scholarly journals Beneficial Effect on Exercise Tolerance of a Comprehensive Rehabilitation Program in Elderly Obese Patients Affected With Heart Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Luca Alessandro Gondoni ◽  
Ferruccio Nibbio ◽  
Annamaria Titon
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Elderly Patients ◽  
Beneficial Effect ◽  
Rehabilitation Program ◽  
Diabetic Patients ◽  
Obese Patients ◽  
Metabolic Equivalents ◽  
Obese Subjects ◽  
Artery Disease

Aims: The number of elderly patients affected with multiple chronic diseases is constantly increasing. Even though multiple studies demonstrated a beneficial effect of cardiac rehabilitation, we do not have data on the outcomes in elderly patients with obesity and heart disease.Methods: We studied 772 consecutive obese subjects (275 women; 35.6%) aged ≥70 years, affected with coronary artery disease and/or heart failure. We conducted a symptom limited exercise test at the beginning and at the end of the program, which consisted of aerobic and strength physical activity, diet, and psychological counseling.Results: Mean body mass index (BMI) at baseline was 37.6 ± 4.4 kg/m2 and decreased to 36.4 ± 4.3 kg/m2 (P < 0.001). At baseline, attained metabolic equivalents (METs) were 4.7 ± 1.7, and by the end of the program, they were 5.6 ± 2.1 (P < 0.001). The mean improvement was 21.6 ± 21.7% (median, 17.6%; 95% CI, 20.0–23.1%). Patients over 80 years old had similar results compared to the younger ones. Diabetics did worse than non-diabetic patients: the improvement they reached was 19.4 ± 18.9% vs. 23.8 ± 23.9% (P = 0.005). The presence of heart failure was significantly related to both the baseline and final performance, but the attained improvement was significantly greater in heart failure patients: 24.3 ± 23.8% vs. 16.3 ± 15.4% (P < 0.001). No patient had adverse events related to the program.Conclusion: This study documents a significant improvement in exercise capacity in elderly obese patients affected with heart disease who underwent a rehabilitation program.

Poor outcome of diabetic patients with coronary artery disease and coexisting heart failure

2008 ◽  
Vol 7 ◽  
pp. 19-19
Author(s):  
B PONIKOWSKA ◽  
E JANKOWSKA ◽  
K WEGRZYNOWSKATEODORCZYK ◽  
S POWIERZA ◽  
L BORODULINNADZIEJA ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Diabetic Patients ◽  
Poor Outcome ◽  
Artery Disease

Abstract 11242: Impact of Peripheral Artery Disease on Prognosis in Heart Failure Patients

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Yuichi Nakamura ◽  
Akiomi Yoshihisa ◽  
Hiroyuki Kunii ◽  
Mai Takiguchi ◽  
Takeshi Shimizu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Ejection Fraction ◽  
Ischemic Heart Disease ◽  
Cardiac Death ◽  
Independent Predictor ◽  
Cardiac Mortality ◽  
Peripheral Artery ◽  
All Cause Mortality ◽  
Artery Disease

Background: A history of peripheral artery disease (PAD) is an independent predictor of cardiac mortality in patients with ischemic heart disease. However, it still remains unclear whether PAD predicts worsening heart failure (HF), cardiac and all-cause mortality in HF patients. Methods and Results: Consecutive 388 HF patients admitted to our hospital for the treatment of decompensated HF were divided into 2 groups based on the presence of PAD: HF with PAD (PAD group, n = 103) and HF without PAD (non-PAD group, n = 285). We compared echocardiographic and laboratory findings, and followed the event of worsening HF, cardiac death, non-cardiac death, and all-cause mortality between the two groups. The PAD group, as compared to non-PAD group, had 1) higher age (69.2 vs. 64.5 years old, P=0.001), 2) higher incidence of New York Heart Association functional class III or IV (56.3% vs. 37.2%, P = 0.001), 3) lower levels of hemoglobin (12.3 vs. 12.9 g/dl, P = 0.020), 4) higher levels of B-type natriuretic peptide (591.0 vs. 256.9 pg/ml, P = 0.017), 5) lower estimated glomerular filtration rate (GFR) (46.2 vs. 58.9 ml/min/1.73m 2 , P < 0.001), and 6) lower left ventricular ejection fraction (42.0 vs. 48.7%, P < 0.001). In the follow-up period (mean 765.6 days), Kaplan-Meier analyses (Figure) showed that the event-free survival from worsening HF, cardiac death, non-cardiac death and all-cause death was significantly higher in non-PAD group than in PAD group (P = 0.017, P < 0.001, P = 0.001 and P = 0.005, respectively, by a log-rank test). In the Cox proportional hazard analyses after adjusting for age, gender, ejection fraction, estimated GFR, and the presence of ischemic heart disease, PAD was an independent predictor of cardiac death (hazard ratio (HR) 2.09, P = 0.019) and all-cause mortality (HR 2.16, P = 0.002) in HF patients. Conclusions: PAD is an independent predictor of cardiac mortality and all-cause mortality in HF patients.

Erythrocyte 2,3-Diphosphoglycerate as Related to Diabetes and Obesity

1975 ◽  
Vol 21 (10) ◽  
pp. 1414-1415 ◽  
Author(s):  
Anastasios Kalofoutis ◽  
Gérard Jullien ◽  
Antonios Koutselinis ◽  
Constantinos Miras
Keyword(s):  
Healthy Subjects ◽  
Diabetic Patients ◽  
Obese Patients ◽  
Obese Subjects ◽  
Diabetes And Obesity

Abstract 2,3-Diphosphoglycerate was determined in the erythrocytes of 17 diabetic and 18 obese patients. Results for obese subjects were significantly (P &lt; .01) different from those obtained for 21 healthy subjects. Results for obese and diabetic patients also differed significantly (P &lt; .01), but not those for diabetic and healthy subjects. Hemoglobin, hematocrit, or bicarbonate measurements did not differ among the three groups.

scholarly journals Comparative Study between Diabetic and non- Diabetic Patients Regarding Prevalence of Coronary Artery Disease and Plaque Composition by Multi-detector CT Coronary Angiography

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H A Morsy ◽  
L A Habib ◽  
E H Abdeldayem ◽  
A I Sayed
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Coronary Artery ◽  
Diabetic Group ◽  
Diabetic Patients ◽  
Increased Risk ◽  
Artery Disease ◽  
Msct Angiography

Abstract Diabetes is known to be a major cardiovascular risk factor associated with significantly increased morbidity and mortality and particularly increased risk of major cardiac events especially myocardial infarction as a manifestation of highly incident coronary artery disease (CAD).This can lead to decreased life expectation and life quality. Major cause for myocardial infarction is plaque rupture. Prevalence of obstructive and non-obstructive plaques is increased in diabetic patients. Background and Objectives The prevalence of coronary heart disease in diabetic patients compared to non- diabetics and evaluating the composition of the plaque in diseased individuals in both groups by usage of multislice computed tomography (MSCT) angiography . Subjects and Methods A total of 80 consecutive MSCT angiography examinations were performed between August 2017 and June 2018. Of these, the patients were evaluated for the presence and type of atherosclerotic plaque and severity of luminal narrowing. Results Eighty (40 in the diabetic group and 40 in the non-diabetic group) patients underwent MSCT angiography with DM prevalence of 0.212 (95% Cl for AOR 0.056 -1.896). Among them, 20 patients (50 %) in the diabetic group and 14 patients (35 %) in the non-diabetic group had +ve coronary heart disease, 33.3 % had significant and moderately significant coronary narrowing on diabetic group and 31.3 % in non-diabetic group on MSCT angiography. Diabetic patients had more soft plaque compared with non-diabetic patients. Conclusion DM is not an independent factor for the disease occurrence in coronary artery disease but is a dependent factor in the association of other risk factors such as smoking ,hypertension and dyslipidemia.

scholarly journals Diabetic cardiomyopathy

2009 ◽  
Vol 116 (10) ◽  
pp. 741-760 ◽  
Author(s):  
Omar Asghar ◽  
Ahmed Al-Sunni ◽  
Kaivan Khavandi ◽  
Ali Khavandi ◽  
Sarah Withers ◽  
...  
Keyword(s):  
Heart Failure ◽  
Diabetic Cardiomyopathy ◽  
Disease Process ◽  
Molecular Targets ◽  
Clinical Trial Data ◽  
Experimental Models ◽  
Trial Data ◽  
Diabetic Patients ◽  
Cardiac Safety ◽  
Artery Disease

Diabetic cardiomyopathy is a distinct primary disease process, independent of coronary artery disease, which leads to heart failure in diabetic patients. Epidemiological and clinical trial data have confirmed the greater incidence and prevalence of heart failure in diabetes. Novel echocardiographic and MR (magnetic resonance) techniques have enabled a more accurate means of phenotyping diabetic cardiomyopathy. Experimental models of diabetes have provided a range of novel molecular targets for this condition, but none have been substantiated in humans. Similarly, although ultrastructural pathology of the microvessels and cardiomyocytes is well described in animal models, studies in humans are small and limited to light microscopy. With regard to treatment, recent data with thiazoledinediones has generated much controversy in terms of the cardiac safety of both these and other drugs currently in use and under development. Clinical trials are urgently required to establish the efficacy of currently available agents for heart failure, as well as novel therapies in patients specifically with diabetic cardiomyopathy.

scholarly journals In Hospital Frequency of Heart Failure in STEMI after Thrombolysis in Patient with Diabetes

2021 ◽  
pp. 66-71
Author(s):  
Abdul Mueed ◽  
Nandlal Rathi ◽  
Shazia Kazi ◽  
Raj Kumar Sachdewani ◽  
. Shahzad ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Heart Disease ◽  
Previous History ◽  
P Value ◽  
Diabetic Patients ◽  
Chi Square ◽  
St Segment Elevation ◽  
Patients With Diabetes ◽  
End Stage

Objective: To determine the frequency of heart failure after thrombolysis in STEMI patients with diabetes mellitus. Methodology: Through a prospective study we have enrolled all the diabetic patients who presented with acute ST-Segment Elevation Myocardial Infarction (STEMI) having age more than 35 years and less than 70 years who underwent pharmacological revascularization both males and females were included in this study. Patients with previous history of revascularization, end stage kidney, liver or heart disease, known advanced valvular heart disease, pregnant women, and those who develop serious complication related to streptokinase were excluded from our study. Echocardiography was done immediately after thrombolysis then after 3 days and then before discharge of the patients to determine the frequency of heart failure. Baseline and clinical data were entered and analysed using SPSS and a chi square test and p-value ≤0.05 was considered as significant. Results: A total of 175 patients were finally analysed and most of them were males as compared to females, 63.42% (N = 111) vs. 36.57% (N = 64), respectively. Mean age and SD of the patients was 55.90±10.49 years and mean duration of DM was 12.95±8.40 years. The overall frequency of heart failure in patients with post-STEMI was 56% (N = 98) and their mean ejection fraction was 38.46±8.20%. Frequency of heart failure in diabetic post-STEMI thrombolysed patients was significantly observed higher with increased age, increased duration of diabetes mellitus, hypertension, and smoking (p≤0.05). Conclusion: High prevalence of heart failure was observed in diabetic patients admitted with acute STEMI and underwent thrombolysis. The burden is even higher in males having age more than 55 years.

scholarly journals Mechanisms by Which Metformin Improves Mortality and Hospital Readmission in Diabetic Patients with Heart Failure

2017 ◽  
Vol 1 (3) ◽  
pp. 01-02
Author(s):  
David Bell
Keyword(s):  
Heart Failure ◽  
Hospital Readmission ◽  
Meta Analysis ◽  
Total Mortality ◽  
Diabetic Patients ◽  
Cardiac Events ◽  
Develop Heart Failure ◽  
Metformin Monotherapy ◽  
Patients With Heart Failure ◽  
Obese Subjects

From the UKPDS it was concluded that metformin decreased cardiac events. However, this only occurred in a small group of obese subjects while in a larger group failing sulfonylurea therapy the addition of metformin resulted in an increase in cardiac events . Indeed, a meta-analysis of metformin studies has shown that overall metformin does not decrease cardiac events. However, if in this meta-analysis the group utilizing metformin and sulfonylurea combinations were removed from the analysis then there was a significant decrease in cardiac events with metformin monotherapy. The major decrease in cardiac events, cardiac mortality and total mortality with metformin is likely due to a decreased susceptibility to develop heart failure. From Medicare billing records of 16,417 diabetic patients with heart failure discharged from hospital on metformin were compared to those with heart failure discharged on a sulfonylurea or insulin, mortality was reduced by 13% and readmission by 8%.

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