scholarly journals Improvement of exercise tests and reduction of heart failure biomarkers in short term follow up after comprehensive rehabilitation program of patients with implanted LVAD

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
T Chwyczko ◽  
E Smolis-Bak ◽  
L Zalucka ◽  
A Segiet-Swiecicka ◽  
E Piotrowicz ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiopulmonary Exercise Test ◽  
Rehabilitation Program ◽  
Exercise Tests ◽  
National Budget ◽  
Funding Sources ◽  
6Mwt Distance ◽  
Galectin 3 ◽  
Comprehensive Rehabilitation ◽  
Public Grant

Abstract Background There is increasing recognition of the importance of rehabilitating patients after LVAD implantation. The novel method of comprehensive rehabilitation starting directly after LVAD implantation was designed for our LVAD patients population. Aim of the study The study aimed to determine, if novel rehabilitation program improves functional and biochemical parameters in patients after recent LVAD implantation. Study group 37 recent LVAD (22 Heart Mate III, 15 HeartWare) recipients (19–67, mean 58.7 years, 35 men) participated in specially designed rehabilitation program. The program included 4–5 weeks of sationary rehabilitation: supervised endurance training on cycloergometer (5 times per week), resistance training, general fitness exercises with elements of equivalent and coordination exercises (every day). It was followed by individual exercises performed at home. At the beginning and at the end of rehabilitation program the patients performed 6 minute walking test (6MWT), cardiopulmonary exercise test (CPET). Following prognostic biomarkers of heart failure: NT-proBNP, galectin-3 and ST2 were also measured. Results See table 1. Increase of 6MWT distance, higher maximal workload, peak VO2 and upward shift of anaerobic threshold in CPET were observed in all patients. Significant reductions of NTproBNP, ST2 and galectin-3 levels were observed. There were no major adverse events during rehabilitation. Conclusions Comprehensive novel rehabilitation in LVAD recipients is safe and results in significant improvement of functional tests and biomarkers of heart failure. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Center for Research and Development: National grant - STRATEGMED II,

Novel rehabilitation program after left ventricular assist device (LVAD) implantation improves functional tests and reduces levels of prognostic heart failure biomarkers

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Chwyczko ◽  
L Zalucka ◽  
E Smolis-Bak ◽  
I Kowalik ◽  
E Noszczak ◽  
...  
Keyword(s):  
Heart Failure ◽  
Exercise Test ◽  
Cardiopulmonary Exercise Test ◽  
Rehabilitation Program ◽  
Left Ventricular ◽  
Prognostic Biomarkers ◽  
Funding Source ◽  
Walking Test ◽  
Cardiopulmonary Exercise ◽  
Galectin 3

Abstract Background Rehabilitation after LVAD implantation is increasingly used. We developed the novel method of comprehensive rehabilitation starting directly after LVAD implantation. Study group 21 recent LVAD (15 Heart Mate III, 6 HeartWare) recipients (56.2±11.7 yrs, 100% men) were included to 5-week rehabilitation program, which included supervised endurance training on cycloergometer (5 times per week), resistance training, general fitness exercises with elements of equivalent and coordination exercises (every day). 6-minute walking test (6MWT), cardiopulmonary exercise test (CPET) and prognostic biomarkers: NT-proBNP, Galectin-3 and ST2 were investigated at the beginning and at the end of rehabilitation program. Results See Table 1. At the end of rehabilitation program, significant increase in 6MWT distance, maximum workload, peak VO2 and upward shift of anaerobic threshold in CPET were observed in all patients. Significant reductions of NTproBNP, ST2 and galectin-3 levels were observed. There were no major adverse events during rehabilitaton. Conclusions Comprehensive novel rehabilitation in LVAD recipients is safe and results in significant improvement of 6-minutes walking test distance and cardiopulmonary exercise test results. Moreover, this novel rehabilitation program reduces levels of prognostic biomarkers of heart failure: NT-proBNP, Galectin-3 and ST2. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Center for Research and Development - STRATEGMED II project

scholarly journals Keeping the plates spinning: a qualitative study of the multifaceted role of caregiving in HFpEF

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
CR Pearson ◽  
E Khair ◽  
F Forsyth ◽  
E Sowden ◽  
C Deaton
Keyword(s):  
Heart Failure ◽  
Qualitative Study ◽  
Informal Caregivers ◽  
Healthcare Providers ◽  
Support Network ◽  
Structured Interviews ◽  
National Budget ◽  
Funding Sources ◽  
Public Grant ◽  
Caregiver Role

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institutes of Health Research School for Primary Care Research OnBehalf Optimise HFpEF Background Heart failure with preserved ejection fraction (HFpEF) accounts for 50% of all heart failure cases yet remains poorly understood, diagnosed and managed, which can add complexity to the caregiver role. No study to date has explicitly investigated the experiences of informal caregivers of people with HFpEF. Objective The aim of this study was to explore and understand the role and experiences of informal caregivers of people with HFpEF. Methods and design A qualitative study using semi-structured interviews involving caregivers alone, patients alone or caregiver/patient dyads. The interviews were performed as part of a larger programme of research in HFpEF. Participants were recruited from three regions of England. Interviews were transcribed verbatim and analysed thematically. Results 22 interviews were conducted with a total of 38 participants, 17 of which were informal caregivers. Three inter-related themes were identified: (1) ‘spinning plates’ - the multifaceted nature of informal caregiving: household manager, health manager and motivator; (2) ‘the spinning falters’- the barriers to caregiving: lack of HFpEF awareness, information and support, the burden of multimorbidity, caregiver stress and the caregiver’s health status; (3) ‘keeping the plates spinning’- the facilitators of caregiving: being informed, being appreciated, having a champion (a health care professional that is key to managing the patient’s HFpEF), and engaging a wider support network. Conclusions Informal caregivers play an important role in supporting people with HFpEF. The experience of caregiving to people with HFpEF is similar to HFrEF, but complicated by challenges of poor HFpEF information and support, and the burden of multimorbidity. Healthcare providers should assess the needs of informal caregivers as part of patient care in HFpEF. Caregivers and patients would both benefit from improved information and management of HFpEF and associated multi-morbidities. Helping caregivers ‘keep the plates spinning’ will require innovative approaches and coordination across the care continuum.

scholarly journals Antiarrhythmic effect of 9-week hybrid cardiac telerehabilitation - subanalysis of the TELEREHabilitation in Heart Failure patients - TELEREH-HF randomized clinical trial

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
P Orzechowski ◽  
R Piotrowicz ◽  
W Zareba ◽  
MJ Pencina ◽  
I Kowalik ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Mortality ◽  
Multivariable Analysis ◽  
Cardiopulmonary Exercise Test ◽  
Antiarrhythmic Effect ◽  
Peak Oxygen Consumption ◽  
National Budget ◽  
Significant Difference ◽  
Public Grant

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The National Centre for Research and Development, Warsaw, Poland. Background. Cardiac rehabilitation is a component of heart failure (HF) management but its effect on ventricular arrhythmias is not well recognized. Purpose. We analyzed the antiarrhythmic effect of a 9-week hybrid cardiac telerehabilitation (HCTR) and its influence on long term cardiovascular mortality in HF patients taken from the TELEREH-HF trial. Methods. We evaluated the presence of non-sustained ventricular tachycardia (nsVT) and frequent premature ventricular complexes ≥10 beats/hour (PVCs ≥10) with 24-hour ECG monitoring at the baseline and after 9-week HCTR or usual care (UC) of 773 HF patients (NYHA I-III, LVEF ≤ 40%). Results. Among 143 patients with nsVT, arrhythmia subsided in 30.8% after HCTR, similarly among 165 patients randomized to UC who had nsVT 34.5% did not show them after 9 weeks (p = 0.481). There was no significant difference in the decrease in PVC ≥10 over 9 weeks between randomization arms (14.9% vs. 17.8%, respectively p = 0.410). Functional response for HCTR (Δ peak oxygen consumption [pVO2] in cardiopulmonary exercise test >2.0 ml/kg/min) did not affect occurrence of arrhythmias. The multivariable analysis of the entire population did not identify HCTR as an independent factor determining improvement in terms of nsVT or PVCs >10.  However, only in the HCTR group, the achievement of the antiarrhythmic effect significantly reduced the cardiovascular mortality in 2 years follow-up (Logrank p = 0.0009) (Figure). Conclusions. Significant improvement in physical capacity after 9 weeks of HCTR did not correlate with the antiarrhythmic effect in terms of  incidence of nsVT or PVCs ≥10. An antiarrhythmic effect after the 9-week HCTR affected long term cardiovascular mortality in HF patients. Abstract Figure

The talk test"s responsiveness to an 8-week exercise-training program in cardiovascular disease patients

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
EM Martins ◽  
LS Silveira ◽  
GS Ribeiro ◽  
AM Vieira ◽  
ABAO Roque ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Exercise Training ◽  
Training Program ◽  
Ventilatory Threshold ◽  
Rehabilitation Program ◽  
Wilcoxon Test ◽  
Heart Rate Variability Analysis ◽  
Funding Sources ◽  
Exercise Training Program ◽  
6Mwt Distance

Abstract Funding Acknowledgements Type of funding sources: None. Background Talk test (TT) is an alternative and accessible tool for prescribing and monitoring aerobic training intensity. Although the TT is reliable and valid for cardiorespiratory assessment, its responsiveness to exercise training remains unexplored. Purpose To evaluate the responsiveness of TT in cardiovascular disease (CVD) patients who underwent an exercise training program. Methods Twenty-one CVD patients (61.7 ± 8.4 years) performed an exercise-training program on phase II of cardiac rehabilitation (45-min 3-times a week). The six-minute walk test (6MWT) and TT were done to assess functional capacity at baseline and after 8 weeks. In the individualized TT the treadmill’s speed and/or grade were increased every 2-min, with speed changes based on a reference equation for the 6MWT distance (6MWD). The subjects were asked to read a 38 words standard paragraph at the last 30s of each stage and to answer if they could talk comfortably. Answer options were i) YES (TT+), ii) UNCERTAIN (TT±), or iii) NO (TT-). The first ventilatory threshold (VT1) was identified by two reviewers using the heart rate variability analysis. A paired t-test was applied to analyze the TT duration and 6MWD. The VT1 and TT workload were analyzed by the Wilcoxon test. Spearman correlation was adopted to compare the TT± and VT1 stages. Results Improvement in the VT1 (2.9 ± 1.2 vs 4.4 ± 1.4 min; p < 0.001), duration (12.1 ± 4.4 vs 14.9 ± 5.2 min; p < 0.001), workload at TT- (67.8 ± 48.4 vs 104.5 ± 65.9 w; p < 0.001), and in the 6MWD (471.5 ± 100.3 vs 533.7 ± 92.9 m; p < 0.001) were observed. There was strong correlation between TT± and VT1 in pre (r = 0.613; p < 0.05) and post-rehabilitation (r = 0.678; p < 0.05). Conclusion Talk test performed on a treadmill showed responsiveness after eight weeks of exercise training, being sensitive to the physiological changes provided by the rehabilitation program in CVD patients.

scholarly journals Anatomical localization and classification of bundle branch blocks using novel CineECG

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
MJ Boonstra ◽  
BN Hilderink ◽  
ET Locati ◽  
FW Asselbergs ◽  
P Loh ◽  
...  
Keyword(s):  
Time Interval ◽  
Heart Model ◽  
National Budget ◽  
Funding Sources ◽  
Conduction Disorders ◽  
Bundle Branch Blocks ◽  
Anatomical Localization ◽  
The Mean ◽  
Diagnostic Work ◽  
Public Grant

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This work was supported by the Dutch Heart Foundation Background Ventricular conduction disorders can induce arrhythmias and impair cardiac function. Bundle branch blocks are diagnosed by 12-lead ECG, but discrimination between complete bundle branch blocks, incomplete bundle branch blocks and normal tracings can be challenging. CineECG computes the mean temporo-spatial isochrone (mTSI) trajectory of activation waveforms in a 3D-heart model from 12-lead ECGs. This trajectory represents the mean trajectory of the ventricular electrical activation at any time interval directly related to ventricular anatomy. In Brugada patients, CineECG has localized the terminal components of ventricular depolarization to right ventricle outflow tract (RVOT). Also, for the localization of bundle branch blocks, the region of latest activation contains the most information. Using CineECG, subject specific anatomically related information about the location of bundle branch blocks is obtained. Purpose This study aimed at exploring whether CineECG can improve the discrimination between complete left/right bundle branch blocks (LBBB/RBBB), and incomplete RBBB (iRBBB). Methods We utilized 400 12-lead ECGs from the online Physionet-XL-PTB-Diagnostic ECG Database with a certified ECG diagnosis. The mTSI trajectory was calculated and projected into the anatomical 3D-heart model. Five CineECG classes were established: "Normal", "iRBBB", "RBBB", "LBBB" and "Undetermined", to which each tracing was allocated. We determined the accuracy of CineECG classification with the gold standard diagnosis. Results A total of 391 ECGs were analyzed (9 ECGs were excluded for noise) and 240/266 were correctly classified as "normal", 14/17 as "iRBBB", 55/55 as "RBBB", 51/51 as "LBBB" and 31 as "undetermined". Average mTSI trajectories were calculated according to ECG diagnosis (Figure). The terminal mTSI contained most information about the BBB localization, as that part directs to the site of latest activation (Figure, red arrow). Conclusion CineECG provided the anatomical localization of different BBBs and accurately differentiated between normal, LBBB and RBBB, and iRBBB. CineECG may aid clinical diagnostic work-up, potentially also contributing to the difficult discrimination between normal, iRBBB and Brugada patients. Abstract Figure. Average CineECG trajectories

scholarly journals Rotational activity presence and its impact in persistent atrial fibrillation follow-up

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
G R Rios-Munoz ◽  
N Soto ◽  
P Avila ◽  
T Datino ◽  
F Atienza ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Treatment Success ◽  
Persistent Atrial Fibrillation ◽  
Recurrence Rates ◽  
National Budget ◽  
Funding Sources ◽  
Cycle Lengths ◽  
Public Grant ◽  
Af Recurrence

Abstract Introduction Treatment of atrial fibrillation (AF) remains sub-optimal, with low success in pulmonary vein isolation (PVI) ablation procedures in long-standing-persistent AF patients. The maintenance mechanisms of AF are still under debate. Rotational activity (RA) events, also known as rotors, may play a role in perpetuating AF. The characterisation of these drivers during electroanatomical (EA) guided ablation procedures in relationship with follow-up and recurrence ratios in AF patients is necessary to design new ablation strategies to improve the AF treatment success. Purpose We report an AF patient cohort of endocardial mapping and PVI ablation procedures with additional RA events detected during the EA study. We aim to study the presence and distribution of RA in AF patients and its impact on AF recurrence when only PVI ablation is performed. Methods 75 persistent consecutive AF patients (age 60.7±9.8, 74.7% men) underwent EA mapping and RA detection with an automatic algorithm. The presence of RA was annotated on the EA map based on the unipolar electrograms (EGMs) registered with a 20-pole catheter. RA presence was analysed at different left atrial locations (37.2±14.8 sites per patient). AF recurrence was evaluated in follow-up after treatment. Results At follow-up (9±5 months), 50% of the patients presented AF recurrence. Patients with RA had more dilated atria in terms of volumes (p=0.002) and areas (p=0.001). Patients with RA exhibited higher mean voltage EGMs 0.6±0.3 mV vs 0.5±0.2 mV (p=0.036), with shorter cycle lengths 169.1±26.0 ms vs. 188.4±44.2 ms (p=0.044). Finally, patients with RA presented more AF recurrence rates than patients with no RA events (p=0.007). No significant differences were found in terms of comorbidities, e.g., heart failure, hypertension, COPD, stroke, SHD, or diabetes mellitus. Conclusions The results show that patients with more RA events and those with RA outside the PVI ablated regions presented higher AF recurrence episodes than those with no RA or events inside the areas affected by radio-frequency ablation. The study suggests that further ablation treatment of the areas harboring RA might be necessary to reduce the recurrence ratio in AF patients. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Instituto de Salud Carlos III; Sociedad Española de Cardiología

scholarly journals CT-based cardiovascular risk stratification benefits in asymptomatic patients

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
AN Rozhkov ◽  
DY Shchekochikhin ◽  
PYU Kopylov
Keyword(s):  
Computed Tomography ◽  
Roc Analysis ◽  
Basic Research ◽  
Cardiovascular Risks ◽  
Diagnostic Significance ◽  
National Budget ◽  
Funding Sources ◽  
Asymptomatic Patients ◽  
Outpatient Practice ◽  
Public Grant

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Russian Foundation for Basic Research Background Cardiovascular risks (CVR) stratification and assessment of atherosclerotic plaques vulnerability in asymptomatic patients are serious challenges in outpatient practice. The use of modern CT techniques can help to personalize stratification. Methods The study included ambulatory patients with suspected coronary heart disease, who underwent computed tomography coronary angiography (CTA) in 2019-2020. CVR was estimated via Score, ACC/AHA, Framingham, MESA scales, CTA was performed on 640-slice computed tomography station. The patients were divided into two groups: patent arteries and atherosclerotic lesions (30-99%). We analyzed of the estimated CVR distribution, using coronary arteries visualization as the cut-off. Then ROC analysis of the scales, and Agatson Index was performed. Results The study included 60 patients, mean age is 61,5 years (65% female). 36,7% had no atherosclerosis; 56,7% had 30-99% coronary artery stenosis.  Our results showed risks overestimation using the SCORE and Framingham scales (+33.33% and +52.38%) and underestimation using ACC/AHA and MESA (-33.33% and -9.52%) in patients without coronary atherosclerosis. The ROC analysis showed that the "standard" scales have no diagnostic significance for zero atherosclerosis (p > 0.05) or for >30% plaques (p > 0.05). Conclusion Our data shows a significant predictive superiority of CTA. Asymptomatic patients with zero or low coronary calcium with low estimated CVR may have a REAL high risk based on morphological plaque criteria.

scholarly journals Cardiovascular benefit of lowering LDL-C below 1 mmol/L (40 mg/dl)

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
N A Marston ◽  
R P Giugliano ◽  
J G Park ◽  
A Ruzza ◽  
P S Sever ◽  
...  
Keyword(s):  
Statin Therapy ◽  
Clinical Benefit ◽  
Recurrent Events ◽  
Pcsk9 Inhibitors ◽  
National Budget ◽  
Funding Sources ◽  
Lower Baseline ◽  
The Difference ◽  
Public Grant

Abstract Background The 2019 ESC/EAS Dyslipidemia Guidelines recommend an LDL-C goal of <1.4 mmol/L (∼55 mg/dl) for patients with very high-risk ASCVD, and <1 mmol/L (∼40 mg/dl) for those with recurrent events within 2 years despite taking maximally tolerated statin therapy. The addition of PCSK9 inhibitors to statin therapy can achieve LDL-C levels well below 1 mmol/L in many patients, yet the clinical benefit of LDL-C lowering beyond this level has recently been questioned. Methods FOURIER was a cardiovascular outcomes trial comparing evolocumab vs. placebo in patients with stable ASCVD on optimized statin therapy with a median follow-up of 2.2 years. We performed an exploratory analysis to determine the consistency of CV risk reduction with LDL-C lowering below ∼1 mmol/L (40 mg/dl) with evolocumab. We modeled the achieved LDL-C at 48 weeks in the two treatment arms as well as the percentage of LDL-C difference between the two arms that was due to LDL-C below ∼1 mmol/L (40 mg/dl) as a function of baseline LDL-C. We then modeled the hazard ratio (HR) for the composite of CV death, MI or stroke (per 1 mmol/L reduction in LDL-C) with evolocumab vs. placebo as a function of baseline LDL-C. Results All 27,564 patients from FOURIER were included in this analysis. Patients with lower baseline LDL-C achieved lower LDL-C levels following evolocumab therapy, with achieved LDL-C typically being below 1 mmol/L (40 mg/dl) once the baseline LDL-C was below 2.4 mmol/L (94 mg/dl) and reaching levels approaching 0.5 mmol/L (∼20 mg/dl). Accordingly, the further baseline LDL-C levels were below 2.4 mmol/L (94 mg/dl), the greater the proportion of the difference in achieved LDL-C between the evolocumab and placebo arms was due to LDL-C levels below ∼1 mmol/L (40 mg/dl), reaching nearly 40% of the difference in LDL-C between treatment arms (Upper Panel). Despite this, the clinical benefit of LDL-C lowering was not attenuated (p=0.78) (and even appeared greater), with robust reductions in risk of CV death, MI or stroke even when LDL-C was lowered to nearly 0.5 mmol/L (∼20 mg/dl) and having close to 40% of the LDL-C difference between treatment arms due to LDL-C lowering below ∼1 mmol/L (40 mg/dl) (Lower Panel). Conclusion PCSK9 inhibitors added to statin therapy can achieve LDL-C well below 1 mmol/L (40 mg/dl). There is no evidence for attenuation of the clinical benefit of lowering LDL-C below this threshold. These data support lowering LDL-C to below 1 mmol/L (40 mg/dl) in patients with ASCVD. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute of Health

scholarly journals Sex differences in cardiovascular research

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
D N Millenaar ◽  
M Dillmann ◽  
T Fehlmann ◽  
A Flohr ◽  
R Mehran ◽  
...  
Keyword(s):  
Senior Author ◽  
Cardiovascular Research ◽  
National Budget ◽  
Female Authors ◽  
Funding Sources ◽  
Research Activities ◽  
Average Impact ◽  
Female Authorship ◽  
Public Grant ◽  
Number Of Citations

Abstract Background Women are underrepresented in cardiovascular publications. We sought to investigate sex-specific differences in cardiovascular research over the last decade. Methods and results All 387,463 cardiovascular publications between 2010–2019 were retrieved from Web-of-Science and analyzed regarding the authors' sex, the average impact factor (IF), the number of citations, co-authors per article, and international collaborations. The number of cardiovascular research articles increased between 2010–2019 from 19,960 to 29,604 articles per year. The number of articles written by female first authors increased by 48.3% (6434 articles in 2010 and 11,343 articles in 2019) and by 35.0% for male first authors (13,526 articles in 2010 and 18,261 articles in 2019). The last/senior author was more likely to be female in articles with female first authors compared with male first authors (28.2% vs. 14.1%; odds ratio 2.48, 95% confidence interval 2.43–2.53, p<0.001). The average IF for articles by female first authors was lower compared to male (3.1±3.8 vs. 3.5±4.9, p<0.001). Likewise, the H-Index was lower for female than male first authors (1.07±0.74 vs. 1.25±0.98, p<0.001), as was the number of citations per articles (14.0±31.1 vs. 18.0±68.8 citations, p<0.001). Female first authors had fewer co-authors per article than their male peers (7.4±19.6 vs. 8.2±35.2; p<0.001) and were less represented in articles with >15 co-authors (3,623 articles by female and 8,941 by male first authors; ratio female to male 0.41). Scientific advancement as the ratio between female to male first authorships was highest in publications from Latin America (ratio 0.92) and lowest in Asia (ratio 0.40). Female authorship articles reached the highest IF in North America (average IF 3.7), the lowest Africa (average IF 1.8). Conclusions Publications in cardiovascular research have increased over the last decade, particularly by female authors. Female researchers are cited less often compared with their male peers and publish with fewer co-authors. The IF remains lower for articles by female researchers. Efforts to further increase women-led research activities are needed FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): German Cardiac SocietyGerman Research Foundation (DFG)

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 ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Cardiac Rehabilitation ◽  
Cardiopulmonary Exercise Testing ◽  
Rehabilitation Program ◽  
Cardiac Rehabilitation Program ◽  
St Segment Elevation ◽  
Funding Sources ◽  
Metabolic Equivalent Of Task ◽  
The Impact

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.

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