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Zhu R, Niu Y, Xu H, Wang S, Mao J, Lei Y, Xiong X, Zhou W, Guo L. Traditional Chinese Exercises for Cardiovascular Diseases: A Bibliometric Analysis. Percept Mot Skills 2024; 131:514-536. [PMID: 38349750 DOI: 10.1177/00315125241230599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
Traditional Chinese exercises (TCEs) have great value in the prevention and effective treatment of cardiovascular diseases (CVD). Our purpose in this study was to summarize present research trends and future directions regarding the link between TCEs and CVD by bibliometrics analysis. We searched the Web of Science Core Collection (WoSCC) for all original articles and reviews on TCEs for CVD published in English before August 7, 2022 using CiteSpace 5.8.R3 and Microsoft Excel 2019 software, and we displayed the results in the form of network maps, line graphs, and tables. We initially obtained 725 articles. Our results showed that the United States was the most influential country in this line of research, with Harvard University the most prolific institution in the field, and, Evidence-Based Complementary and Alternative Medicine was the most productive journal for these articles. The highest-frequency keywords in this research area were Tai Chi, exercise, blood pressure, quality of life, and older adult. Additionally, important research topics included heart rate variability, quality of life, meta-analysis, Baduanjin exercise, and breathing exercise. In addition, our results revealed that among all the TCEs, Tai Chi, Baduanjin, and Qigong emerged as the most extensively studied. However, it's important to note our exclusive focus on literature published in English may have led to our missing important results. Future investigators should broaden their search to include other databases and languages to present a still more comprehensive overview of this field.
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Affiliation(s)
- Ruiting Zhu
- School of Nursing, Jilin University, Changchun, China
| | - Yirou Niu
- School of Nursing, Jilin University, Changchun, China
| | - Haiyan Xu
- School of Nursing, Jilin University, Changchun, China
| | - Saikun Wang
- School of Nursing, Jilin University, Changchun, China
| | - Jing Mao
- School of Nursing, Jilin University, Changchun, China
| | - Yangyang Lei
- School of Nursing, Jilin University, Changchun, China
| | - Xuance Xiong
- Medical College, Beihua University, Jilin, China
| | - Wei Zhou
- Department of Clinical Laboratory, The First Hospital of Jilin University, Changchun, China
| | - Lirong Guo
- School of Nursing, Jilin University, Changchun, China
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Kristiansen J, Grove EL, Pedersen OB, Kristensen SD, Hvas AM. Effect of regular exercise training on platelet function in patients with cardiovascular disease and healthy individuals: A systematic review. Thromb Res 2023; 231:223-235. [PMID: 36609119 DOI: 10.1016/j.thromres.2022.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Regular exercise training is essential in prevention and treatment of cardiovascular disease (CVD), yet the beneficial effects of exercise remain only partly explained. Platelets play a key role in CVD and may be affected by regular exercise training. We aimed to systematically summarise studies investigating the effect of regular exercise training on platelet function in patients with CVD and in healthy individuals. METHODS Studies were identified by PubMed, Embase and Web of Science May 16, 2022. We selected studies investigating markers of platelet function in relation to regular exercise training in patients with CVD and in healthy individuals. Regular exercise was defined as exercise training for four weeks or more. RESULTS Of the included studies, 11 investigated patients with CVD and 29 were on healthy individuals. Studies were heterogeneous regarding design, study population and methodology, and the results were ambiguous. In total, 52 different markers of platelet function were investigated with platelet aggregation, soluble P-selectin, and thromboxane B2 (TXB2) as the most frequently examined. When evaluating between-group changes after regular exercise, two studies found a reduced platelet aggregation in the exercise group whilst three studies did not find a difference between groups. With respect to TXB2, three studies reported a reduction and two studies an increase in the exercise group. There were no between-group differences in the seven studies examining soluble P-selectin. CONCLUSION Regular exercise training has no clear impact on platelet function in patients with CVD or healthy individuals. PROSPERO REGISTRATION CRD42022350539.
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Affiliation(s)
- Jacobina Kristiansen
- Department of Medicine, National Hospital of the Faroe Islands, Tórshavn, Faroe Islands; Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark; Faculty of Health, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - Erik L Grove
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.
| | - Oliver Buchhave Pedersen
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Steen D Kristensen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Anne-Mette Hvas
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
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Antonovici Munteanu MO, Sandu IG, Vasilache V, Sandu AV, Arcana S, Arcana RI, Sandu I. Implications in Halotherapy of Aerosols from the Salt Mine Targu Ocna-Structural-Functional Characteristics. Healthcare (Basel) 2023; 11:2104. [PMID: 37510545 PMCID: PMC10379990 DOI: 10.3390/healthcare11142104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 07/13/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
The paper presents the evolution of the concentration level for four particle size groups of microaerosols (1.0, 2.5, 4.0 and 10.0 µm) in correlation with the microclimatic characteristics (temperature, humidity, lighting, pressure and concentration in CO2 and O2) in three active areas of the Targu Ocna Saltworks, currently used in treatments with solions (hydrated aerosols): in the vicinity of the walls of the old mining salt room, where there is a semi-wet static regime (SSR); in the transition area between the old rooms of exploitation with the semi-wet dynamic regime (DSR); and in the area of the waterfall and the marshy lake with the dynamic wet regime (DWR). The first and last halochamber are the ones recommended for cardio-respiratory, immuno-thyroid and osteo-muscular conditions, as well as in psycho-motor disorders. Based on questionnaires carried out over the course of a year, between 1 September 2021-31 August 2022, in two periods of stationing/treatment: a cold one (15 September 2021-15 December 2021) and a warm one (1 May 2022-30 July 2022), correlated with the data from the Salina medical office, achieved the profile of the improvement rate of the patients' ailments depending on the type of treatment (working regime in halochambers). These studies have allowed the optimization of the treatment conditions in the artificial surface halochambers in order to reduce the stationary period and optimize the treatment cycles.
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Affiliation(s)
- Mihaela Orlanda Antonovici Munteanu
- Doctoral School of Geosciences, Faculty of Geography and Geology, Alexandru Ioan Cuza University of Iași, 22 Carol I, Blvd., 700506 Iasi, Romania
| | - Ioan Gabriel Sandu
- Faculty of Material Science and Engineering, Gheorghe Asachi Technical University, 64 Dumitru Mangeron Blvd., 700050 Iasi, Romania
- Romanian Inventors Forum, 3 Sf. Petru Movila St., L11, 3-3, 700089 Iasi, Romania
| | - Viorica Vasilache
- Arheoinvest Center, Department of Natural and Exact Sciences, Institute of Interdisciplinary Research, Alexandru Ioan Cuza University of Iasi, 22 Carol I Blvd., 700505 Iasi, Romania
| | - Andrei Victor Sandu
- Faculty of Material Science and Engineering, Gheorghe Asachi Technical University, 64 Dumitru Mangeron Blvd., 700050 Iasi, Romania
- Romanian Inventors Forum, 3 Sf. Petru Movila St., L11, 3-3, 700089 Iasi, Romania
- Academy of Romanian Scientists, 54 Splaiul Independentei St., Sect. 5, 050094 Bucharest, Romania
| | - Stefanita Arcana
- Doctoral School of the Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
| | - Raluca Ioana Arcana
- Doctoral School of the Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
- Clinical Hospital of Pulmonary Diseases, Str. Dr. I Cihac, Nr. 30, 700115 Iasi, Romania
| | - Ion Sandu
- Arheoinvest Center, Department of Natural and Exact Sciences, Institute of Interdisciplinary Research, Alexandru Ioan Cuza University of Iasi, 22 Carol I Blvd., 700505 Iasi, Romania
- Academy of Romanian Scientists, 54 Splaiul Independentei St., Sect. 5, 050094 Bucharest, Romania
- National Institute for Research and Development in Environmental Protection, 294 Splaiul Independentei, Sector 6, 060031 Bucharest, Romania
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Denton F, Waddell A, Kite C, Hesketh K, Atkinson L, Cocks M, Jones H, Randeva H, Davenport N, Powell R, Clark C, Kyrou I, Harwood AE, McGregor G. Remote maintenance cardiac rehabilitation (MAINTAIN): A protocol for a randomised feasibility study. Digit Health 2023; 9:20552076231152176. [PMID: 36818155 PMCID: PMC9936404 DOI: 10.1177/20552076231152176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 01/03/2023] [Indexed: 02/18/2023] Open
Abstract
Background Long-term adherence to exercise is often poor for people with coronary heart disease (CHD) who have completed supervised, centre-based cardiac rehabilitation. The aim of this study is to assess the feasibility of a remotely prescribed, delivered and monitored cardiac rehabilitation intervention using a wearable device to support long-term adherence to exercise and physical activity during maintenance of cardiac rehabilitation. Methods After completing cardiac rehabilitation, 30 participants with CHD, will be randomised (1:1) to an intervention (n = 15) or a usual care group (n = 15) in a 12-month feasibility randomised controlled trial (RCT). The intervention will comprise of an exercise consultation, personalised exercise prescription delivered via a wearable activity monitor using biometric feedback, regular monitoring via check-ins, and feedback text-messages for 6-months. Participants will be assessed at baseline (following completion of cardiac rehabilitation) and at three-, six-, and 12-months post-randomisation. The primary outcome will be feasibility, including assessment of eligibility, recruitment, adherence, and acceptability. Secondary outcomes will include exercise capacity, physical activity behaviours, cardiovascular disease risk and quality of life. Semi-structured interviews will be conducted at three-, six-, and 12-months post-randomisation (and with those who drop-out) to explore the acceptability of the study intervention and procedures. A questionnaire will be offered to those who decline participation. Discussion The MAINTAIN study will evaluate the feasibility of conducting a future definitive multi-centre RCT testing a remotely prescribed and monitored long-term mHealth maintenance exercise programme, versus usual care, for people with CHD who have completed cardiac rehabilitation. Trial registration number ClinicalTrials.gov, NCT05292287. Registered on 22/03/2022.
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Affiliation(s)
- Francesca Denton
- Institute of Health and Wellbeing, Coventry University, Coventry, UK
- Francesca Denton, Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, UK.
| | - Alexander Waddell
- Institute of Health and Wellbeing, Coventry University, Coventry, UK
| | - Chris Kite
- Institute of Health and Wellbeing, Coventry University, Coventry, UK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- School of Public Health Studies, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK
| | - Katie Hesketh
- Research Institute of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Lou Atkinson
- School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Matthew Cocks
- Research Institute of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Helen Jones
- Research Institute of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Harpal Randeva
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Nathan Davenport
- UK Department of Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - Richard Powell
- Institute of Health and Wellbeing, Coventry University, Coventry, UK
- UK Department of Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - Cain Clark
- Institute of Health and Wellbeing, Coventry University, Coventry, UK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Ioannis Kyrou
- Institute of Health and Wellbeing, Coventry University, Coventry, UK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
- Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham, UK
- Laboratory of Dietetics and Quality of Life, School of Food and Nutritional Sciences, Department of Food Science & Human Nutrition, Agricultural University of Athens, Athens, Greece
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Amy E Harwood
- Institute of Health and Wellbeing, Coventry University, Coventry, UK
| | - Gordon McGregor
- Institute of Health and Wellbeing, Coventry University, Coventry, UK
- UK Department of Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
- Warwick Medical School, University of Warwick, Coventry, UK
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Effects of Exercise on Heart Failure with Preserved Ejection Fraction: An Updated Review of Literature. J Cardiovasc Dev Dis 2022; 9:jcdd9080241. [PMID: 36005405 PMCID: PMC9409671 DOI: 10.3390/jcdd9080241] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/17/2022] [Accepted: 07/20/2022] [Indexed: 12/12/2022] Open
Abstract
Heart failure with preserved ejection fraction (HFpEF) represents the most common HF phenotype of patients aged > 65 years, with an incidence and a prevalence that are constantly growing. The HFpEF cardinal symptom is exercise intolerance (EI), defined as the impaired ability to perform physical activity and to reach the predicted age-related level of exercise duration in the absence of symptoms—such as fatigue or dyspnea—and is associated with a poor quality of life, a higher number of hospitalizations, and poor outcomes. The evidence of the protective effect between exercise and adverse cardiovascular outcomes is numerous and long-established. Regular exercise is known to reduce cardiovascular events and overall mortality both in apparently healthy individuals and in patients with established cardiovascular disease, representing a cornerstone in the prevention and treatment of many cardio-metabolic conditions. Several studies have investigated the role of exercise in HFpEF patients. The present review aims to dwell upon the effects of exercise on HFpEF. For this purpose, the relevant data from a literature search (PubMed, EMBASE, and Medline) were reviewed. The analysis of these studies underlines the fact that exercise training programs improve the cardiorespiratory performance of HFpEF patients in terms of the increase in peak oxygen uptake, the 6 min walk test distance, and the ventilatory threshold; on the other hand, diastolic or systolic functions are generally unchanged or only partially modified by exercise, suggesting that multiple mechanisms contribute to the improvement of exercise tolerance in HFpEF patients. In conclusion, considering that exercise training programs are able to improve the cardiorespiratory performance of HFpEF patients, the prescription of exercise training programs should be encouraged in stable HFpEF patients, and further research is needed to better elucidate the pathophysiological mechanisms underpinning the beneficial effects described.
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Active Lifestyle Post First Myocardial Infarction: A Comparison between Participants and Non-Participants of a Structured Cardiac Rehabilitation Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063617. [PMID: 35329304 PMCID: PMC8955239 DOI: 10.3390/ijerph19063617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 02/01/2023]
Abstract
Following myocardial infarction (MI), impaired physical, mental, and cognitive functions can reduce participation in the community and diminish quality of life. This study aims to assess active lifestyle participation and functional performance in patients who were participants and non-participants in cardiac rehabilitation. A total of 71 patients were recruited, 6-10 months after the MI event; 38 chose to participate in a cardiac rehabilitation (CR) program, and 33 did not (NCR). Participation and activity patterns in instrumental activities of daily living, as well as physically demanding leisure activities and social activities, were evaluated using the Activity Card Sort (ACS). Hand grip force and timed up and go (TUG) were tested. A total of 74% of the CR group met physical activity recommendations and only 34% continued to smoke, compared to 39% and 71% in the NCR group, respectively. The CR group, compared to the NCR group, had higher levels of daily activity, social leisure, and physically demanding leisure activities (p ≤ 0.001). Null differences between the NCR and CR groups were observed in grip strength and the TUG tests. The study highlighted community participation after MI. Based on a comparison between the groups, the study implies that patients choosing to participate in CR retained higher community participation levels and had better self-management of cardiovascular risk factors.
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El-Sobkey SB. Resistance training is an effective exercise therapy in cardiac rehabilitation program for patients with coronary artery disease: a systematic review. BENI-SUEF UNIVERSITY JOURNAL OF BASIC AND APPLIED SCIENCES 2022. [DOI: 10.1186/s43088-022-00206-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Exercise-based cardiac rehabilitation program is a comprehensive intervention for the rehabilitation of coronary artery disease patients. Exercise therapy is a valuable, effective, and integral intervention of cardiac rehabilitation. Aerobic training is the gold standard exercise therapy in cardiac rehabilitation programs. In addition, combined training with added resistant training is also used. This systematic review aimed to provide the physical therapy clinicians with a consensus regarding the effect of resistant training by answering the question of what is the cardiovascular and non-cardiovascular effect (s) of resistant training in the cardiac rehabilitation program for patients with coronary artery disease?
Main body
The Physiotherapy evidence database (PEDro) was used as a search engine to select articles through study eligibility criteria. Adult or adult and old stable coronary artery disease patients engaged in a site-based (Phase II) exercise-based cardiac rehabilitation program that includes aerobic and resistant training. Selected articles applied cardiovascular and non-cardiovascular outcome measures to measure the effectiveness of resistant training. The author reviewed the selected articles and applied quantitative non-statistical analysis and appraisal for these articles. The systematic selection process resulted in 10 studies with a total participants number of 3877. Analyzing the articles revealed that adding resistant training to aerobic training resulted in a favorable improvement in outcome measures for coronary artery disease patients. Resistant training produced improvement in the exercise capacity (VO2 peak), blood pressure, skeletal muscle strength, endurance, body composition, sleep quality, depression, and health-related quality of life.
Short conclusions
The addition of resistant training to aerobic training in cardiac rehabilitation induces more positive cardiovascular and non-cardiovascular effects for stable coronary artery disease patients.
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Batalik L, Filakova K, Radkovcova I, Dosbaba F, Winnige P, Vlazna D, Batalikova K, Felsoci M, Stefanakis M, Liska D, Papathanasiou J, Pokorna A, Janikova A, Rutkowski S, Pepera G. Cardio-Oncology Rehabilitation and Telehealth: Rationale for Future Integration in Supportive Care of Cancer Survivors. Front Cardiovasc Med 2022; 9:858334. [PMID: 35497988 PMCID: PMC9051023 DOI: 10.3389/fcvm.2022.858334] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/16/2022] [Indexed: 02/05/2023] Open
Abstract
The direct toxicity of cancer treatment threatens patients and survivors with an increased risk of cardiovascular disease or adverse functional changes with subsequent progression of cardiovascular complications. An accumulation of cardiovascular risk factors combined with an unhealthy lifestyle has recently become more common in cancer patients and survivors. It has been recommended to integrate a comprehensive cardiac rehabilitation model called cardio-oncology rehabilitation to mitigate cardiovascular risk. Nevertheless, cardiac rehabilitation interventions limit barriers in low utilization, further exacerbated by the restrictions associated with the COVID-19 pandemic. Therefore, it is essential to integrate alternative interventions such as telehealth, which can overcome several barriers. This literature review was designed as a framework for developing and evaluating telehealth interventions and mobile applications for comprehensive cardio-oncology rehabilitation. We identify knowledge gaps and propose strategies to facilitate the development and integration of cardio-oncology rehabilitation telehealth as an alternative approach to the standard of care for cancer patients and survivors. Despite the limited evidence, the pilot results from included studies support the feasibility and acceptability of telehealth and mobile technologies in cardio-oncology rehabilitation. This new area suggests that telehealth interventions are feasible and induce physiological and psychological benefits for cancer patients and survivors. There is an assumption that telehealth interventions and exercise may be an effective future alternative approach in supportive cancer care.
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Affiliation(s)
- Ladislav Batalik
- Department of Rehabilitation, University Hospital Brno, Brno, Czechia
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czechia
- *Correspondence: Ladislav Batalik,
| | - Katerina Filakova
- Department of Rehabilitation, University Hospital Brno, Brno, Czechia
| | - Ivana Radkovcova
- Department of Rehabilitation, University Hospital Brno, Brno, Czechia
| | - Filip Dosbaba
- Department of Rehabilitation, University Hospital Brno, Brno, Czechia
| | - Petr Winnige
- Department of Rehabilitation, University Hospital Brno, Brno, Czechia
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Daniela Vlazna
- Department of Rehabilitation, University Hospital Brno, Brno, Czechia
- Department of Neurology, University Hospital Brno, Brno, Czechia
- Faculty of Medicine, Masaryk University, Brno, Czechia
| | | | - Marian Felsoci
- Faculty of Medicine, Masaryk University, Brno, Czechia
- Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czechia
| | | | - David Liska
- Faculty of Arts, Department of Physical Education and Sports, Matej Bel University, Banská Bystrica, Slovakia
| | - Jannis Papathanasiou
- Department of Medical Imaging, Allergology & Physiotherapy, Faculty of Dental Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
- Department of Kinesitherapy, Faculty of Public Health “Prof. Dr. Tzecomir Vodenicharov, Ph.D”, Medical University of Sofia, Sofia, Bulgaria
| | - Andrea Pokorna
- Department of Health Sciences, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Andrea Janikova
- Faculty of Medicine, Masaryk University, Brno, Czechia
- Department of Internal Medicine–Hematology and Oncology, University Hospital Brno, Brno, Czechia
| | - Sebastian Rutkowski
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
| | - Garyfallia Pepera
- Clinical Exercise Physiology and Rehabilitation Research Laboratory, Physiotherapy Department, School of Health Sciences, University of Thessaly, Lamia, Greece
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Park MS, Lee S, Ahn T, Kim D, Jung MH, Choi JH, Han S, Ryu KH, Kim EJ. Current status of cardiac rehabilitation among representative hospitals treating acute myocardial infarction in South Korea. PLoS One 2021; 16:e0261072. [PMID: 34879117 PMCID: PMC8654170 DOI: 10.1371/journal.pone.0261072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 11/23/2021] [Indexed: 12/26/2022] Open
Abstract
Cardiac rehabilitation services are mostly underutilized despite the documentation of substantial morbidity and mortality benefits of cardiac rehabilitation post-acute myocardial infarction. To assess the implementation rate and barriers to cardiac rehabilitation in hospitals dealing with acute myocardial infarction in South Korea, between May and July 2016, questionnaires were emailed to cardiology directors of 93 hospitals in South Korea; all hospitals were certified institutes for coronary interventions. The questionnaires included 16 questions on the hospital type, cardiology practice, and implementation of cardiac rehabilitation. The obtained data were categorized into two groups based on the type of the hospital (secondary or tertiary) and statistically analysed. Of the 72 hospitals that responded (response rate of 77%), 39 (54%) were tertiary medical centers and 33 (46%) were secondary medical centers. All hospitals treated acute myocardial infarction patients and performed emergency percutaneous coronary intervention; 79% (57/72) of the hospitals performed coronary artery bypass grafting. However, the rate of implementation of cardiac rehabilitation was low overall (28%, 20/72 hospitals) and even lower in secondary medical centers (12%, 4/33 hospitals) than in tertiary centers (41%, 16/39 hospitals, p = 0.002). The major barriers to cardiac rehabilitation included the lack of staff (59%) and lack of space (33%). In contrast to the wide availability of acute-phase invasive treatment for AMI, the overall implementation of cardiac rehabilitation is extremely poor in South Korea. Considering the established benefits of cardiac rehabilitation in patients with acute myocardial infarction, more administrative support, such as increasing the fee for cardiac rehabilitation services by an appropriate level of health insurance coverage should be warranted.
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Affiliation(s)
- Myung Soo Park
- Department of Cardiology, Hallym University Dongtan Sacred Hospital, Hwaseong, South Korea
| | - Sunki Lee
- Department of Cardiology, Hallym University Dongtan Sacred Hospital, Hwaseong, South Korea
| | - Taehoon Ahn
- Department of Cardiology, Korea University Anam Hospital, Seoul, South Korea
| | - Doyoung Kim
- Department of Cardiology, Hallym University Dongtan Sacred Hospital, Hwaseong, South Korea
| | - Mi-Hyang Jung
- Department of Cardiology, Hallym University Dongtan Sacred Hospital, Hwaseong, South Korea
| | - Jae Hyuk Choi
- Department of Cardiology, Hallym University Dongtan Sacred Hospital, Hwaseong, South Korea
| | - Seongwoo Han
- Department of Cardiology, Hallym University Dongtan Sacred Hospital, Hwaseong, South Korea
| | - Kyu Hyung Ryu
- Department of Cardiology, Hallym University Dongtan Sacred Hospital, Hwaseong, South Korea
| | - Eung Ju Kim
- Department of Cardiology, Korea University Guro Hospital, Seoul, South Korea
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Abraham LN, Sibilitz KL, Berg SK, Tang LH, Risom SS, Lindschou J, Taylor RS, Borregaard B, Zwisler AD. Exercise-based cardiac rehabilitation for adults after heart valve surgery. Cochrane Database Syst Rev 2021; 5:CD010876. [PMID: 33962483 PMCID: PMC8105032 DOI: 10.1002/14651858.cd010876.pub3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND The impact of exercise-based cardiac rehabilitation (CR) following heart valve surgery is uncertain. We conducted an update of this systematic review and a meta-analysis to assess randomised controlled trial evidence for the use of exercise-based CR following heart valve surgery. OBJECTIVES To assess the benefits and harms of exercise-based CR compared with no exercise training in adults following heart valve surgery or repair, including both percutaneous and surgical procedures. We considered CR programmes consisting of exercise training with or without another intervention (such as an intervention with a psycho-educational component). SEARCH METHODS We searched the Cochrane Central Register of Clinical Trials (CENTRAL), in the Cochrane Library; MEDLINE (Ovid); Embase (Ovid); the Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCO); PsycINFO (Ovid); Latin American Caribbean Health Sciences Literature (LILACS; Bireme); and Conference Proceedings Citation Index-Science (CPCI-S) on the Web of Science (Clarivate Analytics) on 10 January 2020. We searched for ongoing trials from ClinicalTrials.gov, Clinical-trials.com, and the World Health Organization International Clinical Trials Registry Platform on 15 May 2020. SELECTION CRITERIA We included randomised controlled trials that compared exercise-based CR interventions with no exercise training. Trial participants comprised adults aged 18 years or older who had undergone heart valve surgery for heart valve disease (from any cause) and had received heart valve replacement or heart valve repair. Both percutaneous and surgical procedures were included. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data. We assessed the risk of systematic errors ('bias') by evaluating risk domains using the 'Risk of bias' (RoB2) tool. We assessed clinical and statistical heterogeneity. We performed meta-analyses using both fixed-effect and random-effects models. We used the GRADE approach to assess the quality of evidence for primary outcomes (all-cause mortality, all-cause hospitalisation, and health-related quality of life). MAIN RESULTS We included six trials with a total of 364 participants who have had open or percutaneous heart valve surgery. For this updated review, we identified four additional trials (216 participants). One trial had an overall low risk of bias, and we classified the remaining five trials as having some concerns. Follow-up ranged across included trials from 3 to 24 months. Based on data at longest follow-up, a total of nine participants died: 4 CR versus 5 control (relative risk (RR) 0.83, 95% confidence interval (CI) 0.26 to 2.68; 2 trials, 131 participants; GRADE quality of evidence very low). No trials reported on cardiovascular mortality. One trial reported one cardiac-related hospitalisation in the CR group and none in the control group (RR 2.72, 95% CI 0.11 to 65.56; 1 trial, 122 participants; GRADE quality of evidence very low). We are uncertain about health-related quality of life at completion of the intervention in CR compared to control (Short Form (SF)-12/36 mental component: mean difference (MD) 1.28, 95% CI -1.60 to 4.16; 2 trials, 150 participants; GRADE quality of evidence very low; and SF-12/36 physical component: MD 2.99, 95% CI -5.24 to 11.21; 2 trials, 150 participants; GRADE quality of evidence very low), or at longest follow-up (SF-12/36 mental component: MD -1.45, 95% CI -4.70 to 1.80; 2 trials, 139 participants; GRADE quality of evidence very low; and SF-12/36 physical component: MD -0.87, 95% CI -3.57 to 1.83; 2 trials, 139 participants; GRADE quality of evidence very low). AUTHORS' CONCLUSIONS: Due to lack of evidence and the very low quality of available evidence, this updated review is uncertain about the impact of exercise-CR in this population in terms of mortality, hospitalisation, and health-related quality of life. High-quality (low risk of bias) evidence on the impact of CR is needed to inform clinical guidelines and routine practice.
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Affiliation(s)
- Lizette N Abraham
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - Kirstine L Sibilitz
- Department of Cardiology, Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Selina K Berg
- Department of Cardiology, Centre for Cardiac, Vascular, Pulmonary and Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Lars H Tang
- The research unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Signe S Risom
- Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
- The Heart Centre, University Hospital Rigshospitalet, Copenhagen, Denmark
- Institute for Nursing and Nutrition, University College Copenhagen, Copenhagen, Denmark
| | - Jane Lindschou
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Copenhagen University Hospital, Copenhagen, Denmark
| | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Well Being, University of Glasgow, Glasgow, UK
| | - Britt Borregaard
- Department of Cardiac, Thoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark
| | - Ann-Dorthe Zwisler
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Casin KM, Calvert JW. Harnessing the Benefits of Endogenous Hydrogen Sulfide to Reduce Cardiovascular Disease. Antioxidants (Basel) 2021; 10:antiox10030383. [PMID: 33806545 PMCID: PMC8000539 DOI: 10.3390/antiox10030383] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/26/2021] [Accepted: 03/01/2021] [Indexed: 02/02/2023] Open
Abstract
Cardiovascular disease is the leading cause of death in the U.S. While various studies have shown the beneficial impact of exogenous hydrogen sulfide (H2S)-releasing drugs, few have demonstrated the influence of endogenous H2S production. Modulating the predominant enzymatic sources of H2S-cystathionine-β-synthase, cystathionine-γ-lyase, and 3-mercaptopyruvate sulfurtransferase-is an emerging and promising research area. This review frames the discussion of harnessing endogenous H2S within the context of a non-ischemic form of cardiomyopathy, termed diabetic cardiomyopathy, and heart failure. Also, we examine the current literature around therapeutic interventions, such as intermittent fasting and exercise, that stimulate H2S production.
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Shah AB, Torguson R, Alexander K, Khan U, Zhang C, Fisher C, Hoffman MD, Sedgley M, Lincoln A, Baggish AL. Cardiovascular risk among ultra-endurance runners. J Sports Med Phys Fitness 2021; 61:1700-1705. [PMID: 33586930 DOI: 10.23736/s0022-4707.21.11903-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Our objective was to determine the prevalence and clinical correlates of conventional cardiovascular risk factors among ultra-endurance marathon runners. METHODS An electronic internet survey to characterize modifiable cardiovascular risk factors including diabetes, hypertension, dyslipidemia, tobacco exposure and obesity (BMI >30) among competitive ultra-endurance runners. RESULTS Among 290 respondents (mean ± SD, 42 ± 11 years, 31.4% female), 106 (36.6%) had at least one established cardiovascular risk factor. Female sex, younger age and participation in competitive high school or collegiate sports were associated with freedom from cardiovascular risk factors. There were no significant associations between risk factor status and either hours per week of running training (risk factor negative = 10 ±7 vs. risk factor positive = 11 ± 8 hours, p=0.42) or years of ultra-endurance competition (6 ± 8 vs. 7 ± 9 years, p=0.38). Runners with at least one cardiovascular risk factor were more likely to have had personal or peer concerns about excessive alcohol use. CONCLUSIONS Conventional cardiovascular risk factors are common among ultra-endurance runners. Early life participation in competitive sports, rather than adult exercise habits, is associated with freedom from the development of cardiovascular risk factors during middle age. Determining mechanistic explanations for the legacy effect of early life exercise as a means to reduce cardiovascular risk among aging athletes represents an important area of future work.
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Affiliation(s)
- Ankit B Shah
- Sports & Performance Cardiology Program, MedStar Health, Baltimore, MD, USA -
| | - Rebecca Torguson
- Sports & Performance Cardiology Program, MedStar Health, Baltimore, MD, USA
| | | | - Umar Khan
- Sports & Performance Cardiology Program, MedStar Health, Baltimore, MD, USA
| | - Cheng Zhang
- Sports & Performance Cardiology Program, MedStar Health, Baltimore, MD, USA
| | - Casey Fisher
- Sports & Performance Cardiology Program, MedStar Health, Baltimore, MD, USA
| | - Martin D Hoffman
- Department of Physical Medicine and Rehabilitation, University of California Davis, Sacramento, CA, USA
| | - Matthew Sedgley
- Sports & Performance Cardiology Program, MedStar Health, Baltimore, MD, USA
| | - Andrew Lincoln
- MedStar Sports Medicine Research Center, Baltimore, MD, USA
| | - Aaron L Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston, MA, USA
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Meiring RM, Tanimukai K, Bradnam L. The Effect of Exercise-Based Cardiac Rehabilitation on Objectively Measured Physical Activity and Sedentary Behavior: A Systematic Review and Meta-analysis. J Prim Care Community Health 2020; 11:2150132720935290. [PMID: 32538312 PMCID: PMC7297483 DOI: 10.1177/2150132720935290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objective: Adequate physical activity following cardiac rehabilitation (CR) is required to reduce secondary cardiovascular disease risk. The aim of this review and meta-analysis was to determine the effect of exercise-based CR on objectively measured physical activity (PA) and sedentary behavior (SB) comparing pre- to postintervention, pre- to postchange compared to a control group, and in a longer term follow-up. Methods: Five databases were searched (PubMed, MEDLINE [OVID], Scopus, SPORTDiscus, and CINAHL) from inception to January 2019. Two reviewers screened and selected 15 studies involving 1434 participants. Data were synthesized descriptively and by meta-analyses. Results: CR resulted in an improvement in activity behaviors compared with preintervention levels (standardized mean difference [SMD] 0.50, 95% CI 0.25-0.55, P < .0001). CR resulted in a greater improvement in activity behaviors in the intervention compared with the control group (SMD 0.25, 95% CI 0.02-0.49, P = .04). Increased PA was maintained (SMD 0.32, 95% CI 0.22-0.41, P < .0001). Eight out of 15 studies showed an improvement in PA outcomes while 7 reported that objectively measured PA did not change immediately following the intervention compared to preintervention levels and/or compared with the control group. Of the 7 studies that reported changes in SB, 4 observed a reduction following CR while 3 reported no change. Conclusion: Participation in exercise-based CR programs is effective in improving PA and SB. However, our descriptive synthesis indicates that only half the studies were successful in improving activity behaviors following exercise-based CR. Standard guidelines for the assessment of activity behaviors following CR would be valuable in understanding of the effects of CR on long-term activity participation.
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Affiliation(s)
- Rebecca Mary Meiring
- Department of Exercise Sciences, University of Auckland, Auckland, New Zealand.,Movement Physiology Research Laboratory, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Kento Tanimukai
- Department of Exercise Sciences, University of Auckland, Auckland, New Zealand
| | - Lynley Bradnam
- Department of Exercise Sciences, University of Auckland, Auckland, New Zealand
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Bielemann RM, Silveira MPT, Lutz BH, Miranda VIA, Gonzalez MC, Brage S, Ekelund U, Bertoldi AD. Objectively Measured Physical Activity and Polypharmacy Among Brazilian Community-Dwelling Older Adults. J Phys Act Health 2020; 17:729-735. [PMID: 32473590 DOI: 10.1123/jpah.2019-0461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 03/23/2020] [Accepted: 04/21/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Previous observations regarding association between physical activity (PA) and use of medicines among older adults are derived from self-reported PA. This study aimed to evaluate the association between objectively measured PA and polypharmacy among older adults with multimorbidity in Southern Brazil. METHODS This study included 875 noninstitutionalized older people, aged ≥60 years. Prescribed medicines used in the 15 days prior to the interview, socioeconomic data, and the presence of comorbidities were self-reported. Accelerometers were used to evaluate PA following the interview. RESULTS Prevalence of polypharmacy (≥5 medicines) was 38.3% (95% confidence interval, 35.0-41.5); those belonging to the lowest tertile of PA used more medicines. The authors observed a significant inverse association for polypharmacy between men belonging to the second and third tertiles of PA for objectively measured overall PA and light PA compared with the most inactive tertile. For women, the association between PA and polypharmacy was significant for overall, light, and moderate to vigorous PA only in the third tertile. CONCLUSIONS Overall, light and moderate to vigorous PA were inversely associated to polypharmacy and differed by gender. Promotion of PA in older adults may be an effective intervention to reduce the number of medicines used independent of the number of comorbidities.
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Bielemann RM, LaCroix AZ, Bertoldi AD, Tomasi E, Demarco FF, Gonzalez MC, Crespo da Silva PA, Wendt A, Mohnsam da Silva IC, Brage S, Ekelund U, Pratt M. Objectively Measured Physical Activity Reduces the Risk of Mortality among Brazilian Older Adults. J Am Geriatr Soc 2020; 68:137-146. [PMID: 31592540 DOI: 10.1111/jgs.16180] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/14/2019] [Accepted: 08/17/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Use of objectively measured physical activity (PA) in older adults to assess relationship between PA and risk of all-causes mortality is scarce. This study evaluated the associations of PA based on accelerometry and a questionnaire with the risk of mortality among older adults from a city in Southern Brazil. DESIGN A cohort study. SETTING Urban area of Pelotas, Southern Brazil. PARTICIPANTS A representative sample of older adults (≥60 y) from Pelotas, enrolled in 2014. MEASUREMENTS Overall physical activity (mg), light physical activity (LPA), and moderate to vigorous physical activity (MVPA) were estimated by raw accelerometer data. The International Physical Activity Questionnaire estimated leisure time and commuting PA. Hazard ratios (excluding deaths in the first 6 mo) stratified by sex were estimated by Cox regression analysis considering adjustment for confounders. RESULTS From the 1451 older adults interviewed in 2014, 145 died (10%) after a follow-up of an average 2.6 years. Men and women in the highest tertile of overall PA had on average a 77% and 92% lower risk of mortality than their less active counterparts (95% confidence interval [CI] = .06-.84 and 95% CI = .01-.65, respectively). The highest tertile of LPA was also related to a lower risk of mortality in individuals of both sexes (74% and 91% lower risk among men and women, respectively). MVPA statistically reduced the risk of mortality only among women (hazard ratio [HR] = .30 and HR = .07 in the second and third tertiles). Self-reported leisure-time PA was statistically associated with a lower risk of mortality only among men. Women in the highest tertiles of commuting PA showed a lower risk of mortality than those in the reference group. CONCLUSION Accelerometry-based PA was associated with a lower risk of mortality among Brazilian older adults. Older individuals should practice any type of PA. J Am Geriatr Soc 68:137-146, 2019.
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Affiliation(s)
- Renata M Bielemann
- Post-Graduate Program in Nutrition and Foods, Federal University of Pelotas, Pelotas, Brazil
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Andrea Z LaCroix
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California
| | - Andréa D Bertoldi
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Elaine Tomasi
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Flávio F Demarco
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Post-Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Maria Cristina Gonzalez
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | | | - Andrea Wendt
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Inácio Crochemore Mohnsam da Silva
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Post-Graduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Michael Pratt
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, California
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Physical Exercise for Frailty and Cardiovascular Diseases. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1216:115-129. [DOI: 10.1007/978-3-030-33330-0_12] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Sabitov YT, Dusypov AA, Abdrakhmanov AS, Orekhov AY, Turubaev EM. [Resynchronization Therapy for Chronic Heart Failure: Diagnostic and Therapeutic Approaches]. KARDIOLOGIYA 2019; 59:84-91. [PMID: 31849315 DOI: 10.18087/cardio.2019.12.n391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 08/19/2019] [Accepted: 09/17/2019] [Indexed: 11/18/2022]
Abstract
Chronic heart failure (CHF) remains one of the most important problems of modern cardiology. One of the effective treatment methods is resynchronization therapy (RT). The article presents an analysis of literature data on the effectiveness of RT in improving the quality of life, reducing the number of hospitalizations and mortality in patients with heart failure with severe left ventricular systolic dysfunction and expanding QRS complex, and also discusses key methods for optimizing RT.
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The association between physical activity and cardiac performance is dependent on age: the Copenhagen City Heart Study. Int J Cardiovasc Imaging 2019; 35:1249-1258. [PMID: 30825135 PMCID: PMC6598956 DOI: 10.1007/s10554-019-01566-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 02/15/2019] [Indexed: 10/31/2022]
Abstract
This study aimed to test the hypothesis that regular physical activity is associated with improved cardiac function measured by tissue Doppler imaging (TDI) in the general population. Within a large prospective community-based population study, cardiac function was assessed in 2221 persons by TDI. Longitudinal displacement (LD), early diastolic velocity (e'), and myocardial performance index (MPI) was obtained by TDI. Linear univariable and multivariable regression analyses were performed in relation to age groups (< 50 years, 50-65 years, > 65 years) and self-reported level of physical activity: I (inactivity), II (light activity), III (moderate activity), and IV (high-level activity). Participants < 50 years in the most active group had significantly better cardiac performance when compared to all other activity levels (higher levels of e', LD, and lower levels of MPI). The findings remained with statistical significance after adjustment for sex, ischemic heart disease, diabetes, hypertension, and body mass index (e' = 11.0, 95% CI (10.4-11.6), p < 0.001; LD = 12.8 (12.3-13.4), p < 0.003; MPI: 0.40 (0.38-0.42), p = 0.02). In age > 65 years, there was a tendency of impaired cardiac function in higher levels of exercise. Interaction analysis revealed that age significantly modified the association between physical activity and cardiac function (p < 0.001). We found a positive association between higher level of physical activity and improved cardiac function in younger persons (< 50 years). In the general population, however, the association interacted with age and amongst persons above 65 years there was a negative association between higher level of physical activity and cardiac function.
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Kaminsky LA, Arena R, Ellingsen Ø, Harber MP, Myers J, Ozemek C, Ross R. Cardiorespiratory fitness and cardiovascular disease - The past, present, and future. Prog Cardiovasc Dis 2019; 62:86-93. [PMID: 30639135 DOI: 10.1016/j.pcad.2019.01.002] [Citation(s) in RCA: 136] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 01/06/2019] [Indexed: 01/12/2023]
Abstract
The importance of cardiorespiratory fitness (CRF) is now well established and it is increasingly being recognized as an essential variable which should be assessed in health screenings. The key findings that have established the clinical significance of CRF are reviewed in this report, along with an overview of the current relevance of exercise as a form of medicine that can provide a number of positive health outcomes, including increasing CRF. Current assessment options for assessing CRF are also reviewed, including the direct measurement via cardiopulmonary exercise testing which now can be interpreted with age and sex-specific reference values. Future directions for the use of CRF and related measures are presented.
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Affiliation(s)
- Leonard A Kaminsky
- Fisher Institute of Health and Well-Being, College of Health, Ball State University, Muncie, IN, United States.
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Øyvind Ellingsen
- Norwegian University Science and Technology and St Olavs University Hospital, Trondheim, Norway
| | - Matthew P Harber
- Clinical Exercise Physiology Program, College of Health, Ball State University, Muncie, IN, United States
| | - Jonathan Myers
- Division of Cardiology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States; School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Cemal Ozemek
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Robert Ross
- School of Kinesiology and Health Studies, Department of Medicine, Division of Endocrinology and Metabolism, Queens University, Ontario, Canada
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Ter Hoeve N, Sunamura M, Stam HJ, Boersma E, Geleijnse ML, van Domburg RT, van den Berg-Emons RJG. Effects of two behavioral cardiac rehabilitation interventions on physical activity: A randomized controlled trial. Int J Cardiol 2018; 255:221-228. [PMID: 29425564 DOI: 10.1016/j.ijcard.2017.12.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 11/17/2017] [Accepted: 12/05/2017] [Indexed: 01/28/2023]
Abstract
BACKGROUND Standard cardiac rehabilitation (CR) is insufficient to help patients achieve an active lifestyle. The effects of two advanced and extended behavioral CR interventions on physical activity (PA) and sedentary behavior (SB) were assessed. METHODS In total, 731 patients with ACS were randomized to 1) 3months of standard CR (CR-only); 2) 3months of standard CR with three pedometer-based, face-to-face PA group counseling sessions followed by 9months of aftercare with three general lifestyle, face-to-face group counseling sessions (CR+F); or 3) 3months of standard CR, followed by 9months of aftercare with five to six general lifestyle, telephonic counseling sessions (CR+T). An accelerometer recorded PA and SB at randomization, 3months, 12months, and 18months. RESULTS The CR+F group did not improve their moderate-to-vigorous intensity PA (MVPA) or SB time compared to CR-only (between-group difference=0.24% MVPA, P=0.349; and 0.39% SB, P=0.529). However, step count (between-group difference=513 steps/day, P=0.021) and time in prolonged MVPA (OR=2.14, P=0.054) improved at 3months as compared to CR-only. The improvement in prolonged MVPA was maintained at 18months (OR=1.91, P=0.033). The CR+T group did not improve PA or SB compared to CR-only. CONCLUSIONS Adding three pedometer-based, face-to-face group PA counseling sessions to standard CR increased daily step count and time in prolonged MVPA. The latter persisted at 18months. A telephonic after-care program did not improve PA or SB. Although after-care should be optimized to improve long-term adherence, face-to-face group counseling with objective PA feedback should be added to standard CR.
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Affiliation(s)
- Nienke Ter Hoeve
- Capri Cardiac Rehabilitation, Rotterdam, The Netherlands; Erasmus University Medical Centre, Department of Rehabilitation Medicine, Rotterdam, The Netherlands.
| | | | - Henk J Stam
- Erasmus University Medical Centre, Department of Rehabilitation Medicine, Rotterdam, The Netherlands
| | - Eric Boersma
- Erasmus University Medical Centre, Department of Cardiology, Rotterdam, The Netherlands
| | - Marcel L Geleijnse
- Erasmus University Medical Centre, Department of Cardiology, Rotterdam, The Netherlands
| | - Ron T van Domburg
- Erasmus University Medical Centre, Department of Cardiology, Rotterdam, The Netherlands
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Saleh ZT, Elshatarat RA, Alhurani AS, Maharmeh M, Salami I, Alduraidi H, Alasad J. Perceptions related to cardiovascular disease and physical activity behavior in Arab men: A qualitative study. Heart Lung 2018; 47:345-350. [PMID: 29779704 DOI: 10.1016/j.hrtlng.2018.04.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 04/26/2018] [Indexed: 10/16/2022]
Abstract
OBJECTIVES To describe the daily physical activity of Arab men living in the United States and to understand how perceptions of cardiovascular disease (CVD) risk influence their inclusion of physical activity into their daily routine. METHODS A qualitative descriptive method using a semi-structured face-to-face interview with each participant was conducted. Twenty young college males (age 26 ± 4 years) were recruited from Arab American community centers. RESULTS The qualitative inductive content analysis revealed three main themes: impact of perceived CVD risk on physical activity behavior and perceived barriers and motivators to be physically active. Arab men primarily perceived gaining weight as the most important CVD risk factor that could promote their physical activity behavior. CONCLUSIONS These findings demonstrate that unawareness about CVD risk and barriers to regular physical activity must be considered in any intervention to engage Arab men in regular physical activity.
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Affiliation(s)
- Zyad T Saleh
- Department of Clinical Nursing, School of Nursing, The University of Jordan, Amman, 11942, Jordan
| | - Rami A Elshatarat
- Department of Medical and Surgical Nursing, College of Nursing, Taibah University, Madinah, Saudi Arabia.
| | - Abdullah S Alhurani
- Department of Clinical Nursing, School of Nursing, The University of Jordan, Amman, 11942, Jordan
| | - Mahmoud Maharmeh
- Department of Clinical Nursing, School of Nursing, The University of Jordan, Amman, 11942, Jordan
| | - Ibrahim Salami
- Department of Clinical Nursing, School of Nursing, The University of Jordan, Amman, 11942, Jordan
| | - Hamza Alduraidi
- Department of Community Health Nursing, School of Nursing, The University of Jordan, Amman, 11942, Jordan
| | - Jafar Alasad
- Department of Clinical Nursing, School of Nursing, The University of Jordan, Amman, 11942, Jordan
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Claessen G, Claeys M, La Gerche A. Atrial deformation in athletes with AF: chronic adverse remodelling or transient mechanical stunning? Eur Heart J Cardiovasc Imaging 2018; 19:154-156. [DOI: 10.1093/ehjci/jex245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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ter Hoeve N, Sunamura M, van Geffen ME, Fanchamps MH, Horemans HL, Bussmann JB, Stam HJ, van Domburg RT, van den Berg-Emons RJ. Changes in Physical Activity and Sedentary Behavior During Cardiac Rehabilitation. Arch Phys Med Rehabil 2017. [DOI: 10.1016/j.apmr.2017.05.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Vancampfort D, Koyanagi A, Ward PB, Rosenbaum S, Schuch FB, Mugisha J, Richards J, Firth J, Stubbs B. Chronic physical conditions, multimorbidity and physical activity across 46 low- and middle-income countries. Int J Behav Nutr Phys Act 2017; 14:6. [PMID: 28100238 PMCID: PMC5241915 DOI: 10.1186/s12966-017-0463-5] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 01/05/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND There are no nationally representative population-based studies investigating the relationship between physical activity, chronic conditions and multimorbidity (i.e., two or more chronic conditions) in low- and middle-income countries (LMICs), and studies on a multi-national level are lacking. This is an important research gap, given the rapid increase in the prevalence of chronic diseases associated with lifestyle changes in these countries. This cross-sectional study aimed to assess the association between chronic conditions, multimorbidity and low physical activity (PA) among community-dwelling adults in 46 LMICs, and explore the mediators of these relationships. METHODS World Health Survey data included 228,024 adults aged ≥18 years from 46 LMICs. PA was assessed by the International Physical Activity Questionnaire (IPAQ). Nine chronic physical conditions (chronic back pain, angina, arthritis, asthma, diabetes, hearing problems, tuberculosis, visual impairment and edentulism) were assessed. Multivariable logistic regression and mediation analyses were used to assess the association between chronic conditions or multimorbidity and low PA. RESULTS Overall, in the multivariable analysis, arthritis (OR = 1.12), asthma (1.19), diabetes (OR = 1.33), edentulism (OR = 1.46), hearing problems (OR = 1.90), tuberculosis (OR = 1.24), visual impairment (OR = 2.29), multimorbidity (OR = 1.31; 95% CI = 1.21-1.42) were significantly associated with low PA. More significant associations were observed in individuals aged ≥50 years. In older adults, depression mediated between 5.1% (visual impairment) to 23.5% (angina) of the association between a chronic condition and low PA. Mobility difficulties explained more than 25% of the association for seven of the eight chronic conditions. Pain was a strong mediator for angina (65.9%) and arthritis (64.9%), while sleep problems mediated up to 43.7% (angina) of the association. CONCLUSIONS In LMICs, those with chronic conditions and multimorbidity are significantly less physically active (especially older adults). Research on the efficacy and effectiveness of PA in the management of chronic diseases in LMICs is urgently needed. Targeted promotion of physical activity to populations in LMICs experiencing chronic conditions may ameliorate associated depression, mobility difficulties and pain that are themselves important barriers for initiating or adopting an active lifestyle.
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Affiliation(s)
- Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Tervuursevest 101, Leuven, 3001 Belgium
- KU Leuven, University Psychiatric Center KU Leuven, Leuvensesteenweg 517, Kortenberg, 3070 Belgium
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, 0883 Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid, 28029 Spain
| | - Philip B. Ward
- School of Psychiatry, UNSW, Sydney, Australia
- Schizophrenia Research Institute, Ingham Institute of Applied Medical Research, Liverpool, NSW Australia
| | - Simon Rosenbaum
- Exercise Physiology Department, School of Medical Sciences, UNSW Australia, Sydney, Australia
| | - Felipe B. Schuch
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Programa de Pós Graduação em Ciências Médicas: Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - James Mugisha
- Kyambogo University, Kampala, Uganda
- Butabika National Referral and Mental Health Hospital, Kampala, Uganda
| | - Justin Richards
- School of Public Health & Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Joseph Firth
- School of Health Sciences, Division of Psychology & Mental Health, University of Manchester, Manchester, UK
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ UK
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Box SE5 8AF, De Crespigny Park, London, UK
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Climstein M, Egger G. Physical Activity. LIFESTYLE MEDICINE 2017. [DOI: 10.1016/b978-0-12-810401-9.00012-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Pedersen BK, Saltin B. Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports 2016; 25 Suppl 3:1-72. [PMID: 26606383 DOI: 10.1111/sms.12581] [Citation(s) in RCA: 1602] [Impact Index Per Article: 200.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2015] [Indexed: 12/12/2022]
Abstract
This review provides the reader with the up-to-date evidence-based basis for prescribing exercise as medicine in the treatment of 26 different diseases: psychiatric diseases (depression, anxiety, stress, schizophrenia); neurological diseases (dementia, Parkinson's disease, multiple sclerosis); metabolic diseases (obesity, hyperlipidemia, metabolic syndrome, polycystic ovarian syndrome, type 2 diabetes, type 1 diabetes); cardiovascular diseases (hypertension, coronary heart disease, heart failure, cerebral apoplexy, and claudication intermittent); pulmonary diseases (chronic obstructive pulmonary disease, asthma, cystic fibrosis); musculo-skeletal disorders (osteoarthritis, osteoporosis, back pain, rheumatoid arthritis); and cancer. The effect of exercise therapy on disease pathogenesis and symptoms are given and the possible mechanisms of action are discussed. We have interpreted the scientific literature and for each disease, we provide the reader with our best advice regarding the optimal type and dose for prescription of exercise.
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Affiliation(s)
- B K Pedersen
- The Centre of Inflammation and Metabolism and The Center for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - B Saltin
- The Copenhagen Muscle Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Future perspectives in cardiac rehabilitation: a new European Association for Cardiovascular Prevention and Rehabilitation Position Paper on ‘secondary prevention through cardiac rehabilitation’. ACTA ACUST UNITED AC 2016; 14:723-5. [DOI: 10.1097/hjr.0b013e3282f3ca25] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ashcraft KA, Peace RM, Betof AS, Dewhirst MW, Jones LW. Efficacy and Mechanisms of Aerobic Exercise on Cancer Initiation, Progression, and Metastasis: A Critical Systematic Review of In Vivo Preclinical Data. Cancer Res 2016; 76:4032-50. [PMID: 27381680 DOI: 10.1158/0008-5472.can-16-0887] [Citation(s) in RCA: 121] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 04/21/2016] [Indexed: 12/13/2022]
Abstract
A major objective of the emerging field of exercise-oncology research is to determine the efficacy of, and biological mechanisms by which, aerobic exercise affects cancer incidence, progression, and/or metastasis. There is a strong inverse association between self-reported exercise and the primary incidence of several forms of cancer; similarly, emerging data suggest that exercise exposure after a cancer diagnosis may improve outcomes for early-stage breast, colorectal, or prostate cancer. Arguably, critical next steps in the development of exercise as a candidate treatment in cancer control require preclinical studies to validate the biological efficacy of exercise, identify the optimal "dose", and pinpoint mechanisms of action. To evaluate the current evidence base, we conducted a critical systematic review of in vivo studies investigating the effects of exercise in cancer prevention and progression. Studies were evaluated on the basis of tumor outcomes (e.g., incidence, growth, latency, metastasis), dose-response, and mechanisms of action, when available. A total of 53 studies were identified and evaluated on tumor incidence (n = 24), tumor growth (n = 33), or metastasis (n = 10). We report that the current evidence base is plagued by considerable methodologic heterogeneity in all aspects of study design, endpoints, and efficacy. Such heterogeneity precludes meaningful comparisons and conclusions at present. To this end, we provide a framework of methodologic and data reporting standards to strengthen the field to guide the conduct of high-quality studies required to inform translational, mechanism-driven clinical trials. Cancer Res; 76(14); 4032-50. ©2016 AACR.
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Affiliation(s)
| | - Ralph M Peace
- Duke University Medical Center, Durham, North Carolina
| | | | | | - Lee W Jones
- Memorial Sloan Kettering Cancer Center, New York, New York.
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Sibilitz KL, Berg SK, Tang LH, Risom SS, Gluud C, Lindschou J, Kober L, Hassager C, Taylor RS, Zwisler AD. Exercise-based cardiac rehabilitation for adults after heart valve surgery. Cochrane Database Syst Rev 2016; 3:CD010876. [PMID: 26998683 DOI: 10.1002/14651858.cd010876.pub2] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Exercise-based cardiac rehabilitation may benefit heart valve surgery patients. We conducted a systematic review to assess the evidence for the use of exercise-based intervention programmes following heart valve surgery. OBJECTIVES To assess the benefits and harms of exercise-based cardiac rehabilitation compared with no exercise training intervention, or treatment as usual, in adults following heart valve surgery. We considered programmes including exercise training with or without another intervention (such as a psycho-educational component). SEARCH METHODS We searched: the Cochrane Central Register of Controlled Trials (CENTRAL); the Database of Abstracts of Reviews of Effects (DARE); MEDLINE (Ovid); EMBASE (Ovid); CINAHL (EBSCO); PsycINFO (Ovid); LILACS (Bireme); and Conference Proceedings Citation Index-S (CPCI-S) on Web of Science (Thomson Reuters) on 23 March 2015. We handsearched Web of Science, bibliographies of systematic reviews and trial registers (ClinicalTrials.gov, Controlled-trials.com, and The World Health Organization International Clinical Trials Registry Platform). SELECTION CRITERIA We included randomised clinical trials that investigated exercise-based interventions compared with no exercise intervention control. The trial participants comprised adults aged 18 years or older who had undergone heart valve surgery for heart valve disease (from any cause) and received either heart valve replacement, or heart valve repair. DATA COLLECTION AND ANALYSIS Two authors independently extracted data. We assessed the risk of systematic errors ('bias') by evaluation of bias risk domains. Clinical and statistical heterogeneity were assessed. Meta-analyses were undertaken using both fixed-effect and random-effects models. We used the GRADE approach to assess the quality of evidence. We sought to assess the risk of random errors with trial sequential analysis. MAIN RESULTS We included two trials from 1987 and 2004 with a total 148 participants who have had heart valve surgery. Both trials had a high risk of bias.There was insufficient evidence at 3 to 6 months follow-up to judge the effect of exercise-based cardiac rehabilitation compared to no exercise on mortality (RR 4.46 (95% confidence interval (CI) 0.22 to 90.78); participants = 104; studies = 1; quality of evidence: very low) and on serious adverse events (RR 1.15 (95% CI 0.37 to 3.62); participants = 148; studies = 2; quality of evidence: very low). Included trials did not report on health-related quality of life (HRQoL), and the secondary outcomes of New York Heart Association class, left ventricular ejection fraction and cost. We did find that, compared with control (no exercise), exercise-based rehabilitation may increase exercise capacity (SMD -0.47, 95% CI -0.81 to -0.13; participants = 140; studies = 2, quality of evidence: moderate). There was insufficient evidence at 12 months follow-up for the return to work outcome (RR 0.55 (95% CI 0.19 to 1.56); participants = 44; studies = 1; quality of evidence: low). Due to limited information, trial sequential analysis could not be performed as planned. AUTHORS' CONCLUSIONS Our findings suggest that exercise-based rehabilitation for adults after heart valve surgery, compared with no exercise, may improve exercise capacity. Due to a lack of evidence, we cannot evaluate the impact on other outcomes. Further high-quality randomised clinical trials are needed in order to assess the impact of exercise-based rehabilitation on patient-relevant outcomes, including mortality and quality of life.
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Affiliation(s)
- Kirstine L Sibilitz
- Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen, Denmark, 2100
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Hammond-Haley M, Patel RS, Providência R, Lambiase PD. Exercise restrictions for patients with inherited cardiac conditions: Current guidelines, challenges and limitations. Int J Cardiol 2016; 209:234-41. [PMID: 26897076 DOI: 10.1016/j.ijcard.2016.02.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 01/07/2016] [Accepted: 02/01/2016] [Indexed: 01/02/2023]
Abstract
Inherited primary arrhythmia syndromes are a clinically heterogeneous group of relatively uncommon but important inherited cardiac conditions that are associated with an increased risk of sudden cardiac death (SCD) in the setting of a structurally normal heart. These include long-QT syndrome (LQTS), Short-QT syndrome (SQTS), Brugada syndrome (BrS) and Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT). The cardiomyopathies represent the other major group of inherited cardiac conditions associated with SCD, of which hypertrophic cardiomyopathy (HCM) is the most common. Exercise is a known trigger of ventricular arrhythmias in many of these conditions, however marked genetic and clinical heterogeneity within individual diseases means that certain patients are at a much greater risk of lethal ventricular arrhythmias during exercise than others. For instance, LQTS type 1 (LQT1) and CPVT patients are at particular risk during exertion, whilst in patients with other genetic variants of LQTS, BrS and SQTS, alternative triggers are more significant precipitants. Many channelopathy (principally Brugada, CPVT) & cardiomyopathy (mainly HCM) patients receive primary or secondary prevention therapy with an implantable cardiac defibrillator (ICD). Exercising with an ICD in situ carries a range of additional risks including inappropriate shocks and lead complications. This review will focus on the risk of exercise-induced SCD in patients with inherited cardiac conditions, the current clinical guidelines in this area and the special consideration of patients with an ICD.
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Affiliation(s)
| | - Riyaz S Patel
- Institute of Cardiovascular Science, University College London, UK; Bart's Heart Centre, Bart's Health NHS Trust, London, UK
| | | | - Pier D Lambiase
- Institute of Cardiovascular Science, University College London, UK; Bart's Heart Centre, Bart's Health NHS Trust, London, UK.
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The Impact of Different Degrees of Feedback on Physical Activity Levels: A 4-Week Intervention Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:6561-81. [PMID: 26067990 PMCID: PMC4483716 DOI: 10.3390/ijerph120606561] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 05/26/2015] [Accepted: 06/03/2015] [Indexed: 11/17/2022]
Abstract
Assessing levels of physical activity (PA) and providing feedback about these levels might have an effect on participant's PA behavior. This study discusses the effect of different levels of feedback--from minimal to use of a feedback display and coach--on PA over a 4-week intervention period. PA was measured at baseline, during and immediately after the intervention. Participants (n=227) were randomly assigned to a Minimal Intervention Group (MIG-no feedback), Pedometer Group (PG-feedback on steps taken), Display Group (DG-feedback on steps, minutes of moderate to vigorous physical activity and energy expenditure) or Coaching Group (CoachG-same as DG with need-supportive coaching). Two-way ANCOVA showed no significant Group×Time interaction effect for the different PA variables between the MIG and PG. Also no differences emerged between PG and DG. As hypothesized, CoachG had higher PA values throughout the intervention compared with DG. Self-monitoring using a pedometer resulted in more steps compared with a no-feedback condition at the start of the intervention. However, adding individualized coaching seems necessary to increase the PA level until the end of the intervention.
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Does cardiac rehabilitation after an acute cardiac syndrome lead to changes in physical activity habits? Systematic review. Phys Ther 2015; 95:167-79. [PMID: 25278337 DOI: 10.2522/ptj.20130509] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Optimal physical activity levels have health benefits for patients with acute coronary syndrome (ACS) and are an important goal of cardiac rehabilitation (CR). PURPOSE The purpose of this study was to systematically review literature regarding short-term effects (<6 months after completion of CR) and long-term effects (≥6 months after completion) of standard CR on physical activity levels in patients with ACS. DATA SOURCES PubMed, EMBASE, CINAHL, and PEDro were systematically searched for relevant randomized clinical trials (RCTs) published from 1990 until 2012. STUDY SELECTION Randomized clinical trials investigating CR for patients with ACS reporting physical activity level were reviewed. DATA EXTRACTION Two reviewers independently selected articles, extracted data, and assessed methodological quality. Results were summarized with a best evidence synthesis. Results were categorized as: (1) center-based/home-based CR versus no intervention, (2) comparison of different durations of CR, and (3) comparison of 2 types of CR. DATA SYNTHESIS A total of 26 RCTs were included. Compared with no intervention, there was, at most, conflicting evidence for center-based CR and moderate evidence for home-based CR for short-term effectiveness. Limited evidence and no evidence were found for long-term maintenance for center-based and home-based CR, respectively. When directly compared with center-based CR, moderate evidence showed that home-based CR has better long-term effects. There was no clear evidence that increasing training volume, extending duration of CR, or adding an extra intervention to CR is more effective. LIMITATIONS Because of the variety of CR interventions in the included RCTs and the variety of outcome measures in the included RCTs, pooling of data was not possible. Therefore, a best evidence synthesis was used. CONCLUSIONS It would appear that center-based CR is not sufficient to improve and maintain physical activity habits. Home-based programs might be more successful, but the literature on these programs is limited. More research on finding successful interventions to improve activity habits is needed.
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Myers J, McAuley P, Lavie CJ, Despres JP, Arena R, Kokkinos P. Physical activity and cardiorespiratory fitness as major markers of cardiovascular risk: their independent and interwoven importance to health status. Prog Cardiovasc Dis 2014; 57:306-14. [PMID: 25269064 DOI: 10.1016/j.pcad.2014.09.011] [Citation(s) in RCA: 433] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The evolution from hunting and gathering to agriculture, followed by industrialization, has had a profound effect on human physical activity (PA) patterns. Current PA patterns are undoubtedly the lowest they have been in human history, with particularly marked declines in recent generations, and future projections indicate further declines around the globe. Non-communicable health problems that afflict current societies are fundamentally attributable to the fact that PA patterns are markedly different than those for which humans were genetically adapted. The advent of modern statistics and epidemiological methods has made it possible to quantify the independent effects of cardiorespiratory fitness (CRF) and PA on health outcomes. Based on more than five decades of epidemiological studies, it is now widely accepted that higher PA patterns and levels of CRF are associated with better health outcomes. This review will discuss the evidence supporting the premise that PA and CRF are independent risk factors for cardiovascular disease (CVD) as well as the interplay between both PA and CRF and other CVD risk factors. A particular focus will be given to the interplay between CRF, metabolic risk and obesity.
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Affiliation(s)
- Jonathan Myers
- Division of Cardiology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States; Stanford University School of Medicine, Stanford, CA, United States.
| | - Paul McAuley
- Winston-Salem State University, Winston-Salem, NC, United States
| | - Carl J Lavie
- Department of Cardiovascular Disease, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, Queensland School of Medicine, New Orleans, LA, United States
| | | | - Ross Arena
- Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, United States
| | - Peter Kokkinos
- Veterans Affairs Medical Center, Washington DC, United States
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Effects of a short-term resistance program using elastic bands or weight machines in cardiac rehabilitation. Sci Sports 2014. [DOI: 10.1016/j.scispo.2013.07.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Vance DD, Chen GL, Stoutenberg M, Myerburg RJ, Jacobs K, Nathanson L, Perry A, Seo D, Goldschmidt-Clermont PJ, Rampersaud E. Cardiac performance, biomarkers and gene expression studies in previously sedentary men participating in half-marathon training. BMC Sports Sci Med Rehabil 2014; 6:6. [PMID: 24552436 PMCID: PMC3996079 DOI: 10.1186/2052-1847-6-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 02/06/2014] [Indexed: 01/26/2023]
Abstract
Background The mechanisms through which exercise reduces cardiovascular disease are not fully understood. We used echocardiograms, cardiac biomarkers and gene expression to investigate cardiovascular effects associated with exercise training. Methods Nineteen sedentary men (22–37 years) completed a 17-week half-marathon training program. Serial measurements of resting heart rate, blood pressure, maximum oxygen consumption, lipids, C-reactive protein, cardiac troponin T, echocardiograms and blood for gene expression were obtained from baseline to peak training. Controls included 22 sedentary men who did not exercise. Results Among the training group, VO2 max increased from 37.1 to 42.0 ml/kg/min (p < 0.001). Significant changes were seen in left ventricular wall thickness and mass, stroke volume, resting heart rate and blood pressure (p < 0.001). The control group demonstrated no significant changes. Expression profiling in the training group identified 10 significantly over-expressed and 53 significantly under-expressed loci involved in inflammatory pathways. Dividing the training group into high and low responders based on percent change in VO2 max identified loci that differentiated these two groups at baseline and after training. Conclusion Intensive exercise training leads to significant increase in cardiac and hemodynamic performance, and significant changes in expression of genes involved in immune and inflammatory response.
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Affiliation(s)
- Danica D Vance
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA.,Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Gordon L Chen
- Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Mark Stoutenberg
- Department of Kinesiology and Sports Science, University of Miami, Miami, FL, USA.,Department of Epidemiology & Public Health, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Robert J Myerburg
- Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA.,Department of Physiology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Kevin Jacobs
- Department of Kinesiology and Sports Science, University of Miami, Miami, FL, USA
| | - Lubov Nathanson
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA
| | - Arlette Perry
- Department of Kinesiology and Sports Science, University of Miami, Miami, FL, USA
| | - David Seo
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA.,Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami, Miami, FL, USA
| | - Pascal J Goldschmidt-Clermont
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA.,Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Evadnie Rampersaud
- John P. Hussman Institute for Human Genomics, University of Miami, Miami, FL, USA.,Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami, Miami, FL, USA
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Soan EJ, Street SJ, Brownie SM, Hills AP. Exercise physiologists: essential players in interdisciplinary teams for noncommunicable chronic disease management. J Multidiscip Healthc 2014; 7:65-8. [PMID: 24511238 PMCID: PMC3913503 DOI: 10.2147/jmdh.s55620] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Noncommunicable diseases (NCDs), such as obesity and type 2 diabetes mellitus, are a growing public health challenge in Australia, accounting for a significant and increasing cost to the health care system. Management of these chronic conditions is aided by interprofessional practice, but models of care require updating to incorporate the latest evidence-based practice. Increasing research evidence reports the benefits of physical activity and exercise on health status and the risk of inactivity to chronic disease development, yet physical activity advice is often the least comprehensive component of care. An essential but as yet underutilized player in NCD prevention and management is the “accredited exercise physiologist,” a specialist in the delivery of clinical exercise prescriptions for the prevention or management of chronic and complex conditions. In this article, the existing role of accredited exercise physiologists in interprofessional practice is examined, and an extension of their role proposed in primary health care settings.
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Affiliation(s)
- Esme J Soan
- Mater Mothers' Hospital, South Brisbane, Australia ; Mater Research Institute - University of Queensland, South Brisbane, Australia ; Griffith Health Institute, Griffith University, Gold Coast, QLD, Australia
| | - Steven J Street
- Mater Mothers' Hospital, South Brisbane, Australia ; Mater Research Institute - University of Queensland, South Brisbane, Australia
| | - Sharon M Brownie
- Griffith Health Institute, Griffith University, Gold Coast, QLD, Australia ; Green Templeton College, Oxford University, Oxford, UK
| | - Andrew P Hills
- Mater Mothers' Hospital, South Brisbane, Australia ; Mater Research Institute - University of Queensland, South Brisbane, Australia ; Griffith Health Institute, Griffith University, Gold Coast, QLD, Australia
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Sibilitz KL, Berg SK, Tang LH, Risom SS, Gluud C, Lindschou J, Kober L, Hassager C, Taylor RS, Zwisler AD. Exercise-based cardiac rehabilitation for adults after heart valve surgery. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2013. [DOI: 10.1002/14651858.cd010876] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Jelinek HF, Huang ZQ, Khandoker AH, Chang D, Kiat H. Cardiac rehabilitation outcomes following a 6-week program of PCI and CABG Patients. Front Physiol 2013; 4:302. [PMID: 24198786 PMCID: PMC3812547 DOI: 10.3389/fphys.2013.00302] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 10/02/2013] [Indexed: 12/03/2022] Open
Abstract
Coronary artery events requiring intervention are associated with depressed cardiac autonomic function. Whether a 6-week cardiac rehabilitation (CR) differs in effectiveness in improving exercise capacity (6MWT), cardiorespiratory function (peakVO2), and autonomic function (HRV) following either cardiac bypass surgery (CABG) or percutaneous coronary revascularization (PCI) is unknown. The current study therefore compared the change in 6MWT and peak VO2 to HRV variables following a 6-week CR program and with patients having either PCI or CABG. Thirty-eight patients, (PCI, n = 22 and CABG, n = 16) participated in the CR program and results for pre and post 6 min walk test (6MWT), peakVO2, and heart rate variability (HRV) were obtained. Our study has shown that a 6 weeks program following either PCI or CABG improves function. However, the effect on post-CABG differs to that of post-PCI patients. The change in distance walked (6MWT, metres) was higher in the CABG (Δ6MWT: 61, p < 0.001) compared to the PCI group (Δ6MWT: 41, p < 0.001). Maximum exercise capacity (peak VO2, ml/kg.min) also changed significantly with a greater change in the CABG group (ΔPCI: 0.7, p < 0.001; ΔCABG: 1.0, p < 0.001) but did not reach normal population values. Although an improvement in HRV parameters was noted for the PCI group, a statistically significant improvement in HRV was observed only in the CABG group for the following; SDNN (ms) (baseline vs. post-rehabilitation (median ± IQR): 31.2 ± 25.6 vs. 51.8 ± 23.1, p < 0.01), RMSSD (19.32 ± 19.9 vs. 42.1 ± 34.2, p < 0.01); LF (ms(2)) (191 ± 216 vs. 631 ± 693, p < 0.01) and HF (107 ± 201 vs. 449 ± 795.0, p < 0.05). A significant interaction in the PCI group but not in the CABG group was observed using correlation analysis between the 6MWT and peak VO2 with HRV parameters indicating that being healthier that is, a better 6MWT and peak VO2 led to better HRV results but no significant effect of CR in the PCI group. When the results were investigated for baseline 6MWT and peak VO2 effect using a covariate analysis, a significant influence of CR on HRV parameters was retained in the CABG group (p = 0.0072). Our study indicates that a 6-weeks CR program benefits both patient groups in terms of exercise capacity, cardiorespiratory function and autonomic nervous system modulation of heart rate, with CABG patients showing the most improvement. HRV can be a useful additional variable to gauge cardiac function following CR.
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Affiliation(s)
- Herbert F. Jelinek
- Australian School of Advanced Medicine, Macquarie UniversitySydney, NSW, Australia
- Department of Biomedical Engineering, Khalifa University of Science, Technology and ResearchAbu Dhabi, United Arab Emirates
- School of Community Health, Charles Sturt UniversityAlbury, NSW, Australia
| | - Zhaoqi Q. Huang
- Department of Cardiology, The Third Affiliated Hospital of Guangzhou Medical CollegeGuangzhou, China
- Department of Cardiac Rehabilitation, Sydney Adventist HospitalSydney, NSW, Australia
| | - Ahsan H. Khandoker
- Department of Biomedical Engineering, Khalifa University of Science, Technology and ResearchAbu Dhabi, United Arab Emirates
| | - Dennis Chang
- Centre for Complementary Medicine Research, University of Western SydneySydney, NSW, Australia
| | - Hosen Kiat
- Australian School of Advanced Medicine, Macquarie UniversitySydney, NSW, Australia
- Department of Cardiac Rehabilitation, Sydney Adventist HospitalSydney, NSW, Australia
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Zaidi A, Sharma S. Exercise and heart disease: from athletes and arrhythmias to hypertrophic cardiomyopathy and congenital heart disease. Future Cardiol 2013; 9:119-36. [PMID: 23259479 DOI: 10.2217/fca.12.81] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The beneficial effects of regular physical activity on cardiovascular health are well established, with convincing evidence of improvements in blood pressure, lipid profile and overall mortality. Conversely, individuals with pre-existing congenital, inherited or acquired heart conditions may experience functional cardiac deterioration or sudden death during even moderate exertion. Exclusion from high-level sporting activity may be mandated in some cases, and pre-participation screening of competitive athletes plays an important role in the identification of such individuals. The issue of screening is complicated by the fact that physiological cardiovascular adaptation in healthy athletes, including modest left ventricular hypertrophy and biventricular cavity dilatation, may create a diagnostic overlap with pathological conditions such as hypertrophic cardiomyopathy. Furthermore, much interest has focused recently on the possibility of irreversible cardiac remodeling in a proportion of veteran endurance athletes, with the potential for arrhythmogenesis and adverse cardiac events.
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Affiliation(s)
- Abbas Zaidi
- Department of Cardiovascular Sciences, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK
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Krstić O, Ilić I, Ranković J, Nedin Ranković G, Đinđić N, Savić T, Karalejić S, Mekić B, Milenković V, Toskić D. CHANGES IN LIPOPROTEIN INDICATOR AND INDICATOR OF ENDOTHELIAL FUNCTION AFTER IMPLEMENTED CARDIOVASCULAR REHABILITATION PROGRAM. ACTA MEDICA MEDIANAE 2012. [DOI: 10.5633/amm.2012.0309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Goyer L, Dufour R, Janelle C, Blais C, L'Abbé C, Raymond E, de Champlain J, Larochelle P. Randomized controlled trial on the long-term efficacy of a multifaceted, interdisciplinary lifestyle intervention in reducing cardiovascular risk and improving lifestyle in patients at risk of cardiovascular disease. J Behav Med 2012; 36:212-24. [PMID: 22402823 DOI: 10.1007/s10865-012-9407-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Accepted: 02/09/2012] [Indexed: 02/07/2023]
Abstract
The objective of the study was to evaluate the efficacy of an interdisciplinary intervention known as Educoeur in reducing cardiovascular risk and improving health behaviors in people without evidence of cardiovascular disease and to compare the Educoeur program to interventions in a specialized clinic and in usual care family practice. In a parallel, randomized, controlled trial of 185 adults with at least two modifiable cardiovascular risk factors, patients were randomly assigned to either Educoeur, specialized clinic or usual care. Cardiovascular risk, biological and lifestyle measures were assessed at baseline and at 2 years. In Educoeur, measurements were also taken before and after the lifestyle group treatment program. In 12 weeks, patients in Educoeur significantly lowered their cardiovascular risk, weight, body mass index, waist circumference, systolic blood pressure, kilocalories intake and improved their VO2 Max and mental health. Changes remained significant at 2 years. Between group comparisons at 2 years demonstrated that Educoeur was significantly better in reducing cardiovascular risk than interventions in usual care. Together, these results highlight the importance of providing interdisciplinary programs that optimize cardiovascular risk reduction and promote active lifestyles in patients at risk of cardiovascular disease.
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Affiliation(s)
- Lysanne Goyer
- Institut de Recherches Cliniques de Montréal, 110 Avenue des Pins Ouest, Montreal, QC, H2W 1R7, Canada
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Niederseer D, Ledl-Kurkowski E, Kvita K, Patsch W, Dela F, Mueller E, Niebauer J. Salzburg Skiing for the Elderly Study: changes in cardiovascular risk factors through skiing in the elderly. Scand J Med Sci Sports 2011; 21 Suppl 1:47-55. [PMID: 21679323 DOI: 10.1111/j.1600-0838.2011.01341.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Numerous studies have shown that treatment of the modifiable cardiovascular risk factors (CVRF) results in a decreased risk to suffer from stroke or myocardial infarction. Despite the fact that exercise training is a potent treatment choice for CVRF, this is the first randomized study to assess the effects of alpine skiing on CVRF in elderly skiers. Subjects (n=42) were randomized into an intervention group (IG; n=22; 12 males/10 females; age: 66.6 ± 2.1 years) completing 12 weeks of guided skiing or a control group (CG; n=20; 10 males/10 females; age: 67.3 ± 4.4 years). CVRF were assessed before and after the intervention period. No cardiovascular event occurred within a total of 795.1 h of skiing. A significant increase in exercise capacity in IG (ΔVO(2 max) : +2.0 mL/kg/min, P=0.005) but not in CG (ΔVO(2 max) : -0.1 mL/kg/min, P=0.858; IG vs CG: P=0.008) as well as a decrease in body fat mass [IG: -2.3%, P<0.0001; CG: ± 0.0%, P=0.866; IG vs CG: P<0.0001] was achieved. Blood pressure, blood lipids, heart rate and everyday physical activity remained essentially unchanged. Alpine skiing in the elderly is safe with respect to cardiovascular events, and improves some, but not all CVRF.
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Affiliation(s)
- D Niederseer
- Department of Sports Medicine, Prevention and Rehabilitation, Institute of Sports Medicine of the State of Salzburg, Paracelsus Medical University Salzburg, Sports Medicine of Olympic Center Salzburg-Rif, Sulzburg, Austria
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Cruz P, Johnson BD, Karpinski SC, Limoges KA, Warren BA, Olsen KD, Somers VK, Jensen MD, Clark MM, Lopez-Jimenez F. Validity of weight loss to estimate improvement in body composition in individuals attending a wellness center. Obesity (Silver Spring) 2011; 19:2274-9. [PMID: 21566566 PMCID: PMC4103167 DOI: 10.1038/oby.2011.102] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The accuracy of weight loss in estimating successful changes in body composition (BC), namely fat mass (FM) loss, is not known and was addressed in our study. To assess the correlation between change in body weight and change in FM, fat% and fat-free mass (FFM), 465 participants (41% male; 41 ± 13 years), who met the criteria for weight change assessment at a wellness center, underwent air-displacement plethysmography (ADP). Body weight and BC were measured at the same time. We categorized the change in body weight, FM and FFM as an increase if there was >1 kg gain, a decrease if there was >1 kg loss and no change if the difference was ≤1 kg. We estimated the diagnostic performance of weight change to identify improvement in BC. After a median time of 132 days, there was a mean weight change was 2.4 kg. From the 255 people who lost >1 kg of weight, 216 (84.7%) had lost >1 kg of FM, but 69 (27.1%) had lost >1 kg of FFM. Of the 143 people with no weight change, 42 (29.4%) had actually lost >1 kg of FM. Of the 67 who gained >1 kg of weight at follow-up, in 23 (34.3%) this was due to an increase in FFM but not in FM. Weight change had a NPV of 73%. Our results indicate that favorable improvements in BC may go undetected in almost one-third of people whose weight remains the same and in one-third of people who gain weight after attending a wellness center. These results underscore the potential role of BC measurements in people attempting lifestyle changes.
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Affiliation(s)
- Paulina Cruz
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Bruce D. Johnson
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Susan C. Karpinski
- Dan Abraham Healthy Living Center; Mayo Clinic, Rochester, Minnesota, USA
| | | | - Beth A. Warren
- Dan Abraham Healthy Living Center; Mayo Clinic, Rochester, Minnesota, USA
| | - Kerry D. Olsen
- Dan Abraham Healthy Living Center; Mayo Clinic, Rochester, Minnesota, USA
| | - Virend K. Somers
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael D. Jensen
- Endocrine Research Unit, Division of Endocrinology, Mayo Clinic, Rochester, Minnesota, USA
| | - Matthew M. Clark
- Dan Abraham Healthy Living Center; Mayo Clinic, Rochester, Minnesota, USA
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Berent R, von Duvillard SP, Crouse SF, Sinzinger H, Green JS, Schmid P. Resistance Training Dose Response in Combined Endurance-Resistance Training in Patients With Cardiovascular Disease: A Randomized Trial. Arch Phys Med Rehabil 2011; 92:1527-33. [DOI: 10.1016/j.apmr.2011.04.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2011] [Revised: 04/16/2011] [Accepted: 04/26/2011] [Indexed: 01/14/2023]
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Fukuda T, Kurano M, Iida H, Takano H, Tanaka T, Yamamoto Y, Ikeda K, Nagasaki M, Monzen K, Uno K, Kato M, Shiga T, Maemura K, Masuda N, Yamashita H, Hirata Y, Nagai R, Nakajima T. Cardiac rehabilitation decreases plasma pentraxin 3 in patients with cardiovascular diseases. Eur J Prev Cardiol 2011; 19:1393-400. [DOI: 10.1177/1741826711422990] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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