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Nakajima M, Mitsuoka H, Orimoto Y, Otsuka S, Morisawa T, Takahashi T, Ishibashi H. Determination of Treatment Efficacy after Revascularization of Intermittent Claudication Patients by Physical Function Assessment. Ann Thorac Cardiovasc Surg 2024; 30:23-00069. [PMID: 37394497 PMCID: PMC10851441 DOI: 10.5761/atcs.oa.23-00069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 05/29/2023] [Indexed: 07/04/2023] Open
Abstract
PURPOSE There have been few reports examining changes in physical activity (PA) after revascularization of lower extremities from the perspective of physical function at discharge. The purpose of this study was to clarify the effects of physical function before discharge on the amount of PA after discharge in patients who underwent revascularization. METHODS The subjects were 34 Fontaine class II patients admitted for elective surgical revascularization or endovascular treatment at two hospitals from September 2017 to October 2019. Triaxial accelerometers were used to measure changes in sedentary behavior (SB) before admission and 1 month after discharge. Multiple regression analysis was performed on the 6-min walking distance (6MWD) at the time of discharge and the change in SB 1 month after discharge; the cutoff value was calculated from the receiver operating characteristic (ROC) curve. RESULTS SB 1 month after discharge significantly decreased in the decreased SB group compared to the increased SB group (575.5 [400-745.2] vs. 649.5 [453.8-809.2], p <0.01). ROC curve was plotted with SB increase/decrease as the dependent variable and 6MWD at discharge as the independent variable; the cutoff value was 357.5 m. CONCLUSION 6MWD measurement at discharge may help predict changes in SB after discharge.
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Affiliation(s)
- Masaharu Nakajima
- Department of Rehabilitation, Faculty of Health Sciences, Nihon Fukushi University, Handa, Aichi, Japan
| | - Hiroki Mitsuoka
- Department of Vascular Surgery, Aichi Medical University, Nagakute, Aichi, Japan
| | - Yuki Orimoto
- Department of Vascular Surgery, Aichi Medical University, Nagakute, Aichi, Japan
| | - Shota Otsuka
- Department of Rehabilitation, Nozomi Heart Clinic, Osaka, Osaka, Japan
| | | | | | - Hiroyuki Ishibashi
- Department of Vascular Surgery, Aichi Medical University, Nagakute, Aichi, Japan
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Yazgan I, Bartlett V, Romain G, Cleman J, Petersen-Crair P, Spertus JA, Hardt M, Mena-Hurtado C, Smolderen KG. Longitudinal Pathways Between Physical Activity, Depression, and Perceived Stress in Peripheral Artery Disease. Circ Cardiovasc Qual Outcomes 2023; 16:544-553. [PMID: 37470195 PMCID: PMC10561081 DOI: 10.1161/circoutcomes.122.009840] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 06/14/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND One-fifth of the patients with peripheral artery disease (PAD) experience depression and stress. Depression and stress may impact patients' abilities to be physically active, a key recommendation for supporting overall PAD management to improve symptoms and reduce the risk of cardiovascular events. We aimed to study interrelationships between 1-year longitudinal trajectories of depression, stress, and physical activity following a PAD diagnosis. METHODS Patients with new or worsening PAD symptoms enrolled at 10 US PORTRAIT study (Patient-Centered Outcomes Related to Treatment Practices in Peripheral Arterial Disease: Investigating Trajectories) vascular specialty clinics (CT, LA, MI, MO, NC, OH, and RI) were assessed at baseline, 3, 6, and 12 months between June 2, 2011 and December 3, 2015. Depressive symptoms were measured with the 8-item Patient Health Questionnaire, perceived stress with the 4-item Perceived Stress Scale and physical activity with items from the INTERHEART study. Path analysis was used to examine the longitudinal relationship between depression and physical activity and perceived stress and physical activity. RESULTS A total of 766 patients were included (mean age of 68.2 [±9.4] years; 57.7% male). Overall, 17.8% reported significant depressive symptoms, 36.0% experienced increased perceived stress, and 44.1% were sedentary upon PAD diagnosis. A decrease in physical activity preceded a rise in subsequent depressive symptoms (β ranges -0.45 [95% CI, -0.80 to -0.09]; -0.81 [95% CI, -1.19 to 0.42]) over the course of 1 year. Low physical activity scores at the initial presentation were followed by high perceived stress at 3 months (β=-0.44 [95% CI, -0.80 to -0.07]). CONCLUSIONS In symptomatic PAD, a decrease in physical activity was followed by an increased risk of depressive symptoms and perceived stress at subsequent intervals over the course of 1 year following PAD diagnosis and treatment. Integrated behavioral health approaches for PAD, addressing physical activity and managing depression or distress, are indicated as collective PAD treatment goals.
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Affiliation(s)
- Idil Yazgan
- Yale School of Medicine, New Haven, CT (I.Y., G.R., J.C., C.M.-H., K.G.S.)
| | | | - Gaëlle Romain
- Yale School of Medicine, New Haven, CT (I.Y., G.R., J.C., C.M.-H., K.G.S.)
- Vascular Medicine Outcomes (VAMOS) Program, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT (G.R., J.C., C.M.-H., K.G.S.)
| | - Jacob Cleman
- Yale School of Medicine, New Haven, CT (I.Y., G.R., J.C., C.M.-H., K.G.S.)
- Vascular Medicine Outcomes (VAMOS) Program, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT (G.R., J.C., C.M.-H., K.G.S.)
| | - Pamela Petersen-Crair
- Department of Psychiatry, Section of Psychology, Yale School of Medicine, New Haven, CT (P.P.-C., M.A.H., K.G.S.)
| | - John A Spertus
- Saint Luke's Mid America Heart Institute, Kansas City, MO (J.A.S.)
- Department of Biomedical and Health Informatics, School of Medicine, University of Missouri Kansas City, Kansas City, MO (J.A.S.)
| | - Madeleine Hardt
- Department of Psychiatry, Section of Psychology, Yale School of Medicine, New Haven, CT (P.P.-C., M.A.H., K.G.S.)
| | - Carlos Mena-Hurtado
- Yale School of Medicine, New Haven, CT (I.Y., G.R., J.C., C.M.-H., K.G.S.)
- Vascular Medicine Outcomes (VAMOS) Program, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT (G.R., J.C., C.M.-H., K.G.S.)
| | - Kim G Smolderen
- Yale School of Medicine, New Haven, CT (I.Y., G.R., J.C., C.M.-H., K.G.S.)
- Vascular Medicine Outcomes (VAMOS) Program, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT (G.R., J.C., C.M.-H., K.G.S.)
- Department of Psychiatry, Section of Psychology, Yale School of Medicine, New Haven, CT (P.P.-C., M.A.H., K.G.S.)
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Banaś W, Wiśniewska J, Mieczkowski A, Czerniak B, Budzyński J. Health-related quality of life after a one-year follow-up of patients undergoing endovascular leg revascularization. INT ANGIOL 2021; 41:48-55. [PMID: 34825802 DOI: 10.23736/s0392-9590.21.04788-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Lower limb revascularization not only improves walking distance, but also disease-specific and general health-related quality of life (HRQoL). Therefore, we analyzed changes in HRQoL after endovascular leg revascularization in patients with chronic lower limb ischemia during a one-year follow-up. PATIENTS AND METHODS The WHOQOL-BREF questionnaire was completed by 50 patients with intermittent claudication (IC) and 50 patients with chronic limb-threatening ischemia (CLTI) who underwent endovascular revascularization with a stent implantation, as well as 40 patients with IC not requiring endovascular intervention who received medical management only. The survey was completed before and then 3 and 12 months after an intervention. RESULTS Patients with CLTI before endovascular intervention had the lowest HRQoL in the somatic, psychological, social, and environmental domains. After endovascular revascularization, these patients achieved the greatest improvement in HRQoL. Scores in the HRQoL domains correlated with Rutherford class, ankle-brachial index, and walking distance. The initial score in the somatic domain predicted the risk of target lesion revascularization (TLR) during the one-year follow-up. CONCLUSIONS Endovascular leg revascularization improved patients' functioning, not only in the physical, but also in the psychological, environmental and social domains of HRQoL. A higher score in the somatic domain of HRQoL before and at 3 months after an intervention predicted the risk of TLR during the one-year follow-up. It is recommended that scores for general HRQoL domains are added to the standard measures of the direct outcome of leg revascularization due to their one-year prognostic value.
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Affiliation(s)
- Wioletta Banaś
- Department of Vascular and Internal Diseases, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Joanna Wiśniewska
- Department of Vascular and Internal Diseases, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Artur Mieczkowski
- Department of Vascular and Internal Diseases, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Beata Czerniak
- Department of Vascular and Internal Diseases, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Jacek Budzyński
- Department of Vascular and Internal Diseases, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland -
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Lyu Y, Yu S, Chi C, Teliewubai J, Li J, Blacher J, Pu J, Zhang Y, Xu Y. Associations of Walking Activity With Hypertensive Mediated Organ Damage in Community-Dwelling Elderly Chinese: The Northern Shanghai Study. Front Cardiovasc Med 2021; 8:734766. [PMID: 34746252 PMCID: PMC8566667 DOI: 10.3389/fcvm.2021.734766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/13/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Walking, as the most common campaign in older people, is recommended to improve their cardiovascular health. However, the direct association between weekly walking activity and asymptomatic hypertensive mediated organ damage (HMOD) remains unclear. Methods: 2,830 community-dwelling elderly subjects (over 65 years) in northern Shanghai were recruited from 2014 to 2018. Weekly walking activity was assessed by International Physical Activity Questionnaires (IPAQ). Within the framework of comprehensive cardiovascular examinations, HMOD, including left ventricular mass index, peak transmitral pulsed Doppler velocity/early diastolic tissue Doppler velocity, creatinine clearance rate, urinary albumin–creatinine ratio, carotid-femoral pulse wave velocity (cf-PWV), carotid intima–media thickness (CIMT), arterial plaque, and ankle-brachial index (ABI), were all evaluated. Results: 1,862 (65.8%) participants with weekly walking activity showed lower CIMT, lower cf-PWV, fewer abnormal ABI, and lower prevalence of hypertension and coronary heart disease (p < 0.05). Walking activity was negatively correlated with age and smokers (correlation coefficient: −0.066, −0.042; both p < 0.05). After adjusting for cardiovascular risk factors and concomitant diseases, walking activity was significantly associated with better indicator of most vascular HMOD in multivariate logistic regressions, including arterial stiffness [odds ratio (OR) = 0.75, p = 0.01], increased CIMT (OR = 0.70, p = 0.03), and peripheral artery disease (OR = 0.72, p = 0.005), but not cardiac or renal HMOD. Subgroup analysis further showed that walking duration ≥1 h/day was significantly associated with decreased risk of most vascular HMOD after adjustment for confounders and moderate-to-vigorous physical activity based on IPAQ (all p < 0.05). Conclusions: In the community-dwelling elderly Chinese, there was a significant negative association of weekly walking activity with vascular HMOD, but not cardiac or renal HMOD. Increased daily walking duration, but not walking frequency, was significantly associated with improved vascular HMOD. Hence, increasing daily walking duration seems to encourage a healthy lifestyle in terms of vascular protection. Clinical Trial Registration:ClinicalTrials.gov, identifier: NCT02368938.
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Affiliation(s)
- Yuyan Lyu
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shikai Yu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chen Chi
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jiadela Teliewubai
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jue Li
- Department of Prevention, Tongji University School of Medicine, Shanghai, China.,Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine, Shanghai, China
| | - Jacques Blacher
- Department of Therapeutics, Paris-Descartes University, Paris, France.,AP-HP, Paris, France.,Diagnosis and Therapeutic Center, Hôtel-Dieu, Paris, France
| | - Jun Pu
- Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yi Zhang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yawei Xu
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
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