Fitness Is Independently Associated with Central Hemodynamics in Metabolic Syndrome

PURPOSE: Fit individuals with metabolic syndrome (MetS) have lower mortality risk compared with less fit counterparts, despite the presence of obesity as a component of the syndrome. To understand the importance of fitness in treating this condition, we examined the association of fitness and fatness with central hemodynamic indices that are known independent predictors of cardiovascular events. METHODS: Sixty-eight individuals with MetS participated in this cross-sectional study. Central hemodynamics is calculated from radial applanation tonometry and comprised aortic reservoir pressure, backward pressure wave (Pb), reflection magnitude (RM), and augmentation index at 75 bpm (AIx75). Cardiorespiratory fitness (CRF) and body fat percentage (BF%) were determined via indirect calorimetry during maximal exercise testing and dual-energy x-ray absorptiometry, respectively. RESULTS: CRF was inversely associated with aortic reservoir pressure (r = -0.29, P = 0.02), Pb (r = -0.42, P < 0.001), RM (r = -0.48, P < 0.001), and AIx75 (r = -0.65, P < 0.001). BF% was also correlated with AIx75 (r = 0.37, P < 0.05) and RM (r = 0.36, P < 0.005) but at a weaker association compared with CRF. Multiple regression analysis revealed CRF as a predictor of aortic reservoir pressure (beta = -0.52, P = <0.01), Pb (beta = -0.41, P < 0.03), and AIx75 (beta = -0.45, P = 0.01), independent of BF% and other confounding factors. CONCLUSIONS: CRF predicts central hemodynamics independent of BF% and other confounding factors. This suggests that CRF improvement may be a higher priority when compared with fat loss for lowering the risk of cardiovascular mortality in MetS individuals

12 min/week of high-intensity interval training reduces aortic reservoir pressure in individuals with metabolic syndrome: a randomized trial.

OBJECTIVE: Decreased aortic reservoir function leads to a rise in aortic reservoir pressure that is an independent predictor of cardiovascular events. Although there is evidence that high-intensity interval training (HIIT) would be useful to improve aortic reservoir pressure, the optimal dose of high-intensity exercise to improve aortic reservoir function has yet to be investigated. Therefore, this study compared the effect of different volumes of HIIT and moderate-intensity continuous training (MICT) on aortic reservoir pressure in participants with the metabolic syndrome (MetS). METHODS: Fifty individuals with MetS were randomized into one of the following 16-week training programs: MICT [n = 17, 30 min at 60-70% peak heart rate (HRpeak), five times/week]; 4 × 4-min high-intensity interval training (4HIIT) (n = 15, 4 × 4 min bouts at 85-95% HRpeak, interspersed with 3 min of active recovery at 50-70% HRpeak, three times/week); and 1 × 4-min high-intensity interval training (1HIIT) (n = 18, 1 × 4 min bout at 85-95% HRpeak, three times/week). Aortic reservoir pressure was calculated from radial applanation tonometry. RESULTS: Although not statistically significant, there was a trend for a small-to-medium group × time interaction effect on aortic reservoir pressure, indicating a positive adaptation following 1HIIT compared with 4HIIT and MICT [F (2,46) = 2.9, P = 0.07, η = 0.06]. This is supported by our within-group analysis wherein only 1HIIT significantly decreased aortic reservoir pressure from pre to postintervention (pre-post: 1HIIT 33 ± 16 to 31 ± 13, P = 0.03; MICT 29 ± 9-28 ± 8, P = 0.78; 4HIIT 28 ± 10-30 ± 9 mmHg, P = 0.10). CONCLUSION: Three sessions of 4 min of high-intensity exercise per week (12 min/week) was sufficient to improve aortic reservoir pressure, and thus may be a time-efficient exercise modality for reducing cardiovascular risk in individuals with MetS

Performance measurement systems in SMEs : a review and a research agenda

In recent years, literature has identified the increasing complexity of small and medium-sized enterprises (SMEs) and highlighted their sensitivity to differences in managerial culture and management systems. Research has shown that performance measurement systems (PMSs) could play an important role in supporting managerial development in these companies. In this paper, the literature on performance measurement in manufacturing SMEs is reviewed and the diffusion, characteristics and determinants of performance measurement in SMEs are analysed. Shortcomings in the performance measurement systems are highlighted and the many factors that seem to constrain PMSs in manufacturing SMEs are defined, e.g. lack of financial and human resources, wrong perception of the benefits of PMS implementation, short-term strategic planning. Moreover, using dimensions defined according to the information found in the literature, two PMS models specifically developed for SMEs are compared with generic PMS models. The comparison points out an evolution in PMS models over time; in particular, the models developed in the last 20 years are more horizontal, process-oriented and focus on stakeholder needs. However, it is not clear whether these changes are due to the evolution of the generic models or an attempt to introduce models suited to the needs of SMEs. To clarify this matter and better to understand PMSs in SMEs, further theoretical and empirical studies are necessary. The main issues still requiring investigation are listed in a research agenda at the end of the paper