Different blood flow patterns in the arteries can alter the adaptive phenotype of vascular endothelial cells (ECs), thereby affecting the functions of ECs and are directly associated with the occurrence of lesions in the early stages of atherosclerosis (AS). Atherosclerotic plaques are commonly found at curved or bifurcated arteries, where the blood flow pattern is dominated by oscillating shear stress (OSS). OSS can induce ECs to transform into pro-inflammatory phenotypes, increase cellular inflammation, oxidative stress response, mitochondrial dysfunction, metabolic abnormalities and endothelial permeability, thereby promoting the progression of AS. On the other hand, the straight artery has a stable laminar shear stress (LSS), which promotes the transformation of ECs into an anti-inflammatory phenotype, improves endothelial cell function, thereby inhibits atherosclerotic progression. ECs have the ability to actively sense, integrate, and convert mechanical stimuli by shear stress into biochemical signals that further induces intracellular changes (such as the opening and closing of ion channels, activation and transcription of signaling pathways). Here we not only outline the relationship between functions of vascular ECs and different forms of fluid shear stress in AS, but also aim to provide new solutions for potential atherosclerotic therapies targeting intracellular mechanical transductions.

Background: Cardiac telerehabilitation offers a flexible and accessible model for patients with coronary artery disease (CAD), effectively transforming the traditional cardiac rehabilitation (CR) approach. Objective: This systematic review and meta-analysis aimed to evaluate the long-term effectiveness of cardiac telerehabilitation. Methods: We searched randomized controlled trials (RCTs) in 7 electronic databases: PubMed, Web of Science, EMBASE, the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, the China National Knowledge Infrastructure, and WANFANG. The primary outcome focused on cardiopulmonary fitness. For secondary outcomes, we examined cardiovascular risk factors (blood pressure, BMI, and serum lipids), psychological scales of depression and anxiety, quality of life (QoL), cardiac telerehabilitation adherence, and adverse events. Results: In total, 10 RCTs fulfilled the predefined criteria, which were reviewed in our meta-analysis. The results showed that after cardiac telerehabilitation, there was a significant difference in the improvement in long-term peak oxygen uptake compared to center-based CR (mean difference [MD] 1.61, 95% CI 0.38-2.85, P=.01), particularly after 6-month rehabilitation training (MD 1.87, 95% CI 0.34-3.39, P=.02). The pooled effect size of the meta-analysis indicated that there were no significant differences in the reduction in cardiovascular risk factor control. There was also no practical demonstration of anxiety scores or depression scores. However, cardiac telerehabilitation demonstrated an improvement in the long-term QoL of patients (MD 0.92, 95% CI 0.06-1.78, P=.04). In addition, the study reported a high completion rate (80%) for cardiac telerehabilitation interventions. The incidence of adverse events was also low during long-term follow-up. Conclusions: Cardiac telerehabilitation proves to be more effective in improving cardiopulmonary fitness and QoL during the long-term follow-up for patients with CAD. Our study highlights monitoring-enabled and patient-centered telerehabilitation programs, which play a vital role in the recovery and development of CAD and in the long-term prognosis of patients.

Background: The global aging population faces great challenges. Wearable activity trackers have emerged as tools to promote physical activity among older adults, potentially improving health outcomes. However, the effectiveness of such interventions on physical activity, body composition, and physical function among community-dwelling older adults remains debated. Objective: This study conducted a systematic review and meta-analysis to evaluate the impact of wearable activity tracker–based interventions on physical activity, body composition, and physical function among community-dwelling older adults. Methods: We searched the PubMed, Embase, Web of Science, and CENTRAL databases from inception until January 2025 to identify related randomized controlled trials. The outcomes were focused on physical activity (physical activity time, daily step count, and daily sedentary time); body composition (BMI and body fat); and physical function (timed up and go test and chair stand test). Subgroup analysis by different controls (usual care or conventional interventions) and different follow-ups (immediate or short term) were performed. Results: In total 23 trials with 4566 participants were eligible for analysis. Compared to usual care, there was lo- to moderate-certainty evidence that the wearable activity tracker–based interventions significantly increased physical activity time (standardized mean difference [SMD]=0.28, 95% CI 0.10-0.47; P=.003) and daily step counts (SMD=0.58, 95% CI 0.33-0.83; P<.001) immediately after intervention, while no significant improvements were observed in daily sedentary time (mean difference [MD]=−1.56, 95% CI −10.88 to 7.76; I2=0%; P=.74). These interventions were at least as effective as conventional interventions but did not show superiority. Compared with usual care, the interventions using wearable activity trackers only demonstrated a notable increase in daily step count over short-term follow-up (SMD=0.23, 95% CI 0.11-0.36; P<.001). As for body composition and physical function, there was low- to moderate-certainty evidence that the wearable activity tracker–based interventions did not have a greater impact on BMI (MD=0.40, 95% CI −0.08 to 0.89; P=.11), body fat (MD=0.67, 95% CI −0.54 to 1.87; P=.28), the timed up and go test (MD=0.14, 95% CI −0.87 to 1.16; P=.78), or the chair stand test (SMD=−0.31, 95% CI −0.62 to 0; P=.05). Conclusions: This systematic review and meta-analysis indicate that wearable activity tracker–based interventions were effective in enhancing physical activity with low to moderate certainty, but did not significantly impact body composition or physical function, with low to moderate certainty, among community-dwelling older adults, particularly immediately after intervention. This intervention showed a more pronounced impact when compared to usual care, rather than to conventional interventions, with low to moderate certainty. It is important to note that this intervention showed moderate-certainty evidence toward improving daily step count, supporting its sustained impact during short-term follow-up. Trial Registration: PROSPERO CRD42024516900; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024516900

Background: The triglyceride-glucose index (TGI), a reliable surrogate indicator of insulin resistance (IR), has been proven to be a predictor of the incidence of ischemic stroke. The role of TGI in predicting the outcomes of stroke patients remains controversial. Susceptibility to IR-related diseases varies among patients of different ages. The study aims to evaluate the predictive value of TGI levels on clinical outcomes of patients with ischemic stroke of different ages.Method: This was a retrospective cohort study including patients with ischemic stroke in the Department of Neurology at West China Hospital. TGI was calculated as ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)/2]. The patients were subdivided into 3 tertiles according to TGI levels. Multivariate logistic regression analyses were conducted to estimate the association between TGI levels and post-stroke outcomes among the whole patients, younger patients (=65). The outcomes included death and unfavorable functional outcome (modified Rankin scale score 3–6) at 3 and 12 months after stroke.Results: A total of 3,704 patients (men, 65.08%, mean age, 61.44 ± 14.15; women 34.92%, mean age, 65.70 ± 13.69) were enrolled in this study. TGI levels were not associated with 3 month or 12 month death in the whole patients. Patients with higher TGI levels (T2 and T3) had a higher risk of 3 month death than those had lower TGI levels (T1) in the younger group (T2 vs. T1: OR 2.64, 95% CI 1.03–6.79, p = 0.043; T3 vs. T1: OR 2.69, 95% CI 1.00–7.10, p = 0.049) but not in the older group. Additionally, Kaplan–Meier estimate analysis illustrated that the 12 month death risk was significantly higher in the group with the highest TGI among younger patients (p for log-rank test = 0.028) but not among older patients. There was an interactive effect between TGI and age on 3 month death (p for interaction = 0.013) and 12 month death (p for interaction = 0.027). However, TGI was not associated with unfavorable functional outcome at 3 month or 12 month after stroke.Conclusion: Elevated TGI independently predicts death at 3 months and 12 months in patients under 65 with ischemic stroke. Regulating TGI is expected to be an approach to enhance prognosis in young individuals affected by ischemic stroke.