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Ciccarone Articles

Ciccarone Center Research

Topic

Exercise and Physical Fitness

Landmark Articles

  • To facilitate the guideline-based implementation of treatment recommendations in the ambulatory setting and to encourage participation in the multiple preventive health efforts that exist, we have organized several recent guideline updates into a simple ABCDEF approach. We would remind clinicians that evidence-based medicine is meant to inform recommendations but that synthesis of patient-specific data and use of appropriate clinical judgment in each individual situation is ultimately preferred.

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  • Unhealthy lifestyle habits are a major contributor to coronary artery disease (CAD). The purpose of the study was to investigate the associations of smoking, weight maintenance, physical activity, and Mediterranean-style diet with coronary calcium, cardiovascular events, and mortality. We discovered that, over the course of nearly 8 years, a combination of regular exercise, healthy diet, smoking avoidance, and weight maintenance contributed to lower coronary calcium incidence, slower calcium progression, and lower all-cause mortality.
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  • Much attention has been directed toward lifestyle modifications as effective means of reducing cardiovascular disease risk. We review recent observational and interventional trials investigating the effects of physical activity on markers of (or causal factors for) atherosclerotic burden and vascular disease. There is a strong correlation between physical activity and triglyceride reduction, apolipoprotein B reduction, HDL increase, change in LDL particle size, increase in tissue plasminogen activator activity, and decrease in CAC. Further research is needed to elucidate the effect on inflammatory markers and intima-media thickness.
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Neighborhood health-promoting resources and obesity risk (the Multi-Ethnic Study of Atherosclerosis).
By: Auchincloss AH, Mujahid MS, Shen M, Michos ED, Whitt-Glover MC, Diez Roux AV.

Altering the residential environment so that healthier behaviors and lifestyles can be easily chosen may be a precondition for sustaining existing healthy behaviors and for adopting new healthy behaviors.

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Comparison of exercise treadmill testing with cardiac computed tomography angiography among patients presenting to the emergency room with chest pain: the Rule Out Myocardial Infarction Using Computer-Assisted Tomography (ROMICAT) study.
By: Blankstein R, Ahmed W, Bamberg F, Rogers IS, Schlett CL, Nasir K, Fontes J, Tawakol A, Brady TJ, Nagurney JT, Hoffmann U, Truong QA.
Although patients with a high number of clinical risk factors are more likely to have obstructive coronary artery disease, those who are young or who would be expected to have a very high exercise capacity are unlikely to have coronary stenosis and therefore may benefit from initial treadmill testing instead of CTA.
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Effects of physical activity on cardiovascular disease.
By: Ahmed HM, Blaha MJ, Nasir K, Rivera JJ, Blumenthal RS.
Much attention has been directed toward lifestyle modifications as effective means of reducing cardiovascular disease risk. We review recent observational and interventional trials investigating the effects of physical activity on markers of (or causal factors for) atherosclerotic burden and vascular disease. There is a strong correlation between physical activity and triglyceride reduction, apolipoprotein B reduction, HDL increase, change in LDL particle size, increase in tissue plasminogen activator activity, and decrease in CAC. Further research is needed to elucidate the effect on inflammatory markers and intima-media thickness.
Read on Pubmed
Use of the Frank-Starling mechanism during exercise is linked to exercise-induced changes in arterial load.
By: Chantler PD, Melenovsky V, Schulman SP, Gerstenblith G, Becker LC, Ferrucci L, Fleg JL, Lakatta EG, Najjar SS.
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Heat acclimation and exercise training interact when combined in an overriding and trade-off manner: physiologic-genomic linkage.
By: Kodesh E, Nesher N, Simaan A, Hochner B, Beeri R, Gilon D, Stern MD, Gerstenblith G, Horowitz M.
Combined heat acclimation (AC) and exercise training (EX) enhance exercise performance in the heat while meeting thermoregulatory demands. We suggest that concerted adjustments induced by AC and EX lead to enhanced metabolic and mechanical performance of the EXAC heart.
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Effects of physical activity on cardiovascular disease.
By: Ahmed HM, Blaha MJ, Nasir K, Rivera JJ, Blumenthal RS.
This paper provides a comprehensive look at the benefits of increased physical activity on lipid changes, thrombotic, inflammatory factors, and measures of subclinical atherosclerosis.
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Preventive cardiology: past, present, and future.
By: Blaha MJ, Gluckman TJ, Blumenthal RS.
The majority of improvement in rates of mortality from CVD since 1960 has been the result of prevention strategies and not treatment of acute CVD. Prevention occurs at three levels: primordial, primary, and secondary. National guidelines direct population-based and individual-based preventive care. This chapter offers an easy to remember memory tool that facilitates comprehensive preventive care: The Ciccarone Center ABCDE approach.
Exercise for restoring health and preventing vascular disease.
By: Stewart KJ, Ratchford EV, Williams MA.
Individuals with heart disease can benefit greatly from exercise training and other aspects of cardiac rehabilitation and secondary prevention programs. Exercise training plays a critical role as a primary treatment of patients with peripheral arterial disease, with the goal of improving quality of life and functional capacity.
Abnormalities in arterial-ventricular coupling in older healthy persons are attenuated by sodium nitroprusside.
By: Chantler PD, Nussbacher A, Gerstenblith G, Schulman SP, Becker LC, Ferrucci L, Fleg JL, Lakatta EG, Najjar SS.
The coupling between arterial elastance (E(A); net afterload) and left ventricular elastance (E(LV); pump performance), known as E(A)/E(LV), is a key determinant of cardiovascular performance and shifts during exercise due to a greater increase in E(LV) versus E(A). This normal exercise-induced reduction in E(A)/E(LV) decreases with advancing age. In conclusion, some age-associated deficiencies in E(A)/E(LV), E(A), and E(LV), in older subjects can be acutely abolished by single-nucleotide polymorphisms (SNPs) infusion. This is relevant to common conditions in older subjects associated with a significant impairment of exercise performance such as frailty or heart failure with preserved ejection fraction.
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Coffee, alcohol, smoking, physical activity and QT interval duration: results from the Third National Health and Nutrition Examination Survey.
By: Zhang Y, Post WS, Dalal D, Blasco-Colmenares E, Tomaselli GF, Guallar E.
Abnormalities in the electrocardiographic QT interval duration have been associated with an increased risk of ventricular arrhythmias and sudden cardiac death. However, there is substantial uncertainty about the effect of modifiable factors such as coffee intake, cigarette smoking, alcohol consumption, and physical activity on QT interval duration. We studied 7,795 men and women from NHANES III. Binge drinking was associated with longer QT interval in men but not in women. QT interval duration was not associated with other modifiable factors, including coffee and tea intake, smoking, and physical activity.
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