The effects of different initiation time of exercise training on left ventricular remodeling and cardiopulmonary rehabilitation in patients with left ventricular dysfunction after myocardial infarction

Zhang, Youming; Lu, Yao; Tang, Yun; Yang, Di; Wu, Hengfang; Bian, Zhiping; Xu, Juan; Li, Zhuoshi; Wang, Liansheng; Chen, Xiangjian

doi:10.3109/09638288.2015.1036174

Cited by 55 publications

(46 citation statements)

References 47 publications

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“…Previous studies have shown that patients with LV systolic dysfunction benefit more from CR. 22 The number of ACS patients undergoing CR was low for various reasons, as analyzed in previous studies, including financial constraints, difficulties in transportation, conflicts with work, low motivation and geographic distance. There are multiple barriers to CR, three of which have been identified as patient-related, physician-related and health system-related factors.…”

Section: Discussionmentioning

confidence: 99%

Cardiac rehabilitation after acute coronary syndrome: Do all patients derive the same benefit?

Rosa

Abreu

Soares

et al. 2017

Revista Portuguesa de Cardiologia

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Introduction: Cardiac rehabilitation (CR) has been demonstrated to improve exercise capacity in acute coronary syndrome (ACS), but not all patients derive the same benefit. Careful patient selection is crucial to maximize resources. Objective: To identify in a heterogeneous ACS population which patients would benefit the most with CR, in terms of functional capacity (FC), by using cardiopulmonary exercise testing (CPET). Methods: A retrospective analysis of consecutive ACS patients who underwent CR and CPET was undertaken. CPET was performed at baseline and after 36 sessions of exercise. Peak oxygen uptake (pVO 2 ), percentage of predicted pVO 2 , minute ventilation/CO 2 production (VE/VCO 2 ) slope, VE/VCO 2 slope/pVO 2 and peak circulatory power (PCP) (pVO 2 times peak systolic blood pressure) were assessed in two moments. The differences in pVO 2 ( pVO 2 ), %pVO 2 , PCP and exercise test duration were calculated. Patients were classified according to baseline pVO 2 (group 1, <20 ml/kg/min vs. group 2, ≥20 ml/kg/min) and left ventricular ejection fraction (group A, <50% vs. group B, ≥50%). Results: We analyzed 129 patients, 86% male, mean age 56.3±9.8 years. Both group 1 (n=31) and group 2 (n=98) showed significant improvement in FC after CR, with a more significant increase in pVO 2 , in group 1 ( pVO 2 4.4±7.3 vs. 1.6±5.4; p=0.018). Significant improvement was observed in CPET parameters in group A (n=34) and group B (n=95), particularly in pVO 2 and test duration. Conclusion: Patients with lower baseline pVO 2 (<20 ml/kg/min) presented more significant improvement in FC after CR. CPET which is not routinely used in assessement before CR in context of ACS, could be a valuable tool to identify patients who will benefit the most.

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Section: Discussionmentioning

confidence: 99%

Cardiac rehabilitation after acute coronary syndrome: Do all patients derive the same benefit?

Rosa

Abreu

Soares

et al. 2017

Revista Portuguesa de Cardiologia

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“…To demonstrate the connections between an albatross plot and established techniques, we first illustrate the albatross plot using a data set that was originally analysed using effect sizes and which could, therefore, be illustrated in a forest plot. Zhang et al performed a meta‐analysis of randomized trials evaluating the effect of exercise training after an acute MI . They examined the endpoint of left ventricular function (LVEF), subgrouping the trials by the period after the MI during which exercise training was initiated.…”

Section: Applicationsmentioning

confidence: 99%

“…Forest plot of studies of the effect of exercise training on left ventricular fraction after acute myocardial infarction, data from Zhang et al I‐V subtotals represent fixed effect meta‐analyses; D+L subtotals represent random effect meta‐analyses. I‐squared is a relative measure of heterogeneity in relation to total variability within each subgroup.…”

Section: Applicationsmentioning

confidence: 99%

“…Zhang et al performed a meta-analysis of randomized trials evaluating the effect of exercise training after an acute MI. 11 They examined the endpoint of left ventricular function (LVEF), subgrouping the trials by the period after the MI during which exercise training was initiated. We reproduce the results in a forest plot in Figure 5.…”

Section: Example 1: Randomized Trials Of Exercise Trainingmentioning

confidence: 99%

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The albatross plot: A novel graphical tool for presenting results of diversely reported studies in a systematic review

Harrison

Jones

Martin

et al. 2017

Research Synthesis Methods

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Meta‐analyses combine the results of multiple studies of a common question. Approaches based on effect size estimates from each study are generally regarded as the most informative. However, these methods can only be used if comparable effect sizes can be computed from each study, and this may not be the case due to variation in how the studies were done or limitations in how their results were reported. Other methods, such as vote counting, are then used to summarize the results of these studies, but most of these methods are limited in that they do not provide any indication of the magnitude of effect.We propose a novel plot, the albatross plot, which requires only a 1‐sided P value and a total sample size from each study (or equivalently a 2‐sided P value, direction of effect and total sample size). The plot allows an approximate examination of underlying effect sizes and the potential to identify sources of heterogeneity across studies. This is achieved by drawing contours showing the range of effect sizes that might lead to each P value for given sample sizes, under simple study designs. We provide examples of albatross plots using data from previous meta‐analyses, allowing for comparison of results, and an example from when a meta‐analysis was not possible.

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“…In a population diagnosed with myocardial infarction, early-initiated exercise in the acute phase has shown greater benefits on exercise capacity than is the case in exercise interventions initiated in a later treatment phase (11). Systematic reviews investigating the effects of preand post-surgical exercise interventions in patients with NSCLC show that exercise may increase exercise capacity of people following lung resection for NSCLC (6,12,13).…”

mentioning

confidence: 99%

Effect of postsurgical rehabilitation programmes in patients operated for lung cancer: A systematic review and meta-analysis

Sommer¹,

Staerkind²,

Christensen³

et al. 2018

J Rehabil Med

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The effects of different initiation time of exercise training on left ventricular remodeling and cardiopulmonary rehabilitation in patients with left ventricular dysfunction after myocardial infarction

Cited by 55 publications

References 47 publications

Cardiac rehabilitation after acute coronary syndrome: Do all patients derive the same benefit?

Cardiac rehabilitation after acute coronary syndrome: Do all patients derive the same benefit?

The albatross plot: A novel graphical tool for presenting results of diversely reported studies in a systematic review

Effect of postsurgical rehabilitation programmes in patients operated for lung cancer: A systematic review and meta-analysis

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