scholarly journals The impact of the cardiac rehabilitation program in patients with mid-range heart failure (40-50%) in improving cardio respiratory predictors

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
HR Rodrigues ◽  
V Ferreira ◽  
L Alves ◽  
D Sousa ◽  
J Pinto ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): Centro Hospitalar Universitário Lisboa Central Methods We studied 30 patients (P) with ejection fraction (EF) 40-50%, in a number of 198 P that participated in cardiac rehabilitation program (CRP). Of these P, 24 (80%) male and 6 (20%) female, 20 P were diagnosed myocardial infarction with ST-segment elevation, 2 P myocardial infarction non ST and 8 P with myocardial hypertrophy non ischemic. Of these P 30% were diabetics, 56% hypertension, 70% dyslipidemia, 36% smokers previous to CRP and body mass index 26,3 medium. All P were submitted to previous echocardiogram, cardiopulmonary exercise testing (CET) and a rehabilitation program minimum 4 sessions and maximum 52 sessions. At the end of the total sessions the echocardiogram and CET were repeated. Results Of the 30 P that participated in CRP only 20 completed the program, while the other 10 P dropped out because of social and economic problems. Of the P that completed the CRP, 70% got better on EF, 80% improved VE/VCO2 slope < 33 therefore are classified VC-II in ventilatory classification (VC), 5% VE/VCO2 slope > 40  VC-III classification, and 15% maintained the initial classification.  50% of the P increased at least one level metabolic equivalent of task (MET) from the first CET. Only 3 of the 20 patients came, once, to the hospital after the CRP with heart failure, and one died but did not fulfill the program. Conclusion Patients with mid-range heart failure submitted to a CRP can improve cardiorespiratory predictors, leading to a better quality of life. However, it is important to find solutions to minimize the causes that make patients to give up CRP.

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
I Burazor ◽  
P Seferovic ◽  
M Ostojic ◽  
B Ivanovic ◽  
M Andjic ◽  
...  

Abstract Heart failure is a major cause of morbidity, mortality and re-hospitalizations and is highly prevalent in myocardial infarction survivors. Cardiac rehabilitation based on exercise training and heart failure self-care counseling have each been shown to improve clinical status and clinical outcomes. We designed our study with aim to evaluate the usefulness of exercise based in house cardiac rehabilitation/ secondary prevention program in patients with heart failure with mid-range ejection fraction (HFmrEF) after myocardial infarction. Patients and methods Out of 2753 patients who were admitted to our three weeks in- hospital secondary prevention program – exercised based cardiac rehabilitation, we analyze a total of 219 patients who were admitted early after coronary revascularization (percutaneus coronary interventions or coronary bypass surgery) with HFmrEF. The majority of patients were males (68%). Risk factors and co morbidities were noted. Patients were selected for exercise training after six minute walking test or exercise stress test (cardiopulmonary dominantly to evaluate unexpected exertional dyspnea). After 3 weeks in house cardiac rehabilitation the patients were re-tested. Results The major comorbidities in our patient population were as follows: hypertension, diabetes and dyslipidemia. Six minutes walking test was performed and the total distance walked ranged from 120 to 480 meters and the beginning of the program. Patient had 7 -days a week training program. After the 3 weeks in hospital exercise rehabilitation the improvement in the test was ∼32%. Cardiopulmonary test showed also improvement of functional capacity.We noted several rhythm disturbance complications by telemetry (VES, SVES). None had acutisation of heart failure (with peripheral edema and congestion). All patients fulfilled cardiac rehabilitation program. Conclusions Supervised multidisciplinary cardiac rehabilitation program, including an individualized exercise component is effective and can improve functional status and exercise tolerance in patient with HFmrEF after myocardial infarction.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Raquel Bravo-Escobar ◽  
Alicia González-Represas ◽  
Adela María Gómez-González ◽  
Ángela Heredia-Torres

AbstractExploring new models of medical care requires evaluating the impact of new care strategies not only on physiological parameters but also on the quality of life of the patient. On the other hand the presence of anxiety together with depression requires further consideration when planning appropriate management strategies. The aim of this study was to examine the effectiveness of a home-based cardiac rehabilitation program incorporating an e-Health technology on health-related quality of life associated with symptoms of anxiety and depression in moderate-risk patients. A multicenter, randomized controlled clinical trial was designed to compare a traditional hospital based cardiac rehabilitation program (n = 38, 35 male) with a mixed home surveillance program where patients exercised at home with a remote electrocardiographic monitoring device (n = 33, 31 male). The Short Form-36 (SF-36) Health Survey and the Goldberg questionnaire were used to evaluate quality of life and the presence of symptoms of anxiety and depression respectively. The results of this study show that the type of cardiac rehabilitation program did not influence the improvement in quality of life (p = 0.854), but the presence of symptoms of anxiety and depression did (p = 0.001). Although both programs achieved a decrease in anxiety and depression symptoms and improved functional capacity (p ≤ 0.001), a significant interaction effect was found between the group with or without anxiety and depression symptoms and the type of program in the bodily pain dimension (p = 0.021). Trial registration: Retrospectively registered NCT02796404 (10/06/2016) in clinialtrials.gov.


Author(s):  
Varoon Chandramohan Jaiswal ◽  
Lata Parmar ◽  
Snehal Ghodey

Introduction: Cardiac rehabilitation and patient education are the two parallel components in the management of coronary heart disease. Although, it is recommended strongly to join an outpatient cardiac rehabilitation program, the enrollment rates are always low. The role of structured patient education in increasing the enrollment in an outpatient cardiac rehabilitation program and its impact on the disability profile of conservatively treated medically stable postmyocardial infarction individuals, after joining and completing the rehabilitation program has not been studied. Aim: To study the impact of structured patient education and outpatient cardiac rehabilitation program on the disability profile of conservatively treated medically stable postmyocardial infarction individuals. Materials and Methods: The study is a mixed method design and will be conducted in two steps. Step 1: It is a qualitative study in which a structured patient education program will be developed based on the framework given by the working Group of Exercise Rehabilitation and Sports (GERS). Step 2: Implementation of the developed program and an outpatient cardiac rehabilitation program in an open-label non randomised clinical trial. Conclusion: The findings of this study will evaluate the need for the development of structured patient education programs for coronary artery disease patients, which may increase the enrollment rates in outpatient cardiac rehabilitation programs and thereby, reducing their disability.


2015 ◽  
Vol 31 (10) ◽  
pp. 1659-1668 ◽  
Author(s):  
Fumitake Yamauchi ◽  
Hitoshi Adachi ◽  
Jun-ichi Tomono ◽  
Shigeru Toyoda ◽  
Koichi Iwamatsu ◽  
...  

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