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  • Frontiers Media SA  (3)
  • 1
    Online Resource
    Online Resource
    The mediation function of resting heart rate in how physical activity improves all-cause mortality: Continuous and automatic measurement via cardiac implantable electronic devices
    Frontiers Media SA ; 2022
    In:  Frontiers in Cardiovascular Medicine Vol. 9 ( 2022-9-26)
    Details
    In: Frontiers in Cardiovascular Medicine, Frontiers Media SA, Vol. 9 ( 2022-9-26)
    Abstract: Physical activity (PA) and resting heart rate (RHR) are connected with all-cause mortality. Moreover, there was an inverse correlation between PA and RHR. However, the causal relationship between PA, RHR, and long-term mortality has been rarely evaluated and quantified, particularly the mediation effect of RHR in the association between PA and all-cause mortality. Objective To describe the relationship between PA and RHR when consistently measured via cardiac implantable electronic devices (CIED) and further explore the mediation effect of PA on all-cause mortality through RHR. Materials and methods Patients who underwent CIED implantation and received remote home monitoring services were included. During the first 30–60 days after CIED implantation, daily PA and RHR were continuously measured and automatically transmitted by CIED. The primary endpoint was all-cause mortality. The multiple linear regression model was used to confirm the relationship between PA and RHR. The predictive values of both PA and RHR for all-cause mortality were assessed by multivariable Cox proportional hazards models. The causal mediation model was further established to verify and quantify the mediation effect of RHR in the association between PA and all-cause mortality. Results A total of 730 patients with CIED were included. The mean daily PA and RHR were 10.7 ± 5.7% and 61.3 ± 9.1 bpm, respectively. During a mean follow-up period of 55.8 months, 187 (26.5%) death was observed. A negative linear relationship between PA and RHR was demonstrated in the multiple regression model (β = −0.260; 95% CI: −0.377 to −0.143, p & lt; 0.001). Multivariable Cox proportional hazards analysis showed that both lower levels of PA (HR = 0.907; 95% CI: 0.878–0.936, p & lt; 0.001) and higher RHR (HR = 1.016; 95% CI: 1.001–1.032, P = 0.031) were independent risk factors of all-cause mortality. Causal mediation analysis further confirmed and quantified the mediation function of RHR in the process of PA improving all-cause mortality (mediation proportion = 3.9%; 95% CI: 0.2–10.0%, p = 0.036). Conclusion The effects of the higher level of PA on improving life prognosis may be partially mediated through RHR among patients with CIED. It indicates that changes in the autonomic nervous function during postoperative rehabilitation exercises should get more attention.
    Type of Medium: Online Resource
    ISSN: 2297-055X
    URL: Article
    DOI: 10.3389/fcvm.2022.928372
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
    detail.hit.zdb_id: 2781496-8
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Sex Differences in Physical Activity and Its Association With Cardiac Death and All-Cause Mortality in Patients With Implantable Cardioverter-Defibrillators
    Frontiers Media SA ; 2020
    In:  Frontiers in Cardiovascular Medicine Vol. 7 ( 2020-12-14)
    Details
    In: Frontiers in Cardiovascular Medicine, Frontiers Media SA, Vol. 7 ( 2020-12-14)
    Abstract: Objective: To clarify the impact of sex on physical activity (PA) levels among patients with implantable cardioverter-defibrillators/cardiac resynchronization therapy defibrillators (ICD/CRT-D) and its association with cardiac death and all-cause mortality. Methods: Overall, data of 820 patients with ICD/CRT-D from the SUMMIT registry were retrospectively analyzed. Baseline PA from 30 to 60 days after device implantation was measured using Biotronik accelerometer sensors. The primary and secondary endpoints were cardiac death and all-cause mortality, respectively. Results: Baseline PA levels were significantly higher in male patients than in female patients (11.40 ± 5.83% vs. 9.93 ± 5.49%, P = 0.001). Males had higher predictive PA cut-off values for cardiac death (11.16 vs. 7.15%) and all-cause mortality (11.33 vs. 7.17%). During the median follow-up time of 75.7 ± 29.1 months, patients with baseline PA & lt;cut-off values had higher cumulative incidence of cardiac death and all-cause mortality in both males and females. At a PA level between the cut-off values of males and females, males had a higher risk of cardiac death (hazard ratio = 4.952; 95%CI = 1.055-23.245, P = 0.043) and all-cause mortality (hazard ratio = 2.432; 95%CI = 1.095-5.402, P = 0.029). Conclusions: Males had higher predictive PA cut-off values for cardiac death and all-cause mortality in patients with ICD/CRT-D. Sex should be considered as an important contributing factor when deciding for PA targets.
    Type of Medium: Online Resource
    ISSN: 2297-055X
    URL: Article
    DOI: 10.3389/fcvm.2020.588622
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2020
    detail.hit.zdb_id: 2781496-8
    Location Call Number Limitation Availability
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  • 3
    Online Resource
    Online Resource
    Environmental Performance Assessment of Energy-Consuming Sectors Through Novel Data Envelopment Analysis
    Frontiers Media SA ; 2022
    In:  Frontiers in Energy Research Vol. 9 ( 2022-1-14)
    Details
    In: Frontiers in Energy Research, Frontiers Media SA, Vol. 9 ( 2022-1-14)
    Abstract: This study evaluates the role of information in the environmental performance index (EPI) in different energy-consuming sectors in Pakistan through a novel slack-based data envelopment analysis (DEA). The index combines energy consumption as the primary input and gross domestic product (GDP) as the desirable output and CO 2 emissions as the undesirable output. Yale’s EPI measures the efficiency of the sectoral level environmental performance of primary energy consumption in the country. Performance analysis was conducted from 2009 to 2018. The sectors were assigned scores between one and zero, with zero indicating maximum decision-making unit (DMU) inefficiency and one indicating maximum DMU efficiency. Despite being in the top-performing sector, agriculture scored only 0.51 in 2018, and the electricity sector obtained 0.412. Results also show that even the best-performing sector operates below the efficiency level. The mining and quarrying sector ranked second by obtaining 0.623 EPI and 0.035 SBEPI. Results also show that much of the energy supply of Pakistan (60.17%) is focused on fossil fuels, supplemented by hydropower (33%), while nuclear, wind, biogas, and solar power account for 5.15%, 0.47%, 0.32%, and 0.03%, respectively. Nonetheless, the overall results for both measures remained reasonably consistent. According to the literature and the energy crisis and climate instability dilemma, the authors conclude that changes to a diverse green power network are a possibility and an imminent need. Similarly, the government should penalize companies with poor performance. Furthermore, to ensure the capacity development and stability of environmental management and associated actions in the country, providing access to knowledge and training to groom human resources and achieve the highest performance is crucial.
    Type of Medium: Online Resource
    ISSN: 2296-598X
    URL: Article
    DOI: 10.3389/fenrg.2021.713546
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
    detail.hit.zdb_id: 2733788-1
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