Long-term effects of different exercise training modes on cytokines and adipokines in individuals with overweight/obesity and cardiometabolic diseases: A systematic review,meta-analysis,and meta-regression of randomized controlled trials

The present study aimed to investigate the evidence on the effects of different long-term training interventions (aerobic [AeT], resistance [RT], and combined [COMB]) and spontaneous physical activity (PA) in modifying cytokines and adipokines in individuals with overweight or obesity with or without cardiometabolic diseases while considering potential confounders. Although exercise interventions have become a potentially effective tool for preventing and treating metabolic diseases, the evidence provided by previous systematic reviews is inconclusive since several potential confounders have yet to be addressed. Therefore, we conducted a systematic literature search in Medline, Cochrane, and Embase databases from January 2000 to July 2022 and performed a meta-analysis. Inclusion criteria retrieved 106 full texts comprising 8,642 individuals with a range BMI of 25.1–43.8 kg m⁻². We found that independently of the training mode, exercise had a beneficial effect on diminishing Adiponectin, C-reactive protein (CRP), IL-6, IL-18, IL-20, Leptin, sICAM, and TNF-α levels circulating levels. Furthermore, by subsequent analysis, we detected differential effects of AeT, RT, and COMB, with sex, age, body composition, and trial length acting as moderators. The comparison of training modes revealed a difference favoring COMB over AeT for regulating the increase in CRP with no differences in the remaining biomarkers. Meta-regression analysis revealed an effect of change in maximal oxygen uptake (VO_2max) on CRP, IL-6, and TNF-α, while IL-10 was influenced by the change in body fat. The results suggest that all interventions, except PA, are effective in lessening this population's inflammatory status, provided that exercise results in an increase of VO_2max.     

Pulmonary hypertension secondary to Takayasu arteritis and atrial septal defect

Clinical Rheumatology -     

Hidden problems in a case of atrial fibrillation

Atrial fibrillation (AF) is the most common cardiac arrhythmia. However, the relation between congenital heart defects and the predisposition to AF is not fully understood. A 65-year-old male was admitted into the emergency department due to progressive dyspnea, orthopnea, palpitations, and edema. Transthoracic echocardiogram showed bi-atrial enlargement and dysplasia of the mitral leaflets with severe mitral regurgitation. Also, a membrane was noted in the LA, dividing the chamber into two parts, suggestive of cor triatriatum sinister. Coronary computed tomography angiography demonstrated a soft tissue septum in the left atrium. Multimodal evaluation is of vital importance for a complete approach, since, detected in time, it has an excellent prognosis.     

Routinary PET/CT imaging for oncological surveillance accompanied by echocardiography may identify early atherosclerotic cardiovascular disease: A case report

Atherosclerosis is a disease where plaque builds up in arteries, resulting in harmful cardiovascular events. Inflammation has a significant role in its progression, starting from the initial stages. Cancer patients, due to their constant exposure to inflammatory processes caused by treatments or illnesses, are at a higher risk of developing this condition. Arterial inflammation can be quantified with ¹⁸F-FDG PET/CT imaging. In this case report, we propose that routinary PET/CT imaging for oncological surveillance could be useful for cardiovascular risk stratification by reviewing a case of a patient with breast cancer whose imaging study revealed arterial inflammation and a subsequent echocardiogram evidenced grade II diastolic dysfunction (potentially, an initial manifestation of the ischemic cascade).