The Canadian journal of cardiology
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In the present review, it is argued that while weight loss is associated with substantial reduction in obesity-related cardiovascular disease risk and remains a desired outcome of relevant treatment strategies, increasing physical activity is associated with marked reduction in waist circumference, visceral fat and cardiometabolic risk factors, concurrent with an increase in cardiorespiratory fitness despite minimal or no change in body weight. Failure to recognize the benefits of exercise independent of weight loss masks opportunities to counsel and educate patients whose sole criteria for gauging obesity reduction success is the bathroom scale.
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Obstructive sleep apnea (OSA) may contribute to the pathogenesis of congestive heart failure (CHF). Nocturnal continuous positive airway pressure (CPAP) therapy can alleviate OSA and may have a role in the treatment of CHF patients. ⋯ Acute CPAP administration decreased stroke volume and LVEF in stable CHF patients with OSA. In contrast, chronic CPAP therapy for seven weeks improved left ventricular systolic function, but did not affect diastolic function or filling pressures. The potential clinical implications of the discrepant effects of CPAP therapy on left ventricular systolic and diastolic function in CHF patients with OSA warrant further study.
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Multidetector computed tomography (MDCT) is useful for assessing left ventricular (LV) volumes and function. Validation has mainly been carried out using Simpson's method of summing up consecutive short-axis areas. Because the latter method is time-consuming, many users prefer using a quicker method, based on a single view or a pair of views. ⋯ The biplane AL method gives results for EF, which correspond closely with the more cumbersome Simpson's method, although volumes are slightly overestimated.