scholarly journals Chinese Home-Based Cardiac Rehabilitation Model Delivered by Smartphone Interaction Improves Clinical Outcomes in Patients With Coronary Heart Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Jing Ma ◽  
Cheng Ge ◽  
Yajun Shi ◽  
Yong Xu ◽  
Chenghui Zhao ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiac Rehabilitation ◽  
Cox Regression ◽  
Control Group ◽  
Cardiovascular Risks ◽  
Cardiac Events ◽  
Clinical Trial Registration ◽  
Home Based ◽  
Secondary Outcomes

Purpose: We evaluated the long-term effect of a smartphone-facilitated home-based cardiac rehabilitation (HBCR) model in revascularized patients with coronary heart disease (CHD) on major adverse cardiac events (MACE), and secondary outcomes, including safety, quality of life, and physical capacity.Methods: It was a prospective observational cohort study including a total of 335 CHD patients after successful percutaneous coronary intervention (PCI) referred to the CR clinic in China between July 23, 2015 and March 1, 2018. Patients were assigned to two groups: HBCR tailored by monitoring and telecommunication via smartphone app (WeChat) (HBCR group, n = 170) or usual care (control group, n = 165), with follow-up for up to 42 months. Propensity score matching was conducted to match patients in the HBCR group with those in the control group. The patients in the HBCR group received educational materials weekly and individualized exercise prescription monthly, and the control group only received 20-min education at baseline in the CR clinic. The primary outcome was MACE, analyzed by Cox regression models. The changes in the secondary outcomes were analyzed by paired t-test among the matched cohort.Results: One hundred thirty-five HBCR patients were matched with the same number of control patients. Compared to the control group, the HBCR group had a much lower incidence of MACE (1.5 vs. 8.9%, p = 0.002), with adjusted HR = 0.21, 95% CI 0.07–0.85, and also had reduced unscheduled readmission (9.7 vs. 23.0%, p = 0.002), improved exercise capacity [maximal METs (6.2 vs. 5.1, p = 0.002)], higher Seattle Angina Questionnaire score, and better control of risk factors.Conclusions: The Chinese HBCR model using smartphone interaction is a safe and effective approach to decrease cardiovascular risks of patients with CHD and improve patients' wellness.Clinical Trial Registration:http://www.chictr.org.cn, identifier: ChiCTR1800015042.

scholarly journals Cardiac Rehabilitation Based on the Walking Test and Telerehabilitation Improved Cardiorespiratory Fitness in People Diagnosed with Coronary Heart Disease during the COVID-19 Pandemic

2021 ◽  
Vol 18 (5) ◽  
pp. 2241
Author(s):  
Ladislav Batalik ◽  
Vladimir Konecny ◽  
Filip Dosbaba ◽  
Daniela Vlazna ◽  
Kristian Brat
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiac Rehabilitation ◽  
Cardiorespiratory Fitness ◽  
Test Time ◽  
Target Heart Rate ◽  
Walking Test ◽  
Novel Approach ◽  
Home Based ◽  
Study Participants

This study investigated an alternative home-based cardiac telerehabilitation model in consideration of the recommendations for the COVID-19 quarantine of people diagnosed with coronary heart disease (CHD). We hypothesized that using a 200 m fast walking test (200 mFWT) and telerehabilitation would create an effective alternative cardiac rehabilitation (CR) intervention that could improve cardiorespiratory fitness. Participants (n = 19, mean age 60.4 ± 9.6) of the 8-week intervention performed regular physical exercise at the target heart rate zone determined by calculations based on the 200 mFWT results. In our study, the participants were supervised using telerehabilitation. A total of 84% of participants completed the 8-week intervention. No adverse events were reported during telerehabilitation. The study participants noted a significant improvement (p < 0.001) in cardiorespiratory fitness expressed by an 8% reduction in the walking test time (Δ 8.8 ± 5.9 s). Home-based telerehabilitation based on 200 mFWT effectively increased the cardiorespiratory fitness in people with CHD with a low to moderate cardiovascular risk. This was a novel approach in CR during the COVID-19 pandemic. As research in this area is justified, this paper may serve as an alternative method of providing healthcare during the COVID-19 pandemic and as a basis for further upcoming randomized controlled trials.

P639Benefits and safety of exercise training in patients with severe three coronary vessels disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J Rojano ◽  
H Ilarraza Lomeli ◽  
M Garcia Saldivia ◽  
M Rius Suarez ◽  
A Lopez Garcia ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
High Risk ◽  
Cardiac Rehabilitation ◽  
Cardiopulmonary Exercise Testing ◽  
Rehabilitation Program ◽  
Control Group ◽  
Syntax Score ◽  
Cardiopulmonary Exercise ◽  
Very High

Abstract Background Coronary heart disease is the leading cause of death in the world. Nowadays, there are still patients with untreatable coronary obstructions and exercise therapy could be an option to improve their quality of life and probably diminish mortality. Cardiac rehabilitation programs are recommended worldwide due its effectiveness and safety. However very high risk patients are often not included. Purpose To evaluate the benefit and safety of exercise therapy as a part of a cardiac rehabilitation program in patients with untreatable severe coronary heart disease. Methods A cohort of patients with coronary heart disease included in a cardiac rehabilitation program were studied. Those with severe coronary heart disease (Syntax score ≥33, group A) were identified. Patients were stratified using clinical records and cardiopulmonary exercise testing. They trained for 30 minutes, five times a week of aerobic exercise (cycle ergometer) and this therapy was complemented with general strength, coordination, balance and flexibility maneuvers. After twenty exercise sessions, a second cardiopulmonary exercise test was performed. Symptom limited cardiopulmonary exercise testing was undertaken using a ramp Balke protocol and cardiopulmonary variables were recorded. These patients were compared with their counterparts without severe coronary heart disease (Control group, group B). Studied variables were presented as frequencies (%), mean (SD), median (range) as appropriate. Comparisons between groups were made using chi square or paired T test as needed. All p values <0.05 were considered stochastically significant. Results From a total of 546 patients, seventy-one had severe coronary heart disease (Syntax score ≥33). There were no significant differences between groups on change of METs value and number of sessions assisted. No major adverse cardiovascular outcome was observed. The percentage of exercise induced arrhythmias was 75% in very high risk group vs 76% in control group, (p>0.05). Results are shown in table 1. Table 1. Characteristics between groups Patients Group A (n=75) Group B (n=471) p value Assisted training sessions 15±7 14±6 ns Increment in MET (ml/kg/min) 1.32±1.34 1.35±1.56 ns Arrhythmias, n (%) 56 (75) 370 (76) ns Angor/ST depression, n (%) 11 (15) 15 (3) <0.01 Differences in workload (Watts) 20±13 22±13 ns Conclusion Exercise training could be performed in an effective and safe manner in patients with very high risk untreated coronary heart disease.

scholarly journals Influence of Waist-to-Hip Ratio on the Prognosis of Heart Failure Patients With Revascularized Coronary Heart Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Yingyue Zhang ◽  
Yan Zhang ◽  
Yajun Shi ◽  
Wei Dong ◽  
Yang Mu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Heart Disease ◽  
Regression Analysis ◽  
Heart Disease ◽  
Cox Regression ◽  
Characteristic Curve ◽  
Cardiac Events ◽  
Cox Regression Analysis ◽  
Waist To Hip Ratio

Background: Heart failure (HF) is considered one of the most common complications of coronary heart disease (CHD), with a higher incidence of readmission and mortality. Thus, exploring the risk factors related to the prognosis is necessary. Moreover, the effect of the waist-to-hip ratio (WHR) on HF patients with revascularized CHD is still unclear. Thus, we aimed to assess the influence of WHR on the prognosis of HF patients with revascularized CHD.Methods: We collected data of HF patients with revascularized CHD who were referred to the Cardiac Rehabilitation Clinic of PLA Hospital from June 30, 2015, to June 30, 2019. Cox proportional hazard regression analysis was used to determine the relationship between WHR and prognosis of HF patients with revascularized CHD. Patients were divided into higher and lower WHR groups based on the cutoff WHR value calculated by the X-tile software. Cox regression analysis was used to analysis the two groups. We drew the receiver operating characteristic curve (ROC) of WHR and analyzed the differences between the two groups. Endpoints were defined as major adverse cardiac events (MACE) (including all-cause mortality, non-fatal myocardial infarction, unscheduled revascularization, and stroke).Results: During the median follow-up of 39 months and maximum follow-up of 54 months, 109 patients were enrolled, of which 91.7% were males, and the mean age was 56.0 ± 10.4 years. WHR was associated with the incidence of MACE in the Cox regression analysis (p = 0.001); an increase in WHR of 0.01 unit had a hazard ratio (HR) of 1.134 (95%CI: 1.057–1.216). The WHR cutoff value was 0.93. Patients in the higher WHR group had a significantly higher risk of MACE than those in the lower WHR group (HR = 7.037, 95%CI: 1.758–28.168). The ROC area under the curve was 0.733 at 4 years. Patients in the higher WHR group had a higher body mass index (BMI; 26.7 ± 3.5 vs. 25.4 ± 2.4, P = 0.033) than patients in the lower WHR group.Conclusions: WHR is an independent risk factor of the long-term prognosis of Chinese HF patients with revascularized CHD. Patients with WHR ≥ 0.93 require intensified treatment. Higher WHR is related to higher BMI and ΔVO2/ΔWR.

scholarly journals Beneficial effects of home-based cardiac rehabilitation on metabolic profiles in coronary heart-disease patients

2016 ◽  
Vol 32 (5) ◽  
pp. 267-275 ◽  
Author(s):  
Jing-Ting Chen ◽  
Tsung-Hsien Lin ◽  
Wen-Chol Voon ◽  
Wen-Ter Lai ◽  
Mao-Hsiung Huang ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiac Rehabilitation ◽  
Metabolic Profiles ◽  
Beneficial Effects ◽  
Home Based

Abstract P312: High State and Trait Hopelessness Levels Predict Lower Home-based Exercise Participation in Patients With Coronary Heart Disease

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Susan L Dunn ◽  
L M Dunn ◽  
Madison P Buursma ◽  
Holli A DeVon ◽  
Lucas Vander Berg ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiac Rehabilitation ◽  
Phase Ii ◽  
Exercise Program ◽  
Regular Exercise ◽  
Exercise Participation ◽  
Time Points ◽  
Home Based ◽  
The Impact

Introduction: Hopelessness is associated with increased adverse events and decreased survival in patients with coronary heart disease (CHD). Hopelessness can persist in these patients and reduce their participation in hospital-based cardiac rehabilitation (CR) exercise following an acute event. Because the majority of CHD patients do not attend a hospital-based CR exercise program, examination of factors affecting home exercise is needed. The purpose of this study was to describe the impact of hopelessness levels on both home- and hospital based CR exercise participation in patients with CHD. Hypothesis: It was hypothesized that higher state and trait hopelessness levels would adversely affect both home- and hospital-based CR exercise participation. Methods: The Theory of Hopelessness Depression was used as a foundation for study aims. Using a descriptive, longitudinal design, 282 patients who had been hospitalized with a CHD event were asked to complete the State-Trait Hopelessness Scale (STHS) during their hospitalization and the STHS and the Cardiac Rehabilitation Exercise Participation Questionnaire at 3, 8, and 12 months after hospital discharge. Patients who provided data at any two concurrent time points over the year were included in the analyses. Regular exercise was defined as walking or biking ≥3 days/week in a home- or hospital-based Phase II CR exercise program. Logistic regression was used to evaluate the relationship between STHS scores on the likelihood that patients would participate in regular exercise in home- or hospital-based Phase II CR settings. Results: Patients were predominantly male (64.9%) with a mean age of 65.4±9.7 years. Patients had persistent, modest levels of state and trait hopelessness across all time points. High levels of state and trait hopelessness were predictive of lower home-based exercise participation (state: OR 0.4, 95% CI [0.1, 0.7], p=0.002; trait: OR 0.4, 95% CI [0.2, 0.8], p=0.01) but not hospital-based Phase II CR exercise, after adjusting for age and sex. Conclusions: These findings demonstrate the importance of assessing hopelessness in patients with CHD and provide critical evidence of the need for clinicians to encourage CHD patients who are feeling hopeless to participate in CR exercise, particularly in the home setting.

scholarly journals The Impact of Complex Cardiac Rehabilitation on Manifestation of Risk Factors in Patients with Coronary Heart Disease

Medicina ◽  
2012 ◽  
Vol 48 (3) ◽  
pp. 24 ◽  
Author(s):  
Raimondas Kubilius ◽  
Lina Jasiukevičienė ◽  
Vytautas Grižas ◽  
Loreta Kubilienė ◽  
Edita Jakubsevičienė ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ldl Cholesterol ◽  
Density Lipoprotein ◽  
Control Group ◽  
Cardiac Events ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
The Impact

Background. Each year more than 4.3 million people in Europe will die of cardiovascular disease. Therefore, the implementation of simple interventions such as smoking cessation, weight loss, improved diets, and increased exercise is the top priority in prevention and rehabilitation programs. The aim of this study was to evaluate the impact of complex rehabilitation on the manifestation of risk factors and cardiac events in patients with coronary heart disease. Material and Methods. A total of 140 patients with coronary heart disease and NYHA functional class II–IV ischemic heart failure were recruited to the study. The patients were divided into 2 groups: 70 patients who underwent a 6-month complex rehabilitation course (rehabilitation group) and 70 patients who received drug treatment only (control group). Smoking, dietary, and physical activity habits were documented using the questionnaires. Blood pressure (BP), body weight and height, and total serum cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglyceride (Tg), and blood glucose levels were measured. Measurements were repeated after 3 and 6 months. Results. After 6 months, significantly reduced systolic BP was observed in both the groups as compared with the baseline values (P<0.05). A significant decrease in the diastolic BP; total cholesterol, LDL-cholesterol, triglyceride and blood glucose levels; body mass index, and percentage of patients with the metabolic syndrome as compared with the baseline data was documented only in the rehabilitation group (P<0.05). All the patients quitted smoking as well as all the patients in the rehabilitation group changed their dietary habits (P<0.05). Fewer patients were excluded from the rehabilitation group because of cardiac events as compared with the control group (7.1% vs. 11.4%, P<0.05). Conclusions. Complex long-term rehabilitation of cardiovascular patients significantly reduced the manifestation of major cardiovascular risk factors and the rate of cardiac events. Aerobic exercise must be the most important part of training but well-done resistance training must also be encouraged.

scholarly journals Telehealth interventions for the secondary prevention of coronary heart disease: A systematic review and meta-analysis

2019 ◽  
Vol 18 (4) ◽  
pp. 260-271 ◽  
Author(s):  
Kai Jin ◽  
Sahar Khonsari ◽  
Robyn Gallagher ◽  
Patrick Gallagher ◽  
Alexander M Clark ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Secondary Prevention ◽  
Cardiac Rehabilitation ◽  
Usual Care ◽  
Weighted Mean Difference ◽  
Grey Literature ◽  
Cardiac Events ◽  
All Cause Mortality

Background: Coronary heart disease (CHD) is a major cause of death worldwide. Cardiac rehabilitation, an evidence-based CHD secondary prevention programme, remains underutilized. Telehealth may offer an innovative solution to overcome barriers to cardiac rehabilitation attendance. We aimed to determine whether contemporary telehealth interventions can provide effective secondary prevention as an alternative or adjunct care compared with cardiac rehabilitation and/or usual care for patients with CHD. Methods: Relevant randomized controlled trials evaluating telehealth interventions in CHD patients with at least three months’ follow-up compared with cardiac rehabilitation and/or usual care were identified by searching electronic databases. We checked reference lists, relevant conference lists, grey literature and keyword searching of the Internet. Main outcomes included all-cause mortality, rehospitalization/cardiac events and modifiable risk factors. (PROSPERO registration number 77507.) Results: In total, 32 papers reporting 30 unique trials were identified. Telehealth was not significant associated with a lower all-cause mortality than cardiac rehabilitation and/or usual care (risk ratio (RR)=0.60, 95% confidence interval (CI)=0.86 to 1.24, p=0.42). Telehealth was significantly associated with lower rehospitalization or cardiac events (RR=0.56, 95% CI=0.39 to 0.81, p<0.0001) compared with non-intervention groups. There was a significantly lower weighted mean difference (WMD) at medium to long-term follow-up than comparison groups for total cholesterol (WMD= −0.26 mmol/l, 95% CI= −0.4 to −0.11, p <0.001), low-density lipoprotein (WMD= −0.28, 95% CI = −0.50 to −0.05, p=0.02) and smoking status (RR=0.77, 95% CI =0.59 to 0.99, p=0.04]. Conclusions: Telehealth interventions with a range of delivery modes could be offered to patients who cannot attend cardiac rehabilitation, or as an adjunct to cardiac rehabilitation for effective secondary prevention.

Sign in / Sign up

Export Citation Format

Share Document