Effects of Xiaoyao San on exercise capacity and liver mitochondrial metabolomics in rat depression model

Objective: This study aimed to investigate the therapeutic effects of Xiaoyao San(XYS), a herbal medicine formula, on exercise capacity and liver mitochondrial metabolomics in a rat model of depression induced by chronic unpredictable mild stress(CUMS).Methods: A total of 24 male SD rats were randomly divided into four groups: control group(C), CUMS control group(M), Venlafaxine positive treatment group(V), and XYS treatment group(X). Depressive behaviour and exercise capacity of rats were assessed by body weight, sugar-water preference test, open field test, pole test, and rotarod test. The liver mitochondria metabolomics were analyzed by using liquid chromatography-mass spectrometry(LC-MS) method. TCMSP database and Gene Cards database were used to screen XYS for potential targets for depression, and GO and KEGG enrichment analyses were performed.Results: Compared with C group, rats in M group showed significantly lower body weight, sugar water preference rate, number of crossing and rearing in the open field test, climbing down time in the pole test,and retention time on the rotarod test(P < 0.01). The above behaviors and exercise capacity indices were significantly modulated in rats in V and X groups compared with M group(P < 0.05, 0.01). Compared with C group, a total of 18 different metabolites were changed in the liver mitochondria of rats in M group.Nine different metabolites and six metabolic pathways were regulated in the liver mitochondria of rats in X group compared with M group. The results of network pharmacology showed that 88 intersecting targets for depression and XYS were obtained, among which 15 key targets such as IL-1β, IL-6, and TNF were predicted to be the main differential targets for the treatment of depression. Additionally, a total of 1 553 GO signaling pathways and 181 KEGG signaling pathways were identified, and the main biological pathways were AGE-RAGE signaling pathway, HIF-1 signaling pathway, and calcium signaling pathway.Conclusion: XYS treatment could improve depressive symptoms, enhance exercise capacity, positively regulate the changes of mitochondrial metabolites and improve energy metabolism in the liver of depressed rats. These findings suggest that XYS exerts antidepressant effects through multi-target and multi-pathway.

The effect of traditional Chinese medicine rehabilitation exercise(pulmonary Daoyin)in patients with chronic obstructive pulmonary disease:A systematic review and meta-analysis

Objective:Previous research has demonstrated that pulmonary Daoyin could be an efficacious way to ameliorate the physical and psychological state of sufferers with chronic obstructive pulmonary disease(COPD)and bolster the quality of life.However,the results are not consistent.Thus,the objective of this research is to assess the impacts of pulmonary Daoyin in individuals with COPD.Methods:Relevant articles were searched in Web of Science,Cochrane Library,PubMed,EMBASE,SinoMed,CNKI,Wanfang,and VIP from database inception to January 2024.Results:There were a total of 15 randomized controlled trials(RCTs)included in this meta-analysis involving 1732 patients,of which 864 participated in the intervention group and 868 in the control group.When comparing with the control group,the COPD patients practicing pulmonary Daoyin demonstrated a significant improvement in 6 min walking distance(mean difference[MD]=24.53,95%confidence interval[CI][18.55,30.52],P<0.00001),forced expiratory volume in the 1 s(FEV_(1))(MD=0.39,95%CI[0.18,0.59],P=0.0002),percentage of FEV_(1)to the predicted value(FEV_(1)%)(MD=5.35,95%CI[3.22,7.48],P<0.0001),the forced vital capacity(FVC)(MD=0.39,95%CI[0.06,0.73],P=0.02),percentage of FVC to the predicted value(FVC%)(MD=7.52,95%CI[4.91,10.13],P<0.00001),the ratio of FEV_(1)/FVC(MD=4.95,95%CI[0.91,8.99],P=0.02),peak expiratory flow rate(standardized MD=0.98,95%CI[0.74,1.22],P<0.00001),modified Medical Research Council(mMRC)scale(MD=-0.47,95%CI[-0.89,-0.04],P=0.03),and Borg scale(MD=-0.65,95%CI[-0.75,-0.55],P<0.00001).Conclusions:Our findings may illuminate the influence of pulmonary Daoyin on exercise ability,breathlessness,and pulmonary function in COPD patients.More rigorous RCTs with larger samples and longer-term interventions will be required moving forward.

Effect of Trimetazidine on Functional Capacity in Patient with Ischaemic Cardiomyopathy (TOFCAPI)

Objective: This study aimed to evaluate the efficacy of trimetazidine on exercise capacity via a six-minute walk test in patients with ischaemic cardiomyopathy and also evaluate the effect of trimetazidine on left ventricular function via echocardiography in the same population. Methods: This prospective observational study, conducted at the National Institute of Cardiovascular Diseases in Dhaka, Bangladesh, enrolled 200 patients with ischaemic cardiomyopathy and a depressed left ventricular ejection fraction (LVEF Results: In this study (n = 200) of ischaemic cardiomyopathy patients, the mean age was 58 years, with 76% of the patients being male. All study subjects received GDMT (Guideline-Directed Medical Therapy) for angina and heart failure. Those who received the modified released form of trimetazidine developed lesions during the 1st and 2nd follow-ups, during which the LVEF, LVIDd, and six-minute walk distance significantly improved (p Conclusion: The findings of the present study demonstrated that the addition of modified-release trimetazidine to GDMT can improve exercise capacity and left ventricular function in patients with ischaemic cardiomyopathy.

Effect of phosphodiesterase-5 inhibition on exercise capacity and clinical status in heart failure with preserved ejection fraction:A randomized clinical trial

Objective To determine the effect of the phosphodiesterase-5 inhibitor sildenafil compared with placebo on exercise capacity and clinical status in HFPEF. Design Multicenter, double-blind, placebo-controlled, parallel-group, randomized clinical trial of 216 sta- ble outpatients with HF, ejection fraction ≥ 50%, elevated N-terminal brain-type natriuretic peptide or elevat- ed invasively measured filling pressures, and reduced exercise capacity. Participants were randomized from October 2008 through February 2012 at 26 centers in North America. Follow-up was through August 30, 2012.

Assessment of aerobic exercise capacity in obesity,which expression of oxygen uptake is the best?

Although the impact of obesity on exercise performance is multifactorial,excessive fat mass which can impose an unfavorable burden on cardiac function and working muscle,will affect the aerobic exercise capacity.Weight loss strategies,such as bariatric surgery can obviously affect both the body composition and aerobic exercise capacity.Maximal oxygen consumption(_VO 2max)is a widely used important indicator of aerobic exercise capacity of an individual and is closely related to body weight,size and composition.An individual's aerobic exercise capacity may show different results depending on howVO_(2)is expressed.The absoluteVO_(2)and_VO 2max relative to body weight are the most commonly used indicators.TheVO_(2)relative to fat-free mass,lean body mass or skeletal muscle mass are not influenced by adipose tissue.The last two are more useful to precisely distinguish between individuals differing in muscle adaptation to maximum oxygen uptake.The_VO 2max relative to body height is used for studying growth in children.With the in-depth study of exercise capacity and body composition in obesity,the relative oxygen uptake has been increasingly reinterpreted.

Cardiac rehabilitation and exercise therapy in the elderly： Should we invest in the aged？

Coronary heart disease （CHD） is the leading cause of death worldwide and becomes increasingly prevalent among patients aged 65 years and older.Elderly patients are at a higher risk for complications and accelerated physical deconditioning after a cardiovascular event,especially compared to their younger counterparts.The last few decades were privy to multiple studies that demonstrated the beneficial effects of cardiac rehabilitation （CR） and exercise therapy on mortality,exercise capacity,psychological risk factors,inflammation,and obesity among patients with CHD.Unfortunately,a significant portion of the available data in this field pertains to younger patients.A viable explanation is that older patients are grossly underrepresented in these programs for multiple reasons starting with the patient and extending to the physician.In this article,we will review the benefits of CR programs among the elderly,as well as some of the barriers that hinder their participation.

Cardiorespiratory fitness measured with cardiopulmonary exercise testing and mortality in patients with cardiovascular disease:A systematic review and meta-analysis

Background Cardiorespiratory fitness(CRF)is inversely associated with mortality in apparently healthy subjects and in some clinical populations,but evidence for the association between CRF and all-cause and/or cardiovascular disease(CVD)mortality in patients with established CVD is lacking.This study aimed to quantify this association.Methods We searched for prospective cohort studies that measured CRF with cardiopulmonary exercise testing in patients with CVD and that examined all-cause and CVD mortality with at least 6 months of follow-up.Pooled hazard ratios(HRs)were calculated using random-effect inverse-variance analyses.Results Data were obtained from 21 studies and included 159,352 patients diagnosed with CVD(38.1%female).Pooled HRs for all-cause and CVD mortality comparing the highest vs.lowest category of CRF were 0.42(95%confidence interval(95%CI):0.28–0.61)and 0.27(95%CI:0.16–0.48),respectively.Pooled HRs per 1 metabolic equivalent(1-MET)increment were significant for all-cause mortality(HR=0.81;95%CI:0.74–0.88)but not for CVD mortality(HR=0.75;95%CI:0.48–1.18).Coronary artery disease patients with high CRF had a lower risk of all-cause mortality(HR=0.32;95%CI:0.26–0.41)than did their unfit counterparts.Each 1-MET increase was associated with lower all-cause mortality risk among coronary artery disease patients(HR=0.83;95%CI:0.76–0.91)but not lower among those with heart failure(HR=0.69;95%CI:0.36–1.32).Conclusion A better CRF was associated with lower risk of all-cause mortality and CVD.This study supports the use of CRF as a powerful predictor of mortality in this population.

Relationship between exercise induced elevation of left ventricular filling pressure and exercise intolerance in patients with atrial fibrillation

Background Elevated left ventricular filling pressure （LVFP） is an important cause of exercise intolerance in patients with atrial fib- dilation （AF）. Exercise stress echocardiography could assess LVFP during exercise. The objective of this study was to investigate the relationship between exercise induced elevation of LVFP and exercise capacity in patients with AF. Methods This study included 145 con- secutive patients （81 men and 64 women; mean age 65.5 ± 8.0 years） with persistent non-valvular AF and normal left ventricular systolic function （left ventdcular ejection fraction 〉 50%）. All patients underwent a symptom-limited cardiopulmonary exercise test （CPET）. Doppler echocardiography was performed both at rest and immediately after exercise. Five consecutive measurements of early diastolic mitral inflow velocity （E） and early diastolic mitral annular velocity （e＇） were taken and averaged. E/e＇ ratio was calculated. Elevated LVFP was defined as E/e＇ 〉 9, and patients with elevated LVFP at rest were excluded. Results Patients were classified into two groups according to LVFP estimated by E/e＇ ratio after exercise： 39 （26.9%） with elevated LVFP after exercise and 106 （73.1%） with normal LVFP. As compared with patients with normal LVFP, the ones with elevated LVFP after exercise had significantly lower peak oxygen uptake （VO2 peak） （21.7 ± 2.3 vs. 26.4 ± 3.8 mL/min per kilogram, P 〈 0.001）, lower anaerobic threshold （19.9 ± 2.5 vs. 26.0± 4.0 mL/min per kilogram, P 〈 0.001）, and shorter exercise time duration （6.2± 0.8 vs. 7.0 ±1.3 min, P 〈 0.001）. Multivariate analysis showed that age, gender and E/e＇ after exercise were significantly correlated with VO2peak. Conclusion Elevated LVFP estimated by E/e＇ ratio after exercise is independently associated with reduced exercise capacity in AF patients.

Science Letters:Brain natriuretic peptide: A potential indicator of cardiomyogenesis after autologous mesenchymal stem cell transplantation?

We observed in a pilot study that there was a transient elevation of brain natriuretic peptide (BNP) level shortly after the transplantation in the patient with ischemic heart failure, which is unexplainable by the simultaneous increase of the cardiac output and six-minute walk distance. Similar findings were observed in the phase I trial. We postulated on the basis of the finding of Fukuda in vitro that this transient elevation of BNP level against the improvement of cardiac function and exercise capacity might indicate cardiomyogenesis in patients after mesenchymal stem cell transplantation. Further study is warranted to verify the hypothesis.

Cardiorespiratory fitness and cancer in women:A prospective pilot study

Purpose:To assess the association between cardiorespiratory fitness(CRF)and the incidence and mortality from cancer in women,and to evaluate the potential public health implications for cancer prevention.Methods:Maximal exercise testing was performed in a pilot cohort of 184 women(59.3 ± 15.2 years)who were followed for 12.0 ± 6.9 years.Cox hazard models adjusted for established cancer risk factors and accounting for competing events were analyzed for all-type cancer incidence and mortality from cancer.Population-attributable risks and exposure impact number were determined for low CRF(<5 metabolic equivalents(METs))as a risk factor.Results:During the follow-up,11.4% of the participants were diagnosed with cancer and 3.2% died from cancer.CRF was inversely and independently associated with cancer outcomes.For every 1-metabolic equivalent increase in CRF,there was a 20% decrease in the risk of cancer incidence(hazard ratio(HR)= 0.80,95% confidence interval(CI):0.69-0.92;p=0.001)and a 26% reduction in risk of cancer mortality(HR = 0.74,95%CI:0.61-0.90;p=0.002).The population-attributable risks of low CRF were 11.6% and 14% for incidence and mortality of cancer,respectively,and the respective exposure impact numbers were 8 and 20.Conclusion:Greater CRF was independently associated with a lower risk of incidence and mortality from cancer in women.Screening for low CRF as a cancer risk factor and referring unfit individuals to a supervised exercise program could be a public health strategy for cancer prevention in middle-age women.

Systolic and Diastolic Strain Measurements Show Left Ventricular Dysfunction in Women with Turner Syndrome

Aim:This study aimed to describe the systolic left ventricular global longitudinal strain(LvGLS)and left ventricular peak early diastolic strain rate(Sre)in adult women with Turner syndrome(TS)and to determine its relationship with exercise capacity and clinical parameters.Methods:In this cross-sectional cohort study,consecutively included adult TS women underwent an electrocardiogram,transthoracic echocardiogram(TTE)and cardiopulmonary exercise test(CPET)on the same day.LvGLS and Sre were measured using 2D speckle tracking analysis(STE)and compared with age-matched healthy female controls.Results:Ninety-four adult women(age 36±13 years)with TS and 32 healthy age-matched female controls were included.Women with TS had a significantly impaired/reduced systolic LvGLS(–17.82±2.98%vs.–21.80±1.85%,p<0.001)and Sre(0.98±0.32 s-1 vs.1.27±0.19 s-1,p>0.001),compared to healthy female controls.Furthermore,TS women had reduced diastolic function as measured by conventional echocardiographic parameters:A higher A-wave(p<0.001),lower E/A-ratio(p=0.001),longer deceleration time(p=0.006),and a higher E/E’-ratio(p<0.001).Women with TS also had a significantly reduced maximal workload(p=0.033),reduced oxygen uptake(p<0.001)and a reduced maximal heart rate(p<0.001)during exercise.Multivariable linear regression analysis revealed that Age,karyotype and QT-duration were significantly associated with Sre,but not with LvGLS,in the TS population.Conclusion:Systolic and diastolic strain and exercise capacity were significantly reduced in TS women compared to healthy women.No correlation between strain itself and exercise capacity could be demonstrated,but correlations with conventional TTE parameters and baseline characteristics were found.

An Overview of Non-exercise Estimated Cardiorespiratory Fitness:Estimation Equations,Cross-Validation and Application

Purpose To summarize current non-exercise prediction models to estimate cardiorespiratory fitness(CRF),cross-validate these models,and apply them to predict health outcomes.Methods PubMed search was up to August 2018 for eligible publications.The current review was comprised of three steps.The first step was to search the literature on non-exercise prediction models.The key words combined non-exercise,CRF and one among prediction,prediction model,equation,prediction equation and measurement.The second step was to search the literature about cross-validation of non-exercise equations.The key words included non-exercise,CRF and one among validation,cross-validation and validity.The last step was to search for application of CRF assessed from non-exercise equations.The key words were non-exercise,CRF,mortality,all-cause mortality,cardiovascular disease(CVD)mortality and cancer mortality.Results Sixty non-exercise equations were identified.Age,gender,percent body fat,body mass index,weight,height and physical activity status were commonly used in the equations.Several researchers cross-validated non-exercise equations and proved their validity.In addition,non-exercise estimated CRF was significantly associated with all-cause mortality and fatal and nonfatal CVD.Conclusions Measurement of CRF from non-exercise models is practical and viable when exercise testing is not feasible.Despite the limitations of equations,application of CRF from non-exercise methods showed accuracy and predictive ability.

Neither autophagy nor exercise training mode affect exercise-induced beneficial adaptations in high fat-fed mice

Exercise mitigates obesity-associated pathologies;however,there is controversy regarding optimal exercise interventions.Autophagy,is known to decrease during obesity and is an important moderator for exercise adaptations.Purpose:To investigate individual and combined effects of different exercise interventions and autophagy inhibition on exercise adaptations during obesity.Methods:C57BL/6J mice initiated 45%high fat diet at 8 weeks of age.After 6 weeks of diet,animals were divided into moderate(MOD)or high intensity interval training interventions(HIIT),animals were further divided into autophagy inhibition or vehicle conditions(n=10/group).Animals exercised and autophagy was inhibited 3X/week by NSC185058 injections,thereby blocking autophagosome formation.Interventions continued for 4 weeks.Results:High fat diet impaired glucose handling~17%;exercise interventions normalized glucoregulation to prehigh fat diet levels,without differences between any interventions.High fat diet induced~25%decrease in aerobic capacity,which returned to baseline after exercise interventions,with no differences between any interventions.No effects of autophagy inhibition were noted.Conclusions:HIIT and MOD training confer similar health-related adaptations.

The effects of Chinese Yam-Epimedium mixture on respiratory function and quality of life in patients with chronic obstructive pulmonary disease

OBJECTIVE:To examine the clinical effects of a mixture of Chinese Yam and Epimedium in patients with stable moderate or severe chronic obstructive pulmonary disease(COPD).METHODS:Forty-nine patients with COPD were randomly allocated to a group whose usual treatment was supplemented with oral Chinese Yam-Epimedium mixture,or a control group given placebo.For each patient,body mass index,airflow obstruction,dyspnea,and exercise capacity were measured and converted into the BODE index before treatment and at one and three months after initiation of treatment.Participants also completed the St George's Respiratory Questionnaire(SGRQ) at the same intervals.RESULTS:After one month,improvements were seen in the BODE index and SGRQ of participants taking Chinese Yam-Epimedium mixture compared to controls.There were statistically significant differences in the SGRQ:three of its components and the total SGRQ scores were significantly decreased(P<0.05),respiratory symptom scores had improved(P<0.01),and the dyspnea component of the BODE index had significantly decreased(P<0.05).Similar improvements were observed after three months of treatment,but exercise tolerance had also improved:the six-minute walking distance had significantly increased(P<0.05) in the treatment group when compared with controls.CONCLUSION:Chinese Yam-Epimedium mixture can significantly improve dyspnea,exercise capacity,and the quality of life of patients with stable moderate or severe COPD.