Liikuntalääketiede elintapasairauksien ehkäisyssä ja hoidossa:pätkittäin arjessa vai kaasu pohjassa?

Tiivistelmä Säännöllisen liikunnan sisällyttäminen viikoittaisen arjen rytmiin lisää kiistatta hyvinvointia ja edistää parempaa terveyttä tarkasteltiinpa sitä elintapasairauksien ennaltaehkäisyn, hoidon tai kuntoutuksen näkökulmasta

Introduction to the research topic: the role of physical fitness on cardiovascular responses to stress

[Extract] This e-book is the culmination of countless hours of meticulous work by global scientists. We would like to thank the researchers for their great contributions to this hot topic. The combination of these studies reflects the importance of the topic amongst researchers and practitioners and the wide interest from numerous laboratories around the world. The contributions include a variety of formats including five original investigations, three review articles, one opinion article and a hypothesis and theory article. Notably, these contributions included both human and animal models that encompassed a range of techniques from molecular mechanisms to real life interventions thus reinforcing the translational approach for the understanding of cardiovascular responses to stress

Commentaries on point: Counterpont: Exercise training-induced bradycardia

[Extract] TO THE EDITOR: In the recent Point:Counterpoint debate (2, 3), both research groups argued that training-induced bradycardia was a result of changes in intrinsic, sinoatrial node firing (i.e., intrinsic rate) or cardiac autonomic/parasympathetic regulation. While Billman (2) stated the possibility of a combination of these mechanisms, no further discussion of this was provided by either research group. Rather, the discussion focused on either mechanism and we would urge researchers to consider a more complex scenario – contribution of either mechanism that is moderated by other factors, or both mechanisms, potentially in combination with other elements (e.g., cardiac tructural changes). For example, training-induced bradycardia was reported in young adults with no changes in heart rate variability (HRV)(4), supporting an intrinsic rate mechanism. However, bradycardia was induced similarly with enhanced HRV in young adults following high-intensity exercise, supporting a cardiac autonomic mechanism (5)

The Role of Physical Fitness on Cardiovascular Responses to Stress

Cardiovascular responses to physical and/ or mental stressors has been a topic of great interest for some time. For example, significant changes of cardiovascular control and reactivity have been highlighted as important mechanisms for the protective effect of exercise as a simple and effective, non medical therapy for many pathologies. However, despite the great number of studies performed to date (e.g. >54,000 entries in Pubmed for "cardiovascular stress"), important questions of the role stress has on cardiovascular function still remain. For instance, What factors account for the different cardiovascular responses between mental and physical stressors? How do these different components of the cardiovascular system interact during stress? Which cardiovascular responses to stress are the most important for identifying normal, depressed, and enhanced cardiovascular function? Can these stress-induced responses assist with patient diagnosis and prognosis? What impact does physical fitness have on the relationship between cardiovascular function and health? The current topic examined our current understanding of cardiovascular responses to stress and the significant role that physical fitness has on these responses for improved function and health. Manuscripts focusing on heart rate variability (HRV), heart rate recovery, and other novel cardiovascular assessments were especially encouraged

Methods of assessment of the post-exercise cardiac autonomic recovery: additional important factors to be considered.

[Extract] The review from Peçanha T. and colleagues [5] has made an important contribution to the applicability of post-exercise, cardiac autonomic assessment utilising heart rate recovery (HRR) and heart rate variability (HRV). We congratulate these authors and would like to highlight important factors that should also be considered in conjunction with this work

Machine learning models in predicting health care costs in patients with a recent acute coronary syndrome:a prospective pilot study

Abstract Background: Health care budgets are limited, requiring the optimal use of resources. Machine learning (ML) methods may have an enormous potential for effective use of health care resources. Objective: We assessed the applicability of selected ML tools to evaluate the contribution of known risk markers for prognosis of coronary artery disease to predict health care costs for all reasons in patients with a recent acute coronary syndrome (n = 65, aged 65 ± 9 years) for 1-year follow-up. Methods: Risk markers were assessed at baseline, and health care costs were collected from electronic health registries. The Cross-decomposition algorithms were used to rank the considered risk markers based on their impacts on variances. Then regression analysis was performed to predict costs by entering the first top-ranking risk marker and adding the next-best markers, one by one, to build up altogether 13 predictive models. Results: The average annual health care costs were €2601 ± €5378 per patient. The Depression Scale showed the highest predictive value (r = 0.395), accounting for 16% of the costs (P = .001). When the next 2 ranked markers (LDL cholesterol, r = 0.230; and left ventricular ejection fraction, r = -0.227, respectively) were added to the model, the predictive value was 24% for the costs (P = .001). Conclusion: Higher depression score is the primary variable forecasting health care costs in 1-year follow-up among acute coronary syndrome patients. The ML tools may help decision-making when planning optimal utilization of treatment strategies

Musculoskeletal pains and cardiovascular autonomic function in the general Northern Finnish population

Abstract Background: Heart rate variability (HRV) and baroreflex sensitivity (BRS) measurements provide means for the objective assessment of cardiovascular autonomic function. As previous studies have associated chronic pain with abnormal autonomic function, we aimed to characterize the relationship between the number of musculoskeletal pain sites (NPS), pain intensity, and cardiovascular autonomic function among the population-based Northern Finland Birth Cohort 1966. Methods: At the age of 46, cohort members self-reported their musculoskeletal pains (enabling the determination of NPS [0–8] and pain intensity [Numerical Rating Scale, NRS, 0–10]) and underwent clinical assessments of cardiovascular autonomic function in seated and standing positions (HRV variables: heart rate [HR] and root mean square of successive differences in beat-to-beat intervals [rMSSD] for the entire cohort; BRS variables: low-frequency systolic blood pressure variability [SBPV] and cross-spectral baroreflex sensitivity [BRS] for those attending the examination in Oulu, Finland). Extensive confounder data were also collected (body mass index, physical activity, smoking, Hopkins Symptom Checklist-25, comorbidities, and medications). The full samples included 4186 and 2031 individuals (HRV and BRS samples, respectively). Three subanalyses focused on individuals with intense and frequent pain, individuals with symptoms of depression and anxiety, and the relationship between pain intensity and autonomic parameters. Results: Linear regression models showed varying associations between NPS, pain intensity, and cardiovascular autonomic parameters. However, after all adjustments NPS was only associated with one outcome among women (BRS, standing: beta = − 0.015, p = 0.048) and two among men (HR, seated: beta = − 0.902, p = 0.003; HR, standing: beta = − 0.843, p = 0.014). Pain intensity was not associated with any outcome after full adjustments. Significant sex*pain interactions were found in the data. Conclusions: Our data suggest that musculoskeletal pain has, at most, a limited independent association with cardiovascular autonomic function. Future studies should carefully account for the potential confounders and sex interactions that this study revealed

Are 15-year trajectories of low back pain and sciatica associated with cardiovascular autonomic function in the general population?:the Northern Finland Birth Cohort 1966 study

Abstract Study Design: A population-based cohort study. Objective: The aim of this study was to examine whether 15-year trajectories of low back pain (LBP) and sciatica are associated with cardiovascular autonomic function in a large general population sample. Summary of Background Data: Previous studies using mainly small patient samples have suggested that LBP and sciatica are associated with abnormal cardiovascular autonomic function, namely altered heart rate variability (HRV) and baroreflex sensitivity (BRS). We examined this association in a large general population sample. Methods: The data collections of the Northern Finland Birth Cohort 1966 consisted of pain questionnaires at 31 and 46 years (history of LBP, sciatica, and other musculoskeletal pains during the previous year; yes/no for each) and measurements of HRV and BRS at 46 years (heart rate, HR; root mean square of successive differences in beat-to-beat intervals, rMSSD; low-frequency systolic blood pressure variability, SBPV; cross-spectral BRS, BRS; each while seated and standing). The data collections also comprised several confounders. Trajectories for LBP, sciatica, and both together (“no pain,” “decreasing,” “increasing,” “long-term pain”) were constructed and general linear models were used to perform comparisons between trajectories (for HR/rMSSD, n = 3398; for SBPV/BRS, n = 1667). Results: In the crude models, LBP and sciatica were associated with higher HR, lower rMSSD, higher SBPV, and lower BRS, but these associations were mostly attenuated by adjustments. Regarding both LBP and sciatica, only the “increasing” trajectory was associated with two of the eight outcomes (standing SBPV, seated BRS) after adjustments. Regarding LBP, the “increasing” trajectory was associated with three (standing SBPV, seated BRS, standing BRS), the “long-term pain” trajectory with one (standing BRS), and the “decreasing” trajectory with one outcome (seated SBPV) after adjustments. Sciatica showed no association with the outcomes after adjustments. Conclusion: We conclude that the 15-year trajectories of LBP and sciatica do not have a consistent independent association with cardiovascular autonomic function among the general population

Physical activity is associated with cardiac autonomic function in adolescent men

Abstract Introduction: Moderate to vigorous physical activity (MVPA) has been shown to be associated with autonomic regulation of the heart measured with heart rate variability (HRV). Only a limited amount of studies have examined this relationship among adolescents, and the effects of increasing PA on HRV is not well established. The aim of this study was to investigate how overall self-reported PA associates with HRV in a large population of adolescent men. Methods: The study was part of the Finnish MOPO study consisting of 3629 young men (mean age 18, SD 1 years) enrolled for military call-ups in 2009—2013. Overall PA, including both the intensity and frequency of habitual exercise, was assessed by a questionnaire and the respondents categorized into four groups of PA (low, moderate, high and top). Short-term HRV, physical performance and body composition were measured. Results: HRV, as indicated by mean ln rMSSD, increased according the PA categories as follows: low (3.65 ms (SD 0.7), p<0.001 vs. other groups), moderate (3.78 ms (0.6) p<0.001), high (3.85 ms (0.6) p<0.001) and top activity (3.93 ms (0.6) p<0.001) According to the multivariable linear regression analysis, a significant positive relationship (β = 0.129, p<0.05) was observed between self-reported PA and ln rMSSD independent of body mass index, waist circumference and fat percentage. Conclusions: Physical activity was positively associated with cardiac autonomic regulation, in adolescent men. A linear increase in HRV according to PA was observed, suggesting that even slight increments in PA might be beneficial for cardiac autonomic regulation The results emphasize the importance of physical activity in improving cardiac health in young people