Exercise Training Improves Cognitive Function and Neurovascular Control in Patients With Heart Failure and Atrial Fibrillation: A Randomized Clinical Trial
Bibliographic record
Abstract
Abstract Background Atrial fibrillation (AF) may be linked to cognitive impairment in heart failure (HF) patients. Regular exercise training has numerous benefits, including improving adults’ overall health and cognitive function. However, the effects of exercise training on cognitive function in heart failure patients with reduced ejection fraction and permanent atrial fibrillation (HFAF) are not well understood. Objective To test the hypothesis that exercise training improves cognitive function and neurovascular control in patients with HFAF. Methods This randomized clinical trial included patients with HFAF, LVEF ≤40%, and resting HR ≤80 bpm. Montreal Cognitive Assessment score (MoCA), muscle sympathetic nerve activity (MSNA), and forearm blood flow (FBF) assessment were performed before and after the 12-week protocol period. Results Twenty-six patients were randomized to exercise training (HFAF-trained, n=13) or no training (HFAF-untrained, n=13). At baseline, no differences between groups were found. Exercise significantly improved the MoCA score from 14.85 to 22.62 ( P <0.0001), as well as those measuring processing visuospatial, memory, and attention function from 2.23 to 3.31 ( P =0.02); from 1.92 to 2.69 ( P =0.01); and from 2.62 to 3.85 ( P =0.002), respectively. HFAF-training significantly decreased MSNA from 49.6±9.5 to 32.0±7.2 burst/min ( P <0.0001) and forearm vascular resistance from 48.8±13.1 to 28.1±7 units ( P <0.0001). Concomitantly, FBF increased from 1.9±0.5 to 3.0±0.7 mL/min/100mL ( P <0.0001). The untrained group increased MSNA from 50.9±10.6 to 57.6±9.2 burst/min ( P =0.004). No significant changes were found in the other variables in untrained patients. Conclusion Exercise training improves cognitive function and neurovascular control in patients with heart failure with reduced ejection fraction and permanent atrial fibrillation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".