Efficacy of risk stratification protocols and clinical, physical, and biochemical parameters to previse signals and symptoms during cardiovascular rehabilitation programs

Abstract

Introduction Despite the benefits, cardiovascular rehabilitation programs (CRPs) have been related to the appearance of signals and symptoms. Risk stratification protocols are commonly used to identify risks during the physical exercise; however, studies that investigate their efficacy to previse signals and symptoms are inconclusive. Furthermore, clinical, physical, and biochemical parameters have been used as risk markers for the appearance of adverse events, and to investigate their efficacy to previse signals and symptoms during the CRP sessions that could better guide the strategies adopted on these programs. Objectives The aim of this study was to evaluate the correlations between risk stratification protocols and clinical, physical, and biochemical parameters with the appearance of signals/symptoms during CRP, as well as to evaluate if modifications on clinical, physical, and biochemical parameters could influence in the appearance of signals/symptoms during CRP. Materials and methods The study was prospectively registered at ClinicalTrials.gov (NCT03446742). Forty-four patient participants of a CRP will be evaluated. First, their risk stratification is going to be performed by 2 evaluators and their clinical, physical, and biochemical parameters are going to be measured. Then, the patients are going to be followed during 24 sessions during their CRP routines in order to identify appearance of their signals/symptoms. So, the patients are going to perform their cardiovascular rehabilitation routines for 6 months and then, their clinical, physical, and biochemical parameters are going to be measured again and they are going to be followed during 24 sessions during their CRP routines in order to identify the appearance of their signals/symptoms.

Are signs and symptoms in cardiovascular rehabilitation correlated with heart rate variability? An observational longitudinal study

“…1). 23 The program was carried out three times a week on alternate days (Mondays, Wednesdays and Fridays), and each session lasted 60 min. Figure 1 shows the sequence of the program and the moments when the monitoring was carried out.…”

“…Figure 1 shows the sequence of the program and the moments when the monitoring was carried out. More information is available on the full protocol of the study that this work belongs to 23 …”

“…More information is available on the full protocol of the study that this work belongs to. 23 In the resistance stage, each patient carried out an individualized aerobic protocol, prescribed accordingly to their HR reserve values, 24 established by the most appropriate training ranges for each individual (40-70% of the HR reserve for patients diagnosed with cardiovascular, pulmonary and metabolic diseases, and 60-80% of HR reserve for individuals who carried out the program preventively 25 ), using a bicycle and a treadmill, with 15 min of exercise in each ergometer, totaling 30 min.…”

An investigation into whether cardiac risk stratification protocols actually predict complications in cardiac rehabilitation programs?

“…Participants of this study were recommended to perform 60-minutes of supervised exercise 3 times per week. Each exercise session was divided into 4 phases: (1) initial rest, 5 minutes – aimed to assess the patients’ initial cardiorespiratory parameters and complications that occurred outside the rehabilitation environment; (2) warm-up, 15 minutes – patients perform progressive resistance exercise aimed to prepare their body for the next step progressively; (3) Aerobic exercise, 30 minutes – patients performed moderate aerobic exercise on a treadmill and/or bike, with exercise intensity prescribed individually and based on the heart rate reserve formula; 25 and (4) relaxation, 10 minutes – return the patient’s cardiorespiratory parameters to values close to the initial ones.…”

“…These complications were recorded per session and only one occurrence was considered if participants reported the same complication more than one time in the same session. More details regarding the cardiac rehabilitation program and simple complications data collection were already reported by Vanzella et al 25 Participants were also asked to reported any complications that occurred out of the cardiac rehabilitation environment. Those would be included in the final analysis.…”