(1) Background: An unhealthy lifestyle is a significant contributor to the development of chronic diseases. Physical activity can benefit primary and secondary prevention. Higher DNase activity is associated with favourable outcomes after cardiovascular (CV) events. In this study, we aimed to investigate the influence of consequent endurance exercise on DNase activity. (2) Methods: 98 subjects with at least one CV risk factor but the physical ability to perform endurance training were included. Individuals performed a bicycle stress test at the beginning and after 8 months to assess physical performance. In between, all participants were instructed to engage in guideline-directed physical activity. Blood samples were drawn in two-month intervals to assess routine laboratory parameters, cell-free DNA (cfDNA), and DNase activity. (3) Results: Prevailing CV risk factors were overweight (65.9%), a positive family history (44.9%), hypertension (32.7%) and smoking (20.4%). Performance changed by 7.8 ± 9.1% after 8 months. Comparison of baseline to 8 months revealed a decrease in cfDNA and an increase in DNase activity. This effect was driven by participants who achieved a performance gain. (4) Conclusions: Regular physical activity might improve CV health by increasing DNase activity and thereby, the capacity to lower pro-inflammatory signalling, complementing measures of primary and secondary prevention.

There is growing evidence that low levels of the circulating soluble receptor of advanced glycation end products (sRAGE) are a valuable predictor of cardiovascular disease (CVD). The aim of this prospective study was to investigate the influence of long-term physical activity on serum sRAGE levels. 109 subjects were recruited, and 98 completed the study. Participants were asked to perform exercise within the calculated training pulse for 8 months. The performance gain was measured/quantified by bicycle stress tests at the beginning and end of the observation period. sRAGE was measured at baseline and after 2/6/8 months by ELISA. Backwards, multiple linear regression analysis was performed to investigate the association of co-variables age, sex, BMI, and performance at baseline, HbA₁c, and lipoprotein a with baseline sRAGE levels. We identified BMI and lipoprotein a as significant predictors for baseline sRAGE levels. Compared to subjects with a performance gain ≤ 4.9% subjects with a gain > 5% showed a significant increase in sRAGE levels up to 22%. sRAGE serum levels correlate negatively with lipoprotein a levels and BMI and long-term physical activity leads to a significant increase in serum sRAGE levels (9–22%), whereby the sRAGE increase is most pronounced in subjects with initially low-performance levels, suggesting that in particular, these subject profit the most from increased physical activity. The sport-mediated increase of sRAGE might be a sign of decreased AGE-mediated inflammation and highlight the protective effect of sports on CVD and other disease which are at least partly mediated by an increased inflammation status.Clinical trials registrationNCT02097199.

Background: Various biomarkers have been associated with coronary artery disease (CAD) and ischemic heart failure. The aim of this study was to investigate the correlation of serum levels of soluble urokinase-type plasminogen activator receptor (suPAR), growth differentiation factor 15 (GDF-15), heart-type fatty acid-binding protein (H-FABP), and soluble suppression of tumorigenicity 2 (sST2) with left ventricular ejection fraction (EF) in CAD patients and controls. Methods and Results: CAD patients were divided into three groups according to their EF as measured by the biplane Simpson method (53–84%, 31–52%, ≤30%). Overall, 361 subjects were analyzed. In total, 155 CAD patients had an EF of 53–84%, 71 patients had an EF of 31–52%, and 23 patients had an EF of ≤30% as compared to 112 healthy controls (age 51.3 ± 9.0 years, 44.6% female). Mean ages according to EF were 62.1 ± 10.9, 65.2 ± 10.1, and 66.6 ± 8.2 years, respectively, with females representing 29.0, 29.6, and 13.0%. suPAR, GDF-15, H-FABP, and sST2 values were significantly higher in CAD patients and showed an exponential increase with decreasing EF. In a multiple logistic regression model, GDF-15 (p = 0.009), and NT-brain natriuretic peptide (p = 0.003) were independently associated with EF. Conclusion: Biomarkers such as suPAR, GDF-15, H-FABP, and sST2 are increased in CAD patients, especially in highly impaired EF. Besides NT-proBNP as a well-known marker for risk prediction, GDF-15 may be an additional tool for diagnosis and clinical follow-up.

Background: Heavy metal pollutants such as cadmium (Cd), lead (Pb), and mercury (Hg) are rarely the subjects of cardiovascular research although they have been suspected for decades to negatively impact the circulatory system. Methods: Apart from detailed anamnestic data, urinary levels of Cd and full blood levels of Pb and Hg were measured in 53 female (mean age: 68.04±7.03 years) and 111 male (mean age: 60.68±11.43 years) nonsmoking or never-smoking patients with angiographically verified and precisely quantified coronary artery disease (CAD). Results: Although Cd was quantifiable in 68.3% of subjects, only 34.1% of these patients exceeded the critical 1 µg/L Human Biomonitoring (HBM)-I level. Median Pb (20 µg/L) and Hg (0.55 µg/L) levels were lower than the HBM-I, as well as reference levels of Pb. Wine consumption was the main source for Pb, fish and wine consumption for Hg, and previous nicotine abuse for Cd. There was no correlation between Cd, Pb, or Hg and severity of CAD although severity correlated positively with atherosclerosis parameters (uric acid, creatinine, triglycerides, blood urea nitrogen, C-reactive protein) and negatively with high density lipoprotein cholesterol. Conclusion: Cd levels detected in CAD patients were high compared to German and European reference levels but it could not be proven that urine levels of Cd and blood levels of Hg or Pb played a major role in the genesis of CAD, particularly when compared to well-known biomarkers such as blood pressure, glucose, and lipids.

Cathepsin S (CS) was shown to play a key role in cancer progression, atherosclerosis, heart valve disease, insulin resistance and diabetes mellitus. The present prospective study aimed to investigate the influence of sports on CS, interleukin-6 (Il-6) and high-sensitivity C-reactive protein (hsCRP) levels. Ninety-eight of 109 participants completed the study. Ergometries were performed at baseline and after 8 months to evaluate/quantify the performance gain. Blood samples were taken at baseline and every 2 months. CS was measured by ELISA (enzyme-linked immunosorbent assay). Compared to the control group (mean performance gain −3.41 ± 4.62%) we observed a significant physical-activity-induced increase of CS levels (3.45–3.73 ng · ml⁻¹; P = 0.027) and a significant decrease of Il-6 (2.43–1.91 pg · ml⁻¹; P = 0.031) and hsCRP-levels (0.11–0.09 mg · dl⁻¹; P = 0.001) in the intervention group (mean performance gain: 12.13 ± 6.32%). Furthermore, the tendency of the progression was significant for CS and Il-6 (P = 0.002/0.033). We could show a significant sports-induced decrease of the classic inflammation parameters hsCRP/Il-6, probably expressing a downregulation of permanently prevalent inflammation processes. Simultaneously CS levels increased significantly. Our results show that increasing CS amounts are not simply to equal with an enhanced inflammation status and might even have beneficial effects on inflammation and angiogenesis.

Background: Several scoring systems have tried to determine the severity of coronary artery disease (CAD) to investigate the connection between CAD severity and laboratory parameters. Methods: In total, 189 male (mean age: 61.86±10.77 years) and 75 female CAD patients (mean age: 67.84±7.70 years) were recruited and underwent angiography, which determined stenosis grade, of 17 coronary segments: no points for each nonstenosed segment or only calcified segments, one point for each stenosis from <30% to <50%, two points for each stenosis from 50% to 70%. The points were added and should represent the severity of patients' CAD. Results: The coronary score correlated positively with systolic blood pressure, creatinine, blood urea nitrogen, lipase, glucose, glycated hemoglobin, triglycerides, C-reactive protein, fibrinogen Clauss, and leukocytes, and correlated negatively with Cl^-, iron, and high-density lipoprotein cholesterol. Stepwise multiple regression analysis with backward elimination revealed diabetes status, sex, and fibrinogen Clauss as significant predictors of coronary score. Conclusion: The coronary score delivers a quite simple but very precise tool for the quantification of CAD severity. These results show plainly the connection between CAD severity and the lipid, glucose, coagulation, and immunologic status of CAD patients, and substantiate the importance of sufficient treatment in this group of patients – in particular, CAD patients suffering from type 2 diabetes mellitus. The coronary score would offer a suitable tool for the investigation of the connection between CAD and new biomarkers. Further studies are needed to investigate the correlation of the coronary score with outcome parameters (eg, death).