Influence Of Cardiac Rehabilitation Research Articles

Influence of cardiac rehabilitation on blood pressure in patients with coronary artery disease

Abstract Funding Acknowledgements Type of funding sources: None. Introduction One of the main goals of cardiac rehabilitation is the optimalisation of the cardiovascular risk to prevent the progression of heart disease. Arterial hypertension is one of the most important risk factors that however remains often undertreated. Purpose We analysed the patient data from our cardiac rehabilitation center over the last 3 years to assess the evolution in exercise capacity and blood pressure before and after the rehabilitation program. Methods Patients diagnosed with coronary artery disease (acute coronary syndrome, elective percutaneous coronary intervention or coronary artery bypass graft) between October 2019 and September 2022 were retrospectively included if they followed at least 50% of the total training sessions. Mean blood pressure at the beginning and end of the cardiac revalidation was derived from the mean values of the first 5 sessions and of the last 5 sessions. A change in 5 mmHg was investigated. Results The study enrolled 378 patients, of which 17 % female, with a mean age of 65.3 ± 9.68 years. Every patient followed an average of 42 training sessions (over < 6 months) and 149 patients (41%) had a systolic blood pressure drop of at least 5 mmHg. This decrease was more prevalent in men (133 of 149 (89%) in this group vs. 171 of 218 (78%) in the group with no difference in blood pressure (p <0,05)). These 149 patients had higher systolic blood pressure at the beginning of the sessions (mean systolic blood pressure of 132 ± 9,64 mmHg, p <0,05) and a significant difference in the number of patients who stopped smoking (86 of 129 (58%) vs. 98 of 218 (45%) (p< 0.05)) and were more likely to have no acute coronary syndrome (i.e. more elective procedures) (107 of 149 (72%) vs. 133 of 218 (61%) (p <0,05)). There was no difference in the antihypertensive treatment between the 2 groups at the beginning of the cardiac rehabilitation. The evolution in exercise capacity between the beginning and the end of the rehabilitation sessions showed in both groups together an increase in exercise capacity of 3ml/min/kg in peak VO2 (=18% improvement in peak VO2). In the group with a decrease of 5 mmHg in blood pressure, the exercise capacity improved on average with 1,6 METS (32%) vs. 1,1 METS (19%) in the group with no change in blood pressure. In other words, a positive trend could be observed for a drop in the systolic blood pressure with at least 5 mmHg in relation with an improvement in exercise capacity (p=0,06). The mean systolic blood pressure for all patients at the end of the cardiac rehabilitation was 124 ± 8.36 mmHg. Conclusion Following cardiac rehabilitation in patients with coronary artery disease, a decrease in blood pressure was seen in 41% of the participants. This decrease was mainly seen in males that stopped smoking and had no acute coronary disease. A trend towards a significant relation between improved exercise capacity (in METS) and improved blood pressure was observed.

Cardiac rehabilitation may influence leptin and VEGF A crosstalk in patients after acute coronary syndrome

Leptin, a well-proven cardiovascular risk factor, influences vascular endothelial growth factor A (VEGF A) synthesis via hypoxia-inducible factor 1 alpha (HIF-1A), nuclear factor kappa-light-chain-enhancer of activated B cells (NfkB) and NILCO (Notch, interleukin 1 [IL1] and leptin cross-talk outcome) pathways. This study aimed to investigate the influence of cardiac rehabilitation (CR) on HIF-1A, NfkB and NILCO dependent leptin and VEGF A cross-talk in patients after acute coronary syndrome (ACS). Fifty post-ACS patients underwent a 2-week CR programme (study group S) and were compared to 50 post-ACS subjects who did not undergo CR (control group K). In group S, at baseline and at completion and in group K once, anthropometric, body composition, blood pressure and heart rate measurements were taken and blood sampling was performed. Serum levels of leptin, VEGF A, VEGF receptor 2 (VEGF R2), HIF-1A, NfkB, interleukin 1-alpha (IL1-alpha) and Notch 1 were determined. In group S, serum VEGF A levels increased while leptin, HIF-1A and VEGF R2 levels decreased and completion but not baseline serum leptin correlated positively with serum VEGF A. Also, serum completion VEGF A correlated positively with NfkB and HIF-1A in group S. Correlation analysis in group S confirmed the significant role of the NILCO pathway in the regulation of VEGF A serum levels mediated by HIF-1A and NfkB. CR may induce the predomination of the NILCO pathway interacting with HIF-1A and NfkB over leptin canonical and non-canonical signalling pathways in the leptin influence on VEGF A in post-ACS patients.Trial registration: ClinicalTrials.gov ID: NCT03935438. The CARDIO-REH randomised study.

The influence of cardiac rehabilitation on the muscular strenght of the hand flexors, muscle mass and walking distance in middle-aged men, depending on the onset of coronary heart disease

Objective:The objective is to assess the influence of cardiac rehabilitation (CR), represented by self-controlled walking in middleaged men with different onsets of coronary heart disease (CHD), on the muscular strength of the hand flexors, muscle mass and 6-minute walking distance.Methods:90 men aged from 45 to 65 with the same prescriptive CHD with different onsets: myocardial infarction (MI) – 56 patients, or stable angina – 34 patients were examined. After 9 months of CR we have assessed the muscular strength of the hand flexors (MSHF), have run the bioelectrical impedance analysis and 6-minute walking test, have determined the level of testosterone in blood serum.Results:In patients with CHD with MI as an onset, MSHF of the right hand increased from 43 to 49 DAN at the average, and from 41 to 46 DAN – of the left hand; equity proportion of muscle tissue increased from 48.4 to 48.8% , 6-minute walking distance – from 450 to 500 meters. In patients with CHD with stable angina as an onset, the proportion of muscle tissue decreased from 48.2 to 47.3 %, 6-minute walking distance – from 405 to 400 meters without significant improvement of MSHF.Conclusions:9-month CR in patients after MI had a positive effect on MSHF, muscle tissue and stamina as opposed to the patients with stable angina.

The influence of cardiac rehabilitation according to the C model on exercise tolerance and hemodynamic indices in patients after cardiac incident

Background and Study Aim: Cardiovascular diseases are currently classified as civilization diseases. The number of cases since the 20th century has dramatically increased. Currently, as many as 46% of all deaths in Poland are caused by diseases of the circulatory system. The aim of the study is to assess the impact of cardiac rehabilitation according to the C model on exercise tolerance and hemodynamic indices in patients after a cardiac incident. Material and Methods: The research was carried out in the Department of Cardiac Rehabilitation in Szymbark. The study group consisted of 32 patients who, after physical examination at admission, were qualified for the preliminary assessment of physical fitness on the basis of 6MWT. The test was carried out the day after the admission, according to current standards. Subsequently, the examined persons underwent a 28-day cycle of early cardiac rehabilitation according to the C model. Results: As a result of a 4-week cardiac rehabilitation, a statistically significant improvement in physical performance was obtained, with a distance increase of 68.34 m on average. A statistically significant change in the level of fatigue according to Skala Borga after the completion of the rehabilitation cycle was demonstrated. Patients with normal body weight, overweight and obesity received a similar increase in 6MWT results due to the rehabilitation cycle. Conclusions: The results of this study indicate the urgent need to educate patients in the prevention and prevention of cardiovascular disease and to increase the availability of rehabilitation for all people after a cardiological incident.

The Influence of Cardiac Rehabilitation on the Health State After ACS

The Influence of Cardiac Rehabilitation on the Health State After ACS

Possible associations between recovery aerobic training and increasing the length of telomeres

It is known that in recent decades, methods of cardiac rehabilitation have been widely used in patients after acute myocardial infarction, coronary syndrome and cardiac operations. The main active factor in cardiac rehabilitation is a program of physical training. On the other hand, it has been established that physical training and/or sufficient physical activity positively affects the length of human telomeres. It is assumed that under the influence of cardiac rehabilitation, the improvement in the course of the disease may be due to an increase in telomere length. We found studies with such positive associations. This primarily concerns people with prediabetes, overweight, multiple risk factors. We established the importance of training in physically active people, athletes, especially with great sports experience. It seems promising to perform studies (training/telomeres) in patients with history of acute myocardial infarction, acute coronary syndrome and cardiac surgery.

The Influence of Cardiac Rehabilitation on Inflammation and Metabolic Syndrome in Women With Coronary Heart Disease

Metabolic syndrome (MetS) and increased inflammatory markers, both predictors of future cardiovascular events, are more prevalent in women with coronary heart disease (CHD). The influence of cardiac rehabilitation (CR) on MetS and inflammatory biomarkers is not well characterized for women. : The purpose of this article was to examine the effects of a 12-week behaviorally enhanced CR exclusively for women compared with traditional CR on components of the MetS and inflammatory markers in women with CHD. The randomized clinical trial used 2 treatment groups, both receiving a comprehensive 12-week CR program, with 1 group receiving a motivationally enhanced intervention exclusively for women. A subset of 91 women (mean age, 61.6 years) from the parent study provided serum samples to examine the effects of CR on high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha), and intercellular adhesion molecule-1 (ICAM-1). After CR, the total sample of women demonstrated significant reductions in hsCRP (P =.002), IL-6 (P <.001), TNF-alpha (P =.010), and ICAM-1 (P =.016). Women in the gender-tailored CR program significantly improved all biomarker levels compared with baseline (P <.05 for all), whereas those in the traditional group improved only hsCRP (P <.05) and IL-6 (P <.05) levels. The combined study group demonstrated improvements in several components of MetS (triglycerides, waist circumference, and systolic blood pressure) but not in others (high-density lipoprotein cholesterol, fasting glucose, and diastolic blood pressure). Cardiac rehabilitation promotes greater improvements in inflammatory biomarkers than in components of MetS for women with CHD. Improvements in body composition or weight may not be a precondition for the benefits of exercise because of loss of abdominal fat. Examining components of MetS as continuous variables is recommended to prevent lost information inherent in dichotomization.

The influence of cardiac rehabilitation on HSCRP level in patients after myocardial infarction treated by percutaneous coronary interventions with or without stenting

The influence of cardiac rehabilitation on HSCRP level in patients after myocardial infarction treated by percutaneous coronary interventions with or without stenting