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Background: Integrated curriculum interventions have been suggested as an effective means to increase physical activity (PA) and health. The feasibility of such approaches in children living in deprivation is unknown. This study sought to pilot an integrated curriculum pedometer intervention in children living in deprivation on school-based PA, body fatness, resting blood pressure, motor skills, and well-being. Methods: Using a pilot cluster randomized intervention design, children (6–7 y old, n = 64) from 2 schools in central England undertook: (1) 10-week integrated curriculum intervention or (2) control (regular school-based activity). School-based PA, body fatness, resting blood pressure, motor skills, and well-being were assessed preintervention and postintervention. Results: For the intervention group, PA was higher on school days when children had physical education lessons or there were physically active integrated curriculum activities. Body fatness significantly decreased, and well-being and perceived physical competence increased, pre–post for the intervention group compared with the control group. Accelerometer-derived PA, motor skills, and resting blood pressure were not significantly different pre–post for intervention or control groups. Conclusions: A 10-week integrated curriculum PA intervention is feasible to conduct and can positively impact aspects of health in 6- to 7-year-old children in England. [ABSTRACT FROM AUTHOR]

Abstract:AimsMethodsResultsConclusionCoronavirus disease (COVID-19) can affect cardiovascular function in health and disease. The present study assessed the effect of prior COVID-19 infection on cardiovascular phenotype at rest and in response to exercise in middle age and older individuals.This case-control, single-centre study recruited 124 participants: 84 with a history of COVID-19 (59.9 ± 7.41 years, 54.8% female) and 40 participants without history of COVID-19 infection (62.8 ± 7.14 years, 62.5% female). All participants underwent non-invasive assessment of arterial function using pulse wave velocity (PWV), augmentation index (Alx) and hemodynamic function (i.e., cardiac index (CI), stroke volume index (SVI), heart rate (HR), mean arterial blood pressure (MAP)) at rest. Cardiopulmonary exercise stress testing with simultaneous gas exchange and hemodynamic (bioreactance) measurements was also performed.There were no differences between COVID-19 and non-COVID-19 groups in PWV (COVID-19: 7.52 ± 1.66 m/s, non-COVID-19: 7.32 ± 1.79 m/s, p = 0.440); Alx (COVID-19: 29.2 ± 9.12%, non-COVID-19: 29.2 ± 8.44%, p = 0.980); CI (COVID-19: 2.85 ± 0.39 L/min/m2, non-COVID-19: 2.79 ± 0.37 L/min/m2, p = 0.407); SVI (COVID-19: 46.5 ± 7.54 mL/m2, non-COVID-19: 47.0 ± 7.59 mL/m2, p = 0.776), HR (COVID-19: 62.3 ± 10.6 beats/min, Non-COVID-19: 60.2 ± 8.52 beats/min, p = 0.263), or MAP (COVID-19: 98.1 ± 11.2 mmHg, non-COVID-19: 96.6 ± 9.46 mmHg, p = 0.464). COVID-19 participants however demonstrated lower O2 consumption at anaerobic threshold (15.5 ± 4.25 vs 16.8 ± 4.51 mL/kg/m2, p = 0.034), peak cardiac index (10.4 ± 2.3 vs 11.3 ± 2.5 L/min/m2, p = 0.040) and peak stroke volume index (82.1 ± 25.3 vs 98.6 ± 37.6 mL/m2, p = 0.028).Healthy middle-age and older individuals with history COVID-19 infection demonstrate reduced exercise tolerance and cardiac function response to exercise. [ABSTRACT FROM AUTHOR]

Background and Aims: Arterial function (specifically arterial stiffness) is an important cardiovascular risk factor. Pulse wave velocity (PWV) and augmentation index (Alx $x$) are established indicators of arterial function. The present study aimed to evaluate the repeatability and reproducibility of PWV and Alx $x$ in healthy individuals. Methods: Forty healthy participants (age 33 ± 11 years, 17 females) underwent resting supine PWV and Alx $x$ assessments. Measurements were made in triplicate and repeated 1 week apart. Alx $x$ was measured by brachial occlusion and PWV was measured from the carotid artery to the femoral artery via the tonometer‐oscillometric method. Repeatability and reproducibility were assessed using the intraclass correlation coefficient (ICC). Interoperator reproducibility was performed on 10 participants. Results: The average values for week‐to‐week visits for PWV and Alx $x$ were 6.20 ± 0.91 versus 6.13 ± 0.91 ms−1 and 14.0 ± 11.8 versus 16.3 ± 12.2% respectively. For same‐day measurements, both PWV and Alx $x$ showed excellent repeatability (PWV: ICC = 0.96, 95% CI: 0.92–0.98, p < 0.01; Alx $x$: ICC = 0.90, 95% CI: 0.84–0.94, p < 0.01) and interoperator reproducibility (PWV: ICC = 0.98, 95% CI: 0.93–1.00, p < 0.01; Alx $x$: ICC = 0.93, 95% CI: 0.69–0.98, p < 0.01). Measurements were repeated 1 week apart and showed good reproducibility (PWV: ICC = 0.77, 95% CI: 0.61–0.87, p ≤ 0.01; Alx $x$: ICC = 0.73, 95% CI: 0.73–0.86, p < 0.01). Conclusion: PWV and Alx $x$ demonstrate excellent repeatability and good reproducibility. Considering these variables are noninvasive and easy‐to‐measure, arterial function assessment may have a role in routine clinical practice to facilitate risk stratification in cardiovascular diseases. Summary: PWV and Alx $x$ are repeatable and reproducible measures of arterial functionPWV is more repeatable and reproducible than Alx $x$ but requires training before operation [ABSTRACT FROM AUTHOR]

Aim: Sacubitril/valsartan treatment reduces mortality and hospitalizations in heart failure with reduced ejection fraction but has limited application in hypertrophic cardiomyopathy (HCM). The aim of this study was to evaluate the effect of sacubitril/valsartan on peak oxygen consumption (VO2) in patients with non‐obstructive HCM. Methods and results: This is a phase II, randomized, open‐label multicentre study that enrolled adult patients with symptomatic non‐obstructive HCM (New York Heart Association class I–III) who were randomly assigned (2:1) to receive sacubitril/valsartan (target dose 97/103 mg) or control for 16 weeks. The primary endpoint was a change in peak VO2. Secondary endpoints included echocardiographic measures of cardiac structure and function, natriuretic peptides and other cardiac biomarkers, and Minnesota Living with Heart Failure quality of life. Between May 2018 and October 2021, 354 patients were screened for eligibility, 115 patients (mean age 58 years, 37% female) met the study inclusion criteria and were randomly assigned to sacubitril/valsartan (n = 79) or control (n = 36). At 16 weeks, there was no significant change in peak VO2 from baseline in the sacubitril/valsartan (15.3 [4.3] vs. 15.9 [4.3] ml/kg/min, p = 0.13) or control group (p = 0.47). No clinically significant changes were found in blood pressure, cardiac structure and function, plasma biomarkers, or quality of life. Conclusion: In patients with HCM, a 16‐week treatment with sacubitril/valsartan was well tolerated but had no effect on exercise capacity, cardiac structure, or function. [ABSTRACT FROM AUTHOR]

Physical activity presents an important cornerstone in the management and care of individuals with hypertrophic cardiomyopathy (HCM). Twenty-one individuals with HCM (age: 52±15 years old, body mass index (BMI): 30±7 kg/m2) completed 7-day monitoring using wrist-worn triaxial accelerometers (GENEActiv, ActivInsights Ltd, UK) and were compared to age and sex-matched healthy controls (age: 51±14 years old, BMI: 25±4 kg/m2). For individuals with HCM, clinical parameters (left atrial diameter and volume, peak oxygen consumption, NTproBNP and Minnesota Living with Heart Failure (MLHF)) were correlated with accelerometry. After adjusting for BMI, individuals with HCM spent less time in moderate-vigorous physical activity (MVPA) (86 (55–138) vs. 140 (121–149) minutes/day, p <0.05) compared to healthy controls. Individuals with HCM engaged in fewer MVPA-5 min (6 (2–15) vs. 27 (23–37) minutes/day, p <0.01) and MVPA-10 min bouts (9 (0–19) vs. 35 (17–54) minutes/day, p <0.01) versus healthy controls. For HCM only, peak oxygen consumption was correlated with MVPA (r =0.60, p <0.01) and MVPA-5 min bouts (r =0.47, p <0.05). MLHF score was correlated with slee p duration (r =0.45, p <0.05). Individuals with HCM should be encouraged to engage in moderate-intensity physical activity bouts and reduce prolonged periods of inactivity in order to potentially improve exercise tolerance and reduce disease burden. [ABSTRACT FROM AUTHOR]

Background and Aims: Single‐use electrocardiography (ECG) leads have been developed to reduce healthcare‐associated infection. This study compared the validity and reliability of short‐term heart rate variability (HRV) obtained from single‐use disposable ECG leads. Methods: Thirty healthy subjects (33 ± 10 years; 9 females) underwent 5‐min resting HRV assessments using disposable (single use) ECG cable and wire system (Kendall DL™ Cardinal Health) and a standard, reusable ECG leads (CardioExpress, Spacelabs Healthcare). Results: Intraclass correlation coefficient (ICC) with 95% confidence interval (CI) between disposable and reusable ECG leads was for the time domain [R‐R interval (ms); 0.99 (0.91, 1.00)], the root mean square of successive normal R‐R interval differences (RMSSD) (ms); 0.91 (0.76, 0.96), the SD of normal‐to‐normal R‐R intervals (SDNN) (ms); 0.91 (0.68, 0.97) and frequency domain [low‐frequency (LF) normalized units (nu); 0.90 (0.79, 0.95), high frequency (HF) nu; 0.91 (0.80, 0.96), LF power (ms2); 0.89 (0.62, 0.96), HF power (ms2); 0.90 (0.72, 0.96)] variables. The mean difference and upper and lower limits of agreement between disposable and reusable leads for time‐ and frequency‐domain variables were acceptable. Analysis of repeated measures using disposable leads demonstrated excellent reproducibility (ICC 95% CI) for R‐R interval (ms); 0.93 (0.85, 0.97), RMSSD (ms); 0.93 (0.85, 0.97), SDNN (ms); 0.88 (0.75, 0.95), LF power (ms2); 0.87 (0.72, 0.94), and HF power (ms2); 0.88 (0.73, 0.94) with coefficient of variation ranging from 2.2% to 5% (p > 0.37 for all variables). Conclusion: Single‐use Kendall DL™ ECG leads demonstrate a valid and reproducible tool for the assessment of HRV. [ABSTRACT FROM AUTHOR]