Forty-seven community-dwelling older adults aged >70 years participated in this Japanese cross-sectional study to determine the relationship between the isometric lower extremity muscle strength measured during knee extension (KE) in single-joint and total leg extension (TLE) in multi-joint tasks, physical performance tests, and functional status. The physical performance was determined by KE and TLE muscle strength, walking capacity, and balance performance tests, while the functional status was evaluated by interview using basic activities of daily living (ADL) and instrumental activities of daily living (IADL) tools. The results indicated that the TLE muscle strength was significantly related to all the other performance tests, while the KE muscle strength was not correlated with the balance test. Also, the bilateral TLE muscle strength was significantly associated with IADL status compared with the KE muscle strength. In conclusion, multi-joint muscle strength testing might be superior to single-joint muscle strength testing for the screening of the functional impairments of older adults.
t is well known that there is a circadian variation in the onset of acute myocardial infarction (AMI), in which a peak incidence occurs in early to late morning and a secondary peak exists in the late evening. 1,2 Investigation of pathophysiologic triggers of AMI showing diurnal variation, such as hemodynamic and hematological variables, has enhanced the understanding of mechanisms of the onset and sequence of coronary heart disease (CHD) events. [3][4][5][6] In recent years, the effects of environmental factors, such as temperature, on the onset of CHD were examined and a seasonal periodicity was reported to exist. Several investigators have showed a seasonal variation in the incidence of the onset of CHD and mortality from AMI with a peak in the winter months. [7][8][9] In contrast, the greatest frequency of its onset was observed during the hottest season of the year. 10 Thus, the results of the previous studies are conflicting and there have been no precise reports on the onset season of CHD in the young population. The purpose of the present study was to investigate whether or not the seasonal difference was present in the onset of CHD in young patients with CHD compared with older patients with CHD living in Nagano Prefecture, a suburban area of Japan. We also examined the association between the onset season of CHD events and disease classification, severity of coronary lesions, and established coronary risk factors in the young patients. Methods SubjectsNagano Prefecture is a suburban community with a population of approximately 2.2 million. The population of people aged ≥65 years accounts for approximately 25% of the whole population. Twenty of the 117 general medical hospitals that hold over 100 beds were selected and asked to be collaborative institutions. These 20 hospitals covered the entire region of Nagano Prefecture.Eligible young subjects aged ≤40 years were admitted to one of these 20 hospitals and diagnosed with CHD between 1992 and 2002, and 101 young patients were enrolled. According to the statistics of National Cardiovascular Center of Japan between 1977 and 1996, AMI events reached a peak in men aged in their 60 s and in women aged in their 70 s, and the population from 50 to 79 years occupied over 80% of the AMI patients. 11 Therefore, eligible older subjects were set patients aged ≥50 years who were diagnosed with CHD from 1992 to 2002, and 94 older patients consented to participate in the study.After written informed consent was obtained from each subject, biological data, including the number of coronary lesions and the particular month of the onset of CHD events, was copied from medical records. The presence of metabolic disorders, including obesity, hypertension, dyslipidemia, and diabetes, was noted. Then, each participant was asked to complete a mailed questionnaire addressing lifestyle factors, such as cigarette smoking, physical activi- Background The aim of the present multicenter study was to investigate whether there is a seasonal difference in the onset of coronary heart dis...
SUMMARYCoronary heart disease (CHD) is recognized as a lifestyle-related disease and is the second leading cause of death in Japan. However, the cardiac risk factor profile of young patients with CHD has not been clarified in suburban areas of Japan. Our study aimed to determine metabolic and lifestyle risk factors in young patients and compare them with older patients living in suburban areas of Nagano Prefecture.A multicenter study was conducted in 86 young (aged less than 40 years) and 91 older (aged 50 years and over) patients diagnosed with CHD from 1992 to 2002. There was a strong association between obesity and the occurrence of CHD events in young patients (odds ratio = 3.61, P = 0.006). Lifestyle in the young patients was characterized by a lack of physical activity and regular physical activity was found to decrease the risk of the CHD events in these patients (odds ratio = 0.31, P = 0.030). In older patients, hypertension was identified as an independent risk factor for CHD events.The results of the present study have demonstrated that obesity and a lack of regular physical exercise are independent risk factors for CHD events in younger patients. Thus, the data may be useful for the effective screening of high-risk individuals and the development of educational programs for the prevention of CHD, especially in younger Japanese. (Int Heart J 2006; 47: 343-350)
Abstract. The objectives of this study were to identify the position where optimal leg muscle force occurs and to analyze the lower extremity muscle activity by comparing different hip and knee joint angle positions using a newly developed closed kinetic chain (CKC) leg press exercise device. Muscle force and electromyogram (EMG) measurements during maximum voluntary isometric leg presses (MVC-CKC) were performed on 6 healthy women in 6 different knee flexion angles (15°, 30°, 45°, 60°, 75°, 90°) and 2 different postures (supine and trunk upright posture). Results showed that the muscle force of MVC-CKC reached its peak at 60° knee flexion angle in both postures. Significant knee angle-dependent differences in EMG activity for both rectus femoris and gastrocnemius muscles were observed, while posturedependent differences in EMG were found in biceps femoris. These particular joint-dependent EMG activities may be explained by the architectural characteristics of bi-articular muscles and muscle lengthtension relationship theory. Co-activation of an antagonist muscle may appear with activation of the gastrocnemius muscle when the knee approaches full extension. Consequently, measurement of isometric CKC leg extension muscle force at 60° knee flexion angle in the trunk upright posture seems to be the optimal position.
We assessed the effects of angiotensin-converting enzyme (ACE) inhibition on changes in the myocardial intracellular creatine kinase (CK) system in relation to left ventricular (LV) remodeling and function in heart failure after myocardial infarction (MI) in rats. We compared the findings at 4 weeks after MI to those at 12 weeks after MI. LV weight and chamber size were significantly increased and percent fractional shortening (%FS) was decreased in untreated MI rats compared with normal control animals both at 4 and 12 weeks after MI. Animals with MI and treated with the ACE inhibitor temocapril showed significantly reduced LV weight and chamber size and increased %FS compared with untreated MI rats at 12 weeks after MI, but not at 4 weeks after MI. At 4 weeks after MI, no significant changes were found in the total creatine and relative distribution of each CK isoenzyme in either the temocapril-treated or untreated animals with MI compared with the normal controls. In contrast, at 12 weeks after MI, untreated MI rats showed significant reductions in the total creatine and mitochondrial and MM-CK fractions and increases in the MB-and BB-CK fractions compared with the controls. The alterations in the mitochondrial and MB-CK fractions were significantly attenuated after 12 weeks of ACE inhibition. Thus, LV myocardial energy metabolism is progressively impaired and its alteration is not related to the magnitude of geometric changes and LV dysfunction after MI. Most of the beneficial effects of ACE inhibition were observed at 12 weeks after MI. Our results may provide an insight into the therapeutic strategy of ACE inhibition in chronic heart failure after MI. (Jpn Heart J 2003; 44: 537-546) Key words: Total creatine, Total creatine kinase, Creatine kinase isoenzyme, Chronic heart failure RECENT studies suggest that long-term angiotensin-converting enzyme (ACE) inhibition exerts beneficial effects on functional and structural changes [1][2][3][4] as well as impaired myocardial energy metabolism 5) in the setting of chronic heart failure From
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