Are Cardiac Events During Exercise Therapy for Heart Failure Predictable From the Baseline Variables?

Nishi, Isao; Noguchi, Teruo; Furuichi, Shinichi; Iwanaga, Yoshitaka; Kim, Jiyoong; Ohya, Hideo; Aihara, Naohiko; Takaki, Hiroshi; Goto, Yoichi

doi:10.1253/circj.71.1035

Cited by 12 publications

(9 citation statements)

References 16 publications

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“…17 ACR should be recommended for moderate-and low-risk patients, whereas RCR should be recommended for patients in a more severe clinical state, high-risk patients with, for instance, developed heart failure. Those patients more often develop complications or worsening of their functional state, including cardiac events, during exercise therapy, 42,43 which is why heart failure patients should be supervised much more carefully, needing medical care 24 h/day at the beginning of the CR program at least and is the reason why we excluded patients with left ventricular ejection fraction <35%. Randomization was not performed in our study because in some regions of our country only one type of CR, ambulatory or residential, is available and so there is no choice for doctors and/or patients.…”

Section: Discussionmentioning

confidence: 99%

Health-Related Quality of Life in Patients With Coronary Heart Disease After Residential vs Ambulatory Cardiac Rehabilitation

Jegier¹,

Szmigielska²,

Bilińska³

et al. 2009

Circ J

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he number of people who survive myocardial infarction or undergo percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG) is growing. These people require adequate treatment and care not only pharmacologically but also nonpharmacologically: physiotherapeutic, psychological and educational. Comprehensive cardiac rehabilitation (CR) is designed to support patients with coronary heart disease (CHD) in their physical, psychological and emotional recovery after acute coronary events and to help them change lifestyle and risk factors, as well as to make their lives longer and improve their quality.Most published studies analyzing the effects of CR have revealed a reduction in total mortality by an average of 30% and cardiovascular mortality by an average of 40% [1][2][3][4][5][6][7][8][9][10] and also reduction in cardiovascular events risk. 1,4,11 Recently, not only mortality and morbidity but also healthrelated quality of life (QOL) has become a key goal for patients with CHD. Many published studies have revealed improvements in the health-related QOL of patients with CHD after CR programs, either the residential model or ambulatory CR (ACR). [12][13][14][15][16][17][18][19][20][21][22][23] The aim of this study was to evaluate the impact of different models of CR, residential vs ambulatory, on healthrelated QOL according to the exercise capacity of patients with CHD. MethodsThis study was designed as a nonrandomized prospective multicenter study in Poland: the National Program of Prevention and Therapy of Cardiovascular Diseases (POLKARD). We studied 562 patients with CHD from 9 centers of CR in Poland. Consecutive patients were referred to 3 ACR and 6 residential CR (RCR) centers no longer than 2 weeks after myocardial infarction or PCI, and no longer than 6 weeks after CABG.The reason for the choice of ACR or RCR center was not the patient's clinical state or risk profile for cardiovascular events, but which type of CR was available where the patient lived. Therefore, randomization in our study was impossible.The first group consisted of 313 patients aged 56.1±8.8 (Received April 24, 2008; revised manuscript received October 8, 2008; accepted October 26, 2008; released online January 29, 2009) Background: The aim of this study was to evaluate the influence of residential (RCR) vs ambulatory (ACR) cardiac rehabilitation (CR) on health-related quality of life (QOL) connected with changes in exercise capacity of patients with coronary heart disease (CHD). Methods and Results:The 562 patients with CHD were studied: 313 participants in RCR and 249 participants in ACR. The examination was performed at the beginning of CR and after 8 weeks. QOL was assessed using the EuroQuol 5D (EQ-5D) and SF36 questionnaires. Exercise testing was performed with evaluation of workload during the last stage of the test and rate of perceived exertion intensity. In the first examination, patients from both groups did not differ significantly. After 8 weeks, a similar improvement in QOL was observed in bo...

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Section: Discussionmentioning

confidence: 99%

Health-Related Quality of Life in Patients With Coronary Heart Disease After Residential vs Ambulatory Cardiac Rehabilitation

Jegier¹,

Szmigielska²,

Bilińska³

et al. 2009

Circ J

View full text Add to dashboard Cite

show abstract

“…While systemic exercise training is not indicated for patients with NYHA classification of Class IV heart failure, some patients may be indicated for partial skeletal muscle training. 184 Although exercise training is generally contraindicated for patients who are elderly, have reduced LVEF, are using ventricular assist devices, or are using ICDs, these patients may be indicated for exercise training.…”

Section: (2) Indications Contraindications and Safety Of Exercisementioning

confidence: 99%

“…Cardiac events that may develop during exercise training include hypotension, arrhythmias, and exacerbation of heart failure. 163, 184 The incidence of cardiac events requiring hospitalization is lower in patients undergoing exercise training than in those not undergoing it. 4,37,173, 174 In a study of 111 patients with moderate or severe heart failure who participated in a 3-month exercise training program in Japan, the incidence of cardiac events (exacerbation of heart failure, hypotension, or arrhythmia) that necessitated termination and interruption of exercise training was 5% and 8%, respectively.…”

Section: ) Safetymentioning

confidence: 99%

Guidelines for Rehabilitation in Patients With Cardiovascular Disease (JCS 2012)

2014

Circ J

244

150

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“…16 Before entering the ET program, patients were confirmed not to have evidence of ischemia or severe arrhythmia during a level walking test. All patients gave written informed consent before entering the program.…”

Section: The Cardiac Rehabilitation Programmentioning

confidence: 99%

Effects of Exercise Training in Patients With Chronic Heart Failure and Advanced Left Ventricular Systolic Dysfunction Receiving .BETA.-Blockers

Nishi

Noguchi

Iwanaga

et al. 2011

Circ J

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Background: It remains unclear whether patients with chronic heart failure (CHF) and advanced left ventricular (LV) dysfunction on β-blocker therapy benefit from exercise training (ET). Methods and Results:We studied 45 CHF patients with advanced LV dysfunction [ejection fraction (LVEF) <25%] and impaired exercise tolerance [normalized peak oxygen uptake (PV · O2) <70%] receiving a β-blocker:33 patients participated in a cardiac rehabilitation program with ET (ET group) and 12 did not (inactive control group). Exercise capacity, LV dimension and plasma B-type natriuretic peptide (BNP) were assessed before and after a 3-month study period. At baseline, both groups had markedly reduced LVEF (ET group 18±4% vs. Control group 18±5%, NS) and impaired exercise capacity (normalized PV · O2 51±10% vs. 55±9%, NS). Although one patient in the ET group withdrew from the program due to worsening CHF, no serious cardiac events occurred during the ET sessions. After 3 months, the ET group (n=24) had significantly improved PV · O2 by 16±15% (1,005±295 to 1,167±397 ml/min, P<0.001), while the PV · O2 of the control group was unchanged. LV end-diastolic dimension decreased in both groups to a similar extent, but plasma BNP was significantly decreased only in the ET group (432 to 214 pg/ml, P<0.05). Conclusions:The data indicate that in CHF patients with advanced LV dysfunction on β-blocker therapy, ET successfully improves exercise capacity and BNP without adversely affecting LV remodeling or causing serious cardiac complications. (Circ J 2011; 75: 1649 - 1655

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Are Cardiac Events During Exercise Therapy for Heart Failure Predictable From the Baseline Variables?

Cited by 12 publications

References 16 publications

Health-Related Quality of Life in Patients With Coronary Heart Disease After Residential vs Ambulatory Cardiac Rehabilitation

Health-Related Quality of Life in Patients With Coronary Heart Disease After Residential vs Ambulatory Cardiac Rehabilitation

Guidelines for Rehabilitation in Patients With Cardiovascular Disease (JCS 2012)

Effects of Exercise Training in Patients With Chronic Heart Failure and Advanced Left Ventricular Systolic Dysfunction Receiving .BETA.-Blockers

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