Background Exercise‐based rehabilitation is an important part of treatment patients following coronary artery bypass graft (CABG) surgery. Hypothesis To evaluate effect of very short/short‐term exercise training on cardiopulmonary exercise testing (CPET) parameters. Methods We studied 54 consecutive patients with myocardial infarction (MI) treated with CABG surgery referred for rehabilitation. The study population consisted of 50 men and 4 women (age 57.72 ± 7.61 years, left ventricular ejection fraction 55% ± 5.81%), who participated in a 3‐week clinical and 6‐month outpatient cardiac rehabilitation program. The Inpatient program consisted of cycling 7 times/week and daily walking for 45 minutes. The outpatient program consisted mainly of walking 5 times/week for 45 minutes and cycling 3 times/week. All patients performed symptom‐limited CPET on a bicycle ergometer with a ramp protocol of 10 W/minute at the start, for 3 weeks, and for 6 months. Results After 3 weeks of an exercise‐based cardiac rehabilitation program, exercise tolerance improved as compared to baseline, as well as peak respiratory exchange ratio. Most importantly, peak VO2 (16.35 ± 3.83 vs 17.88 ± 4.25 mL/kg/min, respectively, P < 0.05), peak VCO2 (1.48 ± 0.40 vs 1.68 ± 0.43, respectively, P < 0.05), peak ventilatory exchange (44.52 ± 11.32 vs 52.56 ± 12.37 L/min, respectively, P < 0.05), and peak breathing reserve (52.00% ± 13.73% vs 45.75% ± 14.84%, respectively, P < 0.05) were also improved. The same improvement trend continued after 6 months (respectively, P < 0.001 and P < 0.0001). No major adverse cardiac events were noted during the rehabilitation program. Conclusions Very short/short‐term exercise training in patients with MI treated with CABG surgery is safe and improves functional capacity.

The study confirmed that the reduction of BMD depends on age and choice of measurement site. The best correlation was obtained in the women with osteopenia at all measurement sites. The discovery of vertebral fractures by lateral thoracic and lumbar spine radiography improves prompt treatment. Reference values of BMD do not exclude vertebral fractures. Of vertebral fractures, 72.5% were asymptomatic and thus spine radiographies are obligatory. Currently discussed is the position of DXA for measuring BMD as a method of detection for patients at risk of fracture.

Although true treatment resistant hypertension is relatively rare (about 7.3% of all patients with hypertension), optimal control of blood pressure is not achieved in every other patient due to suboptimal treatment or nonadherence. The aim of this study was to compare effectiveness, safety and tolerability of various add-on treatment options in adult patients with treatment resistant hypertension The study was designed as multi-center, prospective observational cohort study, which compared effectiveness and safety of various add-on treatment options in adult patients with treatment resistant hypertension. Both office and home blood pressure measures were recorded at baseline and then every month for 6 visits. The study cohort was composed of 515 patients (268 females and 247 males), with average age of 64.7 ± 10.8 years. The patients were switched from initial add-on therapy to more effective ones at each study visit. The blood pressure measured both at office and home below 140/90 mm Hg was achieved in 80% of patients with add-on spironolactone, while 88% of patients taking this drug also achieved decrease of systolic blood pressure for more than 10 mm Hg from baseline, and diastolic blood pressure for more than 5 mm Hg from baseline. Effectiveness of centrally acting antihypertensives as add-on therapy was inferior, achieving the study endpoints in <70% of patients. Adverse drug reactions were reported in 9 patients (1.7%), none of them serious. Incidence rate of hyperkalemia with spironolactone was 0.44%, and gynecomastia was found in 1 patient (0.22%). In conclusion, the most effective and safe add-on therapy of resistant hypertension were spironolactone alone and combination of spironolactone and a centrally acting antihypertensive drug.

Background: Exercise-based rehabilitation is an important part of treatment patients following acute myocardial infarction (MI). However, data are scarce on the efffects of very short-term exercise programs in patients with acute MI treated with primary percutaneous coronary intervention (pPCI). The aim of the study was to evaluate the effects of very short-term exercise training on cardiopulmonary exercise testing (CPET) parameters in patients suffering acute MI treated with pPCI. Methods: We studied 40 consecutive patients with MI treated with pPCI reffered for rehabilitation to our institution. The study population consisted of 39 men and 1 women (age 50,60±8,40 years, left ventricular ejection fraction 53,05±6,74 %), who participated in 3-week clinical cardiac rehabilitation program. The program consisted of cycling for 7 times/week, and daily walking for 45 min at intensity of 70-80% of the individual maximal heart rate. All patients performed symptom-limited CPET on a bicycle ergometer with a ramp protocol of 10w/min. The CPET also performed after cardiac rehabilitation programs. Results: After 3 weeks of exercise-based cardiac rehabilitation program improved exercise tolerance as compared to baseline (peak workload 111,50±15,07 vs 129,00±12,77 watts, respectively, p<0,001), as well as peak respiratory exchage ratio (1,02±0,10 vs 1,08 ± 0,13, respectively, p<0,05). Peak systolic blood pressure, heart rate, peak and after 1 minute of rest were also improved. Most importantly, peak VO2 (18,17±3,30 vs 20,64±3,27 ml/kg/min, respectively, p<0,001), peak VCO2 (1,65±0,28 vs 1,96±0,25 ml/kg/min, respectively, p<0,001), peak ventilation (48,61±10,70 vs 57,27±9,85 L/min, respectively, p<0,001) and peak oxygen pulse (14,16±2,62 vs 60.18±14.19 ml/ beat, respectively, p<0,05) were also improved. No major adverse cardiac events were noted during the rehabilitation program. Conclusion: Very short-term exercise training in patients with acute MI treated with pPCI is safe and improves functional capacity, as well as test duration, work load and heart rate response. cardiac pulmonary exercise testing, exercise training, cardiac rehabilitation, myocardial infarction AbstractKey Words