scholarly journals Current Insights into Exercise-based Cardiac Rehabilitation in Patients with Coronary Heart Disease and Chronic Heart Failure

2020 ◽  
Vol 42 (01) ◽  
pp. 19-26
Author(s):  
Simon Nichols ◽  
Gordon McGregor ◽  
Jeff Breckon ◽  
Lee Ingle
Keyword(s):  
Heart Failure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Chronic Heart Failure ◽  
Exercise Training ◽  
Cardiac Rehabilitation ◽  
Behaviour Change ◽  
Cardiac Patients ◽  
Community Based ◽  
Cardiac Rehabilitation Programme

AbstractCardiac rehabilitation is a package of lifestyle secondary prevention strategies designed for patients with coronary heart disease and chronic heart failure. A community-based cardiac rehabilitation programme provides patients with a structured exercise training intervention alongside educational support and psychological counselling. This review provides an update regarding the clinical benefits of community-based cardiac rehabilitation from a psycho-physiological perspective, and also focuses on the latest epidemiological evidence regarding potential survival benefits. Behaviour change is key to long-term adoption of a healthy and active lifestyle following a cardiac event. In order for lifestyle interventions such as structured exercise interventions to be adopted by patients, practitioners need to ensure that behaviour change programmes are mapped against patient’s priorities and values, and adapted to their level of readiness and intention to engage with the target behaviour. We review the evidence regarding behaviour change strategies for cardiac patients and provide practitioners with the latest guidance. The ‘dose’ of exercise training delivered to patients attending exercise-based cardiac rehabilitation is an important consideration because an improvement in peak oxygen uptake requires an adequate physiological stimulus to invoke positive physiological adaptation. We conclude by critically reviewing the latest evidence regarding exercise dose for cardiac patients including the role of traditional and more contemporary training interventions including high intensity interval training.

A cardiac rehabilitation program increases the acute respond of endothelial progenitor cells after maximum exercise in patients with chronic heart failure

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Kourek ◽  
E Karatzanos ◽  
D Delis ◽  
M Alshamari ◽  
V Linardatou ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Exercise Training ◽  
Cardiac Rehabilitation ◽  
Progenitor Cells ◽  
Endothelial Progenitor Cells ◽  
Rehabilitation Program ◽  
Vascular Endothelial ◽  
Endothelial Progenitor ◽  
Maximum Exercise

Abstract Background Chronic heart failure (CHF) remains a leading cause of morbidity and mortality and it is characterized by vascular endothelial dysfunction. During the last decades, endothelial progenitor cells (EPCs) are being used as an index of the endothelium restoration potential, therefore reflecting the vascular endothelial function. Exercise training has been shown to stimulate the mobilization of EPCs at rest in CHF patients. However, the effect of exercise training on the acute respond of EPCs after maximum exercise in CHF patients remains unknown. Purpose The purpose of the study was to assess the effect of a cardiac rehabilitation (CR) program on the acute respond of EPCs after maximum exercise in patients with CHF. Methods Forty-four consecutive patients (35 males) with stable CHF [mean±SD, Age (years): 56±10, BMI (kg/m2): 28.7±5.2, EF (%): 33±8, Peak VO2 (ml/kg/min): 18.4±4.4, Peak work rate (watts): 101±39] enrolled a 36-session CR program based on high-intensity interval exercise training. All patients underwent an initial symptom limited maximal cardiopulmonary exercise testing (CPET) on an ergometer before the CR program and a final maximal CPET after the CR program. Venous blood was drawn before and after each CPET. Five circulating endothelial populations were identified and quantified by flow cytometry; CD34+/CD45-/CD133+, CD34+/CD45-/CD133+/VEGFR2, CD34+/CD133+/VEGFR2, CD34+/CD45-/CD133- and CD34+/CD45-/CD133-/VEGFR2. EPCs values are expressed as cells/million enucleated cells in medians (25th-75th percentiles). Results The acute mobilization of EPCs after the final CPET was higher than after the initial CPET in 4 out of 5 circulating endothelial populations. Most specifically, difference of the acute mobilization of CD34+/CD45-/CD133+ cells [initial CPET: 25 (15–46) vs final CPET: 49 (26–71), p=0.002], CD34+/CD45-/CD133+/VEGFR2 cells [initial CPET: 3 (2–5) vs final CPET: 8 (5–12), p<0.001], CD34+/CD45-/CD133- cells [initial CPET: 129 (52–338) vs final CPET: 250 (129–518), p=0.03] and CD34+/CD45-/CD133-/VEGFR2 cells [initial CPET: 2 (1–4) vs final CPET: 6 (3–9), p<0.001] increased after the final CPET. The acute mobilization of CD34+/CD133+/VEGFR2 cells [initial CPET: 3 (−1–7) vs final CPET: 5 (0–15), p=0.441] did not differ between the 2 CPETS. Conclusion A 36-session cardiac rehabilitation program increases the acute respond of endothelial progenitor cells after maximum cardiopulmonary exercise training in patients with chronic heart failure, therefore indicating the beneficial effect of exercise training on the vascular endothelial function. Funding Acknowledgement Type of funding source: Public grant(s) – EU funding. Main funding source(s): Co-financed by Greece and the European Union (European Social Fund- ESF) through the Operational Programme “Human Resources Development, Education and Lifelong Learning” in the context of the project

scholarly journals PHARMACOLOGICAL TREATMENT OF OSTEOPOROSIS IN PATIENTS WITH CORONARY HEART DISEASE COMPLICATED BY CHRONIC HEART FAILURE

2019 ◽  
Vol 12 (1) ◽  
pp. 443
Author(s):  
Mariya Marushchak ◽  
Inna Krynytska
Keyword(s):  
Heart Failure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Lumbar Spine ◽  
Chronic Heart Failure ◽  
Vitamin D3 ◽  
Femoral Bone ◽  
Metabolic Disturbances ◽  
Mineral Density ◽  
Multisystem Disorder

Objective: Chronic heart failure (CHF) is a chronic multisystem disorder associated with a myriad of metabolic disturbances. Moreover, CHF may adversely affect bone metabolism and induce a severe bone loss, increasing susceptibility to fractures and osteoporosis. This study investigates the effect of combined calcium with Vitamin D3 supplement called “calcemin advance” and calcitonin in the prophylaxis and treatment of osteopenia and osteoporosis in patients with coronary heart disease (CHD) complicated by CHF with the establishment of their influence on the bone mineral density (BMD).Methods: A total of 59 patients with CHD complicated by CHF. Interventions: The physical examination findings, dual-energy X-ray absorptiometry findings, and treatment results were assessed.Results: The results of the calcemin advance usage in patients with osteopenic changes showed a positive dynamics of the studied parameters, both in the lumbar spine and in the femoral bone. In patients with osteoporosis, the usage of osteoprotective therapy (calcemin advance+miacalcic) contributed to the increasing of BMD in the lumbar spine and in the femoral bone versus patients who received only combined calcium with Vitamin D3 supplement.Conclusions: Our results suggest that bone density screening could be recommended in patients with prevalent CHF. Moreover, the results of our investigation substantiate the necessity and effectiveness of osteoprotective therapy in patients with CHF with osteoporosis by calcitonin (Miacalcic), in combination with combined calcium and Vitamin D3 supplement (calcemin advance), and by only calcemin advance - in patients with CHF and osteopenia.

scholarly journals Impact of cardiac rehabilitation and exercise training programs in coronary heart disease

2017 ◽  
Vol 60 (1) ◽  
pp. 103-114 ◽  
Author(s):  
Sergey Kachur ◽  
Vasutakarn Chongthammakun ◽  
Carl J. Lavie ◽  
Alban De Schutter ◽  
Ross Arena ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Exercise Training ◽  
Cardiac Rehabilitation ◽  
Training Programs
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