Objective Recently, exergames have been used an exercise modality as aerobic fitness activities. However, evidence of its effectiveness on cardiovascular (CV)‐related risk factors remain unclear. Hypothesis We evaluate the effects of exergaming on CV‐related risk factors compared with traditional aerobic exercise in high CV risk patients. Methods Sixty‐five postmenopausal women with high CV risk were randomized among exergame (n = 22), treadmill (n = 22), and control (n = 21) groups. The exergame group was engaged in the running‐based exergame using Exer Heart and the treadmill group walked or jogged on a treadmill. Cardiorespiratory fitness, flow‐mediated dilation, endothelial progenitor cells (EPCs), epicardial fat thickness, metabolic parameters, and anthropometric parameters were measured in patients before and 12 weeks after the training. Results Exergaming significantly improved VO2 peak (P < .001; different from control, P < .05), flow‐mediated dilation (P < .001; different from control, P < .05), EPCs (CD34/CD117+, P < .01). Treadmill exercise was effective at improving VO2 peak (P < .01; different from control, P < .05), flow‐mediated dilation (P < .05), EPCs (CD34/CD117+, P < .01; different from control P < .05). Epicardial fat thickness decreased after both exercise programs (exergame, P < .01; treadmill, P < .01; no different from control). Conclusion Exergaming showed similar effects to traditional aerobic exercise in improving cardiorespiratory fitness and endothelial function in postmenopausal women with high CV risk. These findings suggest that the exergames may serve as an alternative to conventional aerobic exercises for prevention and treatment in high CV risk patients.

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Background Recent studies indicate that participation in exercise-related games can improve executive function, attention processing, and visuospatial skills. Objective The aim of this study was to investigate whether exercise via exergaming (EXG) can improve executive function in patients with metabolic syndrome (MetS). Methods A total of 22 MetS patients were recruited and randomly assigned to an EXG group or a treadmill exercise (TE) group. The reaction time (RT) and electrophysiological signals from the frontal (Fz), central (Cz), and parietal (Pz) cortices were collected during a Stroop task after 12 weeks of exercise. Results During the Stroop congruence (facilitation) judgment task, both the EXG and TE groups showed significantly faster RT after 12 weeks of exercise training. For N200 amplitude, the EXG group demonstrated significantly increased electrophysiological signals from the Fz and Cz cortices. These changes were significantly larger in the EXG group than in the TE group. Separately, for the P300 amplitude, the EXG groups presented significantly increased electrophysiological signals from the Fz, Cz, and Pz cortices, whereas the TE group showed significantly increased electrophysiological signals from the Cz and Pz cortices only. During the Stroop incongruence (interference) judgment task, both the EXG and TE groups showed significantly faster RT. For P300 amplitude, the EXG group had significantly increased electrophysiological signals from the Fz and Cz cortices only, whereas the TE group had significantly increased electrophysiological signals from the Fz, Cz, and Pz cortices. Conclusions EXG improves executive function in patients with MetS as much as normal aerobic exercise does. In particular, a unique benefit of EXG beyond increased aerobic capacity is the improved selective attention among cognitive functions. Thus, EXG could be recommended to someone who needs to improve their brain responses of concentration and judgment as well as physical fitness. Trial Registration ClinicalTrials.gov NCT04015583; https://clinicaltrials.gov/ct2/show/NCT04015583

Background Angina pectoris with a normal coronary angiogram, termed microvascular angina (MVA), is an important clinical entity; however, its causes remain unclear. Autonomic dysfunction is one of the possible causes. Therefore, this study aimed to investigate parasympathetic dysfunction assessed by heart rate recovery (HRR) and increased sympathetic activity assessed by exaggerated blood pressure (BP) response (EBPR) to exercise in MVA. Methods The study participants were consecutive patients with anginal chest pain who underwent both coronary angiography with an ergonovine provocation test and a treadmill exercise test between January 2008 and February 2015. Patients with significant coronary artery disease (coronary artery stenosis ≥50%) or significant coronary artery spasm (≥90%) were excluded. Based on the treadmill exercise test, patients were categorized into the microvascular angina (MVA) group (patients with uniform ST depression ≥1 mm) and the control group. HRR was defined as peak heart rate minus heart rate after a 1 min recovery; blunted HRR was defined as ≤12 beats/min. EBPR was defined as a peak exercise systolic BP ≥210 mmHg in men and ≥ 190 mmHg in women. These parameters were compared between patients with MVA and the controls. Results Among the 970 enrolled patients (mean age 53.1 years; female 59.0%), 191 (20.0%) were diagnosed with MVA. In baseline characteristics, the MVA group had older participants, female predominance, and a higher prevalence of hypertension. The MVA group showed significantly lower HRR 1 min (24.9 ± 15.9 vs. 31.3 ± 22.7, p <  0.001) compared with the control group. Moreover, the proportion of EBPR was significantly higher in the MVA group than in the control group (21.5% vs. 11.6%, p <  0.001). Multivariable logistic regression analysis showed that age (odds ratio (OR), 1.045; 95% confidence interval (CI), 1.026–1.064; p <  0.001), HRR 1 min (OR, 0.990; 95% CI, 0.982–0.999; p = 0.022), and EBPR (OR, 1.657; 95% CI, 1.074–2.554; p = 0.022) were independently associated with MVA. Conclusion HRR and EBPR were associated with MVA, which suggests a link between MVA and autonomic dysregulation.

Purpose This study aimed to investigate the abnormal and borderline ABIs for predicting coronary re-intervention and mortality in patients with coronary artery disease (CAD). Materials and Methods Data from a previous study were obtained and used to investigate the prevalence of peripheral arterial disease among Korean patients with CAD (n=285) in 2010. All patients underwent follow-up coronary angiography as scheduled (asymptomatic: 2-, 5-, and 7-month intervals) or as clinically indicated (symptomatic). Results In total, 33 patients had an abnormal ABI (ab-ABI: <1.0 or >1.4), and 252 had a normal ABI (nl-ABI: 1.0≤ABI≤1.4). The mean follow-up was 47 months. The mortality was significantly higher in the ab-ABI group than in the nl-ABI group (18.2% vs. 6.7%, P=0.0233). MACEs were significantly more common in the ab-ABI group (60.6% vs. 34.5%, P=0. 0036). Moreover, the ab-ABI group had a greater CAD progression than the nl-ABI group (48.5% vs. 31.3%, P=0.0496). The incidence of clinically indicated coronary re-intervention was significantly higher in the ab-ABI group than in the nl-ABI group (33.3% vs. 13.1%, P=0.0025). After adjusting for age, diabetes, dyslipidemia, dialysis, smoking, and obesity, the incidence of clinically indicated re-intervention was significantly higher in the ab-ABI group than in the nl-ABI group (HR, 2.80; 95% CI, 1.24 to 6.34). Conclusion Abnormal and borderline ABI significantly increased the incidence of clinically indicated coronary revascularization and all-cause mortality during a 4-year follow-up among patients with CAD. Hence, ABI could be used to stratify extremely high-risk patients with CAD who may require aggressive surveillance or treatment.