Search Results (781)

Background: Patients undergoing open-heart surgery (OHS) are at risk of postoperative morbidity and mortality. Physical performance has been increasingly recognized as an important factor influencing postoperative outcomes. Therefore, the study aimed to investigate the associations and predictive value of physical performance on postoperative complications and duration of hospital stay. Methods: A prospective cohort study was conducted in 116 patients who were admitted to OHS. Preoperative assessment of physical performance, i.e., Short Physical Performance Battery (SPPB), Five Times Sit to Stand Test (5STS), gait speed (5 m walk test: 5MWT), Timed Up and Go (TUG), and handgrip strength. Duration of hospital stay and incidence of post-operative complications were recorded. Differences between participants with and without postoperative complications were analyzed using independent samples t-tests for continuous variables and chi-square tests for categorical variables. The associations between physical performance and postoperative outcomes were assessed using Spearman’s rank correlation coefficient. Hierarchical regression analysis was conducted to determine the predictive contribution of physical performance. Results: A total of 116 participants were submitted for OHS in two medical school hospitals; however, 108 individuals completed the pre-operative physical performance. The most common procedures were coronary artery bypass grafting and valve surgery. Fifty-one participants (47.22%) experienced postoperative complications, including five deaths, corresponding to 4.63% mortality. For the length of hospital stay analysis, five participants who died postoperatively were excluded, resulting in a final sample of 103 participants. Physical performance was significantly associated with the length of hospital stay (p < 0.05). Hierarchical regression analysis showed that the final prediction model explained 13.4% of the variance in length of hospital stay, with SPPB independently contributing an additional 6.0% to the model, followed by 5STS, 5MWT, handgrip strength, and TUG, which accounted for an additional 5.1%, 4.6%, 4.4%, and 3.7%, respectively. Conclusions: Preoperative physical performance was associated with length of hospital stay. While each measure explained a relatively small proportion of the variance in hospital stay, these assessments offer a simple, non-invasive, and clinically feasible approach to evaluating functional reserve before surgery. These findings highlight the importance of incorporating functional assessment into perioperative care to support risk stratification and guide rehabilitation strategies. Full article

Background/Objectives: Falls have devastating consequences for older adults. The Functional Ambulation and Stair Test (FAST) was developed to characterize older adult mobility and eventual fall risk. This project aimed to determine the criterion validity of the FAST assessment by comparing the relationship between FAST outcomes and existing gold-standard clinical assessments of mobility and fall risk. A secondary aim was assessing the FAST’s capacity to elicit dual-task effects in older adults. Methods: The FAST is a multi-faceted mobility assessment combining stair navigation, turning and level-ground walking; total time and time spent in each phase are the calculated outcomes. Data from 199 older adults completing the FAST, Berg Balance Scale (BBS), Timed Up and Go (TUG), and Ten Meter Walk Test (10MWT) at comfortable and fast speed were evaluated. Relationships between the FAST and clinical outcomes were evaluated with Spearman’s correlations. The FAST and TUG were assessed under single- and dual-task conditions; linear mixed models evaluated the dual-task effects for overall FAST time and each phase. Results: Spearman’s correlations between the FAST and the BBS, TUG, 10MWT comfortable and 10MWT fast were −0.65, 0.88, −0.79, and −0.83, respectively. Participants experienced an 8.6% and 13.2% dual-task cost in the FAST and TUG, respectively. The greatest dual-task cost during the FAST was in the gait initiation, walking, and wide turn phases. Conclusions: Agreement between the FAST and gold-standard clinical mobility assessments confirms the criterion validity of the FAST. Delineation of mobility phases via the FAST offers insight into specific mobility deficits. Future work is ongoing to evaluate the FAST as a fall risk assessment in older adults. Full article

Background: Frailty is associated with adverse postoperative outcomes and functional decline in older adults undergoing colorectal cancer (CRC) surgery. The long-term course of frailty and functional outcomes among patients undergoing prehabilitation before CRC surgery remains insufficiently investigated. Methods: This prospective observational cohort study evaluated long-term functional and physiological outcomes in older adults with frailty syndrome undergoing colorectal cancer (CRC) surgery who participated in a structured prehabilitation program. Forty-one patients aged >70 years were assessed before prehabilitation and at one-year follow-up. Frailty (the Clinical Frailty Scale [CFS] and the 5-item Frailty Index [5-FI]), physical activity, postural function, respiratory parameters, and functional performance (the 6 min walk test [6MWT] and the Timed Up and Go [TUG] test) were evaluated. Results: Of the 93 eligible patients, 41 completed the one-year follow-up and were therefore included in the final analysis. A small but statistically significant increase in frailty was observed using 5-FI (mean difference = 0.029, p = 0.012), with no significant change in CFS. Postural function improved (p = 0.031), while physical activity and functional performance remained stable (6MWT: 392.71 vs. 384.36 m, p = 0.885; TUG: 12.36 vs. 10.42 s, p = 0.051). A significant reduction in pre- and post-exercise oxygen saturation was observed; however, the magnitude of change (before: −1.25%, p = 0.006; after: −0.91%, p < 0.001) was small and of uncertain relevance. Conclusions: Over a one-year follow-up of prehabilitated CRC patients with frailty, their functional performance remained stable despite a subtle progression of frailty. These findings suggest a dissociation between physiological vulnerability and functional status. Due to the observational design of the study and the lack of a control group, the results should be interpreted as descriptive rather than causal. Full article

Background: Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease characterized by poor prognosis and accumulating evidence of systemic vascular involvement. Although cardiovascular comorbidities are recognized in IPF, the presence and extent of subclinical atherosclerosis are yet to be fully characterized. This study determined whether patients with IPF exhibit increased carotid intima–media thickness (CIMT) and altered atherogenic indices compared with healthy controls. Methods: This retrospective case–control study enrolled 117 patients with IPF diagnosed based on international guidelines and 104 age- and sex-matched healthy controls. All participants underwent comprehensive pulmonary function testing, the 6-min walk test (6MWT), laboratory evaluation (including lipid profiles), and bilateral carotid Doppler ultrasonography for CIMT measurement. Atherogenic indices, including the atherogenic coefficient, cholesterol ratio risk (CRR), and atherogenic index, were calculated. Dyspnea severity was evaluated using the visual analog scale (VAS). Results: Patients with IPF exhibited significantly higher CIMT (0.78 ± 0.12 mm vs. 0.68 ± 0.10 mm, p < 0.001) and CRR (4.12 ± 1.23 vs. 3.45 ± 0.98, p < 0.001) compared with controls. After adjustment for age, sex, cumulative smoking exposure expressed as pack-years, BMI, and controlled hypertension, IPF status remained independently associated with higher CIMT (adjusted β = 0.086 mm, 95% CI: 0.057–0.115; p < 0.001) and CRR (adjusted β = 0.482, 95% CI: 0.191–0.773; p = 0.001). Furthermore, patients with IPF had significantly lower HDL cholesterol levels and higher VLDL cholesterol levels. CIMT correlated negatively with 6MWT distance (r = −0.312, p = 0.001) and positively with VAS dyspnea scores (r = 0.287, p = 0.002). Conclusions: Patients with IPF showed higher CIMT and more unfavorable atherogenic profiles than healthy controls, and these associations persisted after adjustment for major vascular risk factors. The observed relationships between CIMT, functional capacity, and dyspnea severity suggest a potential association between IPF and subclinical cardiovascular involvement. Prospective studies are warranted to clarify the clinical relevance and prognostic implications of these findings. Full article

Background: High-intensity interval training (HIIT) is increasingly used in exercise-based cardiac rehabilitation (ebCR) after myocardial infarction (MI), yet the temporal sequence of physiological, cardiac, biochemical, and functional adaptations remains incompletely characterized. Methods: Stable post-STEMI (ST-segment elevation myocardial infarction, MI-group) and previously inactive participants without known cardiovascular, metabolic or systemic disease (CTRL group) completed 12-week supervised outpatient HIIT (4 × 4 min intervals at 85–90% HRpeak (peak heart rate), ~80–90% of VO₂peak, 3 sessions/week). Assessments were performed at baseline (T1), 4 (T2), 8 (T3), and 12 weeks (T4), including cardiopulmonary exercise testing (CPET), echocardiography, blood biomarkers, body composition, six-minute walk test (6MWT), and RAND-36. Longitudinal changes were analyzed using Friedman tests with Dunn post hoc comparisons; between-group differences used Mann–Whitney U tests with Holm correction. Results: VO₂peak increased significantly in both groups (p < 0.001), increasing by ~22% from T1 to T4 in MI (median 20.1 to 24.5 mL·kg⁻¹·min⁻¹) and ~23% from T1 to T4 in CTRL (median 22.3 to 27.6 mL·kg⁻¹·min⁻¹). LVEF (left ventricular ejection fraction) improved early in MI, increasing from 52.5% (50.0–55.0) at T1 to 57.5% (55.2–58.7) at T2 and up to 60% (55.8–60.0) at T4 (all p < 0.001), while LV dimensions remained stable. NT-proBNP (N-terminal pro-B-type natriuretic peptide) showed no significant longitudinal change (p = 0.510), and CRP (C-reactive protein) decreased from 2.1 to 0.7 mg·L⁻¹ (p = 0.008) in MI. Both groups improved body fat % and 6MWT distance (p < 0.001). Conclusions: In low-risk stable post-STEMI patients, longitudinal changes during supervised HIIT-based ebCR were consistent with improved VO₂peak and LVEF, without clinically relevant increases in cardiac stress biomarkers. However, due to the observational design and absence of clinical comparator groups, these findings should be interpreted as descriptive and support further evaluation in larger randomized studies. Full article

Background/Objectives: Short-term functional outcomes after outpatient pulmonary rehabilitation are heterogeneous. We examined whether a study-derived cardio-nutrition-inflammation-oxygen (CNIO) index integrating echocardiographic filling pressure, nutritional status, inflammation, and oxygen requirement was associated with 3-month functional outcomes in chronic respiratory disease. Methods: This single-center retrospective cohort study included 60 adults with chronic obstructive pulmonary disease, interstitial lung disease, or bronchiectasis who completed outpatient pulmonary rehabilitation and had baseline and 3-month functional assessments. The CNIO index was calculated as standardized E/e′ plus standardized ln(neutrophil-to-lymphocyte ratio) plus standardized resting oxygen flow rate minus standardized Geriatric Nutritional Risk Index, and the summed score was then standardized to mean 0 and SD 1. The primary outcome was 3-month 6 min walk test (6MWT) distance, and the exploratory secondary outcome was 3-month Short Physical Performance Battery (SPPB) score. The primary 6MWT analysis used multivariable analysis of covariance adjusted for baseline 6MWT, age, sex, body mass index, and diagnosis, whereas the exploratory SPPB analysis used ordinal logistic regression adjusted for baseline SPPB and the same covariates. Results: Mean 6MWT increased from 340.3 ± 61.0 m to 368.0 ± 102.0 m, corresponding to a mean change of 27.7 ± 90.3 m. Each 1-SD increase in CNIO was associated with a lower 3-month 6MWT distance (β = −43.42 m; 95% confidence interval [CI], −77.55 to −9.30; p = 0.014). In the exploratory ordinal logistic regression model for SPPB, each 1-SD increase in CNIO was associated with lower odds of being in a higher 3-month SPPB category, although the estimate was fragile and the confidence interval was close to the null (odds ratio = 0.39; 95% CI, 0.15 to 0.99; p = 0.048). Bootstrap internal stability analysis for the primary 6MWT model showed a wide percentile bootstrap 95% CI of −76.05 to −13.97 m per 1-SD increase in CNIO, supporting the need for cautious interpretation. Conclusions: In this hypothesis-generating derivation study, a higher standardized CNIO index was associated with lower 3-month 6MWT distance among adults with chronic respiratory disease who completed outpatient pulmonary rehabilitation. The association with SPPB was weaker and should be interpreted cautiously. These findings are not generalizable to patients who discontinue rehabilitation or are hospitalized for exacerbation during follow-up, and prospective external validation in larger, diagnostically stratified cohorts is required before CNIO can be considered for clinical risk stratification or rehabilitation planning. Full article

Objective: Long COVID (LC) has been defined as a chronic condition that occurs after SARS-CoV-2 infection and persists for more than 3 months. Dyspnea is the most common and disabling symptom with several mechanisms identified. The pathophysiology of post-COVID dyspnea is unknown. The aim of this study is to analyze the clinical profile of patients presenting with dyspnea in the context of LC and to assess its possible relation with complementary diagnostic tests. Material and Methods: This is a retrospective cohort study including adult patients diagnosed with LC attending a post-COVID outpatient clinic. Dyspnea was assessed using mMRC and Borg scales. Complementary tests included chest imaging, pulmonary function tests (PFTs) and a six-minute walk test (6MWT). These assessments were performed at several time points throughout follow-up (3, 6, and 12 months). Results: Eighty patients diagnosed with LC were included, the mean age was 60.0 ± 14.4 and 43 (54.8%) were female. Most patients were hospitalized during acute infection (97.5%) and 25 patients experienced respiratory failure. During the follow-up, chest X-rays showed persistent abnormalities in 67.5% of patients, and 6MWT was pathological in 61.3% at 277 days (IQR 176–326) after acute infection. No significant differences were observed in the prevalence of ventilatory failure across dyspnea severity categories. Reduced DLCO was observed in 20% of patients, while obstructive or restrictive patterns were infrequent. Through three follow-up visits, pulmonary function and exercise capacity remained stable, with modest improvements in DLCO and exercise-induced desaturation (p = 0.005). In multivariable analysis, obesity (adjusted OR 7.88; p = 0.023) and lower DLCO (p = 0.049) were independent predictors of more severe dyspnea, highlighting the role of non-pulmonary factors in Long COVID. Conclusions: This study describes the clinical and functional profile of a cohort of patients with LC. Although abnormal findings were frequent, only impaired DLCO and obesity were independently associated with dyspnea severity, while imaging and six-minute walk test abnormalities showed no consistent association with symptom intensity, supporting a multifactorial origin of post-COVID dyspnea. Full article

People living with neurological disorders frequently experience gait impairments that substantially reduce mobility, independence, and quality of life. This pilot study aimed to evaluate the feasibility, safety, and preliminary functional outcomes of integrating the EksoNR robotic exoskeleton (Ekso Bionics, San Rafael, CA, USA) into outpatient neurorehabilitation practice in individuals with chronic neurological impairments. Over an eight-month period, five participants with heterogeneous neurological conditions (two spinal cord injuries, one cerebellar ataxia, one ischemic stroke, and one spastic paraparesis) completed a four-week robotic gait training program consisting of 15 intervention sessions. Functional outcomes were assessed before and after the intervention using standardized clinical tests. Cardiovascular endurance was evaluated using the 6-Minute Walk Test (6MWT), while physical and psychological well-being were assessed with the Functional Independence Measure (FIM) and the Barthel Index, in addition to the WHO Quality of Life (WHOQOL) and EQ-5D-5L questionnaires. Mobility and balance were evaluated using the Timed Up and Go (TUG), Berg Balance Scale (BBS), Tinetti Performance-Oriented Mobility Assessment (POMA), and Walking Index for Spinal Cord Injury II (WISCI II), where applicable. In addition, device-recorded gait parameters, including step count, step length, walking distance, and walking duration, were analyzed. Significant improvements were observed in several device-derived gait parameters, including the number of steps performed with the exoskeleton (p < 0.001), step length (p = 0.003), walking distance (p = 0.002), and walking duration (p < 0.05). Significant improvements were also identified in balance performance (BBS: p = 0.006; Tinetti POMA: p = 0.001), cardiovascular endurance (6MWT: p = 0.017), and EQ-5D-5L scores (p = 0.038). Functional independence measures (FIM and BI), TUG performance, and WHOQOL domains did not demonstrate statistically significant changes. No serious adverse events or device-related injuries occurred during the intervention period. Due to the small and clinically heterogeneous sample, these findings should be interpreted as preliminary exploratory results. Nevertheless, the study supports the feasibility and potential clinical utility of EksoNR-assisted gait rehabilitation and provides a basis for larger controlled investigations. Full article

Background: The factors contributing to physical inactivity in patients with asthma remain unclear. We aimed to explore the pulmonary and extra-pulmonary factors associated with physical activity (PA) in these patients, with stratification by activity intensity. Methods: Patient demographics, Charlson Comorbidity Index, lung function, bronchial and alveolar nitric oxide (NO) levels, six-minute walk test (6 MWT), and PA were cross-sectionally evaluated in healthy participants (n = 14) and patients with asthma (n = 29). The desaturation–distance ratio (DDR) was measured as an index derived from travel distance and desaturation levels during the 6 MWT. Results: Patients with asthma had significantly lower PA than healthy participants, regardless of activity intensity (≥2 metabolic equivalents [METs]: 198 min vs. 240 min, p < 0.05; ≥3 METs: 54 min vs. 86 min, p < 0.05; ≥4 METs: 10 min vs. 26 min, p < 0.01). Extra-pulmonary factors (age, comorbidities, and 6 MW distance) showed higher correlation coefficients with PA as activity intensity increased. Contrastingly, pulmonary factors (asthma severity, airflow limitation, and alveolar exhaled NO) showed lower correlation coefficients with PA as activity intensity increased. The DDR was negatively associated with active time across all activity intensities. Conclusions: Our findings suggest that aging and comorbidities are potential limiting factors for moderate-to-vigorous physical activity, whereas asthma severity and airway dysfunction restrict daily life in patients with asthma. Moreover, the DDR could facilitate detection of real-life physical inactivity in patients with asthma. Full article

Background/Objectives: Bariatric surgery is an effective treatment for severe obesity. Although physiotherapy delivered before and after surgery may support functional recovery, evidence describing real-world multidisciplinary bariatric pathways with embedded perioperative physiotherapy remains limited. This study evaluated perioperative changes in anthropometric, functional, and haemodynamic outcomes in adults who completed preoperative and postoperative physiotherapy within the multidisciplinary Polish KOS-BAR bariatric pathway. Methods: We conducted a single-centre retrospective medical-record study at the University Clinical Centre in Gdańsk. The analysis included a complete-case cohort of 91 adults who completed both supervised physiotherapy cycles and had paired outcome data available. Assessments were performed at four time points: before and after prehabilitation (T1–T2) and before and after postoperative rehabilitation (T3–T4). Outcomes included body mass, body mass index (BMI), waist and chest circumference, 6 min walk test (6MWT) distance with Borg-rated exertion, and haemodynamic measures (heart rate, blood pressure, oxygen saturation) recorded before and after the 6MWT. Results: From T1 to T4, body mass decreased by a median of 26.0 kg and BMI by 8.98 kg/m², with reductions in waist (−19.0 cm) and chest (−13.0 cm) circumference. Exercise tolerance improved (6MWT median change +30.0 m), and post-test perceived exertion decreased (median −1.0 point). Pre-6MWT resting HR, post-6MWT HR, and blood pressure decreased. The 6MWT distance increased after prehabilitation (T1 → T2) and again after postoperative rehabilitation (T3 → T4). Exploratory correlations suggested weak nominal associations between greater weight loss and larger 6MWT improvement (Spearman r = 0.251, p = 0.016) and between BMI reduction and 6MWT improvement (r = 0.226, p = 0.031), but these associations did not remain statistically significant after Bonferroni correction. Conclusions: In this retrospective cohort of programme completers, participation in the multidisciplinary KOS-BAR pathway with embedded preoperative and postoperative physiotherapy was associated with improved anthropometric, functional, perceived-exertion, and haemodynamic outcomes across follow-up. Because of the uncontrolled retrospective design, these findings cannot establish the independent effect of physiotherapy relative to surgery and other components of multidisciplinary care. Prospective controlled studies are needed to clarify causality and long-term durability. Full article

Background/Objectives: To evaluate the associations and concurrent validity between baseline functional and morphofunctional assessments in patients with cardiovascular disease participating in a Phase II cardiac rehabilitation program, as a basis for informing individualized exercise prescription. Methods: We conducted an observational retrospective cross-sectional study of patients enrolled in a Phase II outpatient cardiac rehabilitation program (January 2021–December 2023, Málaga). Functional assessments included handgrip strength (HGS), isometric biceps and quadriceps dynamometry, and direct assessment of 20-repetition maximum (20RM) through dynamic resistance exercises using external loads (defined as the maximum load allowing approximately 20 repetitions to near muscular fatigue). Aerobic capacity was evaluated using the 6-min walk test (6 MWT) and a modified Bruce exercise stress test with estimated METs. Morphofunctional assessment included vector bioimpedance analysis (phase angle [PhA], fat-free mass [FFM], body cell mass [BCM]) and rectus femoris ultrasound (cross-sectional area [RF-CSA] and contracted diameter [RF-CON]). Correlation and linear regression analyses were performed. Results: The sample included 223 participants (78.0% male; age 57.7 ± 8.6 years). HGSmax correlated strongly with 20RM biceps (r = 0.89) and moderately with quadriceps (r = 0.72). 6 MWT distance and speed correlated with ergometry-derived METs (r = 0.38–0.40; p < 0.001), whereas Borg ratings correlated inversely with METs and exercise time (r = −0.32 to −0.34; p < 0.001). PhA, BCM, FFM, and rectus femoris ultrasound measures correlated with both strength and aerobic outcomes (ρ ≈ 0.33–0.50; all p < 0.001). In regression analyses, HGSmax was the main predictor of 20RM biceps (R² = 0.792) and showed moderate predictive capacity for quadriceps performance (R² = 0.521). The MET model demonstrated limited explanatory capacity (R² = 0.288). Conclusions: The integration of simple, accessible, and reproducible tools such as HGS and the 6 MWT with morphofunctional parameters may provide a pragmatic approach to support individualized exercise prescription in cardiac rehabilitation. While stronger associations were observed for upper-limb resistance performance, the predictive capacity for lower-limb strength and aerobic exercise intensity was more moderate and should be interpreted cautiously. These findings support the potential clinical utility of combining functional and morphofunctional assessments in routine cardiac rehabilitation practice. Full article

Background/Objectives: The emergence of methicillin-resistant Staphylococcus aureus (MRSA) has created an urgent need for the development of novel antimicrobial agents. This study aimed to synthesize and characterize a series of benzimidazolium salts and evaluate their antibacterial, antibiofilm, and molecular interaction properties against MRSA and methicillin-susceptible Staphylococcus aureus (MSSA). Methods: Five benzimidazolium salts bearing different substituents were synthesized and characterized by NMR and FTIR analyses. Their antibacterial activities against MRSA and MSSA were investigated using the resazurin-based minimum inhibitory concentration (MIC) assay and agar diffusion method. Antibiofilm activity was evaluated using crystal violet staining, while scanning electron microscopy (SEM) was employed to examine bacterial morphological changes. Gene expression analysis was performed to assess the effects of the most active compound on virulence- and resistance-related genes. In addition, molecular docking studies were conducted against four target proteins (1MWT, 3ZG5, 1JIJ, and 2Y2M). Results: Among the synthesized compounds, compound 1c exhibited the strongest antibacterial activity, with MIC values of 0.25 µg/mL against MRSA and 0.5 µg/mL against MSSA. It also produced the largest inhibition zone diameter (31.0 ± 0.5 mm). SEM analysis revealed significant morphological alterations in treated bacterial cells, indicating disruption of cellular integrity. Gene expression studies demonstrated that compound 1c downregulated several virulence- and resistance-associated genes, including icaA, dltA, dltB, sarA, norA, and norB. All compounds displayed antibiofilm activity, with compound 1c showing the highest inhibition rate (68.6 ± 0.6%). Molecular docking analysis revealed that compound 1c exhibited the strongest binding affinity toward the 2Y2M target protein, with a docking score of −5.322 kcal/mol. Conclusions: The findings demonstrate that benzimidazolium derivatives, particularly compound 1c, possess potent antibacterial and antibiofilm activities against S. aureus strains and effectively modulate virulence- and resistance-related gene expression. Combined with favorable molecular docking results, these compounds represent promising candidates for the development of new therapeutic agents against resistant S. aureus infections. Full article

Background/Objectives: Impaired quality of life (QoL) represents one of the most important clinical determinants in heart failure with preserved ejection fraction (HFpEF). This study aimed to evaluate the incremental explanatory value of functional performance and inflammatory biomarkers for QoL in a clinically stable HFpEF cohort. Methods: A single-center observational study enrolled 110 consecutive patients with stable HFpEF. Functional capacity was assessed using the six-minute walk test (6MWT), expressed mainly as percentage of predicted distance. Health-related QoL was measured using the EQ-5D-5L utility index (primary outcome). Circulating IL-6, CRP, and NT-proBNP were obtained from peripheral blood. Hierarchical multivariable linear regression was applied to quantify the incremental contribution of clinical variables, functional capacity, and biomarkers. Results: The median age was 72 years, and 52.7% of the participants were women. The median 6MWT distance was 340 m (75.9% of predicted), and the median EQ-5D index was 0.76. The baseline clinical regression model (age, sex, atrial fibrillation, and glomerular filtration rate) explained 23.5% of EQ-5D variance. The addition of functional capacity increased explained variance to 45.2% (ΔR² = +0.217). The inclusion of IL-6 and NT-proBNP provided a modest additional increase (R² = 0.468; ΔR² = +0.042 in addition to Model 2). In the fully adjusted model, functional capacity (β = 0.376, p < 0.001) and IL-6 (β = −0.185, p < 0.05) remained independent predictors, whereas NT-proBNP lost significance. Conclusions: In stable HFpEF, objective functional capacity represents the dominant determinant of QoL, while inflammatory activation provides an independent but smaller contribution. Functional assessment may therefore be central to patient-centered phenotyping and therapeutic targeting. Full article

In microwave tomography (MWT), reconstruction accuracy is challenged by modeling error, namely the mismatch between the numerical representation and the actual experiment. Accurate antenna modeling is perceived as an important step toward reducing this error, but the actual benefit of increasing antenna model complexity has not been analyzed in the literature. This work fills this gap by conducting a rigorous numerical analysis of the issue using two popular algorithms for its study: the finite-difference time-domain (FDTD) method for antenna and forward-problem modeling, and the distorted Born iterative method (DBIM) for implementing the iterative inversion algorithm. We consider various FDTD tools of increasing complexity to improve the agreement between the FDTD forward solver and an accurate numerical model implemented in commercial software. After validating these models for different antennas, we perform reconstructions for a stroke-detection scenario. Our results show that in a practical setting, sophisticated antenna modeling in the forward solver does not necessarily improve reconstruction accuracy for monopole-type antennas widely used in MWT. Our model-error analysis confirms that calibration is always necessary in practice and that its impact supersedes efforts to model the antenna more faithfully. Full article

Background: Skeletal myopathy is a common complication of heart failure (HF), contributing to exercise intolerance and impaired physical function. This study explores the relationship between practical skeletal muscle measurements and key biomarkers in HF patients undergoing cardiac rehabilitation. Methods: Sixty-nine stable chronic HF patients participated in a 3-month phase II cardiac rehabilitation program. Physical examinations, including the 6-Minute Walk Test (6MWT), chest expansion, inspiratory diaphragm thickness, and handgrip strength, were conducted. Blood samples were analyzed for myostatin and miRNA-133a. Data were analyzed using paired t-tests, Wilcoxon tests, Chi-square/Fisher’s exact tests, and correlation analyses. Results: Significant improvements were observed in 6MWT distance, chest expansion, and inspiratory diaphragm thickness following rehabilitation (p < 0.001). Handgrip strength also significantly improved post-rehabilitation. Myostatin and miRNA-133a levels did not change significantly post-rehabilitation. However, exploratory cross-sectional analysis revealed trends suggesting that lower myostatin levels correlated with better endurance (p = 0.036), while higher myostatin levels were also observed in patients with better 6MWT performance (p = 0.014). Higher miRNA-133a levels were potentially associated with better overall fitness, including endurance and respiratory function (p < 0.05). Conclusions: Readily performed physical assessments can serve as clinical indicators of the systemic impact of HF on skeletal muscle. The study highlights the importance of evaluating extracardiac function in HF patients, demonstrating potential exploratory associations between physical function and key biomarkers. Full article