scholarly journals Impact of exercise based cardiac rehabilitation program in patients with transcatheter aortic valve replacement

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
LE Estrada Martinez ◽  
JA Lara Vargas ◽  
JA Pineda Juarez ◽  
JD Morales Portano ◽  
JB Gomez Alvarez ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiac Rehabilitation ◽  
Intervention Group ◽  
Rehabilitation Program ◽  
Control Group ◽  
Cardiac Rehabilitation Program ◽  
Double Product ◽  
Oxygen Pulse ◽  
Transcatheter Aortic Valve ◽  
Cardiopulmonary Performance

Abstract Funding Acknowledgements Type of funding sources: None. Introduction  Due to the increase in global prevalence of degenerative valve disease, aortic stenosis (AS) has played a preponderant role in the cardiovascular scenario, especially in patients undergoing transcatheter aortic valve replacement (TAVR). An alternative management for this patients are the cardiac rehabilitation programs (CRP); however, their effect has not been completely understood, both in exercise capacity and quality of life, but neither in the improvement of cardiopulmonary performance and other cardiovascular outcomes.  Purpose: To evaluate the effect of the CRP on exercise tolerance and cardiopulmonary performance in patients with AS undergoing TAVR.  Methods: A cohort study was conducted including 26 patients with AS undergoing TAVR and divided into an intervention group who performed a 4-week supervised training program in the Cardiac Rehabilitation Service and a control group to whom instructions and recommendations to performed unsupervised exercise at home were given. Demographic and clinical data (VO2Max, METS12, oxygen pulse, heart rate, double product, left ventricular ejection fraction, body mass index) were collected at baseline and after a 4-week follow-up. Results: 15 patients were included in the intervention group and 11 patients in the control group. There were no baseline significant differences between groups. After the intervention, significant differences were observed in the METS 12 final gain variable between the control and intervention group (4.55 vs 3.1 p = 0.01). Intergroup analysis showed significant differences (percentage changes) in the intervention group with an increase of METS12 (67.4%, p = 0.001), oxygen pulse (18.21%, p = 0.01), final METS (39.47% p = 0.001) and a decrease in VO2 recovery time (-12.5%, p = 0.05), in the ergometric performance index by heart rate (-38.17%, p = 0.001) and by double product (-38.1%, p = 0.001). Conclusions  A 4-week cardiac rehabilitation program is effective to improve exercise tolerance and cardiopulmonary response in patients with AS undergoing TAVR; improvement was statistically significant in METS12, oxygen pulse, VO2 recovery time, METS-load and ergometric performance index for heart rate and double product. METS12 final gain was statistically significant in intervention group in comparison with the control group. Abstract Figure. Control vs Intervention Group (METS12)

A novel model of home-based, patient-tailored and mobile application-guided cardiac telerehabilitation in patients with atrial fibrillation: A randomised controlled trial

2021 ◽  
pp. 026921552110323
Author(s):  
Cheng Cai ◽  
Zhipeng Bao ◽  
Nan Wu ◽  
Fengming Wu ◽  
Guozhen Sun ◽  
...  
Keyword(s):  
Physical Activity ◽  
Atrial Fibrillation ◽  
Cardiac Rehabilitation ◽  
Mobile Application ◽  
Controlled Trial ◽  
Intervention Group ◽  
Rehabilitation Program ◽  
Control Group ◽  
Cardiac Rehabilitation Program ◽  
Randomised Controlled

Objective: To assess the effectiveness of tele-monitored cardiac rehabilitation in patients who have undergone ablation for atrial fibrillation. Design: Single-centre, prospective, assessment-blinded, randomised controlled trial. Setting: Domiciliary rehabilitation with support from a tertiary care hospital. Subjects: One hundred patients who underwent ablation for atrial fibrillation were recruited. Interventions: Participants were randomly allocated to a 12-week standard rehabilitation treatment (control group) or a comprehensive, domiciliary, mobile application-guided and tele-monitored cardiac rehabilitation program (intervention group) in a 1:1 fashion. Main outcome measures: The primary endpoint was the improvement in VO2peak. The secondary outcomes included adherence, physical activity, beliefs related to cardiovascular disease and exercise self-efficacy. Results: Ninety-seven patients completed follow-up. The mean VO2peak increased significantly in both the intervention group ( n = 49) (baseline vs 12 weeks: 19.1 ± 4.7 vs 27.3 ± 5.6 ml/(min kg), P < 0.01) and the control group ( n = 48) (baseline vs 12 weeks: 18.7 ± 4.9 vs 22.9 ± 6.3 ml/(min kg), P < 0.01). The results of the between-group analysis of aerobic capacity were significantly in favour of the intervention group. During the 12-week program, patients in the intervention group exhibited better adherence than those in the control group. Moreover, self-reported physical activity improved more in the intervention group than in the control group, as did the beliefs related to cardiovascular disease and exercise self-efficacy (all P < 0.01). Conclusions: Our domiciliary, mobile application-guided and tele-monitored cardiac rehabilitation program could lead to a more significant improvements in physical fitness, adherence and health beliefs than standard cardiac rehabilitation in patients who have undergone ablation for atrial fibrillation.

Effects of a Brief Motivational Interviewing Intervention on Adherence of Patients Undergoing Therapy in a Phase II Cardiac Rehabilitation Program

2016 ◽  
Vol 2 (11) ◽  
Author(s):  
Rachel Sieke ◽  
Angele McGrady ◽  
Dalynn Badenhop
Keyword(s):  
Cardiac Rehabilitation ◽  
Motivational Interviewing ◽  
Intervention Group ◽  
Rehabilitation Program ◽  
Program Completion ◽  
Cardiac Rehabilitation Program ◽  
Psychological Benefits ◽  
Relaxation Intervention ◽  
Potential Benefits ◽  
And Control

<p>Patients who complete a structured cardiac rehabilitation program improve physical capacity and reduce distress. However, adherence to program completion ranges widely, and non -completion of cardiac rehabilitation jeopardizes the potential benefits. This study tests the effects of a brief motivational interviewing and relaxation intervention on completion of cardiac rehabilitation in patients referred to the program after a major cardiac event. One hundred four patients were recruited into this study and randomized to the control or a four session intervention group. Patients who completed the intervention were more likely to complete cardiac rehabilitation; specifically the number of sessions completed was significantly greater (p &lt; 0.042) compared to controls. In addition to the intervention, baseline depression and anxiety are important predictors of dropout from rehabilitation. When entering the program, later completers had significantly lower depression (p &lt; 0.009) and anxiety (p &lt; 0.036) scores on standardized psychological inventories in contrast to those patients who later dropped out of rehabilitation. There were no differences in entry diagnosis or number of feet walked between later completers and non-completers. Patients in both the intervention and control groups who completed rehabilitation sustained important physical and psychological benefits. They were able to walk a greater distance and reduced scores on the anxiety and depression inventories.</p>

scholarly journals Cardiorehabilitation of Patients with Acute Coronary Syndrome Who Were Performed Coronary Arteries Revascularization

2017 ◽  
Vol 24 (4) ◽  
Author(s):  
Mykola Shved ◽  
Lesja Tsuglevych ◽  
Iryna Kyrychok ◽  
Tetiana Boiko ◽  
Larysa Levutska
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Rehabilitation Program ◽  
Left Ventricular ◽  
Cardiac Rehabilitation Program ◽  
Coronary Artery Revascularization ◽  
Coronary Syndrome

In patients with acute coronary syndrome who were performed coronary arteries’ revascularization, in the postoperative period disorders of hemodynamics and heart rate variability often develop. The aim of our work was to optimize the cardiac rehabilitation of such patients by individualization of physical activity depending on the state of systolic and diastolic left ventricular dysfunction and heart rate variability.                 40 patients with acute coronary syndrome and coronary artery revascularization were included into the experimental group. The control group consisted of 20 patients of the same age, clinical and laboratory manifestations of ACS who were treated according to the protocol of Ministry of Health of Ukraine. In both groups of patients clinical efficacy of cardiac rehabilitation process was evaluated according to the dynamics of clinical symptoms, systolic and diastolic left ventricular function and heart rate variability.                 In patients with acute coronary syndrome and coronary artery revascularization in the initial state the clinical and laboratory signs of myocardial ischemia disappear, but subclinical and clinical manifestations of heart failure remain.                 During the first month of training, the original accelerated cardiac rehabilitation program leads to the decrease of systolic and diastolic signs of cardiac dysfunction and improves heart rate variability, which significantly improves the quality of life of these patients.                 For monitoring the efficacy and safety of the performance of cardiac rehabilitation program in patients with acute coronary syndrome and coronary artery revascularization, in addition to conventional methods (determination of heart rate, blood pressure, 6-minute test), it is useful to diagnose subclinical stage of heart failure by examination of systolic, diastolic function and vegetative regulation.

scholarly journals The impact of mitral regurgitation grade on exercise capacity following cardiac rehabilitation program after transcatheter aortic valve implantation

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
M Ribeiro Da Silva ◽  
E Vilela ◽  
A Mosalina Manuel ◽  
A Barbosa ◽  
J Almeida ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Cardiac Rehabilitation ◽  
Rehabilitation Program ◽  
Cardiac Rehabilitation Program ◽  
Transcatheter Aortic Valve ◽  
Grade Ii ◽  
Aortic Valve Implantation ◽  
Valve Implantation ◽  
The Impact

Abstract Introduction Severe aortic stenosis (AS) and mitral regurgitation (MR) often coexist. Transcatheter aortic valve implantation (TAVI) is becoming widely used for the treatment of patients (pts) with symptomatic severe AS. However, conflicting data reside concerning the impact of MR on outcomes after TAVI. Also, very few data exist regarding the benefits of a cardiac rehabilitation program (CRP) following TAVI in pts with MR. Purpose To evaluate the effect of a CRP in functional parameters after TAVI, particularly in pts with MR grade ≥ II. Methods Retrospective study which included all pts submitted to TAVI between 2014 and 2020 that completed a CRP following the procedure. Cardiopulmonary exercise tests (CPET) were performed after TAVI at baseline (pre-CRP) and post-CRP. We evaluated pre- and post-CRP peak oxygen consumption (pVO2), pVO2 at the anaerobic threshold (AT), respiratory exchange ratio (RER), VE/VCO2 and CPET duration. The exercise protocol included low/medium intensity exercises and consisted of sessions 3 times per week carried over 3 months. MR grading severity was assessed with transthoracic echocardiography performed after TAVI and was divided into 2 groups (grade &lt; II vs grade ≥ II). Results Fifty-two pts were included, 59,6% were male, mean age of 78,6±8,6 years-old. Mean Society of Thoracic Surgery (STS) risk score was 4,9. Mean pre-TAVI aortic valve area was 0,68 cm2, with a mean gradient of 45,5 mmHg and a mean ejection fraction (EF) of 51%. The majority of pts implanted a self-expandable prosthesis (55,8%). Twenty-seven (51,9%) pts had MR grade ≥ II. Baseline characteristics were similar between pts with MR grade &lt; II vs MR grade ≥ II, with the exception of the prevalence of coronary artery disease which was higher in MR grade ≥ II (p=0,036). Patients with MR grade &lt; II had higher maximum and median aortic gradients before TAVI (p&lt;0,05 for all). The mean number of cardiac rehabilitation sessions was 21±7, without differences between both groups. In pts with MR grade ≥ II, there was an improvement in CPET duration after CRP (HF protocol from 03:57 min to 05:02 min; p=0,017 and modified Bruce protocol from 06:03 min to 06:41 min; p=0,049) but without significant changes in pVO2 (14,7 mL/kg/min to 14,9 mL/kg/min; p=0,990), RER or VEVCO2/VO2 ratio. Patients with MR grade &lt; II significantly improved pVO2 (13,8 mL/kg/min to 14,7 mL/kg/min; p=0,015), and CPET duration with HF protocol from 05:04 min to 06:23 min; p=0,006 after CRP. There was also an improvement in VEVCO2/VO2 ratio, although not statically significant. Conclusions Patients with MR grade &lt; II after TAVI who underwent a CRP significantly improved pVO2 and CPET duration. Although pts with MR grade ≥ II did not improved pVO2 after a CRP, an improvement in CPET duration may translate into a clinical benefit in these pts. These results highlight the importance of further research and personalization among this potentially higher risk subset of pts. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Effect of Sleep Intervention Programs on the Quality of Sleep of Patients in Cardiac Rehabilitation Center

2021 ◽  
Author(s):  
Fatemeh Ghaneh ◽  
Mahdieh Ghanbari Firozabadi ◽  
Farzan Madadizadeh ◽  
KHadijeh Nasiriani
Keyword(s):  
Sleep Quality ◽  
Cardiac Rehabilitation ◽  
Rehabilitation Program ◽  
Intervention Programs ◽  
Control Group ◽  
Cardiac Rehabilitation Program ◽  
Quality Of Sleep ◽  
Significant Difference ◽  
Experimental Group

Abstract Background Patients with cardiovascular problems experience sleep disorders. Due to the importance of adequate sleep and rest for the growth and repair of damaged cells, it is necessary to use appropriate interventions to improve it.This study determined the effect of sleep intervention programs during cardiac rehabilitation on patients' sleep quality.Methods In this clinical trial study, 35 individuals participated in the cardiac rehabilitation program as the experimental group and 35 served as the control group. The program included 12 weeks of exercise, 3 sessions per week, and 3 sessions of training programs each lasting for 45 minutes, and a special two-session sleep improvement program. Data were collected using the Pittsburgh sleep quality index and analysed with descriptive and inferential statistical methods.ResultsThe two study groups were matched with age, sex, marital status, smoking and current disease diagnosis (P>0.05). The scores of sleep quality of patients were 9.2±1.58 before and 4.40±1.14 after intervention in the experimental group and 9.02±2.56 before and 7.48 ±1.86 after placebo in the control group. There was no significant difference before (P=0.73), but a significant difference after an intervention (P=0.0001). Also, scores of sleep quality of patients were significantly different in the experimental and control groups before and after the intervention (P=0.0001). Conclusion Findings indicated that the quality of sleep of cardiac patients improved after using the sleep intervention program during the cardiac rehabilitation program. Therefore, it is suggested to implement sleep improvement programs as an effective, easy, and feasible technique.

Severity of depression and its relationship with the parameters obtained in the cardiopulmonary exercise test in patients of a cardiac rehabilitation program

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.A Ruiz Avalos ◽  
C.M Ortiz Calderon ◽  
J Rojano Castillo ◽  
H Ilarraza Lomeli
Keyword(s):  
Heart Rate ◽  
Angiotensin Ii ◽  
Cardiac Rehabilitation ◽  
Exercise Tolerance ◽  
Rehabilitation Program ◽  
Cardiac Rehabilitation Program ◽  
Angiotensin Ii Receptor ◽  
Angiotensin Ii Receptor Antagonists ◽  
Receptor Antagonists ◽  
Cardiopulmonary Exercise

Abstract Background Cardiovascular diseases are the leading cause of global morbidity and mortality. Depression causes specific disorders such as autonomic nervous system dysfunction, neurohormonal axis imbalance, proinflammatory and prothrombotic states. The alteration profiles in the parameters measured in the cardiopulmonary exercise testing (CPET) associated with the different severities of depression have not yet been characterized. Purpose To determine the association of the degree of depression and the parameters obtained in the CPET in patients undergoing a cardiac rehabilitation program. Methods Observational, comparative, cross-sectional, retrospective study of adult patients examined in the period from January 1, 2010 to December 31, 2017. Independent variables were degrees of depression according to Beck depression inventory, dependent variables were parameters reported in the CPET. Categorical variables were reported in frequency and continuous variables as averages. The comparison between groups was made with x2, T test, ANOVA according to type and number of variables and their distribution. Pearson's correlation to determine association. Results From a total of 594 patients: 490 were men (82.4%), age 57.34±11.3. Maximum METs 7.49±2.42, heart rate (HR) response (percentage of theoretical maximum heart rate achieved) 82.79±12.69 and systolic blood pressure response (SBP) (ratio of peak SBP to resting SBP) 1.29±0.18. Bivariate analysis found significant differences between Beck's depression scale and study variables: Male (p&lt;0.0001), married (p=0.022), diabetes (p=0.012), surgical revascularization (p=0.05), use of angiotensin II receptor antagonists (p=0.027). Conclusions The present study found association of depressive symptoms with male gender, married marital status, diabetes, surgical myocardial revascularization and treatment with angiotensin II receptor antagonists. In the CPET, significant differences were found in exercise tolerance measured by METs, HR response and SBP response between subjects without depression and those with mild and moderate depression. Depression and Exercise Tolerance Funding Acknowledgement Type of funding source: None

scholarly journals The Effect of Cardiac Rehabilitation Program on Depression in Patients After Acute Coronary Events

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
S A Alsioufy ◽  
E Elfiky ◽  
A M Shabana ◽  
R Raymond
Keyword(s):  
Secondary Prevention ◽  
Cardiac Rehabilitation ◽  
Rehabilitation Program ◽  
Psychological Status ◽  
Control Group ◽  
Depression Symptoms ◽  
Study Group ◽  
Cardiac Rehabilitation Program ◽  
Male Patients ◽  
Coronary Events

Abstract Background Cardiac Rehabilitation (CR) is a multidisciplinary approach for secondary prevention of coronary heart diseases as well as its comorbid psychological disorders such as depression. Its importance is not well established like other secondary prevention measures although it is one of the most cost-effective methods. Objectives The aim of this study is to examine the effect of the cardiac rehabilitation on depression symptoms in patients after acute coronary events and potential improvement in patient prognosis and reduction of overall morbidity and mortality. Methods This analysis is a double armed intervention study that was conducted in the period between March 2018 and August 2018 on 60 patients who were referred to the CR clinic after surviving acute coronary events. Patient selection was done so that a study group of 30 patients who completed the CR program and a control group of 30 patients who dropped out early from the CR program were included. It included mainly Egyptian patients who were referred the Ain Shams University Hospital CR clinic. The patients were studied as regard their full history and examination, and their psychological status was assessed using the Patient Health Questionnaire 9 (PHQ-9) before and after the rehabilitation program. Verbal consent was taken from each patient, confidentiality was ensured, patients were informed about findings in their results and they had the right to refuse inclusion Results The study included a majority of male patients: 51 male patients (85%) and 9 female patients (16.5%). The mean age was 52 years. 15% of the patients were diabetic and 40% hypertensive, 46.7% were smokers and 48.3% were dyslipidemic. There was no statistically significant correlation between age, gender and risk factors and whether or not the patients completed the cardiac rehabilitation program or dropped out. Most patients were presenting after anterior STEMI (63.3%) followed by inferior STEMI (21.7%) with a minority of NSTE-ACS patients (15%). There was a statistically significant effect of the CR on the CCS class but not on the NYHA class. The median PHQ-9 score before joining the program in the control group of 15.5, while that of the study group ranged from 8 to 20 with a median of 13, which was a significantly different score (P 0.03). Right after finishing the program the study groups PHQ-9 score median was 6.5. Three months after the beginning of the CR program the median PHQ-9 score was 23.5 and 0 for the control group. The change of the PHQ-9 over the course of 3 month from the beginning of the CR program was significantly improved for the study group with (P 0.00) and the median PHQ-9 score decreased from 13 to 0, while the control groups PHQ-9 score significantly deteriorated with a median score changing from 15.5 to 23.5. Conclusion CR is a highly effective method in reduction of the comorbid depression in coronary disease patient and should be recommended as a routine management after acute coronary events.

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