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Physiology Friday #262: Everything You Need to Know about Zone 2 Training

Physiologically Speaking

Greetings! Welcome to the Physiology Friday newsletter. Details about the sponsors of this newsletter including FSTFUEL electrolytes, Examine.com , and my book “VO2 Max Essentials ” can be found at the end of the post. You can find more products I’m affiliated with on my website. Physiologically Speaking is a reader-supported publication.

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Hypoxia in myocardial infarction and natriuretic peptides

Open Heart

Background Mechanical stress on the heart is commonly considered the sole stimulus explaining the synthesis and release of circulating natriuretic peptides and their derivatives. While one of the most critical paradigms in cardiology is that mechanical load increases oxygen consumption, clinical studies on these peptides have neglected the relationship between mechanical stress and oxygen metabolism.

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Rethinking how we study the impact of heat on heart health

Science Daily - Heart Disease

A new study reveals that encapsulated heating methods, an often-used heat simulation method, significantly increase heart rates and cardiac strain compared to natural heat exposure like those experienced during hot weathers. Understanding how extreme heat impacts heart function is crucial for developing effective strategies to protect vulnerable groups, especially as global temperatures continue to rise.

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The effect of enhanced external counterpulsation on anxiety and depression in patients with paroxysmal atrial fibrillation: a randomized controlled trial

Frontiers in Cardiovascular Medicine

ObjectiveThis study aimed to investigate the effects of Enhanced External Counterpulsation (EECP) on anxiety and depression in patients with Paroxysmal Atrial Fibrillation (PAF).MethodsA cohort of 100 patients diagnosed with PAF at the Fuzhou First Hospital between January 2023 and June 2024 were enrolled in this study. Patients were randomly assigned to either the control group (n=50) or the EECP group (n=50) in this randomized controlled trial.

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Bridging Innovation & Patient Care: The Growing Role of AI

Speaker: Simran Kaur, Co-founder & CEO at Tattva Health Inc.

AI is transforming clinical trials—accelerating drug discovery, optimizing patient recruitment, and improving data analysis. But its impact goes far beyond research. As AI-driven innovation reshapes the clinical trial process, it’s also influencing broader healthcare trends, from personalized medicine to patient outcomes. Join this new webinar featuring Simran Kaur for an insightful discussion on what all of this means for the future of healthcare!

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Mitochondrial quality control in cardiomyocytes: safeguarding the heart against disease and ageing

Nature Reviews - Cardiology

Nature Reviews Cardiology, Published online: 20 March 2025; doi:10.1038/s41569-025-01142-1 In this Review, Ravindran and Gustafsson describe the mechanisms involved in regulating mitochondrial quality control in cardiomyocytes, discuss how these pathways are altered in cardiovascular disease and ageing, and highlight the therapeutic potential of targeting mitochondrial quality control pathways in cardiovascular disease.

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Cardiovascular Toxicity in Patients Treated for Childhood Cancer: A Scientific Statement From the American Heart Association

Circulation

Circulation, Ahead of Print. The field of cardio-oncology has expanded over the past 2 decades to address the ever-increasing issues related to cardiovascular disease in patients with cancer and survivors. There is increasing recognition that nearly all cancer treatments pose some short- or long-term risk for development of cardiovascular disease and that pediatric patients with cancer may be especially vulnerable to cardiovascular disease because of young age at treatment and expected long life

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Effects of 1-year exercise in patients with atrial fibrillation: study protocol for the Norwegian Exercise in Atrial Fibrillation (NEXAF) randomised controlled trial

Open Heart

Introduction Atrial fibrillation is the most prevalent sustained arrhythmia worldwide and is expected to increase substantially within the coming years. Although lifestyle changes and risk factor modification are now acknowledged as central components of atrial fibrillation management, the effects of exercise on disease-specific outcomes are still not extensively documented due to few high-quality randomised trials.

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Association between neutrophil to lymphocyte ratio and all-cause mortality in critical patients with coronary artery disease - a study based on the MIMIC-IV database

Frontiers in Cardiovascular Medicine

BackgroundNeutrophil-to-lymphocyte ratio (NLR) has been presented as a possible indicator associated with the outcomes of growing patients and an available predictor of inflammation. Nevertheless, just a handful of researches shed light on the association between NLR and the consequences of critical patients with coronary artery disease (CAD). The study aimed to investigate the correlation between NLR and all-cause mortality of short-term and long-term in patients with CAD.MethodsWe obtained obj

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Cholesterol-elevating substances found in coffee from machines at work

Medical Xpress - Cardiology

The coffee from most of the coffee machines in workplaces contains relatively high levels of cholesterol-elevating substances. There is a big difference in comparison to coffee made in regular paper filter coffee makers, which filter out most of these substances.

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A Transformative Two Days: Recap of the Management of Calcified Coronary Lesions Training

ADN Center of Excellence

Over the past two days, interventional cardiologists from around the worldgathered at Freeman Hospital, Newcastle, for an intensive and enriching experience focused on tackling one of the most complex challenges in percutaneous coronary intervention (PCI): calcified coronary lesions.

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Amulet’s Slight Edge over Watchman for LAAO

CardiacWire

Although theres still ongoing debate on who should receive LAAO devices, new five year results from the Amulet IDE trial confirm that both Abbotts Amulet occluder and Boston Scientifics Watchman 2.5 are safe and effective in the long run. LAAO (left atrial appendage occlusion) devices help prevent stroke in patients with AFib by sealing off the left atrial appendage where blood clots can form.

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MIRACLE2 score validation for neuroprognostication after out-of-hospital cardiac arrest: a district general hospital experience

Open Heart

Introduction and objectives Decision-making regarding prognosticating out-of-hospital cardiac arrest (OHCA) remains challenging at the front door. The MIRACLE2 score provides a simple and practical tool for early neuroprognostication to aid decision-making. The study aims to validate the MIRACLE2 score in a district general hospital (DGH). Material and methods This is a retrospective analysis of the patients with OHCA and return of spontaneous circulation (ROSC) in the community who attended the

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Knowledge domains and hotspots of the association between hypertension and noise: a bibliometric analysis and visualization study from 2003 to 2023

Frontiers in Cardiovascular Medicine

ObjectivesNoise pollution has become an increasingly severe environmental issue in modern society and has been recognized for its adverse effects on cardiovascular diseases. Hypertension induced by noise exposure has garnered significant research interest and a large quantity of studies have been conducted. This study aims to employ bibliometric methods to comprehensively review the literature on the relationship between noise exposure and hypertension and to analyze the current state of researc

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Bayer to Present New Investigational Heart Failure Data, Continued Portfolio Research in Chronic Kidney Disease at ACC.25

DAIC

tim.hodson Tue, 03/25/2025 - 16:19 March 25, 2025 Bayer plans to present data from 13 new analyses from across the KERENDIA (finerenone) comprehensive clinical trial program at the American College of Cardiology (ACC) 74 th Annual Scientific Session & Expo 2025 , in Chicago, IL, March 29-31, 2025. Ten presentations will feature new data from the pivotal Phase III FINEARTS-HF cardiovascular (CV) outcomes trial, which investigated KERENDIA for treatingt adult patients with heart failure (HF) wit

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Static Versus Dynamic Risk of Sudden Cardiac Death: Implications for Improvement of Prediction and Prevention

Journal of Cardiovascular Electrophysiology

ABSTRACT Sudden cardiac death (SCD) is a major public health challenge, resulting in significant loss of life each year. Effective prevention relies on identifying individuals at elevated risk; however, accurate prediction of SCD has proven difficult. The current clinical strategy relies on a static risk assessment, primarily using left ventricular ejection fraction (LVEF)<35% as a key criterion.

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Childhood Cancer Survivors More Likely to Develop Aging-Related Health Conditions

Med Page Today

(MedPage Today) -- Survivors of childhood cancer were much more likely to develop an aging-associated health condition before the age of 65, with earlier onset, compared with the general population, according to a modeling study. While 20% of.

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Risk of myocardial infarction and stroke following bloodstream infection: a population-based self-controlled case series

Open Heart

Background Cardiovascular disease (CVD) events triggered by inflammation are an underappreciated and poorly quantified cause of morbidity and mortality in patients with bloodstream infections (BSIs). We aimed to determine the risk of myocardial infarction (MI) and stroke after BSI. Methods This self-controlled case series study was conducted within the Secure Anonymised Information Linkage Databank, containing anonymised population-scale electronic health record data for Wales, UK.

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Cardio-cerebral infarction: a narrative review of pathophysiology, treatment challenges, and prognostic implications

Frontiers in Cardiovascular Medicine

Cardio-cerebral infarction (CCI) is a rare clinical syndrome characterized by the simultaneous or sequential occurrence of acute myocardial infarction (AMI) and acute ischemic stroke (AIS). Despite its complex pathogenesis and more severe prognosis compared to isolated AMI or AIS, no consensus has been established regarding its definition, classification, epidemiology, treatment protocols, or prognostic management.

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New Insight: Exploring ENCELTO for MacTel with Rich Small, CEO of Neurotech

HCPLive

Veeral Sheth, MD, is joined by the CEO of Neurotech to discuss the historic approval of revakinagene taroretcel (ENCELTO) for macular telangiectasia type 2.

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Imperative Care Expands Precision Thrombectomy Portfolio

DAIC

tim.hodson Mon, 03/24/2025 - 15:48 March 24, 2025 Imperative Care, Inc. recently announced U.S. Food and Drug Administration (FDA) 510(k) clearance of the 82 cm version of its Symphony 16F catheter. The catheter is designed to elevate care for patients with venous thrombosis, a serious condition caused by a blood clot forming in the veins of the legs or abdomen that can have a life-threatening impact if left untreated.

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Eight ways to reduce your stroke risk—no matter what age you are

Medical Xpress - Cardiology

As a nurse working in a neurocritical care, I witnessed the sudden and devastating effects of stroke on survivors and their caregivers.

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Pyridostigmine in the management of orthostatic hypotension: a systematic review and meta-analysis

Open Heart

Background Current pharmacological approaches for the treatment of orthostatic hypotension (OH) may detrimentally affect supine blood pressure (BP). This side effect is often unacceptable and limits the utility of medical management. Pyridostigmine has been proposed as a potential treatment alternative which may improve OH without worsening supine hypertension.

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Gender correlation between sleep duration and risk of coronary heart disease: a systematic review and meta-analysis

Frontiers in Cardiovascular Medicine

ObjectiveThe influence of extreme sleep duration on coronary heart disease (CHD) risk across genders remains a debated topic.MethodsThis analysis gathers observational studies that explore association between varying sleep durations and CHD risks. Trend estimation employs generalized least squares, converting specific category risk estimates into relative risks (RR) per hour of sleep increase.

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TMS Reduces Pain, Yields Functional Improvements in Women With Fibromyalgia

HCPLive

Analgesic effects lasted up to week 8 while function improvements lasted until week 16 in a new randomized, controlled trial.

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Dementia Risk Rises for Older Women With Changing Sleep Patterns

Med Page Today

(MedPage Today) -- Changes in sleep patterns among cognitively unimpaired women in their 80s were associated with an increased risk of dementia, a longitudinal study showed. Compared with women who had stable sleep patterns, those who had increasing.

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Sonolysis reduces risk for periprocedural cerebrovascular events during carotid endarterectomy

Medical Xpress - Cardiology

For patients undergoing carotid endarterectomy, sonolysis is safe and results in a significant reduction in the composite incidence of ischemic stroke, transient ischemic attack, and death within 30 days, according to a study published online March 19 in The BMJ.

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The effect of strength training interventions on people with congenital heart disease: a systematic review

Open Heart

Aim To assess the effectiveness and safety of strength training (ST) interventions in people with congenital heart disease (ConHD). Methods Participants included people of all ages diagnosed with all complexity of ConHD. Interventions included strength training or inspiratory muscle training (IMT) which were delivered in whole or as part of a more holistic programme.

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Association of plasma aldosterone concentration with peripheral artery disease in hypertensive patients: insights from a large cross-sectional analysis

Frontiers in Cardiovascular Medicine

ObjectivesTo investigate the relationship between plasma aldosterone concentration (PAC) and the prevalence of peripheral artery disease (PAD) in hypertensive patients and to determine any potential threshold effects.MethodsThis cross-sectional study analyzed data from 13,157 hypertensive individuals from the People's Hospital of Xinjiang Uygur Autonomous Region, China.

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Anxiety, Social Struggles, Coping Strategies in Adults with Food Allergies

HCPLive

A study highlights how food allergies impact adults' mental health and social lives, revealing anxiety, isolation, and the need for better support systems.

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Think Twice Before Quitting Oral Anticoagulants After Afib Ablation?

Med Page Today

(MedPage Today) -- For people with atrial fibrillation (Afib or AF), stopping oral anticoagulation (OAC) after a "successful" catheter ablation left them exposed to increased risk, according to a Japanese hospital's dataset. At Nagoya University.

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Demystifying a genetic disease of the heart muscle

Medical Xpress - Cardiology

Affecting 1 in 500 people, hypertrophic cardiomyopathy is a condition in which the walls of the left ventricle, the heart's main pumping chamber, become abnormally thick. "HCM is one of the primary causes of sudden death among young, apparently healthy patients; it is also a frequent cause of heart failure requiring surgery or a transplant," says Dr.

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Impact of COVID-19 pandemic on rates of congenital heart disease procedures among children: prospective cohort analyses of 26 270 procedures in 17 860 children using CVD-COVID-UK consortium record linkage data

Open Heart

Background The COVID-19 pandemic necessitated major reallocation of healthcare services. Our aim was to assess the impact on paediatric congenital heart disease (CHD) procedures during different pandemic periods compared with the prepandemic period, to inform appropriate responses to future major health services disruptions. Methods and results We analysed 26 270 procedures from 17 860 children between 1 January 2018 and 31 March 2022 in England, linking them to primary/secondary care data.

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Early experience with a novel transapical transcatheter aortic valve system in patients with severe aortic stenosis: a prospective, multicenter study

Frontiers in Cardiovascular Medicine

ObjectivesRegistered, prospective, multicenter study of the short-term clinical outcomes of a novel transcatheter aortic valve system (Xcor system, Saint Medical Technology, Inc., Nanjing) to evaluate its safety and efficacy.Methods130 high risk patients with symptomatic severe AS from 11 institutions were treated with the novel Xcor system. All patients were pre-TAVR assessed by transthoracic echocardiography and computed tomography of the aortic valve (AV) and relevant left cardiac and vascula

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Oxypurinol Formulation May Be Adapted for Gout Treatment

HCPLive

XORTX is meeting with the FDA in a Type B meeting regarding a potential NDA for XORLO.

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Type 2 Diabetes Patients Also Reap Benefits of Automated Insulin Delivery

Med Page Today

(MedPage Today) -- An automated insulin delivery (AID) system boosted glycemic control in insulin-treated adults with type 2 diabetes using continuous glucose monitoring (CGM), a randomized trial showed. Over 13 weeks, drops in HbA1c averaged.

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Insomnia can lead to heart issues: Psychologist recommends changes that can improve sleep

Medical Xpress - Cardiology

About 10% of Americans say they have chronic insomnia, and millions of others report poor sleep quality. Ongoing research has found that bad sleep could lead to numerous health problems, including heart disease.