Sudden cardiac death (SCD) is a catastrophic cardiac event, that is often the first, last and only cardiac event for unfortunate victims. In a study published July 1,2016 in the Mayo Clinic Proceedings, led by David Jimenez-Pavon, Enrique Artero, DC Lee and senior author , Dr Steven Blair from the Aerobics Center Longitudinal Study, my colleagues and I reported on a cohort of over 55,000 followed for 15 years on average , during which 109 SCDs occurred.
What is the best practice for cardiac rehabilitation really? The clinical practice in Europe differs enormously with regard to how we do it, when we do it and where we do it, despite numerous guidelines and several scientific papers regarding this topic. The Take Heart project aims to identify the best clinical practice in cardiac rehabilitation and thereby improve the quality and attendance rates among eligible patients with coronary heart disease (CHD).
In Europe, CHD accounts for an estimated 1.95 million deaths each year and is estimated to cost the EU economy € 60 billion a year. In secondary prevention, exercise training is associated with reduced morbidity and mortality in CHD. Exercise-based cardiac rehabilitation is therefore strongly recommended to patients with CHD, and should be offered to all eligible patients. However, the reality is quite the opposite! It is estimated that less than 30 % of eligible patients attend the cardiac rehabilitation.
The Crown Prince of Norway tested his fitness using our Fitness Calculator during an event at Egertorget in Oslo at the World Activity Day in May – and as expected he was quite fit.
Physical fitness is key to a long, healthy life. Your body’s ability to transport and use oxygen during exercise is the most precise measure of overall cardiovascular fitness. The more oxygen your body can transport and utilize, the higher your maximal oxygen uptake (VO2max) and hence your cardiovascular fitness. Your fitness depends, among other things, on your age, gender and how often and how hard you train. You can increase your fitness though training!
The advisory unit concerns the dissemination of knowledge about exercise training as treatment for people with coronary heart disease, heart failure, peripheral artery disease and chronic obstructive pulmonary disease (COPD). The service is involved in education, research and promotion of exercise training as medicine for those cardiopulmonary conditions.
Depression is common and estimates suggest that in a family of four, one of the family members will likely suffer from mental health problems. Depression is even 3 times more common in patients after a heart attack than in the general population. Depression after a heart attack is bad not only because of the accompanying emotional distress, it also increases the risk of having another heart attack or premature death.
The CO-rebreathing technique for measuring total blood volume and hemoglobin mass is safe to perform in stable coronary artery disease patients having completed cardiac rehabilitation. Trine Karlsen and colleagues show this in a resent study ”Safety of the CO-Rebreathing Method in Patients with Coronary Artery Disease”, published in the Medicine and Science in Sports and Exercise Journal.
“The aim of the study was to investigate the use of this methodology in stable coronary artery disease patients to allow for an implementation of the methodology in this patient group”, Karlsen says. Knowledge of total blood volume and absolute hemoglobin mass is vital when evaluating cardiovascular physiology and function, as well as physical activity performance.
PAI is a result of research based on the HUNT study where more than 60 000 individuals has been monitored over a period of more than 20 years. The goal is to make PAI the new world standard of activity tracking. PAI is an individual metric that makes sense of measured heart rate data, and significantly reduces the risk of lifestyle related diseases.
Guest blog: Collaborator Jasna Marinovic, Assistant professor at University of Split School of Medicine Department of Integrative Physiology
Membrane potential is one of the most basic properties of all living cells that is vital for proper cellular function and homeostasis. At rest, most cells in our body exhibit negative membrane potential, which is primarily established via continuous efflux of potassium (K+) ions through their respective channels. In excitable cells, such as cardiac myocytes, K+-channel opening affects cellular excitability, action potential frequency and duration, with resulting impact on contraction strength, ionic balance, oxygen demand, etc.
Among different subtypes of channels specialized for conducting potassium, a unique group, which is expressed at high density in membrane of cardiac cells, are the ATP-sensitive K+ (KATP) channels. Although under no-stress conditions they do not actively participate in action potential formation, their evolutionary conservation and abundance implicate their physiological importance. Indeed, the KATP channels serve as cellular metabolic sensors, opening in situations of cardiac stress and translating metabolic changes into alterations of membrane potential. Intactness of the KATP channels was shown essential for cardiac tolerance to stress and adaptations to increased workload, such as during increased blood pressure, chronic exercise, oxidative stress, as well as acute damage by cardiac ischemia. In humans, mutations in KATP channel subunits were found in a subset of patients with idiopathic heart failure and were associated with worse clinical outcome as compared to patients without the mutations.
As medical scientists, we work towards a major goal: to improve human health through prevention and treatment of disease. Given the size of this challenge, a key feature of the most successful projects is capacity to bring together collaborators with complementary expertise and common interests. We at CERG have established partnership with scientists from all over the world, and in recent years we have strengthened our collaborations with researchers from the University of Sao Paulo (Brazil). As a highlight of this collaboration, we are excited to join our colleagues in Sao Paulo this week for the first UTFORSK Seminar in Exercise Physiology.