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Nanotechnology has widespread applications in sports; however, there are very few studies reporting the use of nanotechnology to enhance physical performance. We hypothesize that a natural-mineral-based novel nanomaterial, which was developed from Japanese hot springs, might overcome the limitations. We examined if it could enhance physical performance. We conducted a treadmill exercise test on 18 students of athletic clubs at Fukushima University, Japan, and measured heart rate, oxygen consumption, maximal oxygen consumption, CO 2 production, and respiratory quotient 106 times in total. The results showed that the elevation of heart rate was significantly suppressed in the natural-mineral-based nanomaterial group, while no differences were observed in oxygen consumption, maximal oxygen consumption, CO 2 production, and respiratory quotient between groups. To our knowledge, this result is the first evidence where an improvement of cardiovascular and pulmonary functions was induced by bringing a natural-mineral-based nanomaterial into contact with or close to a living body without pharmacological intervention or physical intervention. This could open new avenue of biomedical industries even in an eco-friendly direction. The precise mechanisms remain a matter for further investigation; however, we may assume that endothelial NO synthase, hemoglobin and endothelium-derived hyperpolarizing factor are deeply involved in the improvement of cardiovascular and pulmonary functions. [ABSTRACT FROM AUTHOR]

Objective: Arterial stiffness is related to arteriolosclerotic diseases and is a marker of adverse cardiovascular events. Mitral annular calcification (MAC) is progressive calcium deposition on the posterior and inferior mitral annulus and is associated with atherosclerotic cardiovascular diseases. Cardio-ankle vascular index (CAVI) is a measurement technique used to estimate the degree of arterial stiffness without effect from blood pressure. The aim of this study is to research arterial stiffness using CAVI in patients with MAC. Materials and Methods: The study was cross-sectional and observational and included 98 patients with MAC confirmed by echocardiography who referred to the cardiology clinics and met study inclusion criteria and 38 controls without MAC. CAVI measurements were obtained by using the Vascular Screening System VaSera VS-1000 (Fukuda Denshi, Tokyo, Japan) device. Results: The two groups were similar in terms of demographic characteristics, including age, sex, hypertension, coronary artery disease, body surface area, and smoking (P > .05). Left atrial volume index was significantly higher in patients with MAC compared with the control group (P < .001). Right arm CAVI, left arm CAVI, and mean CAVI were significantly higher in the MAC group than the control group (P = .037, P = .005, and P = .014, respectively) and increased with MAC severity. There was a significant positive correlation between mean CAVI and MAC grade (r = 0.278, P = .001). Also, when ankle-brachial index (ABI) was measured with CAVI, left and right extremity ABI values were significantly lower in patients with MAC (P = .017 and P = .005, respectively). Conclusion: CAVI increased in all patients with MAC and associated with increasing grade of calcification. [ABSTRACT FROM AUTHOR]

Purpose The study purpose was to investigate whether years of clinical experience and experience of encountering heart failure affect perceptions of the need for physical assessment, and the nature of the association between perceptions and years of clinical experience. Methods: This study was survey‐based. Of hospitals in Japan with ≥200 beds, 298 hospitals were randomly selected as candidate research sites. Ultimately, 44 hospitals agreed to participate in this study. A self‐administered questionnaire measuring 48 physical assessment skills was developed and distributed to nurses. The questionnaire rated the perceived need for 48 skills assessing acute progression of heart failure. Results: Of 1,113 nurses sampled, 373 (33.5%) responded. Of these, 347 completed questionnaires (response rate: 93.0%). Nurses' perceived need for skills involving systematic or cardiovascular system assessment decreased with clinical experience. Nurses' perceived need for skills involving cardiovascular symptoms and circulatory failure assessment increased with clinical experience. We found four patterns of change for nurses' perceptions of physical assessment skills according to clinical experience. Conclusions: The findings showed that differences in nurses' perceived need for physical assessment skills were associated with differences in clinical experience. Nurses with more experience selected more suitable skills for detecting acute progression of heart failure. Nurses' perceptions of the need for specific skills were proportional to years of clinical experience, and there may be a threshold value of years of experience. [ABSTRACT FROM AUTHOR]

Aim: The cardio‐ankle vascular index (CAVI) reflects functional arterial stiffness, which is related to endothelial dysfunction. CD34‐positive cells carry out an important function in endothelial repair. However, there have been no reports assessing the association between CAVI and the number of circulating CD34‐positive cells. Methods: We carried out a cross‐sectional study of 249 Japanese men, aged 60–69 years, who underwent annual health checkups between 2013 and 2015. As individuals with high levels of circulating CD34‐positive cells might indicate the influence of consumptive reduction of circulating CD34‐positive cells as a result of aggressive endothelial repair, participants were stratified by circulating CD34‐positive cell levels, using the median value in this population (0.95 cells/μL) as the cut‐off. Results: For participants with low circulating CD34‐positive cell levels, logarithmic values of circulating CD34‐positive cells were inversely associated with CAVI (multivariable standardized parameter estimate [β] = −0.22, P = 0.014), but not for participants with high levels (β = −0.04, P = 0.638). In addition, even when no significant associations between CAVI and carotid intima‐media thickness were detected for participants with low circulating CD34‐positive cell levels (β = −0.02, P = 0.865), significant positive associations were identified for participants with high levels (β = 0.22, P = 0.028). Conclusions: As circulating CD34‐positive cell count might indicate endothelial repair activity, the present results show that CAVI is affected by insufficient endothelial repair in individuals with low circulating CD34‐positive cell counts. Our results also show that a positive association between CAVI and carotid intima‐media thickness exists only in individuals with aggressive endothelial repair, which indicates the presence of organic arterial disease, such as atherosclerosis. Geriatr Gerontol Int 2019; 19: 557–562. [ABSTRACT FROM AUTHOR]

Objective: To examine changes in the bone and cardiovascular parameters and tolerability in middle-aged Japanese women taking equol supplement for a year. Design: This was a prospective observational study. Subjects and Setting: Participants were 74 women receiving outpatient care at Hamasite Medical Clinic, Minato-ku, Tokyo, from 2013 to 2015. Interventions: Participants received per oral equol-containing supplement, 10 mg/day. Outcome measures: The primary outcome measures were percent changes in bone and cardiovascular parameters after 1 year supplementation with equol. The secondary measures included factors affecting the parameter changes and adverse effects associated with equol use for a year. Results: Reduction in arterial stiffness was observed after 12 months of equol supplement (1402.3 cm/s vs.1367.3 cm/s, p  < 0.001). Significant reductions in respective parameters were observed in women with moderate and high risk for arteriosclerosis (median [95% confidence interval]: −3.2% [−5.79 to −0.74]; −12.65% [−18.52 to −4.28]; respectively); hypertriglyceridemia −45.53% [−70.24 to −5.58]; bone resorption risk (−15.15% [−23.71 to 1.56]; and bone fracture risk −26.68% [−76.43 to −5.99]. All 15 women with high baseline parathyroid hormone levels had achieved a median of 50% [−54.11 to −31.69] reduction from their baseline values. These associations were further confirmed in the results of multiple linear regression analysis. There were no reported adverse events or abnormal findings in the blood chemistry, Pap smear, mammography, and transvaginal ultrasound during periodic follow-ups. Conclusion: One year equol supplement was tolerable and induced improvement of certain bone and cardiovascular parameters, especially in higher risk groups. Further controlled studies are needed to explore long-term equol use for wellbeing of middle-aged women. [ABSTRACT FROM AUTHOR]

To determine whether maximum bite force ( MBF), an objective measure of oral function, is associated with development of frailty in community-dwelling older adults. This prospective cohort study included community-dwelling Japanese adults aged 75 years at baseline (n = 322). Baseline MBF was measured using an electronic recording device (Occlusal Force-Meter GM10). Follow-up examinations, including physical fitness and anthropometric evaluation and structured questionnaires, were administered annually over a 5-year period to determine the incidence of frailty, which was defined by the presence of 3 or more of the following 5 components derived from the Cardiovascular Health Study: low level of mobility, low physical activity level, weakness, shrinking and poor endurance and energy. Adjusted hazard ratios ( HRs) of incidence of frailty according to sex-stratified tertiles of baseline MBF were calculated using Cox proportional hazards regression models. During the follow-up, 49 participants (15.2%) developed frailty. Participants in the lower tertile of MBF exhibited a significantly greater risk of frailty than those in the upper tertile. After adjustment for sex, depression, diabetes and Eichner index, the adjusted HRs for frailty in the upper through lower tertiles of MBF were 1.00 (reference), 1.27 (95% confidence interval [ CI]: 0.50-3.20) and 2.78 (95% CI: 1.15-6.72), respectively ( P for trend = .01). Poor oral function, as indicated by low MBF, increases the risk of development of frailty among elderly men and women. [ABSTRACT FROM AUTHOR]

Background and Objectives: Arterial stiffness is a leading cause of cardiovascular disease (CVD), and it is considered to be affected by dietary intake. However, few studies have examined the relationship between major dietary patterns and brachial-ankle pulse wave velocity (baPWV) among Japanese middle-aged subjects. We studied whether major dietary patterns were associated with baPWV in this population.Methods and Study Design: Between 2009 and 2012, 70 Japanese middle-aged subjects (39 men and 31 women) with no history of stroke, coronary heart disease, or cancer were studied. Dietary intake was documented using a validated food-frequency questionnaire, and dietary patterns were generated using factor analysis. Correlational analyses were performed between baPWV and identified dietary patterns and between baPWV and individual risk factors (total cholesterol, triglyceride, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], non- HDL-C, LDL/HDL ratio, and augmentation index).Results: Two dietary patterns were identified: a rice-rich pattern (high in rice, breads, oils and fats, meats, and confectionery) and a vegetable-rich pattern (high in vegetables, fruit, fish, and seaweed). The rice-rich pattern was not associated with baPWVor other risk factors. A significant inverse correlation was found between baPWV and the vegetable-rich dietary pattern (p<0.05).Conclusions: Our findings suggest that a dietary pattern characterized by high consumption of vegetables, seafood, seaweed, fruit, and pulse is inversely associated with arterial stiffness measured by baPWV. This diet offers an additional nutritional approach to the prevention and treatment of arterial stiffness. [ABSTRACT FROM AUTHOR]

Aortic pulse wave velocity (PWV) has been accepted as the gold standard for arterial stiffness measurement. However, PWV depends on blood pressure (BP). To eliminate the BP dependency of PWV, the cardio–ankle vascular index (CAVI) was developed. This study aimed to define the relationship between CAVI and aortic atherosclerosis or structure on multidetector computed tomography (MDCT). Patients with (n = 49) or without (n = 49) coronary artery disease were studied. The lumen and vessel diameters and wall thickness were calculated from the cross-sectional area at the pulmonary bifurcation level by 64-slice MDCT. The CAVI was measured within 3 days before MDCT. Multivariate analysis showed that the vessel diameter of the ascending and descending aorta on MDCT depends on age, body surface area, and diastolic BP. The CAVI significantly correlated with the vessel diameter (r = .453) and wall thickness (r = .387) of the thoracic descending aorta (P < .001, respectively). The CAVI was an independent predictor of the descending aortic wall thickness on multiple stepwise regression analysis. These data suggest that CAVI, a simple index, is useful for evaluating thoracic aortic atherosclerosis. [ABSTRACT FROM AUTHOR]

AV Nodal Remodeling Induced by AF Background An animal experiment showed that long-term atrial pacing or persistent atrial fibrillation (AF) caused electrical remodeling of the atrioventricular (AV) node. We aimed to test the hypothesis that persistent AF decreases the AV conductivity in human hearts. Methods and Results We retrospectively compared the cardiac electrophysiological properties between patients with paroxysmal AF who underwent catheter ablation (PXAF, N = 254) and those with persistent or longstanding persistent AF (PSAF, N = 213). The PSAF patients were more likely than PXAF patients to have longer atrial-His (AH) (96.3 ± 25.7 vs. 91.3 ± 20.4 milliseconds; P = 0.02) and His-ventricle (HV) (43.1 ± 9.4 vs. 41.2 ± 8.6 milliseconds; P = 0.02) intervals. The AV nodal effective refractory period (ERP) (299.1 ± 74.6 vs. 276.2 ± 58.9 milliseconds; P < 0.001) and Wenckebach cycle length (420.9 ± 80.3 vs. 386 ± 58.6 milliseconds; P < 0.001) were also more prolonged in the PSAF patients. We found a dual AV nodal physiology with a similar frequency in both groups. The AH interval, fast pathway ERP, and Wenckebach cycle length in the PSAF patients were more likely than in the PXAF patients to be prolonged among the patients without dual pathways, while those intergroup differences were never seen among the patients with dual pathways. In subgroup analyses including only PSAF patients, there was no difference in the AV conductivity between the patients with persistent AF and those with longstanding persistent AF. Conclusions Persistent AF may cause a mild decrease in the AV nodal function in human hearts. Electrical remodeling may be uncommon if dual AV nodal pathways are present, and its extent may not depend on the duration of persistent AF. [ABSTRACT FROM AUTHOR]

Background The United States and Japan have similar standards of living, healthcare systems, and industrializations but exhibit markedly divergent life expectancies both at birth and at later ages (50 or 65 years old). Arterial stiffness has been widely regarded as a barometer of biological or physiological aging and could provide insight into the inter-country differences. Objectives To determine whether the increases in arterial stiffness across the adult age range are greater in U.S. than Japanese adults. Design Cross-sectional analyses. Setting Laboratory-based study. Participants Healthy, nonsmoking Japanese (n = 400) and U.S. (n = 400) adults without cardiovascular and other chronic diseases. Measurements Indices of arterial stiffness, including carotid-femoral (cf PWV) and brachial-ankle pulse wave velocity (ba PWV) were measured, along with a variety of ancillary measures. The recruitment method, measurement technique, and protocol were standardized and identical between U.S. and Japanese facilities. Results cf PWV and ba PWV increased progressively with advancing age in all subgroups (stratified according to sex and country). The rates of age-related increases in arterial stiffness were not different between U.S. and Japanese men, but age-associated increases in cf PWV were significantly greater in U.S. than Japanese women, widening the intercountry differences at older age ranges. Conclusion Japanese women had smaller increases in central arterial stiffness with advancing age than U.S. women. [ABSTRACT FROM AUTHOR]

Aim To study whether there is an association between serum immunoglobulin G4 ( IgG4) concentration and cardiac function among cardiology inpatients. Methods This retrospective study included 91 patients who had sinus rhythm. Of 91 patients, 70 patients (77%) were aged ≥60 years (elderly group) and the remaining 21 patients (23%) were aged <60 years (younger group). Results Serum IgG4 concentrations were found to be negatively correlated with brain natriuretic peptide ( BNP) and with E/e′, an indicator for cardiac diastolic function in the elderly group, but not in the younger group. In contrast, IgG4 was significantly correlated with neither left ventricular mass nor ejection fraction in either group. Multivariate regression analysis showed that, in the elderly group, the association between IgG4 and E/e′, and that between IgG4 and BNP, were independent of age, sex, systolic blood pressure and renal function; log-transformed IgG4 showed a negative association with log-transformed E/e′ and log-transformed BNP, with a standardized correlation coefficient of −0.26 (95% confidence interval −0.49 to −0.03, P = 0.030 and −0.22 (95% confidence interval −0.44 to −0.11, P = 0.043), respectively. Conclusion Serum IgG4 concentration might be associated with cardiac diastolic function among elderly cardiology inpatients. Geriatr Gerontol Int 2014; 14: 582-588. [ABSTRACT FROM AUTHOR]

Background Postural tachycardia syndrome ( POTS) manifests as marked tachycardia while standing. We noticed two forms of circulatory response to orthostatic stress in POTS. We investigated cardiovascular and autonomic nervous response to orthostatic stress in the two forms. Methods We studied 79 patients with POTS and 38 healthy control subjects ( Ct). Beat-to-beat blood pressure ( BP) and heart rate ( HR) were non-invasively and continuously measured in the supine and standing positions. Autonomic nervous function was evaluated on power spectral analysis of HR variability and diastolic BP variability. We divided the subjects into two groups: standing-induced tachycardia ( SI group; increase in HR ≥35 beats/min) and supine tachycardia ( Su group; standing HR ≥115 beats/min with standing-induced HR increase <35 beats/min). Results The Su group had higher supine BP and HR compared with the other groups, indicating dominant sympathetic control of the heart in the supine position. While rising, the SI group had a higher increase in HR than the Ct group, indicating excessive withdrawal of vagal tone. The Su group had a smaller increase in HR and a greater decrease of systolic BP and cardiac index by standing compared with the SI group. These results suggest that compensatory mechanisms of sympathetic function during standing failed in the Su group, probably because of exhaustion by the nearly maximum effort to generate sympathetic drive even in the supine position with low central blood volume. Conclusion There is a difference between the two types of POTS, in the balance of resting autonomic function and hemodynamic response to standing. [ABSTRACT FROM AUTHOR]

Background. Despite increasing attention toward forest therapy as an alternative medicine, very little evidence continues to be available on its therapeutic effects. Therefore, this study was focused on elucidating the health benefits of forest walking on cardiovascular reactivity. Methods. Within-group comparisons were used to examine the cardiovascular responses to walking in forest and urban environments. Forty-eight young adult males participated in the two-day field research. Changes in heart rate variability, heart rate, and blood pressure were measured to understand cardiovascular reactivity. Four different questionnaires were used to investigate the changes in psychological states after walking activities. Results. Forest walking significantly increased the values of ln(HF) and significantly decreased the values of ln(LF/HF) compared with the urban walking. Heart rate during forest walking was significantly lower than that in the control. Questionnaire results showed that negative mood states and anxiety levels decreased significantly by forest walking compared with urban walking. Conclusion. Walking in the forest environment may promote cardiovascular relaxation by facilitating the parasympathetic nervous system and by suppressing the sympathetic nervous system. In addition, forest therapy may be effective for reducing negative psychological symptoms. [ABSTRACT FROM AUTHOR]

We previously found that forest environments reduced stress hormones such as adrenaline and noradrenaline and showed the relaxing effect both in male and female subjects. In the present study, we investigated the effects of walking under forest environments on cardiovascular and metabolic parameters. Sixteen healthy male subjects (mean age 57.4 ± 11.6 years) were selected after obtaining informed consent. The subjects took day trips to a forest park in the suburbs of Tokyo and to an urban area of Tokyo as a control in September 2010. On both trips, they walked for 2 h in the morning and afternoon on a Sunday. Blood and urine were sampled on the morning before each trip and after each trip. Blood pressure was measured on the morning (0800) before each trip, at noon (1300), in the afternoon (1600) during each trip, and on the morning (0800) after each trip. The day trip to the forest park significantly reduced blood pressure and urinary noradrenaline and dopamine levels and significantly increased serum adiponectin and dehydroepiandrosterone sulfate (DHEA-S) levels. Walking exercise also reduced the levels of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) and urinary dopamine. Taken together, habitual walking in forest environments may lower blood pressure by reducing sympathetic nerve activity and have beneficial effects on blood adiponectin and DHEA-S levels, and habitual walking exercise may have beneficial effects on blood NT-proBNP levels. [ABSTRACT FROM AUTHOR]