The purpose of this study was to discuss the procedures for establishing indices for physical senility from simple physical fitness tests through linear regression analysis. The fluctuation of residuals obtained from the various regression analyses and the statistical procedures for dealing with the variables when the assumptions concerning the residuals were contradicted, were discussed. In this study, 168 females (mean age 37.7, SD 11.3, range 20 to 65years) who were registered with one occupational insurance organization were examined. They each underwent tests to establish readings for seven variables, including five physical fitness tests: standing trunk flexion (FLEX), sit-ups in 30seconds (SIT-UP), vertical jump (VERT), repetitious side step in 20seconds (SIDE), and step test (STEP-ME). Two blood pressure readings while at rest were also taken (SBP, DBP). The results can be summarized as follows. In the forward stepwise regression analysis, the order of entered variables was VERT (R=0.637), SIT-UP (R=0.673), DBP (R=0.696), FLEX (R=0.704), and SIDE (R=0.717). The equation is y=61.38-0.569×(VERT)-0.513×(SITUP)+0.183×(DBP)+0.283×(FLEX)-0.328×(SIDE). Minimum AIC estimates (MAICE) were achieved for this equation. The correlation coefficient between residuals and predicted value was 0.345 (p<0.05). To satisfy the assumptions of the standard regression model, the researchers worked with transformed variables instead of working with original variables. The transformations of the raw data into logarithms and into reciprocals is described. According to the rules of variable elimination using ridge regression analysis, SBP and STEP-ME were eliminated from the set of seven variables. However, an examination of the residuals indicated that there were no advantages with using these transformations compared to the general linear model using raw data. The ratio of the predicted age for each client obtained from the predictive equation and chronological age is regarded as a marker of aging. Therefore, it is necessary for researchers to examine what kind of life styles result in such individual differences.
Upper case are ; Age, NOS ; Physical Fitness ; predictive ; Diastolic blood pressure

BACKGROUND AND OBJECTIVES: Although Doppler echocardiography has been used to identify left ventricular (LV) diastolic dysfunction, its limitations suggest there is a need for new biomarkers to measure the diastolic dysfunction. Because the B-type natriuretic peptide (BNP) levels correlate with the LV diastolic pressure, we hypothesized that the BNP would be useful for diagnosing and monitoring the patients with diastolic heart failure. SUBJECTS AND METHODS: We prospectively studied a total of 69 consecutive patients (mean age: 68+/-12 yrs, 31 men and 38 women) who presented to the emergency room with suspected dyspnea of a cardiac origin from November 2003 to May 2004. BNP sampling and Doppler echocardiography were performed for all the study patients. We diagnosed the systolic heart failure (SHF) and diastolic heart failure (DHF) on the conditions that both the clinical and echocardiographic criteria for systolic and diastolic dysfunction were fulfilled. From June 2004 to May 2005, we also performed clinical examinations, measurement of the tissue Doppler derived E/E' and the BNP level at baseline and at 1 year after pharmacologic treatment for 42 consecutive patients who were diagnosed with DHF in the ER and the outpatient clinic. RESULTS: We diagnosed SHF in 37 patients, DHF in 19 patients and we excluded HF in 13 patients (the control group). The mean BNP levels of the SHF and DHF groups were 716+/-532 pg/mL and 390+/-446 pg/mL, respectively, and these values were significantly higher than that of the control group (13+/-14 pg/mL, p<0.01). The area under the receiver-operating characteristic (ROC) curve for BNP to diagnose DHF was 0.94 (95% CI: 0.86 to 1.02, p<0.001). We also compared the BNP levels with the E/E' in terms of the changes of the functional status for the 42 patients suffering with DHF. After treatment, the blood pressure (BP) was significantly decreased from 162+/-26/91+/-15 to 141+/-16/80+/-12 mmHg (p<0.001), the New York Heart Association (NYHA) functional class was decreased from 2.3+/-0.7 to 1.7+/-0.6 (p<0.001), and the E/E' was decreased from 15.9+/-5.7 to 13.8+/-5.1 (p<0.01), but there were no significant changes of the BNP levels, from 213+/-404 to 208+/-464 pg/mL, following treatment. CONCLUSION: A BNP assay is clinically useful for diagnosing DHF, and a cut-off value of BNP can be suggested for screening DHF. However, the tissue doppler derived E/E' is the better index for monitoring changes in the functional status of DHF patients than is the BNP level.
Ambulatory Care Facilities ; Biomarkers ; Blood Pressure ; Diagnosis* ; Dyspnea ; Echocardiography ; Echocardiography, Doppler ; Emergency Service, Hospital ; Follow-Up Studies* ; Heart ; Heart Failure ; Heart Failure, Diastolic* ; Heart Failure, Systolic ; Humans ; Male ; Mass Screening ; Natriuretic Peptide, Brain* ; Prospective Studies

The incidence of diastolic heart failure increases dramatically with age. We investigated the impact of long-term exercise training on age-related diastolic dysfunction. Old (25-month-old) male Fischer 344 rats were studied after 12 weeks of treadmill exercise training or sedentary cage life (N=7, in each group). We determined cardiac performance using a pressure-volume conductance catheter and magnetic resonance imaging. Collagen volume fraction (CVF) and myocardial collagen solubility by pepsin as an index of advanced glycation end products (AGEs) crosslinked collagen were measured. The maximal slope of systolic pressure increment (+dP/dt) and the slope of end-systolic pressure-volume relation were higher, and end diastolic volume (EDV), delta EDV (the percentage of the EDV increment-to-baseline EDV) and the slope of end-diastolic pressure-volume relation were lower in training group. The maximal slope of diastolic pressure decrement (-dP/dt) and time constant of LV pressure decay (tau) had no difference. AGEs cross-linked collagen, not CVF was reduced by exercise training. Long-term exercise training appears to attenuate age-related deterioration in cardiac systolic function and myocardial stiffness and could be reduce in pathologic AGEs cross-linked collagen in myocardium.
*Aging ; Animals ; Blood Pressure ; Collagen/*metabolism ; Glycosylation End Products, Advanced/metabolism ; Heart Failure, Diastolic/metabolism/*physiopathology ; Magnetic Resonance Imaging ; Male ; Myocardium/*metabolism ; Physical Conditioning, Animal ; Rats ; Rats, Inbred F344 ; Solubility ; Stroke Volume/physiology

Anesthesiologists frequently see asymptomatic patients with diastolic dysfunction or heart failure for various surgeries. These patients typically show normal systolic function but abnormal diastolic parameters in their preoperative echocardiographic evaluations. The symptoms that are sometimes seen are similar to those of chronic obstructive pulmonary disease. Patients with diastolic dysfunction, and even with diastolic heart failure, have the potential to develop a hypertensive crisis or pulmonary congestion. Thus, in addition to conventional perioperative risk quantification, it may be important to consider the results of diastolic assessment for predicting the postoperative outcome and making better decisions. If anesthesiologists see female patients older than 70 years of age who have hypertension, diabetes, chronic renal disease, recent weight gain, or exercise intolerance, they should focus on the patient's diastologic echocardiography indicators such as left atrial enlargement or left ventricular hypertrophy. In addition, there is a need for perioperative strategies to mitigate diastolic dysfunction-related morbidity. Specifically, hypertension should be controlled, keeping pulse pressure below diastolic blood pressure, maintaining a sinus rhythm and normovolemia, and avoiding tachycardia and myocardial ischemia. There is no need to classify these diastolic dysfunction, but it is important to manage this condition to avoid worsening outcomes.
Blood Pressure ; Echocardiography ; Estrogens, Conjugated (USP) ; Female ; Heart Failure* ; Heart Failure, Diastolic ; Heart* ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Myocardial Ischemia ; Pulmonary Disease, Chronic Obstructive ; Renal Insufficiency, Chronic ; Tachycardia ; Weight Gain

BACKGROUND: The strength of each heart beat and the stiffness of large arteries contribute to blood pressure (BP). When the large arteries are stiff and their resistance greater, the afterload increases and this may change the function of the heart. However, the relation between common carotid artery stiffness and heart function in hypertensive patients has not been clarified. METHODS: Two hundred and twenty hypertensive patients underwent transthoracic and carotid echocardiography. Measurements of local arterial stiffness were taken at the right common carotid artery level and stiffness parameter (beta), pressure-strain elasticity modulus and intima-media thickness were calculated. Brachial cuff BP was measured just before starting the carotid study. The patients with any cardiovascular disease, diabetes mellitus, stroke, transient ischemic attack, or carotid stenosis were excluded. RESULTS: Carotid artery stiffness parameter (beta) was correlated with age and left ventricular mass index (p < 0.005). Even though beta was not correlated with LV systolic function, it was inversely correlated with diastolic function as measured by early mitral annular velocity. When the artery was stiffer, early mitral annular velocity (e') decreased (p < 0.001) and the index of left atrial (LA) pressure (early diastolic mitral inflow E velocity/e') increased (p = 0.001). In logistic regression, diastolic dysfunction was affected by age (beta -0.385, p = 0.001), LA volume index (beta 0.175, p = 0.013) and beta (beta -0.273, p = 0.019). CONCLUSION: In hypertensive patients, changes in carotid artery stiffness can affect the diastolic function, independent of age and LA volume index. Therefore, measurements and control of carotid stiffness can play an important role in the prevention of diastolic heart failure.
Arteries ; Blood Pressure ; Cardiovascular Diseases ; Carotid Arteries ; Carotid Artery, Common ; Carotid Stenosis ; Diabetes Mellitus ; Echocardiography ; Elastic Modulus ; Female ; Heart ; Heart Failure, Diastolic ; Humans ; Ischemic Attack, Transient ; Logistic Models ; Stroke ; Vascular Stiffness

OBJECTIVETo study the effects of different doses of berberine on hemodynamic parameters and calcium ion concentration ([Ca2+]i) of diastole heart failure rat models.

METHODThe mouse models of diastole heart failure were made by the imcomplete ligation of abdominal aorta. Forty Wistar heart failure rats were divided randomly into four groups, with 10 for each group (n = 10). Heart failure rats were treated according to different doses drugs as follows: Model (natrii chloride 2 mL), berberine (63 mg x kg(-1) x d(-1)), berberine (42 mg x kg(-1) x d(-1)), berberine (21 mg x kg(-1) x d(-1)) ig, for each of the four groups respectively, 4 weeks after coarctation of ascending aorta operation; and 10 age matched sham operation group was taken as control (natrii chloridi, 2 mL). After administration four weeks, cardiac function was determined by catheter. Isolate single cardiomyocytes of rat which were loaded with Ca(2+)-sensitive fluorescent indicator Fluo-3/AM. [Ca2+]i represented by fluorescent intensity [FI] was measured by laser scanning cofocal microscope [LSCM].

RESULTThe rats of operation group have no significant changes with those of the control on left ventricular systolic pressure (LVSP) and maximal rising rate of ventricular pressure (+dp/dt(max)), left ventricular end diastolic pressure (LVEDP) was much higher in operation group (P < 0.01), but maximal falling rate of ventricular pressure (-dp/dt(max)) was depressed (P < 0.01), left ventricular relax time constant quantity (T) was markedly extended (P < 0.01). [Ca2+]i level in carkiac muscle cell was elevated markedly (P < 0.05). Compared with operation group, high dose of Ber can decrease LEVDP, improve (-dp/dt(max)) (P < 0.01), decurtate left ventricular relax time constant quantity (P < 0.01) and decrease [Ca2+]i level better than those of middle and low dose group (P < 0.01).

CONCLUSIONBerberine is an effective new potent drug for conspicuous symptom relief of heart failure with positive dose dependency and step down [Ca2+]i of myocardial cell.

Animals ; Berberine ; pharmacology ; therapeutic use ; Blood Pressure ; drug effects ; Calcium ; metabolism ; Dose-Response Relationship, Drug ; Female ; Heart Failure, Diastolic ; drug therapy ; metabolism ; pathology ; physiopathology ; Heart Ventricles ; drug effects ; physiopathology ; Hemodynamics ; drug effects ; Male ; Myocytes, Cardiac ; drug effects ; metabolism ; Rats ; Rats, Wistar ; Ventricular Pressure ; drug effects