Home-based exercise training is an important therapeutic strategy in chronic heart failure patients with sleep apnoea, and strength training resulted in a higher increase in muscle strength and endurance.

SUMMARYThe 6 minute walk test (6 MWT) has been shown to provide a clinically useful index of functional capacity in chronic heart failure. We hypothesized that similar results would be found in patients who had a recent (ie, within a week) myocardial infarction (MI). Twenty-five patients (23 males, aged 43 to 72 years) who had undertaken an exercise stress test without complications underwent 3 consecutive 6 MWTs (1 hour apart). Heart rate, systolic and diastolic blood pressure, the level of perceived exertion (Borg scale), and the walking distance were determined. In addition, chest pain was assessed by a 0 to 10 numerical rating scale (NRS) and the ECG was continuously monitored. All subjects were able to successfully complete the exercise tests without major cardiovascular complications: mild chest pain (NRS 1 to 3) was found in 3 patients. A Bland-Altman analysis revealed that the mean bias ± 95% confidence interval of the differences on distance walked between test 2 -test 1 were substantially higher than test 3 -test 2 differences (18 ± 66 m and 6 ± 41 m, respectively). The intraclass correlation coefficients were consistently high for all physiological and sensorial responses at the end of the 6 MWTs (range, 0.75 to 0.95). The 6 MWT is a safe and reproducible measurement of functional capacity in stable patients after a noncomplicated MI, even when performed within a week of the event. Therefore, this test might be useful for the evaluation of exercise tolerance in phases I and II of inpatient cardiovascular rehabilitation programs or to assess functional responses to selected interventions. (Int Heart J 2006; 47: 533-540)

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Objective: To evaluate the prevalence of myocardial perfusion abnormalities and the possible association between myocardial perfusion defects and traditional coronary artery disease (CAD) risk factors as well as systemic lupus erythematosus (SLE) related risk factors. Patients and methods: Female patients with SLE, disease duration .5 years, age 18-55 years, who had used steroids for at least one year were enrolled. Traditional CAD risk factors evaluated were arterial hypertension, diabetes mellitus, dyslipidaemia, postmenopausal status, smoking, obesity, and premature family CAD profile. Myocardial perfusion scintigraphy was evaluated by single photon emission computed tomography with technetium 99m-sestamibi at rest and after dipyridamole induced stress. Results: Eight two female patients with SLE without angina pectoris with mean (SD) age 37 (10) years, disease duration 127 (57) months, SLE Disease Activity Index (SLEDAI) score 6 (5), and SLICC/ACR-DI score 2 (2) were evaluated. Myocardial perfusion abnormalities were found in 23 patients (28%). The mean (SD) number of CAD risk factors was 2.2 (1.6). There was a significant positive correlation between age and number of CAD risk factors. Lower high density lipoprotein (HDL) cholesterol level showed a significant association with abnormal scintigraphy. Logistic regression analysis showed that lower HDL cholesterol level and diabetes mellitus were associated with myocardial perfusion abnormalities. Current vasculitis was also associated with abnormal scintigraphy. Conclusions: Lower HDL cholesterol level and diabetes mellitus have a significant influence on abnormal myocardial perfusion results found in asymptomatic patients with SLE. Current vasculitis was associated with abnormal myocardial scintigraphy. These data suggest that abnormal myocardial scintigraphy may be related to subclinical atherosclerosis.T he survival of patients with systemic lupus erythematosus (SLE) has improved in the past three decades. Despite the improved survival patients with SLE still die at a rate that is three times greater than that of the general population.

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