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Article ; Online: Exercise training in cardiac rehabilitation: Setting the right intensity for optimal benefit.

Sabbahi, Ahmad / Canada, Justin M / Babu, Abraham Samuel / Severin, Richard / Arena, Ross / Ozemek, Cemal

2022 Volume 70, Page(s) 58–65

Abstract: Cardiac rehabilitation (CR) programs are recommended standard-of-care by all major cardiovascular medicine professional organizations. Exercise training is the cornerstone for CR, with aerobic training being the primary form of training. The benefits of ... ...

Abstract	Cardiac rehabilitation (CR) programs are recommended standard-of-care by all major cardiovascular medicine professional organizations. Exercise training is the cornerstone for CR, with aerobic training being the primary form of training. The benefits of exercise training are multiple; however, improved cardiorespiratory fitness is of utmost importance. Moderate-intensity continuous training, supplemented with resistance training, has traditionally been the most common form of exercise training in CR. This review discusses the role of aerobic exercise training in CR and the importance of effective and personalized exercise prescription for optimized results. We also focus on the benefits and utility of high-intensity interval training across different clinical populations commonly seen in the CR setting.
MeSH term(s)	Cardiac Rehabilitation/methods ; Exercise ; Exercise Test ; Exercise Therapy/methods ; High-Intensity Interval Training ; Humans
Language	English
Publishing date	2022-02-08
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	209312-1
ISSN	1873-1740 ; 1532-8643 ; 0033-0620
ISSN (online)	1873-1740 ; 1532-8643
ISSN	0033-0620
DOI	10.1016/j.pcad.2022.02.001
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Article ; Online: Early reduction in cardiorespiratory fitness and diastolic reserve following radiation therapy for lung cancer.

Thomas, Georgia / Weiss, Elisabeth / Del Buono, Marco Giuseppe / Moroni, Francesco / West, Josh / Myers, Rachel / Kontos, Emily / Golino, Michele / Abbate, Antonio / Canada, Justin M

Cardio-oncology (London, England)

2024 Volume 10, Issue 1, Page(s) 15

Abstract: Background: Contemporary radiotherapy for the treatment of lung cancer is effective in targeting tumor tissue while limiting heart exposure, yet cardiac toxicity still occurs, often becoming clinically apparent years later. Cardiorespiratory fitness ( ... ...

Abstract	Background: Contemporary radiotherapy for the treatment of lung cancer is effective in targeting tumor tissue while limiting heart exposure, yet cardiac toxicity still occurs, often becoming clinically apparent years later. Cardiorespiratory fitness (CRF) is an independent predictor of cardiovascular, cancer-related, and overall mortality and may serve as a sensitive measure of subclinical cardiac toxicity following anti-cancer treatments. Prior work has demonstrated a significant relationship between reduced CRF and impaired left-ventricular (LV) diastolic reserve in cancer survivors following thoracic radiotherapy. The purpose of this study was to assess early longitudinal changes in CRF and cardiac function in patients with lung cancer following radiotherapy. Methods: Ten patients (69 [61-76] years, 70% female) with lung cancer without known cardiovascular disease scheduled to receive radiotherapy involving a clinically-relevant heart dose (≥ 5 Gy to > 10% of heart volume) were evaluated prior to and following treatment. Changes in CRF (peak oxygen consumption [VO Results: The VO Conclusions: Patients with lung cancer receiving radiotherapy with a clinically-significant heart dose experience reductions in CRF (VO
Language	English
Publishing date	2024-03-12
Publishing country	England
Document type	Journal Article
ISSN	2057-3804
ISSN (online)	2057-3804
DOI	10.1186/s40959-024-00216-2
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Article ; Online: Exercise Cardiovascular Magnetic Resonance: A Review.

Trankle, Cory R / Canada, Justin M / Jordan, Jennifer H / Truong, Uyen / Hundley, W Gregory

Journal of magnetic resonance imaging : JMRI

2021 Volume 55, Issue 3, Page(s) 720–754

Abstract: While pharmacologic stress cardiovascular magnetic resonance imaging (MRI) is a robust noninvasive tool in the diagnosis and prognostication of epicardial coronary artery disease, clinical guidelines recommend exercise-based testing in those patients who ...

Abstract	While pharmacologic stress cardiovascular magnetic resonance imaging (MRI) is a robust noninvasive tool in the diagnosis and prognostication of epicardial coronary artery disease, clinical guidelines recommend exercise-based testing in those patients who can exercise. This review describes the development of exercise cardiovascular MRI protocols, summarizes the insights across various patient populations, and highlights future research initiatives. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 2.
MeSH term(s)	Coronary Artery Disease/diagnostic imaging ; Exercise ; Exercise Test ; Humans ; Magnetic Resonance Imaging/methods ; Magnetic Resonance Spectroscopy
Language	English
Publishing date	2021-03-03
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1146614-5
ISSN	1522-2586 ; 1053-1807
ISSN (online)	1522-2586
ISSN	1053-1807
DOI	10.1002/jmri.27580
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Article ; Online: Cardiopulmonary exercise testing during the COVID-19 pandemic.

Mihalick, Virginia L / Canada, Justin M / Arena, Ross / Abbate, Antonio / Kirkman, Danielle L

Progress in cardiovascular diseases

2021 Volume 67, Page(s) 35–39

Abstract: The outbreak of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has presented a global public health emergency. Although predominantly a pandemic of acute respiratory disease, corona virus infectious disease-19 (COVID-19) ...

Abstract	The outbreak of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has presented a global public health emergency. Although predominantly a pandemic of acute respiratory disease, corona virus infectious disease-19 (COVID-19) results in multi-organ damage that impairs cardiopulmonary (CP) function and reduces cardiorespiratory fitness. Superimposed on the CP consequences of COVID-19 is a marked reduction in physical activity that exacerbates CP disease (CPD) risk. CP exercise testing (CPET) is routinely used in clinical practice to diagnose CPD and assess prognosis; assess cardiovascular safety for rehabilitation; and delineate the physiological contributors to exercise intolerance and exertional fatigue. As such, CPET plays an important role in clinical assessments of convalescent COVID-19 patients as well as research aimed at understanding the long-term health effects of SARS-CoV-2 infection. However, due to the ventilatory expired gas analysis involved with CPET, the procedure is considered an aerosol generating procedure. Therefore, extra precautions should be taken by health care providers and exercise physiologists performing these tests. This paper provides recommendations for CPET testing during the COVID-19 pandemic. These recommendations include indications for CPET; pre-screening assessments; precautions required for testing; and suggested decontamination protocols. These safety recommendations are aimed at preventing SARS-CoV-2 transmission during CPET.
MeSH term(s)	COVID-19/immunology ; Exercise Test/methods ; Exercise Test/standards ; Humans ; Practice Guidelines as Topic ; Sterilization/methods
Language	English
Publishing date	2021-05-06
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	209312-1
ISSN	1873-1740 ; 1532-8643 ; 0033-0620
ISSN (online)	1873-1740 ; 1532-8643
ISSN	0033-0620
DOI	10.1016/j.pcad.2021.04.005
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Article ; Online: Letter by Carbone et al Regarding Article, "Evidence Supporting the Existence of a Distinct Obese Phenotype of Heart Failure With Preserved Ejection Fraction".

Carbone, Salvatore / Canada, Justin M / Abbate, Antonio

Circulation

2018 Volume 137, Issue 4, Page(s) 414–415

Language	English
Publishing date	2018-01-18
Publishing country	United States
Document type	Letter ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	80099-5
ISSN	1524-4539 ; 0009-7322 ; 0069-4193 ; 0065-8499
ISSN (online)	1524-4539
ISSN	0009-7322 ; 0069-4193 ; 0065-8499
DOI	10.1161/CIRCULATIONAHA.117.030432
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Article ; Online: Physical activity, sedentary behaviors and all-cause mortality in patients with heart failure: Findings from the NHANES 2007-2014.

Kim, Youngdeok / Canada, Justin M / Kenyon, Jonathan / Billingsley, Hayley / Arena, Ross / Lavie, Carl J / Carbone, Salvatore

PloS one

2022 Volume 17, Issue 7, Page(s) e0271238

Abstract: Background: Limited data are available examining the effects of both moderate- and vigorous-intensity physical activity (MVPA) and sedentary behavior (SB) on longevity among patients with heart failure (HF). This study examined the associations of MVPA ... ...

Abstract	Background: Limited data are available examining the effects of both moderate- and vigorous-intensity physical activity (MVPA) and sedentary behavior (SB) on longevity among patients with heart failure (HF). This study examined the associations of MVPA and SB with all-cause mortality in HF patients using a nationally representative survey data. Methods: National Health and Nutrition Examination Survey data (2007-2014) were used. 711 adults with self-reported congestive HF, linked to 2015 mortality data were analyzed. Self-reported MVPA and SB minutes were used to create the three MVPA [No-MVPA, insufficient (I-MVPA; <150 min/wk), and sufficient (S-MVPA; ≥150 min/wk)] and two SB (<8 and ≥8 hrs/d) groups. Cox proportional hazard models were constructed to test the associations of MVPA and SB with all-cause mortality. Results: 119 deaths occurred over an average of 4.9 years of follow-up. Lower MVPA and higher SB were independently associated with poor survival (P < .001). Joint and stratified analyses showed that the protective effect of MVPA was most pronounced among patients with SB<8 hrs/d. There was no difference in the mortality risk by SB levels within I-MVPA and S-MVPA groups; however, in the No-MVPA group, those with SB≥8 hrs/d had a greater risk of mortality compared to those with <8 hrs/d (Hazard ratio = 1.60). Conclusion: In this HF cohort, MVPA and SB were independently and jointly associated with all-cause mortality. The beneficial effect of MVPA is attenuated by excessive SB; however, engaging in some amount of MVPA may provide a protective effect and attenuates the detrimental effects associated with excessive SB.
MeSH term(s)	Accelerometry ; Adult ; Exercise ; Heart Failure ; Humans ; Nutrition Surveys ; Sedentary Behavior ; Surveys and Questionnaires
Language	English
Publishing date	2022-07-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0271238
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Article ; Online: Right Ventricular Contractile Reserve: A Key Metric to Identifying When Cardiorespiratory Fitness Will Improve With Pulmonary Vasodilators.

Arena, Ross / Ozemek, Cemal / Canada, Justin M / Lavie, Carl J / Borghi-Silva, Audrey / Bond, Samantha / Popovic, Dejana / Argiento, Paola / Guazzi, Marco

Current problems in cardiology

2022 Volume 48, Issue 1, Page(s) 101423

Abstract: Cardiorespiratory fitness (CRF) has been proposed as a vital sign for the past several years, supported by a wealth of evidence demonstrating its significance as a predictor of health trajectory, exercise/functional capacity, and the quality of life. ... ...

Abstract	Cardiorespiratory fitness (CRF) has been proposed as a vital sign for the past several years, supported by a wealth of evidence demonstrating its significance as a predictor of health trajectory, exercise/functional capacity, and the quality of life. According to the Fick equation, oxygen consumption (VO
MeSH term(s)	Humans ; Cardiorespiratory Fitness ; Exercise Test ; Heart Ventricles ; Quality of Life ; Vasodilator Agents ; Ventricular Dysfunction, Right ; Clinical Trials as Topic
Chemical Substances	Vasodilator Agents
Language	English
Publishing date	2022-09-24
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	441230-8
ISSN	1535-6280 ; 0146-2806
ISSN (online)	1535-6280
ISSN	0146-2806
DOI	10.1016/j.cpcardiol.2022.101423
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Article ; Online: Effects of Replacing Sedentary Time With Physical Activity on Mortality Among Patients With Heart Failure: National Health and Nutrition Examination Survey Follow-Up Study.

Kim, Youngdeok / Canada, Justin M / Kenyon, Jonathan / Billingsley, Hayley E / Arena, Ross / Lavie, Carl J / Carbone, Salvatore

Mayo Clinic proceedings

2022 Volume 97, Issue 10, Page(s) 1897–1903

Abstract: A sedentary lifestyle is prevalent among patients with heart failure (HF) and is associated with poor prognosis and survival, possibly owing to the displacement of health-enhancing behaviors, such as physical activity (PA). However, there is limited ... ...

Abstract	A sedentary lifestyle is prevalent among patients with heart failure (HF) and is associated with poor prognosis and survival, possibly owing to the displacement of health-enhancing behaviors, such as physical activity (PA). However, there is limited evidence examining the displacement effects of reducing duration of sedentary time (ST) on clinical outcomes in patients with HF. The current study examined the theoretical effects of relocating ST with PA on all-cause and cardiovascular disease (CVD)-specific mortality risks in patients with HF. We analyzed 265 patients with HF who participated in the National Health and Nutrition Examination Survey from 2003 to 2006. Cox proportional hazards regression model was fitted to estimate mortality risks based on objectively measured ST well as time spent in light-intensity PA (LPA) and moderate- and vigorous-intensity PA (MVPA). The theoretical changes in the hazard ratio (HR) by replacing ST with LPA or MVPA were examined using isotemporal substitutional modeling. On average, patients with HF spent 70% of waking hours per day in ST (9.01 hours), followed by LPA (29%; 3.75 hours) and MVPA (1%; 0.13 hours). Ten-minute substitution of ST with LPA was associated with significantly lower all-cause and CVD-specific mortality risks (hazard ratio [HR]=0.93 for both). The mortality risks progressively decreased as more ST was relocated to LPA. The relocation effects of ST with MVPA were not statistically significant, possibly because of limited MVPA accrued in this clinical population. The current study provides empirical evidence about the potential health benefits of replacing a modest amount of ST with LPA among patients with HF.
MeSH term(s)	Accelerometry ; Cardiovascular Diseases ; Exercise ; Follow-Up Studies ; Heart Failure ; Humans ; Nutrition Surveys ; Sedentary Behavior
Language	English
Publishing date	2022-06-23
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	124027-4
ISSN	1942-5546 ; 0025-6196
ISSN (online)	1942-5546
ISSN	0025-6196
DOI	10.1016/j.mayocp.2022.05.009
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Article ; Online: Simultaneous exercise stress cardiac magnetic resonance and cardiopulmonary exercise testing to elucidate the Fick components of aerobic exercise capacity: a feasibility and reproducibility study and pilot study in hematologic cancer survivors.

Canada, Justin M / McCarty, John / Jordan, Jennifer H / Trankle, Cory R / DeCamp, Kevin / West, Josh D / Reynolds, Mary Ann / Myers, Rachel / Sweat, Katey / McGhee, Virginia / Arena, Ross / Abbate, Antonio / Hundley, W Gregory

Cardio-oncology (London, England)

2023 Volume 9, Issue 1, Page(s) 31

Abstract: Background: Patients treated for hematologic malignancy often experience reduced exercise capacity and increased fatigue; however whether this reduction is related to cardiac dysfunction or impairment of skeletal muscle oxygen extraction during activity ...

Abstract	Background: Patients treated for hematologic malignancy often experience reduced exercise capacity and increased fatigue; however whether this reduction is related to cardiac dysfunction or impairment of skeletal muscle oxygen extraction during activity is unknown. Cardiopulmonary exercise testing (CPET) coupled with stress cardiac magnetic resonance (ExeCMR), may provide a noninvasive method to identify the abnormalities of cardiac function or skeletal muscle oxygen extraction. This study was performed to determine the feasibility and reproducibility of a ExeCMR + CPET technique to measure the Fick components of peak oxygen consumption (VO Methods: We studied 16 individuals undergoing ExeCMR to determine exercise cardiac reserve with simultaneous measures of VO Results: Study procedures were successfully completed without any adverse events in all subjects (N = 16, 100%). The protocol demonstrated good-excellent test-retest reproducibility for peak VO Conclusions: Noninvasive measurement of peak VO
Language	English
Publishing date	2023-07-10
Publishing country	England
Document type	Journal Article
ISSN	2057-3804
ISSN (online)	2057-3804
DOI	10.1186/s40959-023-00182-1
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Article ; Online: Interleukin-1 blockade in heart failure: an on-treatment and off-treatment cardiorespiratory fitness analysis.

Moroni, Francesco / Golino, Michele / Carbone, Salvatore / Trankle, Cory / Del Buono, Marco Giuseppe / Talasaz, Azita / Arena, Ross / Canada, Justin M / Biondi-Zoccai, Giuseppe / Van Tassel, Benjamin / Abbate, Antonio

ESC heart failure

2023 Volume 10, Issue 5, Page(s) 3199–3202

Abstract: Aims: Interleukin-1 (IL-1) blockade may improve exercise capacity in patients with heart failure (HF) patients. The extent of the improvement and its persistence beyond discontinuation of IL-1 blockade is unknown.: Methods and results: The primary ... ...

Abstract	Aims: Interleukin-1 (IL-1) blockade may improve exercise capacity in patients with heart failure (HF) patients. The extent of the improvement and its persistence beyond discontinuation of IL-1 blockade is unknown. Methods and results: The primary objective was to determine changes in cardiorespiratory fitness and cardiac function on-treatment with IL-1 blocker, anakinra, and off-treatment, after treatment cessation. We performed cardiopulmonary exercise testing, Doppler echocardiography, and biomarkers in 73 patients with HF, 37 (51%) females, 52 (71%) Black-African-American, before and after treatment with anakinra 100 mg daily. In a subset of 46 patients, testing was also repeated after treatment cessation. Quality of life was assessed in each patient using standardized questionnaires. Data are presented as median and interquartile range. Treatment with anakinra for 4 [2-12] weeks was associated with a significant improvement in high-sensitivity C-reactive protein (from 6.2 [3.3-15.4] to 1.4 [0.8-3.4] mg/L, P < 0.001), peak oxygen consumption (VO Conclusions: These data validate IL-1 as an active and dynamic modulator of cardiac function and cardiorespiratory fitness in HF.
MeSH term(s)	Female ; Humans ; Male ; Interleukin-1 ; Interleukin 1 Receptor Antagonist Protein/therapeutic use ; Cardiorespiratory Fitness ; C-Reactive Protein ; Quality of Life ; Heart Failure/diagnosis ; Biomarkers
Chemical Substances	Interleukin-1 ; Interleukin 1 Receptor Antagonist Protein ; C-Reactive Protein (9007-41-4) ; Biomarkers
Language	English
Publishing date	2023-07-04
Publishing country	England
Document type	Journal Article
ZDB-ID	2814355-3
ISSN	2055-5822 ; 2055-5822
ISSN (online)	2055-5822
ISSN	2055-5822
DOI	10.1002/ehf2.14460
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