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Arias Labrador E, Vilaró Casamitjana J, Blanco Díaz S, Brugué Pascual E, Buxó Pujolràs M, Grau JI, Ramos Blanes R, Brugada Terradellas R. [Effects of a Phase III cardiac rehabilitation program on functional capacity and body composition for coronary heart disease]. Rehabilitacion (Madr) 2022:S0048-7120(22)00094-9. [PMID: 36437126 DOI: 10.1016/j.rh.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 04/04/2022] [Accepted: 10/22/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION AND OBJECTIVES The effects of a phase III cardiac rehabilitation program (CRP) have been insufficiently studied in terms of training methods and administration. We studied the impact on functional capacity, body composition and physical activity engagement of interdisciplinary program based on aerobic and community strength therapeutic exercise after an acute coronary syndrome. TRIAL DESIGN Randomised clinical trial. METHODS Eighty consecutive patients with stable ischemic heart disease and preserved systolic function before phase II CRP were included. They were distributed into a control group (CG), with autonomous exercise, and an experimental group (EG), that follows supervised community program based on aerobic exercise and overload dynamic muscle strength, and an educational strategy through short messaging. Both groups underwent monthly inpatient group therapy. Results were compared after 12 months. RESULTS Functional capacity presented higher levels in the EG and measured by the 6-min walk test (26.0±27.4m; P<.001), and maximal exercise test (0.6±2.2METs; P=.021). Home physical activity measured in minutes by IPAQ questionnaire increased more in the EG (90±78min/week) (P=.047), and the sitting time during the week decreased (-50.25±94.48min/day) (P=.001). There were no differences in body mass index, although we found a higher percentage of adipose tissue in CG after 12 months (P=.039). CONCLUSIONS A multidisciplinary community phase III CRP based on aerobic and dynamic muscle strength therapeutic exercise combined with a short message service educational strategy was feasible. After 12 months, patients in the EG presented higher levels on functional capacity, reported higher physical activity engagement compared to the CG.
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Affiliation(s)
- E Arias Labrador
- Unitat de Rehabilitació Cardíaca, Institut d'Assistència Sanitària, Hospital Santa Caterina, Salt, Girona, España; Institut d'Investigació Biomèdica de Girona, IDIBGI, Salt, Girona, España.
| | - J Vilaró Casamitjana
- Facultat de Ciències de la Salut Blanquerna, Global Research on Wellbeing (GRoW), Universitat Ramon Llull, Barcelona, España
| | - S Blanco Díaz
- Unitat de Rehabilitació Cardíaca, Institut d'Assistència Sanitària, Hospital Santa Caterina, Salt, Girona, España
| | - E Brugué Pascual
- Unitat de Rehabilitació Cardíaca, Institut d'Assistència Sanitària, Hospital Santa Caterina, Salt, Girona, España
| | - M Buxó Pujolràs
- Institut d'Investigació Biomèdica de Girona, IDIBGI, Salt, Girona, España
| | - J I Grau
- Unitat de Rehabilitació Cardíaca, Institut d'Assistència Sanitària, Hospital Santa Caterina, Salt, Girona, España
| | - R Ramos Blanes
- Hospital Universitari Dr. Josep Trueta de Girona, Girona, España
| | - R Brugada Terradellas
- Unitat de Rehabilitació Cardíaca, Institut d'Assistència Sanitària, Hospital Santa Caterina, Salt, Girona, España; Institut d'Investigació Biomèdica de Girona, IDIBGI, Salt, Girona, España; Hospital Universitari Dr. Josep Trueta de Girona, Girona, España
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[Effects of home-based strength training during COVID-19 lockdown in acute coronary syndrome]. Rehabilitacion (Madr) 2021; 56:11-19. [PMID: 33958199 PMCID: PMC8045452 DOI: 10.1016/j.rh.2021.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/25/2021] [Accepted: 04/07/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION AND OBJECTIVE Cardiac rehabilitation has the highest level of recognition in medical guideline references. The rise of COVID-19 pandemic, particularly during the first months of strict containment, cause to temporally stop most of the ongoing programs. We studied the effects of an interdisciplinary phase II secondary prevention in patients diagnosed with a recent acute coronary syndrome with the use of new technologies, home-exercise and telemedicine. METHODS Between the 2nd and 11th of March 2020, we included 37 patients with recent acute coronary syndrome (76.4%), low-risk and preserved systolic function and underwent a 12-week treatment. A dynamic muscle toning with overload domiciliary training program was applied, in addition to nutritional counselling, as well as psychological and educational therapy. RESULTS Of the initial cohort, 30 patients finished. At the end of the program, we observed and increased functional capacity over the 6-min walking test (+47.13m; 95% CI: 32.82-61.45, P<.001), and improvement to the subjective feeling of dyspnoea on the modified Borg scale (-0.5 units; 95% CI: -0.76 to -0.24, P=.001), and an improvement over both initial and final training systolic blood pressure (-6.67mmHg; 95% CI: -10.98 to -2.35, P=.004) (-7mmHg; 95% CI: -12.86 to -1.14, P=.021). We also observed an increase in the level of physical activity during leisure time in the IPAQ questionnaire (+1162.93min/week; 95% CI: 237.36-2088.5, P=.016), and in the Mediterranean eating habits on the PREDIMED test (+2.1units; 95% CI: 1.32-2.28, P<.001). CONCLUSIONS After three months of a domiciliary cardiac rehabilitation program, patients increased their functional capacity, feeling of dyspnoea, blood pressure and eating habits. Domiciliary telemedicine cardiac rehabilitation program produces an improvement in the patient after acute coronary syndrome.
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Arias Labrador E, Vilaró Casamitjana J, Blanco Díaz S, Ariza Turiel G, Paz Bermejo MA, Pujol Iglesias E, Berenguel Anter M, Fluvià Brugués P, Iglesies Grau J, Brugué Pascual E, Gonzalez Ramírez R, Buxó Pujolràs M, Ramos Blanes R, Brugada Terradellas R. [Effects of an interdisciplinary program combining aerobic interval training and dynamic strength in acute coronary syndrome]. Rehabilitacion (Madr) 2021; 56:99-107. [PMID: 33814157 DOI: 10.1016/j.rh.2021.02.003] [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: 10/28/2020] [Revised: 01/11/2021] [Accepted: 02/10/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION AND OBJECTIVES Cardiac rehabilitation has the highest level of recognition in medical guideline references, however there are still little-explored training modalities. We study the effects of an interdisciplinary program after acute coronary syndrome (ACS) in phase II secondary prevention. METHODS Between January 2008 and December 2018, 439 patients with stable ischemic heart disease and preserved systolic function were included, as maximum 2 month after the ACS. A combined aerobic resistance training program in a variable continuous method and muscle toning with overload and/or ballast was applied, in addition to nutritional counseling and psychological-educational therapy for 12 weeks. RESULTS 378 patients finished. The functional capacity increases in the incremental stress test (1.76 METS; CI 95%: 1.59-1.96, p < 0.001) and in the six minutes walking test (32.58 m; CI 95%: 29.24-35.92, p < 0.001). Leisure physical activity in IPAQ increased (763.27 min/week; CI 95%: 583.31-943.16, p < 0.001) and the time sitting during the week decreased (-28.85 min/day; CI 95%: -43.94 to -13.77, p < 0.001). Also, eating habits improved in PREDIMED (2.58 units; CI 95%: 1.43-3.73, p < 0.001), decreased body weight (-0.88 kg; CI 95%: -1.26 to -0.49, p < 0.001), the abdominal perimeter (1.57 cm; CI 95%: 2.23-0.90, p < 0.001) and adipose tissue (-0.80%; CI 95%: -1.10 to -0.51, p < 0.001). CONCLUSIONS An interdisciplinary program with high intensity variable continuous training combined with dynamic muscle toning increases functional capacity, the level of physical activity, improves body composition and eating habits in ACS patients.
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Affiliation(s)
- E Arias Labrador
- Unitat de Rehabilitació Cardíaca Institut d'Assistència Sanitària. Hospital Santa Caterina, Salt, España; Institut d'Investigació Biomèdica de Girona, Salt, España.
| | - J Vilaró Casamitjana
- Facultat de Ciències de la Salut Blanquerna, Global Research on Wellbeing (GRoW), Universitat Ramon Llull, Barcelona, España
| | - S Blanco Díaz
- Unitat de Rehabilitació Cardíaca Institut d'Assistència Sanitària. Hospital Santa Caterina, Salt, España
| | - G Ariza Turiel
- Institut d'Investigació Biomèdica de Girona, Salt, España
| | - M A Paz Bermejo
- Unitat de Rehabilitació Cardíaca Institut d'Assistència Sanitària. Hospital Santa Caterina, Salt, España
| | - E Pujol Iglesias
- Unitat de Rehabilitació Cardíaca Institut d'Assistència Sanitària. Hospital Santa Caterina, Salt, España
| | - M Berenguel Anter
- Unitat de Rehabilitació Cardíaca Institut d'Assistència Sanitària. Hospital Santa Caterina, Salt, España
| | - P Fluvià Brugués
- Unitat de Rehabilitació Cardíaca Institut d'Assistència Sanitària. Hospital Santa Caterina, Salt, España
| | - J Iglesies Grau
- Unitat de Rehabilitació Cardíaca Institut d'Assistència Sanitària. Hospital Santa Caterina, Salt, España
| | - E Brugué Pascual
- Unitat de Rehabilitació Cardíaca Institut d'Assistència Sanitària. Hospital Santa Caterina, Salt, España
| | - R Gonzalez Ramírez
- Unitat de Rehabilitació Cardíaca Institut d'Assistència Sanitària. Hospital Santa Caterina, Salt, España
| | - M Buxó Pujolràs
- Facultat de Ciències de la Salut Blanquerna, Global Research on Wellbeing (GRoW), Universitat Ramon Llull, Barcelona, España
| | - R Ramos Blanes
- Facultat de Medicina de la Universitat de Girona, Girona, España
| | - R Brugada Terradellas
- Unitat de Rehabilitació Cardíaca Institut d'Assistència Sanitària. Hospital Santa Caterina, Salt, España; Institut d'Investigació Biomèdica de Girona, Salt, España; Facultat de Medicina de la Universitat de Girona, Girona, España; Centre de Genètica Cardiovascular, Institut d'Investigació Biomèdica de Girona, IDIBGI, Salt, España; Hospital Universitari Dr. Josep Trueta de Girona, Girona, España; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, España
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García-Bravo S, Cano-de-la-Cuerda R, Domínguez-Paniagua J, Campuzano-Ruiz R, Barreñada-Copete E, López-Navas MJ, Araujo-Narváez A, García-Bravo C, Florez-Garcia M, Botas-Rodríguez J, Cuesta-Gómez A. Effects of Virtual Reality on Cardiac Rehabilitation Programs for Ischemic Heart Disease: A Randomized Pilot Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228472. [PMID: 33207670 PMCID: PMC7696478 DOI: 10.3390/ijerph17228472] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/06/2020] [Accepted: 11/13/2020] [Indexed: 02/06/2023]
Abstract
(1) Background: The aim of the present study was to determine the effects of a virtual reality (VR) program, as a complementary tool to a conventional cardiac rehabilitation (CR) program in phase II of patients with ischemic heart disease compared to a conventional treatment group. (2) Methods: A single blinded randomized clinical trial was conducted. The patients were randomized to a control group (CG) or an experimental group (EG). The EG carried out a training based on VR of aerobic exercise using the XBOX ONE console and Kinect sensor. Ergometry, metabolic equivalents (METS), Functional Independence Measure, 6-min walk test (6MWT), the Short Form Health Survey-36 Questionnaire (SF-36), the Beck Depression Inventory-II, and the degree of satisfaction and adherence to treatment were used as outcome measures. (3) Results: Our results showed no statistically significant differences between the two groups. Statistical analysis within group for the EG showed statistically significant changes in the variables HR final ergometry, ergometry minutes, % ergometry, METS, final HR 6MWT, 6MWT distance, 6MWT number of laps, and for the SF-36 and Beck Depression Inventory-II. (4) Conclusion: A VR-based video game program, as an adjunct tool to a CR program, showed improvements in ergometry, METS, resistance to fatigue and health-related quality of life with excellent adherence and satisfaction perceived by patients with ischemic heart disease in phase II.
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Affiliation(s)
- Sara García-Bravo
- International Doctorate School, Rey Juan Carlos University, 28922 Madrid, Spain; (S.G.-B.); (C.G.-B.)
- Clínica de Fisioterapia Physiocare, 28026 Madrid, Spain
| | - Roberto Cano-de-la-Cuerda
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain;
- Correspondence: ; Tel.: +34-91-488-86-74
| | - Joaquín Domínguez-Paniagua
- Cardiac Rehabilitation Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, 28922 Madrid, Spain; (J.D.-P.); (R.C.-R.); (E.B.-C.); (M.J.L.-N.); (A.A.-N.)
| | - Raquel Campuzano-Ruiz
- Cardiac Rehabilitation Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, 28922 Madrid, Spain; (J.D.-P.); (R.C.-R.); (E.B.-C.); (M.J.L.-N.); (A.A.-N.)
| | - Estrella Barreñada-Copete
- Cardiac Rehabilitation Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, 28922 Madrid, Spain; (J.D.-P.); (R.C.-R.); (E.B.-C.); (M.J.L.-N.); (A.A.-N.)
| | - María Jesús López-Navas
- Cardiac Rehabilitation Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, 28922 Madrid, Spain; (J.D.-P.); (R.C.-R.); (E.B.-C.); (M.J.L.-N.); (A.A.-N.)
| | - Aurora Araujo-Narváez
- Cardiac Rehabilitation Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, 28922 Madrid, Spain; (J.D.-P.); (R.C.-R.); (E.B.-C.); (M.J.L.-N.); (A.A.-N.)
| | - Cristina García-Bravo
- International Doctorate School, Rey Juan Carlos University, 28922 Madrid, Spain; (S.G.-B.); (C.G.-B.)
- Clínica de Fisioterapia Physiocare, 28026 Madrid, Spain
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain;
| | - Mariano Florez-Garcia
- Rehabilitation Service, Hospital Universitario Fundación Alcorcón, 28922 Madrid, Spain;
| | | | - Alicia Cuesta-Gómez
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain;
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Regal Ramos R. ¿Qué evidencia científica tienen los métodos propuestos para valorar la discapacidad laboral de los pacientes con síndrome de sensibilización central? Semergen 2020; 46:411-414. [DOI: 10.1016/j.semerg.2020.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 04/18/2020] [Accepted: 05/09/2020] [Indexed: 10/23/2022]
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Evaluation of Consumption of Poultry Products Enriched with Omega-3Fatty Acids in Anthropometric, Biochemical, and Cardiovascular Parameters. J FOOD QUALITY 2018. [DOI: 10.1155/2018/9620104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
An alternative for prevention and treatment for cardiovascular diseases (CVD) is increasing the intake of bioactive compounds asomega-3. However, several countries as México do not consume regularly foods with high content ofomega-3, mainly fish products due to cultural, social, and economic factors. Therefore, the addition ofomega-3in other food sources could contribute to completing the requirements established of these fatty acids. To evaluate the effect of the consumption of poultry products supplemented withomega-3in healthy population, a phase 1, double blind randomized, controlled parallel-group trial was carried out. After 14 weeks, the supplemented group had an increase in HDL, reducing the atherogenic index. The supplementation withomega-3in poultry products could contribute to a cardioprotective effect. It is necessary to complete studies with a higher evaluation period to determine the improvement in anthropometric and cardiovascular parameters.
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Massardo T, Lavados H, Jaimovich R, Carmona A, Rau C, Herrera E, Quevedo L, Prat H. Concordancia entre observadores con distinta experiencia en interpretación de electrocardiograma de esfuerzo en SPECT de perfusión miocárdica. ACTA ACUST UNITED AC 2009; 28:278-82. [DOI: 10.1016/j.remn.2009.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Accepted: 04/22/2009] [Indexed: 10/20/2022]
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García-Borbolla M, García-Borbolla R, Valenzuela LF, Trujillo F. Taquicardia ventricular inducida por prueba de esfuerzo en paciente con síndrome de Brugada. Rev Esp Cardiol 2007; 60:993-4. [PMID: 17915159 DOI: 10.1157/13109656] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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9
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Valor predictivo de la presión diferencial del pulso en el diagnóstico de isquemia miocárdica silente en pacientes con diabetes tipo 2. Rev Esp Cardiol 2007. [DOI: 10.1016/s0300-8932(07)75073-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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10
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Morcillo C, Valderas JM, Roca JM, Oliveró R, Núñez C, Sánchez M, Bechich S. La determinación de calcio coronario con tomografía computarizada en la evaluación del riesgo cardiovascular: un estudio descriptivo. Rev Esp Cardiol 2007. [DOI: 10.1157/13100278] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Camprubí M, Mercé J, Bardají A. Rotura cardiaca durante la prueba de esfuerzo. Rev Esp Cardiol (Engl Ed) 2007. [DOI: 10.1016/s0300-8932(07)75017-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gómez MJ, Roldán I, Díez JL, García K, Sanmiguel D, Salvador A, de Arellano AR, Hernández-Mijares A. Predictive Value of Differential Pulse Pressure in the Diagnosis of Silent Myocardial Ischemia in Patients With Type-2 Diabetes. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/s1885-5857(07)60196-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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13
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Peteiro J. Ecocardiografía de estrés en pacientes con infarto agudo de miocardio. ¿Cuál es la extensión de la enfermedad coronaria y cómo evaluarla? Rev Esp Cardiol (Engl Ed) 2006. [DOI: 10.1157/13089738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Alonso-Gómez ÁM, Belló MC, Fernández MA, Torres A, Alfageme M, Aizpuru F, Martínez-Ferrer J, Díaz A, Arós F. Ecocardiografía de estrés en la detección de enfermedad de la arteria descendente anterior en pacientes con infarto de miocardio inferior y test de esfuerzo positivo. Rev Esp Cardiol 2006. [DOI: 10.1157/13089741] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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15
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Álvarez-Tamargo JA, Simarro Martín-Ambrosio E, Romero-Tarín E, Albadalejo-Salinas VJ, de la Hera JM, Martín-Fernández M, Aguado MG, Barriales-Álvarez V, Morís de la Tassa C. Comparación angiográfica de los criterios e índices de alto riesgo para ergometría convencional en pacientes diagnosticados de angina inestable en función del sexo, la edad o el uso de fármacos bradicardizantes. Rev Esp Cardiol 2006. [DOI: 10.1157/13087897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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16
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Martín Castellanos A. Reconocimientos médicos para la actividad físico-deportiva. Semergen 2006. [DOI: 10.1016/s1138-3593(06)73256-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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17
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Reconocimientos médicos para la actividad físico-deportiva. Semergen 2006. [DOI: 10.1016/s1138-3593(06)73241-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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González-de Dios J, Balaguer-Santamaría A, Ochoa-Sangrador C. Utilidad de la Colaboración Cochrane en la cardiología pediátrica. Rev Esp Cardiol (Engl Ed) 2005. [DOI: 10.1157/13078555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Martínez-Sellés M, Ortiz J, Estévez Á, Andueza J, de Miguel J, Bueno H. Un nuevo índice de riesgo para pacientes con ECG normal o no diagnóstico ingresados en la unidad de dolor torácico. Rev Esp Cardiol 2005. [DOI: 10.1157/13077229] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Alonso Martín JJ, Curcio Ruigómez A, Cristóbal Varela C, Tarín Vicente MN, Serrano Antolín JM, Talavera Calle P, Graupner Abad C. Indicaciones de revascularización: aspectos clínicos. Rev Esp Cardiol 2005. [DOI: 10.1157/13071894] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Zarauza J, Rodríguez-Lera MJ, Ceballos B, Piedra L, Dierssen T, Pérez J. [Follow-up findings one year after discharge from a chest pain unit]. Rev Esp Cardiol 2003; 56:1137-40. [PMID: 14622546 DOI: 10.1016/s0300-8932(03)77025-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
One hundred and twenty five consecutive patients discharged from a chest pain unit (group I, 32 with the diagnosis of probable ischemic heart disease and group II, 93 with the diagnosis of non-vascular pain) were prospectively followed up for one year. In group I (treadmill exercise testing were positive at a high workload in 15, negative in 9 and inconclusive in 4), one patient had non-ST elevation acute coronary event 15 days after discharge and two patients had unstable angina at 3 and 5 months. There were no events among the patients who had positive or inconclusive exercise testing. In group II (treadmill exercise testing were negative in 85 and inconclusive in 5) one patient had non-ST elevation acute coronary event at 7 months and one had unstable angina at 11 months. In conclusion, patients discharged from a chest pain unit, including those patients with positive treadmill exercise at a high workload, have a favorable mid-term outcome.
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Affiliation(s)
- Jesús Zarauza
- Servicio de Cardiología. Hospital Sierrallana. Torrelavega. Cantabria. Spain.
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Abstract
In recent years, the characteristics of patients who suffer acute myocardial infarction without complications during hospitalization have changed. In addition, the range of non-invasive studies available for evaluating left ventricular systolic function, residual myocardial ischemia, and myocardial viability in these patients has improved. Left ventricular systolic function and residual ischemia should be evaluated in all patients before release. The non-invasive technique used (exercise test, echocardiography, nuclear cardiology, magnetic resonance imaging) depends on availability, experience, and results at each institution. Coronary arteriography should be performed in patients with significant ischemia or severe left ventricular systolic dysfunction in non-invasive studies. In these cases coronary angiography must be performed to determine if coronary arteries are suitable for revascularization before performing a test of myocardial viability.
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Affiliation(s)
- Jaume Candell Riera
- Servei de Cardiologia. Hospital General Universitari Vall d'Hebron. Barcelona. España.
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Sánchez Criado V, Martínez Castellano A, López Medina IM. La prueba de esfuerzo en el paciente con cardiopatía isquémica. ENFERMERIA CLINICA 2003. [DOI: 10.1016/s1130-8621(03)73803-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Del Val Gómez M, Gallardo FG, Salazar ML, Terol I. [Prognostic value of normal myocardial radionuclide scan in patients with positive treadmill test]. Rev Esp Cardiol 2002; 55:991-4. [PMID: 12236930 DOI: 10.1016/s0300-8932(02)76739-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The purpose of this study was to determine the prognostic value of a normal 201Tl scan in patients with a positive treadmill exercise stress test. We analyzed retrospectively 85 consecutive patients with a positive treadmill exercise test and normal Tl201 scan who were studied for the diagnosis of coronary artery disease from January 1996 to December 2000. The pretest probability of coronary artery disease was intermediate or high in all patients. Seventy-eight patients (89%) were followed up for 2.03 years. Forty patients (51%) were men. Age was 56 years. The cardiac events considered were angina, revascularization, nonfatal myocardial infarction, and cardiac death. During the follow-up period, none of the patients suffered a major cardiac event. Eight patients had episodes of chest pain and one had angor that required revascularization. Patients with an intermediate probability of coronary artery disease before the test and normal myocardial radionuclide scan had a very good prognosis even with a positive treadmill exercise test.
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Affiliation(s)
- M Del Val Gómez
- Servicios de Medicina Nuclear, Hospital Carlos III, Instituto de Salud Carlos III, Madrid, Spain.
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Bayón Fernández J, Alegría Ezquerra E, Bosch Genover X, Cabadés O'Callaghan A, Iglesias Gárriz I, Jiménez Nácher JJ, Malpartida De Torres F, Sanz Romero G. [Chest pain units. Organization and protocol for the diagnosis of acute coronary syndromes]. Rev Esp Cardiol 2002; 55:143-54. [PMID: 11852005 DOI: 10.1016/s0300-8932(02)76574-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The two main goals of chest pain units are the early, accurate diagnosis of acute coronary syndromes and the rapid, efficient recognition of low-risk patients who do not need hospital admission. Many clinical, practical, and economic reasons support the establishment of such units. Patients with chest pain account for a substantial proportion of emergency room turnover and their care is still far from optimal: 8% of patients sent home are later diagnosed of acute coronary syndrome and 60% of admissions for chest pain eventually prove to have been unnecessary.We present a systematic approach to create and manage a chest pain unit employing specialists headed by a cardiologist. The unit may be functional or located in a separate area of the emergency room. Initial triage is based on the clinical characteristics, the ECG and biomarkers of myocardial infarct. Risk stratification in the second phase selects patients to be admitted to the chest pain unit for 6-12 h. Finally, we propose treadmill testing before discharge to rule out the presence of acute myocardial ischemia or damage in patients with negative biomarkers and non-diagnostic serial ECGs.
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Alvarez Tamargo JA, Barriales Alvarez V, Sanmartín Pena JC, Hevia Nava S, Veganzones Bayón A, Simarro Martín-Ambrosio E, Cortina Llosa A. [Angiographic correlates of the high-risk criteria for conventional exercise testing and the Duke treadmill score]. Rev Esp Cardiol 2001; 54:860-7. [PMID: 11446962 DOI: 10.1016/s0300-8932(01)76412-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To compare the sensitivity, the specificity, the positive and negative predictive value and the predictive accuracy of the Duke Treadmill Score, the Spanish Society of Cardiology (SEC) and American College of Cardiology/American Heart Association (ACC/AHA) high-risk criteria for exercise testing in the detection of left main disease, three vessel disease and two vessel disease involving the proximal left anterior descending artery. PATIENTS AND METHOD A cohort of 199 patients (age 75 years) consecutively admitted to hospital for unstable angina was studied. All patients underwent an exercise stress test and coronariography. RESULTS The SEC high-risk Criteria showed a sensitivity of 69.2% and a specificity of 49.0%. The ACC/AHA high-risk Criteria demonstrated a sensitivity of 98.1% and a specificity of 23.8% and the Duke Treadmill Score presented a sensitivity of 30.8% and a specificity of 90.5%. In patients with moderate risk in the Duke Treadmill Score we found a sensitivity of 62.9% and a specificity of 39.8% for the SEC high-risk criteria, while the ACC/AHA high-risk Criteria presented a sensitivity of 100.0% and a specificity of 5.8%. CONCLUSIONS The ACC/AHA high-risk Criteria showed a higher sensitivity while the Duke Treadmill Score presented a higher specificity for the detection of left main disease, three vessel disease and two vessel disease involving the proximal left anterior descending artery. The ACC/AHA and SEC high-risk Criteria were found to be very useful in the group of patients with moderate risk in the Duke Treadmill Score.
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