Effects Of Cardiac Rehabilitation Program Research Articles

Physical and Mental Components of Quality of Life after a Cardiac Rehabilitation Intervention: A Systematic Review and Meta-Analysis.

Background: This study aimed to analyze the effect of cardiac rehabilitation programs on the health-related quality of life of patients after a coronary cardiac event using patient-reported outcome measures (PROMs) for up to 6 months of evaluation. Methods: A comprehensive search was carried out in the MEDLINE, CINAHL, CENTRAL, and Web of Science databases for randomized controlled trials comparing the cardiac rehabilitation program with usual care. Two independent reviewers assessed the studies for inclusion, risk of bias using the Cochrane tool, and quality of evidence through the GRADE system. A meta-analysis was performed on studies assessing health-related quality of life with the SF-12 (Physical Component Summary and Mental Component Summary) up to 6 months after the program. Results: Twelve studies encompassed 2260 patients who participated in a cardiac rehabilitation program after a coronary event, with a mean age of 60.06 years. The generic PROMs used to assess quality of life were the SF-12, SF-36, EQ-5D-3L, EQ-5D-5L, and GHQ, and the specific coronary heart disease PROMs were MacNew and HeartQoL. There was a positive effect of participation in cardiac rehabilitation on the physical component of health-related quality of life at 6 months (MD [7.02]; p = 0.04] and on the mental component (MD [1.06]; p = 0.82) after applying the SF-12. Conclusions: This study highlights the significant benefits of cardiac rehabilitation programs on health-related quality of life, particularly in the physical domain at 6 months. Assessing outcomes over time through PROMs after coronary heart events is essential, thus making it possible to personalize patients' care and improve their health status.

Optimization of Cardiorespiratory Fitness and Quality of Life in Women with Chronic Heart Failure after a Cardiac Rehabilitation Program

Introduction: Women with heart failure (HF) tend to experience a greater symptom burden and lower quality of life, possibly due to phenotypic differences and unique gender-associated risk factors. Despite evidence on the effects of cardiac rehabilitation programs (CRP) in the general population, there is underrepresentation of women in these programs. Additionally, the impact of CRP on cardiorespiratory variables obtained through cardiopulmonary exercise testing (CPET) and health-related quality of life (HRQoL) in women with HF remains unknown. Objective: To assess the impact of a CRP on cardiorespiratory fitness (CRF) in cardiorespiratory variables obtained through CPET and HRQoL in women with HF. Methods: A quasi-experimental study included HF patients who completed a CRP from June 2019 to December 2023. The CRP involved nutritional assessment, psychosocial evaluation, educational sessions, and concurrent training. It comprised 30 minutes of aerobic resistance training at 65-80% of heart rate reserve (HRR) and 30 minutes of strength training at 30-50% of 1-repetition maximum (1RM), with a frequency of 3 sessions per week for 4 to 6 weeks. CPET was conducted at the beginning and end of the program, analyzing cardiorespiratory variables. HRQoL was assessed using the SF-36 questionnaire. Gains in CRF and HRQoL at the end of the program in both men and women were analyzed. Results: Out of 217 included patients, 29.9% were women. At the program's onset, women showed lower exercise tolerance than men (workload 5.4±2.57 METs vs. 6.62±2.53 METs) and worse HRQoL (62.03%±18.37 vs. 68.38%±18.37). However, post-intervention, they optimized their CRF (%predicted VO2 [%VO2p] initial 56.62%±20.11 vs final 80.12%±30.32, p=<0.001). Significant improvements in cardiorespiratory variables were observed in both cases: delta METs-load 3.02, p=<0.001, delta peak oxygen consumption (VO2peak) 1.83 ml/kg/min, p=<0.001, delta oxygen pulse (PO2) 1.21, p=0.021, delta cardiac power output (CPO) 1917, p=0.004, with a rightward shift in ventilatory thresholds and improvement in HRQoL (62.03%±18.37 vs. 78.81%±12.9, p=<0.001) post-CRP. The only variable with no significant changes in either case was VE/VCO2 slope (delta -0.51, p=0.736). Additionally, in women with reduced left ventricular ejection fraction (<50%), variables with no significant improvement included CPO (delta 959.22, p=0.283) and time to recovery of VO2 kinetics (TRCVO2) (delta -0.74, p=0.957). In patients with preserved left ventricular ejection fraction (≥50%), variables with no significant change included PO2 (delta 1.08, p=0.173), TRCVO2 (delta 26.82, p=0.099), and the first ventilatory threshold (VT1) (delta 0.09, p=0.504). Program attendance was 87.5% in both groups. Conclusion: Implementing a CRP in women with HF resulted in significant improvements in all evaluated cardiorespiratory variables (except for VE/VCO2 slope) and quality of life. These findings support the importance of ensuring women's access and participation in cardiac rehabilitation programs. Addressing existing barriers is crucial to maximize the long-term benefits of CRP in the female population with HF.

Enhancing Quality of Life through a Supervised Cardiac Rehabilitation Program along with a conventional conditioning exercise program at home in Cardiovascular Disease Patients

Objectives: Debilitating day-to-day practices, including a sedentary lifestyle, increased unhealthy food consumption habits, no exercise, smoking, remarkably low HDL, and high cholesterol levels, lead to increased obesity, diabetes, and cardiovascular diseases (CVD), affecting the quality of life. Supervised, steady, and long-term aerobic exercise training benefits cardiorespiratory fitness, psychological status, and quality of life. Therefore, the study’s objective was to determine the effect of cardiac rehabilitation program (CRP) on heart rate (HR), systolic and diastolic blood pressure (SBP and DBP), and quality of life (QOL) in CVD patients.
 Materials and Methods: The study followed a two-arm parallel group randomized comparative design. Thirty participants (n=15/group) with CVD (aged between 45-76 years) were randomly allocated to two groups (CRP vs. Control). CRP Group received the CRP and a conventional conditioning exercise program (CEP) at home and the Control Group received the conventional CEP only at home. The outcomes, HR, SBP, DBP, and QOL, were assessed using a sphygmomanometer and short-form 36 (SF-36) questionnaire’s physical component summary (PCS) and mental component summary (MCS) scale, respectively. The t-test and Wilcoxon test were used to analyze between and within-group comparisons for all the outcomes scores, keeping the significance level α at 95% (p<0.05) for all the statistical analyses.
 Results: The mean scores comparison of the outcomes, HR, PCS, and MCS, were found significant (95% CI, p<0.05) within CRP and Control groups; however, SBP and DBP mean scores were found insignificant (95% CI, p>0.05) within both groups, except DBP mean score which was found significant (p<0.05) within CRP Group. Comparing the outcomes mean scores between the groups at four-week post-intervention, except PCS and MCS (95% CI, p<0.05), HR, SBP, and DBP were found to be insignificant (p>0.05). 
 Conclusions: The CRP and conventional CEP at home together and conventional CEP at home alone were equally effective in decreasing HR and improving QOL in CVD patients. However, the CRP and conventional CEP at home together showed more effectiveness than the conventional CEP at home in improving the QOL in CVD patients.

Effectiveness of cardiac rehabilitation programs on medication adherence in patients with cardiovascular disease: A systematic review and meta-analysis

BackgroundEducation to improve medication adherence is one of the core components of cardiac rehabilitation (CR) programs. However, the evidence on the effectiveness of CR programs on medication adherence is conflicting. Therefore, we aimed to summarize the effectiveness of CR programs versus standard care on medication adherence in patients with cardiovascular disease. MethodsA systematic review and meta-analysis was conducted. Seven databases and clinical trial registries were searched for published and unpublished articles from database inception to 09 Feb 2022. Only randomised controlled trials and quasi-experimental studies were included. Two independent reviewers conducted the screening, extraction, and appraisal. The JBI methodology for effectiveness reviews and PRISMA 2020 guidelines were followed. A statistical meta-analysis of included studies was pooled using RevMan version 5.4.1. ResultsIn total 33 studies were included with 16,677 participants. CR programs increased medication adherence by 14 % (RR = 1.14; 95 % CI: 1.07 to 1.22; p = 0.0002) with low degree of evidence certainty. CR also lowered the risk of dying by 17 % (RR = 0.83; 95 % CI: 0.69 to 1.00; p = 0.05); primary care and emergency department visit by mean difference of 0.19 (SMD = −0.19; 95 % CI: −0.30 to −0.08; p = 0.0008); and improved quality of life by 0.93 (SMD = 0.93; 95 % CI: 0.38 to 1.49; p = 0.0010). But no significant difference was observed in lipid profiles, except with total cholesterol (SMD = −0.26; 95 % CI: −0.44 to −0.07; p = 0.006) and blood pressure levels. ConclusionsCR improves medication adherence with a low degree of evidence certainty and non-significant changes in lipid and blood pressure levels. This result requires further investigation.

Effect of cardiac rehabilitation program on kinesiophobia and functional capacity in open heart surgery

Background: Open heart surgery is the major surgical procedure that is the most frequently conducted in general hospitals. Kinesiophobia and functional capacity are greatly compromised after open heart surgery. Cardiac rehabilitation helps in secondary prevention and minimizes different risk factors of cardiovascular disease. Objective: To determine the effect of a cardiac rehabilitation program on kinesiophobia and functional capacity after open heart surgery. Methodology: A quasi-experimental study was conducted at Rehman medical institute, Peshawar. The sample size was calculated as 45 by using G power, both male and female patients of aged 50 to 70 years who underwent open heart surgery were selected through a nonprobability purposive sampling technique from July 2021 to February 2022. Patients having any neurodegenerative disease, disorder of stance and gait, or drug intoxication were excluded. Pre and post-assessment after a week after was done using scale Tampa scale of kinesiophobia-11 for kinesiophobia and 6 minutes walk test for functional capacity. Phase 1 cardiac rehabilitation program was used as an intervention after open heart surgery. Paired t-test was applied to determine the mean difference in a group pre and post-interventional. SPSS version 23 was used to analyze the data. Results: The Mean age of the patients was 59.71±5.01 years. The results showed a significant improvement in kinesiophobia (28.96±4.67 versus 21.76±3.51, p<0.001) and functional capacity on 6 MWT (227.11±74.40 versus 326.02±80.05, p<0.001) after cardiac rehabilitation program was observed in study participants enrolled. Conclusion: The study concluded that cardiac rehabilitation programs have a significant effect on kinesiophobia and functional capacity after open heart surgery. Keywords: cardiac rehabilitation, functional capacity, kinesiophobia, open heart surgery.

Effectiveness of cardiac rehabilitation programs in improving medication adherence in patients with cardiovascular disease: a systematic review protocol.

The objective of this review is to measure the effectiveness of cardiac rehabilitation programs versus standard care on medication adherence in patients with cardiovascular disease. Poor adherence to long-term medications increases the risk of morbidity and mortality, and decreases quality of life in patients with cardiovascular diseases. Several strategies have been trialed to improve medication adherence, one of which is cardiac rehabilitation programs. Although evidence has indicated that such programs increase medication adherence, the extent of their effectiveness and translation into clinical practice is not well documented. Our systematic review will collect and analyze the available evidence for clinical practice implementation. The search will aim to locate randomized controlled trials. Where randomized controlled trials are not available, quasi-experimental studies, case-control studies, observational studies, and other study designs will be included. Studies that measure effectiveness of cardiac rehabilitation programs compared with standard care on medication adherence in cardiovascular disease patients will be included. Databases, including MEDLINE (Ovid), Emcare (Ovid), Embase (Ovid), Cochrane CENTRAL, Scopus, CINAHL (EBSCO), and unpublished sources will be searched. Articles in English and non-English-language articles with an English abstract, published from database inception to the present, will be included. Articles will be screened and reviewed by 2 independent reviewers for inclusion. Critical appraisal tools will be applied to the included studies. Data will be extracted using the appropriate extraction tools and synthesized for the objectives of the study. PROSPERO CRD42021284705.

Analysis of the status of cardiac rehabilitation in Spain: an exploratory review

Little is known about the characteristics of the cardiac rehabilitation programs currently implemented in Spain, the aim was therefore to know more about the effectiveness of cardiac rehabilitation in patients with ischemic heart disease in Spain, through an exploratory systematic review of the scientific literature on cardiac rehabilitation carried out in different databases from 2010 to 2018. We reviewed 35 articles whose objective was to measure the effectiveness of cardiac rehabilitation programs from different perspectives. More than twice as many men as women participated and only 8.6% were clinical trials. The studies showed improvements in relation to mortality and physiological and quality of life variables, but with discrepant results in morbidity, moods, maintenance long-term healthy habits and profitability of the programs.

Beneficial Effects of a Short Course of Physical Prehabilitation on Neurophysiological Functioning and Neurovascular Biomarkers in Patients Undergoing Coronary Artery Bypass Grafting

This study aimed to evaluate the effects of a short course of physical prehabilitation on neurophysiological functioning and markers of the neurovascular unit in patients undergoing coronary artery bypass grafting (CABG). We performed a prospective randomized study involving 97 male CABG patients aged 45–70 years, 47 of whom underwent a 5–7-day preoperative course of aerobic physical training (PhT). Both groups of patients were comparable with respect to baseline clinical and anamnestic characteristics. An extended neuropsychological and electroencephalographic (EEG) study was performed before surgery and at 7–10 days after CABG. Markers of the neurovascular unit [S100β, neuron-specific enolase (NSE), and brain-derived neurotrophic factor (BDNF)] were examined as metabolic correlations of early postoperative cognitive dysfunction (POCD) at three time points: before surgery, within the first 24 h after surgery, and 7–10 days after CABG. POCD developed in 58% of patients who underwent preoperative PhT, and in 79.5% of patients who did not undergo training, 7–10 days after CABG. Patients without prehabilitation demonstrated a higher percentage of theta1 power increase in the relative change values as compared to the PhT patients (p = 0.015). The short preoperative course of PhT was associated with low plasma S100β concentration, but high BDNF levels in the postoperative period. Patients who underwent a short preoperative course of PhT had better cognitive and electrical cortical activity indicators. Markers of the neurovascular unit indicated lower perioperative brain injury after CABG in those who underwent training. A short course of PhT before CABG can decrease the brain’s susceptibility to ischemia and reduce the severity of cognitive impairments in cardiac surgery patients. Electrical brain activity indicators and neurovascular markers, such as S100β and BDNF, can be informative for the effectiveness of cardiac rehabilitation programs.

Cardiac rehabilitation and improvement of chronotropic incompetence: Is it the exercise or just the beta blockers?

Clinical use of chronotropic response has been limited due to lack of consensus on the appropriate formula for chronotropic index (Ci) calculation and the definition of chronotropic incompetence. To assess the effects of cardiac rehabilitation programs (CRP) on Ci, irrespective of betablockers (BB) use and dosage. Assess the relative contribution of change in Ci on improvement in functional capacity. Retrospective analysis of a sample of patients admitted to a CRP after acute coronary syndrome, with at least 12 months of follow-up. Ci was calculated using the conventional (CCi) and the Brawner formula (BCi) for age-predicted maximum heart rate. Ci and functional capacity were estimated at three time points: T1 and T2, before and at the end of the CRP, and T3, at 12 months. The sample was categorized according to BB dosage modification between T1 and T3: G1 - reduced; G2 - no change; G3 - increased. In G1, CCi increased from 63.5% in T1 to 77.9% in T3; in G2, from 67.3% to 77.9%; in G3, from 71.2% to 75.4%. In G1, BCi increased from 110.4% to 140.0%; in G2, from 122.8% to 140.1%; in G3, from 133.3% to 139.2%. An average increase in 1.0% in CCi was associated with an average increase in functional capacity of 0.37 METS. Chronotropic index significantly improves with CRP, irrespective of BB dose changes. CCi is more closely related with improvement in functional capacity than BCi. Improvement of Ci is an important predictor of functional capacity and prognosis in cardiovascular disease patients.

Cardiac rehabilitation and improvement of chronotropic incompetence: Is it the exercise or just the beta blockers?

IntroductionClinical use of chronotropic response has been limited due to lack of consensus on the appropriate formula for chronotropic index (Ci) calculation and the definition of chronotropic incompetence. ObjectivesTo assess the effects of cardiac rehabilitation programs (CRP) on Ci, irrespective of betablockers (BB) use and dosage. Assess the relative contribution of change in Ci on improvement in functional capacity. MethodsRetrospective analysis of a sample of patients admitted to a CRP after acute coronary syndrome, with at least 12 months of follow-up. Ci was calculated using the conventional (CCi) and the Brawner formula (BCi) for age-predicted maximum heart rate. Ci and functional capacity were estimated at three time points: T1 and T2, before and at the end of the CRP, and T3, at 12 months. The sample was categorized according to BB dosage modification between T1 and T3: G1 – reduced; G2 – no change; G3 – increased. ResultsIn G1, CCi increased from 63.5% in T1 to 77.9% in T3; in G2, from 67.3% to 77.9%; in G3, from 71.2% to 75.4%. In G1, BCi increased from 110.4% to 140.0%; in G2, from 122.8% to 140.1%; in G3, from 133.3% to 139.2%. An average increase in 1.0% in CCi was associated with an average increase in functional capacity of 0.37 METS. ConclusionsChronotropic index significantly improves with CRP, irrespective of BB dose changes. CCi is more closely related with improvement in functional capacity than BCi. Improvement of Ci is an important predictor of functional capacity and prognosis in cardiovascular disease patients.

A randomized trial to evaluate the impact of exercise-based cardiac rehabilitation for the prevention of chemotherapy-induced cardiotoxicity in patients with breast cancer: ONCORE study protocol

BackgroundAnthracyclines and monoclonal antibodies against human epidermal growth factor receptor-2 (HER2) are frequently used to treat breast cancer but they are associated with risk of developing cardiotoxicity. Implementation of cardioprotective strategies as part of breast cancer treatment are needed. To date, a limited number of studies have examined the effectiveness of cardiac rehabilitation programs or exercise programs in the prevention of cardiotoxicity through an integral assessment of cardiac function. The ONCORE study proposes an exercise-based cardiac rehabilitation program as a non-pharmacological tool for the management of chemotherapy-induced cardiotoxicity.MethodsThe study protocol describes a prospective, randomized controlled trial aimed to determine whether an intervention through an exercise-based CR program can effectively prevent cardiotoxicity induced by anthracyclines and/or anti-HER2 antibodies in women with breast cancer. Three hundred and forty women with breast cancer at early stages scheduled to receive cardiotoxic chemotherapy will be randomly assigned (1:1) to participation in an exercise-based CR program (intervention group) or to usual care and physical activity recommendation (control group). Primary outcomes include changes in left ventricular ejection fraction and global longitudinal strain as markers of cardiac dysfunction assessed by transthoracic echocardiography. Secondary outcomes comprise levels of cardiovascular biomarkers and cardiopulmonary function through peak oxygen uptake determination, physical performance and psychosocial status. Supervised exercise program-related outcomes including safety, adherence/compliance, expectations and physical exercise in- and out-of-hospital are studied as exploratory outcomes. Transthoracic echocardiography, clinical test and questionnaires will be performed at the beginning and two weeks after completion of chemotherapy.DiscussionThe growing incidence of breast cancer and the risk of cardiotoxicity derived from cancer treatments demand adjuvant cardioprotective strategies. The proposed study may determine if an exercise-based CR program is effective in minimizing chemotherapy-induced cardiotoxicity in this population of women with early-stage breast cancer. The proposed research question is concrete, with relevant clinical implications, transferable to clinical practice and achievable with low risk.Trial registration ClinicalTrials.gov Identifier: NCT03964142. Registered on 28 May 2019. Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT03964142

Effect of Cardiac Rehabilitation Program on Heart Rate Recovery in Diabetic Patients Post Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention

Effect of Cardiac Rehabilitation Program on Heart Rate Recovery in Diabetic Patients Post Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention

The Effect of Cardiac Rehabilitation Program on Depression in Patients After Acute 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.

LONG TERM EFFECTS OF OUTPATIENT CARDIAC REHABILITATION IN PATIENTS WITH ACUTE DECOMPENSATED HEART FAILURE

Cardiac rehabilitation(CR) programs in patients with heart failure is recommended. However, there are few reports concerned with the long term effects of CR program in patients with ADHF. We retrospectively enrolled 251 patients (aged: 63.0±12.5 years) who started the CR program after

Does a Comprehensive Inpatient Rehabilitation Program Improve Patients' and Caregivers' Emotional State in LVAD Patients?

Few studies evaluated the effect of cardiac rehabilitation programs on perceived emotional and health status of left ventricular assist device (LVAD) patients, and none explored their effect on caregivers' strain. We enrolled 119 adult LVAD patients, together with their caregivers (n = 91), in two Rehabilitation Institutes that provided inpatient multidisciplinary activities. At admittance and prior to discharge they completed questionnaires evaluating patient emotional state and subjective perception of health status, caregiver strain, and patient and caregiver perception of the VAD. Six months after discharge, patients and caregivers were contacted again and asked specific questions about their quality of life. Patients' state anxiety and depression symptoms significantly diminished at discharge (0.000), whereas their perception of general health status rose (0.000). Caregivers' perceived strain also significantly decreased (0.001) and the perceived device management skill grew both for patients and caregivers (0.000). A substantial amount (36%) of psychologically frail patients and caregivers, although improving their emotional condition, never reached that of the less frail subjects. At the 6-month follow-up, both patients and caregivers appeared stable in evaluating respectively their general health and their caregiving-related strain, compared to discharge. Our data show that a comprehensive inpatient rehabilitation program improves the emotional state of LVAD patients and of their caregivers, even in psychologically frailer subjects. Team approach makes patients and caregivers self-confident about device management, increasing their knowledge, clarifying their doubts, and encouraging them to handle the difficulties met during the rehabilitation period, suggesting strategies to cope with daily life at home.

Effect of cardiac rehabilitation on cardiovascular risk factors in chronic heart failure patients.

IntroductionCardiac rehabilitation improves disease-related symptoms, quality of life, and clinical outcomes. This study was done to evaluate the effect of cardiac rehabilitation program on cardiovascular risk factors in chronic heart failure patients as well as functional capacity and health related quality of life.MethodsThe study was conducted on 80 Patients with chronic stable heart failure. All patients had full history and thorough physical examination. Body mass index (BMI), waist circumference, glycated hemoglobin (HbA1c), lipid profile, and echocardiography, all of which were done before and after recruitment in a 2 months cardiac rehabilitation program (through prescribed exercise training, 2 sessions/week for 2 months). The changes in functional capacity were evaluated by 6-min walk test (6MWT) and the changes in the health related quality of life were measured by Minnesota living with heart failure questionnaire (MLHFQ), both were done before and after the rehabilitation program.ResultsThere was a highly significant reduction in the blood pressure, heart rate, BMI, waist circumference, the smokers’ number and the glycated hemoglobin (HbA1c) (P < 0.01). However, there was no statistically significant reductions in low density lipoproteins (LDL), Triglycerides (P > 0.05). Highly significant improvements were noted in the functional capacity and the health related quality of life as evidenced by improvement in the 6MWT and the MLHFQ scores (total score, physical and psychological domains, P < 0.01).ConclusionCardiac rehabilitation had a significant improvement of cardiovascular risk factors, functional capacity and Health related quality of life in patients with chronic heart failure.

Effect of cardiac rehabilitation programme following elective percutaneous coronary angiography on depressive symptoms: A cohort study

BackgroundDepression is a common condition in cardiac patients. We investigated the effect of cardiac rehabilitation on depressive symptoms as detected by Beck depression inventory II score (BDI) in patients who underwent percutaneous coronary intervention (PCI). MethodsIn this cohort, 95 patients met our criteria. Patients were then studied in two groups based on their participation in the rehabilitation program to rehabilitation (exposure) and the control (non-exposure) groups. The control group consisted of those who only participated in the introductory session and decided not to continue the program. Finally, demographic and clinical parameters as well as the BDI scores were compared between the study groups. ResultsData of 35 patients who completed rehabilitation program was compared with 60 patients who did not. There was no significant difference between the study groups regarding the demographic and clinical variables, except for a higher frequency of family history for CAD in the control group (p<0.001). The frequency of the patients with no or mild depression was significantly higher in the rehabilitation group than the controls (p=0.02). There was also a significant increase in the BDI score of the control group and a significant decrease in the rehabilitation group (p<0.001). After adjustment for confounders (family history and severity of CAD), not attending the rehabilitation program was a strong risk factor for depression (OR=10.8, 95% CI: 1.3, 88.5; P=0.027). ConclusionOverall, this study showed that not attending cardiac rehabilitation program following elective PCI was a risk factor for depression.

Effect of cardiac rehabilitation program on the Framingham risk score and C-reactive protein after CABG

Introduction: Coronary artery bypass grafting (CABG) does not have an effect on the etiopathogenic factors of atherosclerosis, thus, it is crucial to control risk factors. Objective: To analyze the effect of a cardiac rehabilitation (CR) program on cardiovascular risk factors, the Framingham risk score (FRS) and levels of C-reactive protein (CRP) of patients undergoing CABG. Methods: A descriptive, cross-sectional and retrospective study was conducted with a sample of 49 patients, who were participating in a program (24 weeks). Body mass index (BMI), waist circumference (WC), FRS, risk (%) of developing coronary artery disease in 10 years (CAD risk), serum levels of LDL-c, triglycerides (TG) and CRP were assessed. Results: The variables BMI, WC, LDL-c, TG, CRP levels, FRS and CAD risk showed significant reductions (p

Effect of Cardiac Rehabilitation Program on Quality Of life of Patients Undergoing Heart Valves Surgeries

Cardiac rehabilitation is a safe and effective way to treat patients who have experienced cardiac events. The aim of the present study is to evaluate the effectiveness of cardiac rehabilitation program on quality of life of patients undergoing heart valves surgeries. Quasi-experimental, pretest – posttest was utilized in this study. A convenience sample of sixty adult male and female patients .The first tool Patient’s health need assessment sheet second tool German version of the Short-Form Health Survey (SF-36). Results concluded that; All subscales scores of the SF-36 survey was shown to have a significant increase after application of cardiac rehabilitation program. Conclusion: Providing written program for patients was much more effective on improvement health-related quality of life of patients undergoing heart valvular surgeries. Recommendations: a nurse rehabilitator is of great value in both cardio thoracic surgery department and the out-patient clinic and a rehabilitation program are of great importance for the cardiac patients.

Predictors of changes in functional capacity on a cardiac rehabilitation program

IntroductionThe effectiveness of cardiac rehabilitation programs (CRP) strongly influences the recovery of functional capacity (FC), resulting in improved prognosis and survival. ObjectiveTo determine the cardiovascular risk factors that predict changes in FC in patients on CRP. MethodsWe performed a cross-sectional descriptive retrospective study of patients who began a CRP between January 2008 and December 2013. The dependent variable was changes in FC estimated in metabolic equivalents (METs) achieved in stress testing at the beginning and end of the phase II program. The independent variables were age, gender, dyslipidemia, diabetes, smoking, body mass index, physical activity level and reason for referral to the CRP. ResultsThe sample included 1399 patients, of whom 1125 (80.4%) completed the program. FC improved in most patients (93%), with a mean gain of 1.45±1.19 METs. Patients aged 45–65 and over 65 years achieved a greater increase in FC compared with other age groups. Patients admitted to the CRP after coronary artery bypass graft surgery obtained a greater improvement in FC compared to patients with acute coronary syndrome. Non-diabetic patients benefited more than diabetic patients. No significant differences were seen between the groups in the other variables. ConclusionThis study highlights the need for new and individualized approaches in certain subgroups of patients on CRP.