Cardiac Rehabilitation for the Elderly: Qi Gong and Group Discussions

2005 ◽  
Vol 12 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Therese Stenlund ◽  
Britta Lindström ◽  
Marie Granlund ◽  
Gunilla Burell
Keyword(s):  
Physical Activity ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Elderly Patients ◽  
Intervention Group ◽  
Control Group ◽  
Group Discussions ◽  
Physical Ability ◽  
Qi Gong ◽  
Artery Disease

Background Over the last decade several studies have shown that patients with coronary artery disease even above the age of 70 can be successfully treated with advanced medical and surgical methods. Unfortunately, rehabilitation programmes for this group are rarely offered. It is important to develop forms of rehabilitation that are adapted to the specific needs of this increasing group of elderly patients. The aim of this randomized study was to investigate whether the combination of Qi Gong and group discussions would increase physical ability for elderly patients ≥ 73 years with coronary artery disease. Methods A total of 95 patients (66 men and 29 women), with documented coronary artery disease, were randomized to an intervention group (n = 48) mean age 77 ± 3 (73-82) or to a control group (n = 47) mean age 78 ± 3 (73-84). The intervention groups met weekly over 3 months. The control group got usual care. Physical ability was assessed at baseline and after the intervention. Results Patients in the intervention group increased their self-estimated level of physical activity (P = 0.011), and their performance in the one-leg stance test for the right leg (P = 0.029), co-ordination (P = 0.021) and the box-climbing test for right leg (P = 0.035). Conclusion A combination of Qi Gong and group discussions appear to be a promising rehabilitation for elderly cardiac patients in terms of improving self-reported physical activity, balance and co-ordination. This could be an option for elderly patients who do not participate in the ordinary cardiac rehabilitation. Eur J Cardiovasc Prev Rehabil 12:5-11 © 2005 The European Society of Cardiology

scholarly journals The Effect of Intensive Dietary Intervention on the Level of RANTES and CXCL4 Chemokines in Patients with Non-Obstructive Coronary Artery Disease: A Randomised Study

Biology ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 156
Author(s):  
Magdalena Makarewicz-Wujec ◽  
Jan Henzel ◽  
Mariusz Kruk ◽  
Cezary Kępka ◽  
Łukasz Wardziak ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Dietary Intervention ◽  
Obstructive Coronary Artery Disease ◽  
Intervention Group ◽  
Control Group ◽  
Pathophysiological Mechanism ◽  
Study Objective ◽  
Dash Diet ◽  
Artery Disease

Background: Inflammation is the key pathophysiological mechanism of the initiation and progression of atherosclerosis. The study objective was to assess the effects of a dietary intervention based on the model of the dietary approaches to stop hypertension (DASH) diet on the levels of chemokines RANTES and CXCL4 in patients with non-obstructive coronary artery disease. Methods: As part of Dietary Intervention to Stop Coronary Atherosclerosis in Computed Tomography (DISCO-CT) study, patients were randomised to an intervention group (n = 40), where the DASH diet was introduced along with optimal pharmacotherapy, and to a control group (n = 39), with optimal pharmacotherapy alone. In the DASH group, systematic dietary counselling was provided for the follow-up period. RANTES and CXCL4 levels were determined using ELISA. Results: In the DASH group, the RANTES level insignificantly reduced from 42.70 ± 21.1 ng/mL to 38.09 ± 18.5 ng/mL (p = 0.134), and the CXCL4 concentration significantly reduced from 12.38 ± 4.1 ng/mL to 8.36 ± 2.3 ng/mL (p = 0.0001). At the same time, an increase in the level of both chemokines was observed in the control group: RANTES from 34.69 ± 22.7 to 40.94 ± 20.0 ng/mL (p = 0.06) and CXCL4 from 10.98 ± 3.6 to 13.0 5± 4.8 ng/mL (p = 0.009). The difference between the changes in both groups was significant for both RANTES (p = 0.03) and CXCL4 (p = 0.00001). The RANTES/CXCL4 ratio reduced in the control group (from 3.52 ± 2.8 to 3.35 ± 2.8; p = 0.006), while in the DASH group, an increase was observed (from 3.54 ± 1.7 to 4.77 ± 2.4; p = 0.001). Conclusions: A 12-month-long intensive dietary intervention based on DASH diet guidelines as an addition to optimal pharmacotherapy causes changes in the levels of chemokines CXCL4 and RANTES and their mutual relationship in comparison to conventional treatment.

TUMOR NECROSIS FACTOR ALFA IN VERY ELDERLY PATIENTS WITH CORONARY ARTERY DISEASE

2021 ◽  
pp. 64-70
Author(s):  
С.В. Тополянская ◽  
Т.А. Елисеева ◽  
О.Н. Вакуленко ◽  
Л.И. Дворецкий
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Elderly Patients ◽  
Type I Collagen ◽  
Cholesterol Concentration ◽  
Control Group ◽  
Type I ◽  
Very Elderly ◽  
Tnf Α ◽  
Artery Disease

Представлены результаты исследования концентрации TNF-α, а также взаимосвязи этого цитокина с рядом патологических состояний у больных старческого возраста c ИБС по сравнению с контрольной группой больных без ИБС. Средняя концентрация TNF-α достигала 9,2±4,7 пг/мл (3,9-31,9 пг/мл) при нормальных значениях TNF-α <8,1 пг/мл. Повышение уровня TNF-α обнаружено у 54,6 % больных. У больных ИБС средняя концентрация TNF-α достигала 10±4,9 пг/мл, тогда как в группе пациентов без ИБС - 6,1±1,8 пг/мл (р=0,000001). Содержание TNF-α было выше у пациентов с ХСН (р=0,002) и гиперурикемией (р=0,000006). Была выявлена достоверная позитивная корреляция уровня TNF-α и мочевой кислоты (р<0,000001), мочевины (р=0,00004), креатинина (р=0,002) и β-Cross Laps (продуктов деградации коллагена), р=0,0001, в сыворотке крови. Обнаружена отрицательная корреляция TNF-α и холестерина ЛПВП (р=0,00005), а также лептина (р=0,01). Отмечено снижение концентрации TNF-α с возрастом (р=0,006). The results of a study of the concentration of TNF-α as well as the relationship of this cytokine with a number of pathological conditions in very elderly patients with coronary artery disease compared with the control group of patients without CAD are presented in the article. The average group concentration of TNF-α reached 9,2±4,7 pg/ml (from 3,9 to 31,9 pg/ml) with normal TNF-α values of less than 8,1 pg/ml. An increase in the level of TNF-α was detected in 54,6 % of patients. In patients with coronary artery disease the average concentration of TNF-α reached 10±4,9 pg/ml, while in the group of patients without CAD - 6,1±1,8 pg/ ml (р=0,000001). TNF-α content was higher in patients with chronic heart failure (р=0,002) and with hyperuricemia (р=0,000006). The correlation analysis revealed a significant positive correlation between the level of TNF-α and uric acid (р<0,000001), between the concentration of TNF-α and the content of β-Cross Laps (degradation products of type I collagen) (р=0,0001), as well as serum creatinine (р=0,002) and urea (p=0,00004) levels. In addition, a negative correlation was found between the values of TNF-α and high-density lipoprotein cholesterol concentration (р=0,00005), as well as leptin level (h=0,01). A decrease in the concentration of TNF-а was observed with increasing age of the patients (р=0,006).

scholarly journals The Effect of a WeChat-Based Tertiary A-Level Hospital Intervention on Medication Adherence and Risk Factor Control in Patients With Stable Coronary Artery Disease: Multicenter Prospective Study (Preprint)

2021 ◽  
Author(s):  
Boqun Shi ◽  
Xi Liu ◽  
Qiuting Dong ◽  
Yuxiu Yang ◽  
Zhongxing Cai ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Medication Adherence ◽  
Stable Coronary Artery Disease ◽  
Intervention Group ◽  
Control Group ◽  
Artery Disease ◽  
Multicenter Prospective Study ◽  
Level Hospital

BACKGROUND In China, ischemic heart disease is the main cause of mortality. Having cardiac rehabilitation and a secondary prevention program in place is a class IA recommendation for individuals with coronary artery disease. WeChat-based interventions seem to be feasible and efficient for the follow-up and management of chronic diseases. OBJECTIVE This study aims to evaluate the effectiveness of a tertiary A-level hospital, WeChat-based telemedicine intervention in comparison with conventional community hospital follow-up on medication adherence and risk factor control in individuals with stable coronary artery disease. METHODS In this multicenter prospective study, 1424 patients with stable coronary artery disease in Beijing, China, were consecutively enrolled between September 2018 and September 2019 from the Fuwai Hospital and 4 community hospitals. At 1-, 3-, 6-, and 12-month follow-up, participants received healthy lifestyle recommendations and medication advice. Subsequently, the control group attended an offline outpatient clinic at 4 separate community hospitals. The intervention group had follow-up visits through WeChat-based telemedicine management. The main end point was medication adherence, which was defined as participant compliance in taking all 4 cardioprotective medications that would improve the patient’s outcome (therapies included antiplatelet therapy, β-blockers, statins, and angiotensin-converting-enzyme inhibitors or angiotensin-receptor blockers). Multivariable generalized estimating equations were used to compare the primary and secondary outcomes between the 2 groups and to calculate the relative risk (RR) at 12 months. Propensity score matching and inverse probability of treatment weighting were performed as sensitivity analyses, and propensity scores were calculated using a multivariable logistic regression model. RESULTS At 1 year, 88% (565/642) of patients in the intervention group and 91.8% (518/564) of patients in the control group had successful follow-up data. We matched 257 pairs of patients between the intervention and control groups. There was no obvious advantage in medication adherence with the 4 cardioprotective drugs in the intervention group (172/565, 30.4%, vs 142/518, 27.4%; RR 0.99, 95% CI 0.97-1.02; <i>P</i>=.65). The intervention measures improved smoking cessation (44/565, 7.8%, vs 118/518, 22.8%; RR 0.48, 95% CI 0.44-0.53; <i>P</i>&lt;.001) and alcohol restriction (33/565, 5.8%, vs 91/518, 17.6%; RR 0.47, 95% CI 0.42-0.54; <i>P</i>&lt;.001). CONCLUSIONS The tertiary A-level hospital, WeChat-based intervention did not improve adherence to the 4 cardioprotective medications compared with the traditional method. Tertiary A-level hospital, WeChat-based interventions have a positive effect on improving lifestyle, such as quitting drinking and smoking, in patients with stable coronary artery disease and can be tried as a supplement to community hospital follow-up. CLINICALTRIAL ClinicalTrials.gov NCT04795505; https://clinicaltrials.gov/ct2/show/NCT04795505

scholarly journals Benson’s Relaxation for Fatigue Patient with Coronary Artery Disease

2020 ◽  
Vol 2 (1) ◽  
pp. 63-69
Author(s):  
Mulyanti Roberto Muliantino ◽  
Tuti Herawati ◽  
Masfuri
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Cardiac Rehabilitation ◽  
Recovery Period ◽  
Intervention Group ◽  
Relaxation Technique ◽  
Pharmacological Intervention ◽  
Control Group ◽  
Artery Disease ◽  
And Control

Fatigue is the major symptoms in patients with coronary artery disease, during recovery period after cardiac events and during cardiac rehabilitation. Benson’s relaxation is one of relaxation as modalities therapy to reduce fatigue, however few studies related to this technique in planned intervention. This study was to measure the effectiveness of Benson’s relaxation in fatigue of coronary artery disease patients during cardiac rehabilitation. It was a quasi-experimental pretest posttest control group design. This study included 29 respondents in Dr.M. Djamil Hospital were assigned to intervention group which receiving Benson’s relaxation technique (n=15) and control group with routine care (n=14). Benson’s relaxation technique was administered for 5 days 2 times a day, each 20 minutes to intervention group. Fatigue was measured using Maastricht Questionnaire (MQ). The result indicated significant reduction in mean of fatigue between intervention and control group (p value < 0,001). The study concluded that Benson’s relaxation technique is an effective non-pharmacological intervention to reduce fatigue in coronary artery disease patients. Keywords: Benson’s relaxation; fatigue; coronary artery disease

Surgical Strategy for Moderate Ischemic Mitral Valve Regurgitation: Repair or Ignore?

2014 ◽  
Vol 17 (4) ◽  
pp. 201 ◽  
Author(s):  
Adem İ Diken ◽  
Garip Altıntaş ◽  
Adnan Yalçınkaya ◽  
Gökhan Lafçı ◽  
Onur Hanedan ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Intervention Group ◽  
Control Group ◽  
Artery Pressure ◽  
Artery Disease

<p><strong>Background:</strong> Ischemic heart disease is a significant complication of atherosclerosis. Myocardial infarction after the development of coronary artery disease can lead to a number of serious complications, including ischemic mitral regurgitation (IMR). Currently there is no consensus regarding the preferred therapeutic modality for moderately severe IMR. In this study, the postoperative outcome of concomitant coronary artery bypass (CABG) and mitral valve repair was compared with that of CABG alone in two groups of patients with moderately severe IMR.</p><p><strong>Methods:</strong> A total of 84 patients who underwent operations for coronary artery disease and moderately severe IMR were included in the study. Preoperative demographic and clinical characteristics were recorded at the time of admission. The severity of mitral regurgitation was graded using transthoracic echocardiography and left ventriculography.</p><p><strong>Results:</strong> Significant postoperative improvements were observed in ejection fraction and systolic diameter compared to preoperative values (<em>P</em> = .006 and <em>P</em> = .020 respectively, in the intervention group, <em>P</em> = .001 and <em>P</em> = .001 respectively, in the control group). The decrease in pulmonary artery pressure (PAP) was significant only in the intervention group (<em>P</em> = .001). There was a significantly marked reduction in the severity of IMR in the intervention group compared to control.</p><p><strong>Conclusion:</strong> Surgical repair of the mitral valve in conjunction with CABG for moderately severe IMR appears to be more effective than isolated CABG for certain outcome parameters, including decreased severity of mitral regurgitation and decreased pulmonary artery pressure.</p>

Preoperative Cardiac Events in Elderly Patients with Hip Fracture Randomized to Epidural or Conventional Analgesia

2003 ◽  
Vol 98 (1) ◽  
pp. 156-163 ◽  
Author(s):  
Idit Matot ◽  
Arieh Oppenheim-Eden ◽  
Ruand Ratrot ◽  
Julia Baranova ◽  
Elyad Davidson ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Hip Fracture ◽  
Elderly Patients ◽  
Epidural Analgesia ◽  
Control Group ◽  
Cardiac Events ◽  
Early Administration ◽  
Adverse Cardiac Events ◽  
Artery Disease

Background Perioperative myocardial ischemia occurs in 35% of unselected elderly patients undergoing hip fracture surgery. Perioperative epidural analgesia may reduce the incidence of adverse cardiac events. Methods The effect of early administration of epidural analgesia during the stressful period, on cardiac events was evaluated in a prospective randomized study in 68 patients with hip fractures who either had known coronary artery disease or were at high risk for coronary artery disease. On admission to the emergency room, patients were assigned to receive a usual care analgesic regimen (intramuscular meperidine, control group, n = 34) or continuous epidural infusion of local anesthetic and opioid (epidural group, n = 34). Monitoring in the preoperative period included a preoperative history and physical examination, daily assessment of cardiac adverse events, serial electrocardiograms, cardiac enzymes, and pain scores. Results Preoperative adverse cardiac events were significantly more prevalent in the control group compared with the epidural group (7 of 34 0 of 34; = 0.01). Adverse cardiac events included fatal myocardial infarction in three, fatal congestive heart failure in one, nonfatal congestive heart failure in one, and new onset atrial fibrillation in two. The incidence of intraoperative and postoperative adverse cardiac events was similar for the two groups. The significant difference between groups in the incidence of preoperative cardiac events prompted interruption of the study after the planned interim analysis. Conclusions The authors' data indicate that compared with conventional analgesia, early administration of continuous epidural analgesia is associated with a lower incidence of preoperative adverse cardiac events in elderly patients with hip fracture who have or are at risk for coronary artery disease. Preoperative epidural analgesia may be advantageous for this surgical population.

Features of diabetes mellitus in very elderly patients

2019 ◽  
Vol 1 (9) ◽  
pp. 13-19
Author(s):  
S. V. Topolyanskaya ◽  
T. M. Kolontai ◽  
O. N. Vaculenko ◽  
L. I. Dvoretski
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Elderly Patients ◽  
Very Elderly ◽  
Younger Patients ◽  
Patients With Diabetes ◽  
Artery Disease

Modern concepts about features of diabetes mellitus in very elderly patients are described in the article. Special attention to the therapeutic methods of management of very elderly patients with diabetes mellitus has been devoted. The results of diabetes mellitus study in patients with coronary artery disease older than 75 years in comparison with younger patients are presented.

Should Percutaneous Coronary intervention be the Standard Treatment Strategy for Significant Coronary Artery Disease in all Octogenarians?.

2020 ◽  
Vol 16 ◽  
Author(s):  
George Kassimis ◽  
Grigoris V. Karamasis ◽  
Athanasios Katsikis ◽  
Joanna Abramik ◽  
Nestoras Kontogiannis ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Elderly Patients ◽  
Symptom Relief ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
St Segment ◽  
Percutaneous Coronary ◽  
Artery Disease

Coronary artery disease (CAD) remains the leading cause of cardiovascular death in octogenarians. This group of patients represents nearly a fifth of all patients treated with percutaneous coronary intervention (PCI) in real-world practice. Octogenarians have multiple risk factors for CAD and often greater myocardial ischemia than younger counterparts, with a potential of an increased benefit from myocardial revascularization. Despite this, octogenarians are routinely under-treated and belittled in clinical trials. Age does make a difference to PCI outcomes in older people, but it is never the sole arbiter of any clinical decision, whether in relation to the heart or any other aspect of health. The decision when to perform revascularization in elderly patients and especially in octogenarians is complex and should consider the patient on an individual basis, with clarification of the goals of the therapy and the relative risks and benefits of performing the procedure. In ST-segment elevation myocardial infarction (MI), there is no upper age limit regarding urgent reperfusion and primary PCI must be the standard of care. In non-ST-segment elevation acute coronary syndromes, a strict conservative strategy must be avoided; whereas the use of a routine invasive strategy may reduce the occurrence of MI and need for revascularization at follow-up, with no established benefit in terms of mortality. In stable CAD patients, invasive therapy on top of the optimal medical therapy seems better in symptom relief and quality of life. This review summarizes the available data on percutaneous revascularization in the elderly patients and particularly in octogenarians, including practical considerations on PCI risk secondary to ageing physiology. We also analyse technical difficulties met when considering PCI in this cohort and the ongoing need for further studies to ameliorate risk stratification and eventually outcomes in these challenging patients.

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