Right ventricular failure(RVF)remains the primary cause of death in patients with pulmonary arterial hypertension.We review the pathophysiology of RVF,including the remodeling and ventriculoarterial uncoupling that oc...Right ventricular failure(RVF)remains the primary cause of death in patients with pulmonary arterial hypertension.We review the pathophysiology of RVF,including the remodeling and ventriculoarterial uncoupling that occurs when the failing right side of the heart is unable to compensate for a rising afterload.Secondly,the noninvasive imaging techniques used in the assessment of RVF are explored,including echocardiography,cardiac magnetic resonance imaging,computed tomography,and positron emission tomography.Third,we describe how these imaging techniques and a patient’s clinical characteristics may be used to determine prognosis.Lastly,we explore the medical and surgical/interventional treatment options for RVF.Despite these treatment options,morbidity and mortality remain high in this patient population.The discovery of new prognostic indicators,use of hybrid imaging for early detection of RVF,and strategies to prevent the development of RVF will be important if outcomes in this patient population are to improve.展开更多
We and others have published extensively on the benefits of physical activity(PA),exercise training,and cardiorespiratory fitness(CRF)to decrease the prevalence of cardiovascular diseases(CVDs)and CVD and all-cause mo...We and others have published extensively on the benefits of physical activity(PA),exercise training,and cardiorespiratory fitness(CRF)to decrease the prevalence of cardiovascular diseases(CVDs)and CVD and all-cause morbidity and mortality.^(1-5)Both PA and CRF are important;however,CRF,which is mostly obtained through PA,although there is a genetic component,seems to be even more important than PA for predicting prognosis.^(1,4-6)Certainly,the wealth of data from across the world has indicated that increasing PA to enhance CRF while mitigating sedentary behavior would go a long way to lessen the world-wide obesity epidemic and reduce CVD and all-cause mortality.展开更多
There has been considerable innovation and advancement in the field of exercise and physical activity (PA).In regards to the battle against chronic non-communicable disease,however,we believe the model of PA that woul...There has been considerable innovation and advancement in the field of exercise and physical activity (PA).In regards to the battle against chronic non-communicable disease,however,we believe the model of PA that would prove most salu-tary is one closely mimicking that of our hunter-gatherer ancestors.For the purpose of longevity,the human body and our genetic makeup have been evolutionarily adapted to respond best to moderate amounts of high-intensity interval training,in conjunction with high amounts of low intensity exercise.Moreover,to optimize resiliency and cardiorespiratory fitness,a hunter-gatherer fitness regimen must include cross training targeted at flexibility,balance and strength.Though not com-monly understood,the health benefits from exercise comprise a reverse J-curve.The endurance athletes residing on the furthest reaches of the PA spectrum appear to lose a substantial portion of the exercise-related longevity and cardiovascular benefits due to cardiac overuse injury.Conversely,there is an emerging body of evidence suggesting leisure time exercise done with peers in a natural environment is significantly superior to that training done in solitude.This idea of the "power of play" lends support to the ancestral model of PA whereby humans are evolutionary adapted to be highly social,outdoor creatures capable of a diverse range of PA at varying intensities.展开更多
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 ...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.展开更多
The 2012 grade C recommendation from the United States Preventive Service Task Force(USPSTF)is that clinicians may choose to selectively counsel adults about healthful diet and physical activity(PA)for cardiovascular ...The 2012 grade C recommendation from the United States Preventive Service Task Force(USPSTF)is that clinicians may choose to selectively counsel adults about healthful diet and physical activity(PA)for cardiovascular disease(CVD)prevention,in adults without known CVD,hypertension(HTN),diabetes mellitus(DM)or dyslipidemia(1).展开更多
文摘Right ventricular failure(RVF)remains the primary cause of death in patients with pulmonary arterial hypertension.We review the pathophysiology of RVF,including the remodeling and ventriculoarterial uncoupling that occurs when the failing right side of the heart is unable to compensate for a rising afterload.Secondly,the noninvasive imaging techniques used in the assessment of RVF are explored,including echocardiography,cardiac magnetic resonance imaging,computed tomography,and positron emission tomography.Third,we describe how these imaging techniques and a patient’s clinical characteristics may be used to determine prognosis.Lastly,we explore the medical and surgical/interventional treatment options for RVF.Despite these treatment options,morbidity and mortality remain high in this patient population.The discovery of new prognostic indicators,use of hybrid imaging for early detection of RVF,and strategies to prevent the development of RVF will be important if outcomes in this patient population are to improve.
文摘We and others have published extensively on the benefits of physical activity(PA),exercise training,and cardiorespiratory fitness(CRF)to decrease the prevalence of cardiovascular diseases(CVDs)and CVD and all-cause morbidity and mortality.^(1-5)Both PA and CRF are important;however,CRF,which is mostly obtained through PA,although there is a genetic component,seems to be even more important than PA for predicting prognosis.^(1,4-6)Certainly,the wealth of data from across the world has indicated that increasing PA to enhance CRF while mitigating sedentary behavior would go a long way to lessen the world-wide obesity epidemic and reduce CVD and all-cause mortality.
文摘There has been considerable innovation and advancement in the field of exercise and physical activity (PA).In regards to the battle against chronic non-communicable disease,however,we believe the model of PA that would prove most salu-tary is one closely mimicking that of our hunter-gatherer ancestors.For the purpose of longevity,the human body and our genetic makeup have been evolutionarily adapted to respond best to moderate amounts of high-intensity interval training,in conjunction with high amounts of low intensity exercise.Moreover,to optimize resiliency and cardiorespiratory fitness,a hunter-gatherer fitness regimen must include cross training targeted at flexibility,balance and strength.Though not com-monly understood,the health benefits from exercise comprise a reverse J-curve.The endurance athletes residing on the furthest reaches of the PA spectrum appear to lose a substantial portion of the exercise-related longevity and cardiovascular benefits due to cardiac overuse injury.Conversely,there is an emerging body of evidence suggesting leisure time exercise done with peers in a natural environment is significantly superior to that training done in solitude.This idea of the "power of play" lends support to the ancestral model of PA whereby humans are evolutionary adapted to be highly social,outdoor creatures capable of a diverse range of PA at varying intensities.
文摘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.
文摘The 2012 grade C recommendation from the United States Preventive Service Task Force(USPSTF)is that clinicians may choose to selectively counsel adults about healthful diet and physical activity(PA)for cardiovascular disease(CVD)prevention,in adults without known CVD,hypertension(HTN),diabetes mellitus(DM)or dyslipidemia(1).
