie Chen, Neil Alexander Hoye
BACKGROUND: Atrial fibrillation (AF) is highly common, and is most frequently observed in individuals with hypertension and structural cardiac disease. Sympathetic hyperactivity plays a fundamental role in the progression, maintenance and aggravation of arrhythmia. Endurance exercise training clearly lowers sympathetic activity in sympathoexcitatory disease states, and is well-tolerated by patients with chronic kidney disease (CKD). METHODS: We assessed 50 CKD patients with hypertension...
September 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28796004/effects-of-exercise-training-on-exercise-capacity-cardiac-function-bmi-and-quality-of-life-in-patients-with-atrial-fibrillation-a-meta-analysis-of-randomized-controlled-trials
#18
Michitaka Kato, Akira Kubo, Fumi Nihei, Michio Ogano, Hisato Takagi
Exercise training has become part of the standard care for patients with cardiovascular disease. We investigated the effects of exercise training on exercise capacity, cardiac function, BMI, and quality of life in patients with atrial fibrillation (AF). We searched for randomized-controlled trials of supervised exercise training versus care without exercise training (the control) in patients with permanent or nonpermanent AF published up to November 2016. Standard mean differences (SMD) or mean differences (MD), and 95% confidence intervals (CIs) were calculated using random-effect models...
September 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
https://www.readbyqxmd.com/read/28775185/frequency-of-exercise-induced-st-t-segment-deviations-and-cardiac-arrhythmias-in-recreational-endurance-athletes-during-a-marathon-race-results-of-the-prospective-observational-berlin-beat-of-running-study
#19
Juliane Herm, Agnieszka Töpper, Alexander Wutzler, Claudia Kunze, Matthias Krüll, Lars Brechtel, Jürgen Lock, Jochen B Fiebach, Peter U Heuschmann, Wilhelm Haverkamp, Matthias Endres, Gerhard Jan Jungehulsing, Karl Georg Haeusler
OBJECTIVES: While regular physical exercise has many health benefits, strenuous physical exercise may have a negative impact on cardiac function. The 'Berlin Beat of Running' study focused on feasibility and diagnostic value of continuous ECG monitoring in recreational endurance athletes during a marathon race. We hypothesised that cardiac arrhythmias and especially atrial fibrillation are frequently found in a cohort of recreational endurance athletes. The main secondary hypothesis was that pathological laboratory findings in these athletes are (in part) associated with cardiac arrhythmias...
August 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28768468/predictive-value-of-exercise-induced-atrial-natriuretic-peptide-secretion-for-the-presence-of-left-atrial-low-voltage-areas-in-patients-with-persistent-atrial-fibrillation
#20
Ran Yin, Zhongming Yang, Jingtian Peng, Bingong Li, Yongnan Fu, Zheqi Zheng
Objectives Left atrial (LA) low-voltage areas (LVAs) are a strong predictor of atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI). However, a non-invasive method for evaluating LA-LAVs has not been established yet. The objective of our study was to assess the predictive value of the plasma atrial natriuretic peptide (ANP) level for the presence of LA-LVAs in patients with persistent AF (PeAF). Methods Seventy-two PeAF patients underwent an exercise stress test preprocedurally. LA voltage maps were created after PVI...
August 2017: Acta Cardiologica
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