(1) Background: Current guidelines emphasize the importance of regular moderate and/or high intensity aerobic exercises in cardiovascular disease prevention. Our study aimed to evaluate the utility of the International Physical Activity Questionnaire Long Form (IPAQ-L) for its physical activity (PA) quantification in patients with heart failure with reduced ejection fraction. (2) Methods: We conducted a cross-sectional study of 110 patients aged between 34 and 69 years admitted to the Cardiovascular Rehabilitation Clinic. All patients underwent a clinical examination, blood tests, a cycle ergometer exercise stress test and individual assessment of their weekly PA level using the IPAQ-L. (3) Results: Obesity, hypertension and type 2 diabetes were highly prevalent in our study group but did not influence the IPAQ-L results. In terms of physical performance, moderate intensity was the most common level of intensity found in our study group. Regarding the data on the relationship between the IPAQ-L questionnaire and cardiopulmonary exercise testing (CPET) parameters, vigorous PA was correlated with predicted maximal oxygen uptake (p = 0.025) and moderate PA, in addition to walking, were correlated with heart rate reserve (p = 0.005 and p = 0.009, respectively). (4) Conclusions: IPAQ-L can be used for the evaluation of individual PA levels within a cardiovascular rehabilitation program, but cannot substitute for the importance and utility of CPET.
The bidirectional relation between body mass index (BMI) and heart failure (HF) is complex and not fully understood. The obesity paradox phenomena is controversial and related to patient selection, parameters used for defining abnormal weight, characteristics of HF. Our study sustain the importance of controlling risk factors, in particular plasma glucose, lipid levels, as well as hypertension in patients with HF and BMI over 25 kg/m2. Also, in contrast to the randomized control studies our results can only partially support data related to obesity paradox phenomena.
Repetitive or recurrent hospitalizations are a general major health issue in patients with chronic disease. Congestive heart failure, is associated with a high incidence and presence of early rehospitalization, but variables in order to identify patients at increased risk and also an analysis of potentially remediable factors contributing to readmission have not been previously reported and it remains still a difficult problem. We retrospectively assessed 100 patients aged between 48-85 years old, of which 75% were men, who had been hospitalized with documentation of congestive heart failure in St. Spiridon County Emergency Hospital. They were hospitalized between 2010-2017. Even if recurrent heart failure was the most common cause for readmission or rehospitalization, other cardiac disorders and noncardiac illnesses were also accounted for readmission. Predictive factors of an increased probability of readmission included prior patient�s medical heart failure history, heart failure decompensation precipitated or accelerated by an ischaemic episode, atrial fibrillation or uncontrolled hypertension. Factors contributing to preventable readmissions included noncompliance with medications or diet, inadequate discharge planning or follow-up, failure of both social support system and the seek of a promp medical attention when symptoms reappeared. We also identified an inappropriate colaboration with family doctors especially for the patients from rural areas. Patients were more likely to cite side effects of prescribed medications rather than nonadherence as a precipitating factor for readmission. Thus, we can appreciate that early rehospitalization in patients with congestive heart failure may be avoidable in up to 50% of cases. Identification of high risk patients is possible and also necessary shortly after admission in order to identify nonpharmacological interventions designed to decrease readmission frequency.
Obesity, a component of the metabolic syndrome, is a rising public health problem, continuously increasing in the European countries. The therapeutic success of the patient with metabolic syndrome requires a multidisciplinary approach to lifestyle changes, weight loss, continuous and dynamic dietary improvement, sedentary reduction, normalization of blood pressure, glycemia and lipid parameters. We performed a retrospective study that was conducted in the Clinical Rehabilitation Hospital in Iasi, with 4627 patients that were admitted in the Cardiovascular Rehabilitation Clinic from January 2011 to December 2015 with the diagnosis of metabolic syndrome according to WHO definition (Group 1) or with other comorbidities (Group 2). In the first group were included 1064 patients diagnosed with metabolic syndrome. This group has predominantly smoking female patients. Also, in group 1 were diagnosed more patients with left ventricular hypertrophy and coronary heart disease compared to group 2. Most of the patients with inflammatory syndrome were included in the group without metabolic syndrome (group 2). The results of our study confirm that metabolic syndrome is a cluster of abnormalities whose evolution determines the development of coronary heart disease. All this would advocate for treating metabolic syndrome as the primary method of preventing cardiovascular disease.
The Romanian academic publishing market has recently gained a new volume bearing the title “Thirty Years since the End of the Cold War” [“30 de ani de la sfârşitul Războiului Rece”], edited and printed by Editura ASE, the publishing outlet of the Bucharest University of Economic Studies. This 435-page work was published under the supervision of Associate Professor Marius-Cristian Neacşu, Ph.D. as its coordinator and author, alongside several other co-authors under the patronage of the Master’s Program in Geopolitics and Business.
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