1
|
Wang L, Mei F, Min M, He X, Luo L, Ma Y. Adoption of the cardiopulmonary exercise test in the exercise ability and cardiopulmonary function rehabilitation of coronary artery disease (CAD) patients. BMC Cardiovasc Disord 2024; 24:313. [PMID: 38902630 PMCID: PMC11191307 DOI: 10.1186/s12872-024-03958-0] [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: 07/03/2023] [Accepted: 11/24/2023] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND This study aimed to explore the application of cardiopulmonary exercise testing in coronary artery disease (CAD) patients, evaluate its impact on exercise ability and cardiopulmonary function in patients with coronary heart disease (CHD), and promote the application of cardiopulmonary exercise testing in CAD management. METHODS Fifty CHD patients after percutaneous coronary intervention (PCI) were recruited and randomly enrolled into the control (Ctrl) group and intervention (Int) group. Routine health education and health education combined with RT training were carried out for the two groups. Blood lipid levels and lung function were compared between the two groups after intervention. Cardiac function was evaluated by Doppler ultrasonography, and cardiopulmonary fitness and exercise ability were evaluated by a cardiopulmonary exercise test (CPET). The self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were employed to evaluate negative emotions. The 36-item short-form (SF-36) was adopted to evaluate quality of life. RESULT Compared with those in the Ctrl group, the levels of serum total cholesterol (TC), triglycerides (TGs), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) decreased in the Int group, while the levels of high-density lipoprotein increased (P < 0.05). The quantitative load results showed that compared with the Ctrl group, the heart rate (HR) and self-perceived fatigue degree of the Int group decreased, and the ST segment increased (P < 0.05). Compared with the Ctrl group, the left ventricular ejection fraction (LVEF), forced expiratory volume at 1 s (FEV1), ratio of forced expiratory volume to forced vital volume (FEV1/FVC%), and maximum chase volume (MVV) increased in the Int group, while the left ventricular end diastolic diameter and left ventricular end contractile diameter decreased (P < 0.05). The results of the CPET showed that compared with the Ctrl group, minute ventilation/carbon dioxide production slope, VE/VCO2 - Peak, anaerobic threshold (AT), peak oxygen pulse (VO2/HR peak), oxygen uptake efficiency platform (OUEP), increasing power exercise time (IPEt), HR recovery 1 min after exercise, peak load power (Watt peak), and value metabolic equivalent (Watt peak) increased in the Int group (P < 0.05). Compared with the Ctrl group, the SAS and SDS scores in the Int group decreased (P < 0.05). The results of the quality of life evaluation showed that compared with the Ctrl group, the score of the SF-36 dimensions increased in the Int group (P < 0.05). CONCLUSION RT training can reduce postoperative blood lipid and quantitative load levels in CAD patients and improve adverse mood. Furthermore, it can improve patients' cardiopulmonary function, cardiopulmonary fitness, exercise ability, and quality of life.
Collapse
Affiliation(s)
- Lingling Wang
- Department of Cardiology,Xiangyang No.1, People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, 441000, China
| | - Fan Mei
- Department of Cardiology,Xiangyang No.1, People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, 441000, China
| | - Mengyi Min
- Department of Cardiology,Xiangyang No.1, People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, 441000, China
| | - Xiuyan He
- Nursing Department, Grade 7, Health Center of Jimo District, Qingdao, Shandong, 266200, China
| | - Lili Luo
- Nursing Department, Duanbolan Health Center of Jimo District, Qingdao, Shandong, 266200, China
| | - Youxia Ma
- Nursing Department, Shandong First Medical University, Taian, Shandong, 271000, China.
- Pulmonary and Critical Care Medicine Nursing Care, Laishan Hosital, Yantaishan Hospital, Yantai, 264000, China.
| |
Collapse
|
2
|
Yang Z, Hu N, Zhang F, Gao Y, Zhang C, Wang A. A Practical Tool for Measuring Home-Based Cardiac Rehabilitation Self-Management Behavior: A Multiphase Cross-Sectional Study. J Am Heart Assoc 2024; 13:e034486. [PMID: 38639372 PMCID: PMC11179869 DOI: 10.1161/jaha.124.034486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/25/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Optimal self-management is the key to home-based cardiac rehabilitation for patients with heart disease. At present, there is a lack of a specific assessment tool to evaluate the home-based cardiac rehabilitation self-management behavior in patients with heart disease. Therefore, the aim of this study was to develop the Home-Based Cardiac Rehabilitation Self-Management Scale and validate its psychometric properties among patients with coronary heart disease. METHODS AND RESULTS A multiphase cross-sectional study was conducted that study covered 3 phases: (1) item generation and revision, (2) item evaluation and preliminary exploration, and (3) assessment of the psychometric properties of the scale. A scale with 21 items was developed to measure the home-based cardiac rehabilitation self-management behavior. The content validity index of the scale was 0.980. In exploratory factor analysis, the 5-factor structure supported by eigenvalues and screen plot explained 74.326% of the total variation. In confirmatory factor analysis, all fitting indicators were acceptable, further supporting the construct validity of the scale. The criterion validity of the scale was 0.783. In the reliability analysis, the Cronbach's α coefficient of the scale was 0.882, with a dimensionality range of 0.780 to 0.936. The split-half reliability coefficient and test-retest reliability coefficient were 0.774 and 0.770, respectively. CONCLUSIONS This study is the first to develop and validate a practical tool. This scale can comprehensively and accurately assess the self-management behavior of patients with heart disease in a home-based cardiac rehabilitation environment.
Collapse
Affiliation(s)
- Zhen Yang
- The First Affiliated Hospital of China Medical UniversityShenyangLiaoning ProvinceChina
| | - Na Hu
- The First Affiliated Hospital of China Medical UniversityShenyangLiaoning ProvinceChina
| | - Fengpei Zhang
- The First Affiliated Hospital of China Medical UniversityShenyangLiaoning ProvinceChina
| | - Yu Gao
- The First Affiliated Hospital of Jinzhou Medical UniversityJinzhouLiaoning ProvinceChina
| | - Chunqi Zhang
- The First Affiliated Hospital of Jinzhou Medical UniversityJinzhouLiaoning ProvinceChina
| | - Aiping Wang
- The First Affiliated Hospital of China Medical UniversityShenyangLiaoning ProvinceChina
| |
Collapse
|
3
|
Zhen L. Effect of nursing intervention based on the psycho-cardiology medicine model in elderly patients after Percutaneous coronary intervention for coronary heart disease. Asian J Surg 2024; 47:2304-2305. [PMID: 38326116 DOI: 10.1016/j.asjsur.2024.01.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 01/26/2024] [Indexed: 02/09/2024] Open
Affiliation(s)
- Liu Zhen
- Department of Cadre Ward of Heart Center, General Hospital of Ningxia Medical University, Yinchuan, 750004, China.
| |
Collapse
|
4
|
Albustami M, Hartfiel N, Charles JM, Powell R, Begg B, Birkett ST, Nichols S, Ennis S, Hee SW, Banerjee P, Ingle L, Shave R, McGregor G, Edwards RT. Cost-effectiveness of High-Intensity Interval Training (HIIT) vs Moderate Intensity Steady-State (MISS) Training in UK Cardiac Rehabilitation. Arch Phys Med Rehabil 2024; 105:639-646. [PMID: 37730193 DOI: 10.1016/j.apmr.2023.09.005] [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: 04/28/2023] [Revised: 08/25/2023] [Accepted: 09/05/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE To perform a cost-effectiveness analysis of high-intensity interval training (HIIT) compared with moderate intensity steady-state (MISS) training in people with coronary artery disease (CAD) attending cardiac rehabilitation (CR). DESIGN Secondary cost-effectiveness analysis of a prospective, assessor-blind, parallel group, multi-center RCT. SETTING Six outpatient National Health Service cardiac rehabilitation centers in England and Wales, UK. PARTICIPANTS 382 participants with CAD (N=382). INTERVENTIONS Participants were randomized to twice-weekly usual care (n=195) or HIIT (n=187) for 8 weeks. Usual care was moderate intensity continuous exercise (60%-80% maximum capacity, MISS), while HIIT consisted of 10 × 1-minute intervals of vigorous exercise (>85% maximum capacity) interspersed with 1-minute periods of recovery. MAIN OUTCOME MEASURES We conducted a cost-effectiveness analysis of the HIIT or MISS UK trial. Health related quality of life was measured with the EQ-5D-5L to estimate quality-adjusted life years (QALYs). Costs were estimated with health service resource use and intervention delivery costs. Cost-utility analysis measured the incremental cost-effectiveness ratio (ICER). Bootstrapping assessed the probability of HIIT being cost-effective according to the UK National Institute for Health and Care Excellence (NICE) threshold value (£20,000 per QALY). Missing data were imputed. Uncertainty was estimated using probabilistic sensitivity analysis. Assumptions were tested using univariate/1-way sensitivity analysis. RESULTS 124 (HIIT, n=59; MISS, n=65) participants completed questionnaires at baseline, 8 weeks, and 12 months. Mean combined health care use and delivery cost was £676 per participant for HIIT, and £653 for MISS. QALY changes were 0.003 and -0.013, respectively. For complete cases, the ICER was £1448 per QALY for HIIT compared with MISS. At a willingness-to-pay threshold of £20,000 per QALY, the probability of HIIT being cost-effective was 96% (95% CI, 0.90 to 0.95). CONCLUSION For people with CAD attending CR, HIIT was cost-effective compared with MISS. These findings are important to policy makers, commissioners, and service providers across the health care sector.
Collapse
Affiliation(s)
- Mohammed Albustami
- Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University, Bangor, UK
| | - Ned Hartfiel
- Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University, Bangor, UK
| | - Joanna M Charles
- Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University, Bangor, UK
| | - Richard Powell
- Department of Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK; Centre for Sport Exercise & Life Sciences, Institute of Health & Well-being, Coventry University, UK
| | - Brian Begg
- Cardiff Centre for Exercise & Health, Cardiff Metropolitan University, Cardiff, Wales UK; Aneurin Bevan University Health Board, Gwent, Wales, UK
| | - Stefan T Birkett
- Department of Sport and Exercise Sciences. Manchester Metropolitan University, Manchester, UK
| | - Simon Nichols
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK; Sport and Physical Activity Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Stuart Ennis
- Department of Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK; Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Siew Wan Hee
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Prithwish Banerjee
- Centre for Sport Exercise & Life Sciences, Institute of Health & Well-being, Coventry University, UK; Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK; Department of Cardiology, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - Lee Ingle
- Department of Sport, Health & Exercise Science, University of Hull, Hull, UK
| | - Rob Shave
- Centre for Heart Lung and Vascular Health, University of British Columbia, Okanagan, Canada
| | - Gordon McGregor
- Department of Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK; Centre for Sport Exercise & Life Sciences, Institute of Health & Well-being, Coventry University, UK; Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
| | - Rhiannon T Edwards
- Centre for Health Economics and Medicines Evaluation (CHEME), Bangor University, Bangor, UK
| |
Collapse
|
5
|
Zhou F, Yuan H, Sun J, Ran H, Pan H, Wu P, Yang Q. Two-dimensional speckle tracking imaging cardiac motion-based quantitative evaluation of global longitudinal strain among patients with coronary Heart Disease and functions of left ventricular ischemic myocardial segment. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2024; 40:351-359. [PMID: 37953370 DOI: 10.1007/s10554-023-02993-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 10/21/2023] [Indexed: 11/14/2023]
Abstract
To investigate two-dimensional speckle tracking imaging (2D-STI)-based quantitative evaluation of the influences of different levels of coronary artery stenosis on left ventricular functions and its clinical diagnostic values, 120 patients with coronary heart disease (CHD) were divided into control group (30 cases), mild stenosis group (30 cases), moderate stenosis group (30 cases), and severe stenosis group (30 cases) according to coronary angiography (CAG) results. They underwent routine ultrasound examination and 2D-STI examination. Receiver operating characteristic (ROC) curves were drawn to evaluate the sensitivity and specificity of different levels of coronary artery stenosis. Global longitudinal strain (GLS) of left ventricular myocardium among patients in moderate and severe stenosis groups remarkably declined (P < 0.05). Global radial strain (GRS) and global circular strain (GCS) among patients in severe stenosis group dramatically reduced (P < 0.05). ROC curves revealed that available GLS=-17.2 was the cut-off value for screening moderate coronary stenosis. The sensitivity, specificity, and area under the curve (AUC) amounted to 57.3%, 58.4%, and 0.573, respectively. GLS, GRS, and GCS could be used to screen severe coronary stenosis. When GLS=-16.5 was the cut-off value for screening severe coronary stenosis, sensitivity, specificity, and AUC amounted to 84.3%, 82.5%, and 0.893, respectively. With the aggravation of stenosis, left ventricular systolic function of CHD patients was impaired more significantly. 2D-STI technique could be adopted for the quantitative evaluation of left ventricular strain of patients with coronary stenosis and provided a new method for early clinical diagnosis of CHD.
Collapse
Affiliation(s)
- Feiou Zhou
- Department of Cardiovascular, First People's Hospital of Linping District, Hangzhou, 311100, Zhejiang Province, China
| | - Hong Yuan
- Department of Cardiovascular, First People's Hospital of Linping District, Hangzhou, 311100, Zhejiang Province, China
| | - Jindong Sun
- Department of Cardiovascular, First People's Hospital of Linping District, Hangzhou, 311100, Zhejiang Province, China
| | - Hongmei Ran
- Department of Ultrasound, First People's Hospital of Linping District, Hangzhou, 311100, Zhejiang Province, China
| | - Hong Pan
- Department of Cardiovascular, First People's Hospital of Linping District, Hangzhou, 311100, Zhejiang Province, China
| | - Peian Wu
- Department of Cardiovascular, First People's Hospital of Linping District, Hangzhou, 311100, Zhejiang Province, China
| | - Qian Yang
- Department of Cardiovascular, The Second Affillated Hospital of Zhejiang University School of Medicine, Hangzhou, 310000, Zhejiang Province, China.
| |
Collapse
|
6
|
Wang G, Zhang HC, Zhang SJ, Yao YY, Zhao Y, Wang Z, Zhang T. Correlations between the peripheral coronary fat attenuation index based on computed tomography images, high-risk plaque and degree of coronary artery stenosis in patients with coronary atherosclerosis. Technol Health Care 2024; 32:1619-1628. [PMID: 38427512 DOI: 10.3233/thc-230676] [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] [Indexed: 03/03/2024]
Abstract
BACKGROUND Coronary artery disease can be quantified by measuring the fat attenuation index (FAI). OBJECTIVE To explore the correlations between FAI, high-risk plaque and the degree of coronary artery stenosis. METHODS The clinical data of patients with coronary atherosclerosis who underwent a coronary computed tomography (CT) angiography examination between July 2020 and June 2023 were selected for retrospective analysis. These patients were classified into a high-risk plaque group and non-high-risk plaque group according to the presence of CT high-risk plaque. The diagnostic value of FAI and FAI combined with the degree of stenosis was evaluated for CT high-risk plaque. RESULTS Differences in age, body mass index, smoking history, FAI and the degree of stenosis between the two groups were statistically significant (all P< 0.05). The results of a binary logistic regression analysis revealed that FAI (odds ratio (OR): 1.131, 95% confidence interval (CI): 1.101-1.173, P< 0.001) and the degree of stenosis (OR: 1.021, 95% CI: 1.012-1.107, P< 0.001) were risk factors for high-risk plaque. CONCLUSION The FAI can be used to monitor the inflammation level of the coronary artery; the higher the FAI is, the higher the risk of plaque and degree of stenosis.
Collapse
|
7
|
Huang X, Pang S, Zhao Y, Qian J, Zhong J, Liu S. Efficacy and safety of different traditional Chinese health exercises in patients with coronary heart disease combined with chronic heart failure: A network meta-analysis. Medicine (Baltimore) 2023; 102:e36522. [PMID: 38115269 PMCID: PMC10727649 DOI: 10.1097/md.0000000000036522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Non-pharmacological treatments, particularly TCM health exercises, have garnered attention for their affordability, ease of access, and potential health advantages. Despite this interest, systematic and direct comparative studies assessing the effectiveness and safety of these therapies in patients with CHD-CHF remain scarce. METHODS This study aimed to compare the efficacy and safety of conventional treatment, conventional treatment integrated with aerobic endurance training, and various TCM health exercises in treating patients with CHD-CHF using NMA. The analysis was designed to provide a reference for developing treatment plans. To achieve this, literature databases were searched for RCTs on different TCM health exercises for CHD-CHF patients up to December 6, 2022. Major outcomes analyzed included NT-proBNP, LVEF, 6-minute walk test, MLHFQ, clinical effectiveness, and adverse event occurrence. The Cochrane risk of bias tool was employed to assess the risk of bias in the included RCT studies. Systematic review with NMA was conducted using RevMan 5.4 and Stata for cumulative ranking, and comparative adjustment funnel plot analysis. RESULTS Traditional Chinese medicine gong methods included BaDuanJin (A) and TaiChiQuan (B). The NMA and SUCRA results revealed that: A + D and A + C + D were most likely to be the best interventions to improve NT-proBNP; B + D and A + C + D were most likely to be the best interventions to improve LVEF; A + D and A + C + D were the best interventions to improve 6WMT in CHD-CHF patients; B + C + D had the best effect on shrinking LVESD;A + D and B + C + D was likely the best interventions for contracting LVEDD;B + D and A + D were consistent in their capacity to improve MLHFQ in patients with CHD-CHF, but B + D had better efficacy. Unlike A + C + D, B + C + D was the best intervention to improve MLHFQ. In contrast with interventions, including Dand C + D, B + D was the most clinically effective intervention. Unlike interventions including B + C + D, C + D, and D, A + C + D was the most clinically efficient intervention. CONCLUSION The findings of this NMA showed that traditional Chinese health exercises integrated with conventional treatment are more effective than conventional treatment (D) alone in patients with CHD-CHF, with A + D, B + D, B + C + D, and A + C + D considered potentially optimal treatment interventions.
Collapse
Affiliation(s)
- Xiwei Huang
- Graduate School of Guangzhou University of Traditional Chinese Medicine, Guangzhou City, Guangdong Province, China
- People’s Liberation Army General Hospital of Southern Theatre Command, Guangzhou City, Guangdong Province, China
| | - Shuwen Pang
- Graduate School of Guangzhou University of Traditional Chinese Medicine, Guangzhou City, Guangdong Province, China
- People’s Liberation Army General Hospital of Southern Theatre Command, Guangzhou City, Guangdong Province, China
| | - Yueli Zhao
- Graduate School of Guangzhou University of Traditional Chinese Medicine, Guangzhou City, Guangdong Province, China
- People’s Liberation Army General Hospital of Southern Theatre Command, Guangzhou City, Guangdong Province, China
| | - Jing Qian
- Graduate School of Guangzhou University of Traditional Chinese Medicine, Guangzhou City, Guangdong Province, China
- People’s Liberation Army General Hospital of Southern Theatre Command, Guangzhou City, Guangdong Province, China
| | - Jiahui Zhong
- Graduate School of Guangzhou University of Traditional Chinese Medicine, Guangzhou City, Guangdong Province, China
- Guangdong Provincial People’s Hospital, Guangzhou City, Guangdong Province, China
| | - Shuai Liu
- Graduate School of Guangzhou University of Traditional Chinese Medicine, Guangzhou City, Guangdong Province, China
- People’s Liberation Army General Hospital of Southern Theatre Command, Guangzhou City, Guangdong Province, China
| |
Collapse
|
8
|
Fang F, Huang Y, Liu Z, Liu X, Huang X. Correlation analysis of central arterial pressure parameters and the severity of atherosclerotic lesions in coronary arteries: A retrospective study. Medicine (Baltimore) 2023; 102:e36466. [PMID: 38050197 PMCID: PMC10695555 DOI: 10.1097/md.0000000000036466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 11/13/2023] [Indexed: 12/06/2023] Open
Abstract
To investigate the correlation between central arterial pressure (CAP) parameters and the severity of atherosclerotic lesions in the coronary arteries, understand the value of CAP in assessing the risk of coronary heart disease (CHD), and provide a theoretical basis for the prevention and treatment of CHD. Between January 2021 and January 2022, 224 patients admitted to our hospital for complete coronary angiography (CAG) were included in this retrospective study. CAP parameters, including central systolic pressure (CSP), diastolic pressure (CDP), and pulse pressure (CPP), and Gensini scores were collected; the association between CAP parameters and the severity of coronary lesions was analyzed using the Pearson correlation coefficient (r) and multivariate regression analysis. CPP was significantly higher in the coronary multi-branch lesion group than in the single-branch lesion group in patients with CHD (P < .05). CSP, CDP, and CPP were significantly higher in the high Gensini score group than in the low Gensini score group for coronary vascular lesions; furthermore, CSP and CPP were significantly higher in the high Gensini score group than in the medium Gensini score group (P < .05). Pearson correlation analysis showed that CSP and CPP were positively and CDP was negatively correlated with the severity of coronary artery lesions in patients with CHD (P < .05). Logistic regression analysis showed that a history of diabetes, CSP, CDP, and CPP were independent risk factors for severe atherosclerotic lesions in the coronary arteries (P < .05). noninvasive CAP-related indices, such as CSP, CDP, and CPP, are independently correlated with and can be used to predict the severity of coronary lesions in patients with CHD, which may be beneficial for guiding clinical diagnosis and treatment.
Collapse
Affiliation(s)
- Fang Fang
- Department of Basic Medicine, Changde Vocational and Technical College, Changde, Hunan, China
| | - Ying Huang
- Department of Basic Medicine, Changde Vocational and Technical College, Changde, Hunan, China
| | - Zhiyong Liu
- Department of Cardiovascular, Changde First Hospital of Traditional Chinese Medicien, Changde, Hunan, China
| | - Xuemei Liu
- Department of Internal Medicine, The Orthopedics Hospital of Traditional Chinese Medicine Zhuzhou City, Zhuzhou, Hunan, China
| | - Xiaoyun Huang
- Department of Cardiovascular, Hengyang Hospital of Traditional Chinese Medicine, Hengyang, Hunan, China
| |
Collapse
|
9
|
Shen T, Wang Y, Ren C, Song Y, Gao W, Liu F, Li G, Wei Z, Wang P, Zhao W. The effects of CPET-guided cardiac rehabilitation on exercise tolerance in older persons with CHD after PCI. Sci Rep 2023; 13:19994. [PMID: 37968506 PMCID: PMC10651904 DOI: 10.1038/s41598-023-47494-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 11/14/2023] [Indexed: 11/17/2023] Open
Abstract
Prescribing appropriate exercise is an important means to improve the safety and efficacy of cardiac rehabilitation. Improper exercise may induce an increased cardiovascular risk in older persons with coronary heart disease. Cardiopulmonary exercise testing (CPET)-guided cardiac rehabilitation could be helpful for providing clinical evidence for cardiac rehabilitation therapy in older persons after percutaneous coronary intervention (PCI). We retrospectively included older persons who underwent PCI and cardiac rehabilitation based on CPET at the Cardiac Rehabilitation Center of Peking University Third Hospital from January 2014 to December 2019. Patients' baseline and follow-up clinical data were collected. A total of 403 older persons after PCI were included in the study. The mean age was 80.5 ± 4.3. The mean follow-up time was 12 ± 2 months. During the follow-up period, no significant exercise-related adverse events occurred, and the peak oxygen uptake (VO2peak) increased compared with baseline (15.5 ± 3.8 ml/min/kg vs. 17.3 ± 4.1 ml/min/kg). Among the 90 patients (22.2%) without exercise habits at baseline who started regular exercise during follow-up, the improvement in VO2peak was most significant, at 3.2 ± 0.4 ml/min/kg. Cardiac rehabilitation based on CPET improved exercise habits and exercise tolerance in older persons with coronary heart disease after PCI.
Collapse
Affiliation(s)
- Tao Shen
- Department of Cardiology, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Yuwei Wang
- Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing, China
| | - Chuan Ren
- Department of Cardiology, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Yanxin Song
- Department of Cardiology, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Wei Gao
- Department of Cardiology, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China
| | - Fen Liu
- Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing, China
| | - Gang Li
- Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing, China
| | - Zhimin Wei
- Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing, China.
| | - Peng Wang
- Physical Examination Center, Peking University Third Hospital, Beijing, China.
| | - Wei Zhao
- Department of Cardiology, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing, China.
- Physical Examination Center, Peking University Third Hospital, Beijing, China.
| |
Collapse
|
10
|
Yang B, Ma K, Xiang R, Yang G, Luo Y, Wu F, Mao M. Uric acid and evaluate the coronary vascular stenosis gensini score correlation research and in gender differences. BMC Cardiovasc Disord 2023; 23:546. [PMID: 37940848 PMCID: PMC10634079 DOI: 10.1186/s12872-023-03581-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND AND AIMS Recent studies have shown that the negative effect of uric acid (UA) on coronary arteries determines the severity of atherosclerotic disease. This study aims to explore the relationship between serum UA level and Gensini score, which reflects the severity of coronary artery disease. METHODS A total of 860 patients with suspected coronary heart disease who were admitted to hospital due to angina pectoris or myocardial ischemia related symptoms and received coronary angiography were selected. Based on the findings of the angiography, they were categorized into two groups: the coronary heart disease (CHD) group (n = 625) and the control group (n = 235). The uric acid levels and other clinical data were compared between these groups. Additionally, the prevalence of coronary heart disease and Gensini score were compared between the groups, considering gender-specific quartiles of uric acid levels. The clinical baseline data were analyzed using appropriate statistical methods, and multivariate logistic regression analysis was conducted to identify independent risk factors for coronary heart disease. RESULTS Of 860 patients (mean age, 63.97 ± 11.87 years), 528 were men (mean age, 62.06 ± 11.5 years) and 332 were women (mean age, 66.99 ± 10.11 years). The proportion of smoking, diabetes, hypertension, and hyperlipidemia in the coronary heart disease group was higher than that in the control group (P < 0.05). HbA1C, Gensini score, BMI, TG and hsCRP in the coronary heart disease group were higher than those in the control group (P < 0.05), and HDL-C was lower than that in the control group (P < 0.05). There were no significant differences in age, heart rate, Cr, TC and LDL-C between the two groups (P > 0.05).Multivariate logistic regression analysis showed that age, hypertension, hsCRP and SUA levels increased the risk of coronary heart disease, and the difference was statistically significant(OR = 1.034,95%CI 1.016-1.052, P = 0.001; OR = 1.469,95%CI 1.007-2.142, P = 0.046;OR = 1.064,95%CI 1.026-1.105, P = 0.001; OR = 1.011,95%CI 1.008-1.014, P < 0.001). CONCLUSION Serum uric acid is positively correlated with Gensini score in patients with coronary heart disease, which is an independent factor for evaluating the degree of coronary artery stenosis and has a predictive effect.
Collapse
Affiliation(s)
- Bao Yang
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400010, China
| | - Kanghua Ma
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400010, China
| | - Rui Xiang
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400010, China
| | - Guoli Yang
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400010, China
| | - Yue Luo
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400010, China
| | - Fan Wu
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400010, China
| | - Min Mao
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Yuzhong, Chongqing, 400010, China.
| |
Collapse
|
11
|
Dele-Ojo BF, Oseni TIA, Duodu F, Echieh CP, Blankson PK, Alabi BS, Sarpong DF, Tayo BO, Boima V, Coleman MA, Ogedegbe G. The effect of mobile health technology on blood pressure control among patients with hypertension in Ghana and Nigeria. RESEARCH SQUARE 2023:rs.3.rs-3272069. [PMID: 37790348 PMCID: PMC10543310 DOI: 10.21203/rs.3.rs-3272069/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Background More than half of patients with hypertension in sub-Saharan African do not achieve blood pressure control. This study determined the effect of mobile health technology on systolic blood pressure reduction and blood pressure (BP) control among patients with hypertension in Nigeria and Ghana. Methods A randomised control trial of 225 adults with hypertension attending two General/Medical Outpatient Clinics each in Nigeria and Ghana was randomized into intervention (n = 116) and control (n = 109) arm respectively. Patients in the intervention arm received messages twice weekly from a mobile app for six months in addition to the usual care while the control arm received usual care only. The study outcomes were systolic blood pressure (SBP) reduction and blood pressure control at six months, while the secondary outcome was medication adherence at six months. Data were collected at 0 and 6 months, it was analysed using SPSS-21 software at a significance level of p < 0.05. Binary logistic regression was used to generate the predictors of good blood pressure control. Results The mean age for the control and intervention were 60.2 ± 13.5 and 62.6 ± 10.8 years respectively; p-value = 0.300. The intervention group had greater reductions in SBP (-18.7mmHg vs -3.9mmHg; p < 0.001) and greater BP control rate (44.3% vs 24.8%; p-value 0.002). Conclusions The mobile health intervention resulted in significant SBP reduction rate and improvement in BP control rate in the 6th month. However, improvement in adherence level in the 3rd month and was not sustained in the 6th month. The addition of mobile health technology may be extended for use in the national hypertension control plan. Female gender, formal education and being in the intervention arm were predictors of blood pressure control.
Collapse
|
12
|
Yang Z, Sun Y, Wang H, Zhang C, Wang A. A scale for measuring home-based cardiac rehabilitation exercise adherence: a development and validation study. BMC Nurs 2023; 22:259. [PMID: 37550733 PMCID: PMC10405489 DOI: 10.1186/s12912-023-01426-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/31/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND The benefits of home-based cardiac rehabilitation exercise are well-established and depend on long-term adherence. However, there is no uniform and recognized cardiac rehabilitation criterion to assess home-based cardiac rehabilitation exercise adherence for patients with cardiovascular disease. This study aimed to develop a home-based cardiac rehabilitation exercise adherence scale and to validate its psychometric properties among patients with chronic heart failure. METHODS The dimensions and items of the scale were created based on grounded theory research, literature content analysis, and defined by a Delphi survey. Item analysis was completed to assess the discrimination and homogeneity of the scale. Factor analysis was adopted to explore and validate the underlying factor structure of the scale. Content validity and calibration validity were evaluated using the Delphi survey and correlation analysis, respectively. Reliability was evaluated by Cronbach's α coefficients, split-half reliability coefficients, and test-retest reliability coefficients. RESULTS A scale covering four dimensions and 20 items was developed for evaluating home-based cardiac rehabilitation exercise adherence. The content validity index of the scale was 0.986. In exploratory factor analysis, a four-factor structure model was confirmed, explaining 75.1% of the total variation. In confirmatory factor analysis, the four-factor structure was supported by the appropriate fitting indexes. Calibration validity of the scale was 0.726. In terms of reliability, the Cronbach's α coefficient of the scale was 0.894, and the Cronbach's α coefficients of dimensions ranged from 0.848 to 0.914. The split-half reliability coefficient of the scale was 0.695. The test-retest reliability coefficient of the scale was 0.745. CONCLUSION In this study, a home-based cardiac rehabilitation exercise adherence scale was developed and its appropriate psychometric properties were confirmed.
Collapse
Affiliation(s)
- Zhen Yang
- The First Affiliated Hospital of China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, Liaoning Province, China
| | - Yuanhui Sun
- The First Affiliated Hospital of China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, Liaoning Province, China
| | - Huan Wang
- The First Affiliated Hospital of China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, Liaoning Province, China
| | - Chunqi Zhang
- The First Affiliated Hospital of Jinzhou Medical University, No.2, Section 5, Renmin Street, Guta District, Jinzhou City, Liaoning Province, China
| | - Aiping Wang
- The First Affiliated Hospital of China Medical University, No.155, Nanjing North Street, Heping District, Shenyang, Liaoning Province, China.
| |
Collapse
|
13
|
Wang F, Cai J, Liu J, Duan B, Yang Y, Yang Q. Effects of traditional Chinese exercise on physiological indicators and quality of life in patients with coronary heart disease: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e34233. [PMID: 37390231 PMCID: PMC10313288 DOI: 10.1097/md.0000000000034233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/15/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND The efficacy of traditional Chinese exercise (TCE)-based intervention in the improvement of physiological indicators and quality of life in patients with coronary heart disease (CHD) is controversial. METHOD Five databases were systematically searched for relevant articles published from inception to February 2023. Controlled trials examining TCE intervention in patients with CHD. The treatment effects were estimated using a random-effect meta-analysis model with standardized mean differences (Hedges g). The categorical and continuous variables were used to conduct moderator analyses. Two investigators independently screened abstracts and full-text articles and graded the certainty of evidence based on the Grading of Recommendations Assessment, Development and Evaluation approach. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (identifier CRD42023401934). RESULT Ten studies involving a total of 718 participants were included in the final analysis. In the physiological indicators outcomes, the meta-analytic findings revealed large and significant improvements in systolic blood pressure (g = 0.78, 95% confidence interval [CI] = 0.51-1.05, P = .00, I2 = 98%), diastolic blood pressure (g = 0.90, 95% CI = 0.61-1.20, P = .00, I2 = 98%) and body mass index (g = 1.05, 95% CI = 0.75-1.34, P = .00, I2 = 99%), small and significant improvements in heart rate (g = 0.28, 95% CI = 0.01-0.54, P = .04, I2 = 98%) and ventilatory equivalents/carbon dioxide (g = -1.10, 95% CI = -1.47 to -0.74, P = .00, I2 = 96%).In the quality of life outcomes, the findings revealed small and significant improvements in physical functioning (g = -3.01, 95% CI = -3.45 to -2.57, P = .00, I2 = 96%), bodily pain (g = -2.16, 95% CI = -2.57 to -1.74, P = .00, I2 = 98%), vitality (g = -3.67, 95% CI = -4.16 to -3.16, P = .00, I2 = 97%) and mental health (g = -1.23, 95% CI = -1.771 to -0.692, P = .00, I2 = 99%). The moderator shows that the effects of TCE on physiological indicators and quality of life were moderated by PEDro score, type of exercise, exercise frequency, exercise duration, and number of sessions. CONCLUSION TCE intervention is a beneficial nonpharmacological approach to improving physiological indicators in patients with CHD, especially in systolic blood pressure, diastolic blood pressure, and body mass index. However, there was no significant effect on quality of life. Our findings require broader clinical trials and higher-quality study designs to strengthen the evidence.
Collapse
Affiliation(s)
- Fan Wang
- Harbin Medical University, Harbin, Heilongjiang Province, China
| | - Jingjing Cai
- Shiyan Hospital of Integrated Traditional Chinese and Western Medicine, Shiyan, Hubei Province, China
| | - Jihong Liu
- Shiyan Hospital of Integrated Traditional Chinese and Western Medicine, Shiyan, Hubei Province, China
| | - Banyan Duan
- Shiyan Hospital of Integrated Traditional Chinese and Western Medicine, Shiyan, Hubei Province, China
| | - Yingying Yang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Qianfang Yang
- Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang Province, China
| |
Collapse
|
14
|
Yang WY, Xu Y, Ye L, Rong LJ, Feng J, Huang BL, Chien CW, Tung TH. Effects of Baduanjin exercise on quality-of-life and exercise capacity in patients with heart failure: A systematic review and meta-analysis. Complement Ther Clin Pract 2023; 50:101675. [PMID: 36436262 DOI: 10.1016/j.ctcp.2022.101675] [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: 06/09/2022] [Revised: 10/07/2022] [Accepted: 10/25/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE Exercise training is an efficient non-pharmacological intervention for patients with heart failure (HF). This study aimed to objectively evaluate the effects of Baduanjin exercise on the quality of life (QOL) and exercise capacity in patients with HF. METHODS PubMed, Embase, the Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), and Wanfang data were searched from the date of their inception until 30 September 2022. All randomised controlled trials (RCTs) evaluating the effects of Baduanjin exercise on QOL and exercise capacity in patients with HF were selected. The primary outcomes were QOL, assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and exercise capacity, evaluated using the 6-min walking test (6-MWT). A meta-analysis was performed by comparing the MLHFQ domain scores. Review Manager 5.3 and Stata 14.0, were used for the data analysis. RESULTS Baduanjin exercise showed a favourable improvement of the overall QOL (mean difference = -8.25; 95% confidence interval: -13.62 to -2.89; P = 0.003) and exercise capacity (mean difference = 118.49; 95% confidence interval: 52.57 to 184.41; P = 0.0004). Meta-analyses of the MLHFQ domain score indicated that Baduanjin exercise significantly improved the patients' physical (mean difference = -2.83; 95% confidence interval: -3.76, -1.90; P < 0.00001), emotional (mean difference = -2.52; 95% confidence interval: -3.67 to -1.37; P < 0.0001), and general QOL (mean difference = -2.61; 95% confidence interval: -5.17 to -0.06; P = 0.05), based on the decrease in the MLHFQ domain score. Marked statistical heterogeneity (I2> 70%) was observed for all the QOL and exercise capacity outcomes. CONCLUSIONS Baduanjin exercise is a safe, feasible, and acceptable intervention that can improve the QOL and exercise capacity in patients with HF. However, more RCTs with rigorous research designs are needed to assist in the rehabilitation of such patients.
Collapse
Affiliation(s)
- Wei-Ying Yang
- Nursing Department, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, China
| | - Ying Xu
- Institute for Hospital Management, Tsinghua University, Shenzhen Campus, China
| | - Li Ye
- Institute for Hospital Management, Tsinghua University, Shenzhen Campus, China
| | - Li-Juan Rong
- Institute for Hospital Management, Tsinghua University, Shenzhen Campus, China
| | - Jing Feng
- Nursing Department, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, China
| | - Bei-Lei Huang
- Nursing Department, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, China
| | - Ching-Wen Chien
- Institute for Hospital Management, Tsinghua University, Shenzhen Campus, China.
| | - Tao-Hsin Tung
- Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, China; Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, China.
| |
Collapse
|
15
|
Liu Y, Su M, Lei Y, Tian J, Xue L, Zhang L. Patient Preferences for Cardiac Rehabilitation - A Systematic Review. Patient Prefer Adherence 2023; 17:75-88. [PMID: 36636288 PMCID: PMC9831083 DOI: 10.2147/ppa.s392417] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 11/30/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Although a large number of studies have demonstrated the effectiveness of cardiac rehabilitation(CR), patient preferences for CR remain unclear. Knowing patient preferences may contribute to increasing patient participation and adherence, thus improving patient prognosis. METHODS A systematic search was carried out using electronic databases and manual reference checks from inception until 15th June 2022. Quantitative studies, qualitative studies and mixed methods studies assessing patient preferences for CR were included. Two researchers independently conducted study selectionand data extraction. CR preferences were divided into three categories: CR settings, CR components, and CR contents. A narrative synthesis was applied to integrate the results of the included studies. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of included studies. RESULTS Ultimately, 17 publications were included in this study. Regarding CR settings, most patients preferred the hospital to home, some considered both, and a few were willing to accept the local CR club as an alternative setting to the hospital. For CR components, regardless of age and gender, patients considered exercise training and nutrition counseling to be the most important and smoking cessation to be the least important. In exercise intervention of CR contents, progress discussion and encouragement were rated as most critical, and non-conflicting with other activities was rated as least critical. In psychological intervention of CR contents, most patients were willing to accept psychological intervention, and a few patients wanted to heal the trauma with the passage of time. CONCLUSION This systematic review provides important insights into patient preferences for CR, clarifying patient preferences for CR settings, components, and contents, along with possible influencing factors. Patient preferences may change due to the COVID-19 epidemic, and there is still a need to focus on patient preferences for CR and conduct more relevant primary research to validate the findings of this paper in the future.
Collapse
Affiliation(s)
- Yunyue Liu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China
| | - Mengyu Su
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China
| | - Yang Lei
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China
- Correspondence: Yang Lei, School of Nursing, Nanjing Medical University, No. 101, Longmian Avenue, Jiangning District, Nanjing, Jiangsu Province, People’s Republic of China, Tel +86 19955062997, Fax +86 258 6869 555, Email
| | - Jinping Tian
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China
- Department of Cardiology, the First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China
- Jinping Tian, The First Affiliated Hospital with Nanjing Medical University, No. 300, Guangzhou Road, Gulou District, Nanjing, Jiangsu Province, People’s Republic of China, Tel +86 13851550156, Fax +86 519 6809 1881, Email
| | - Leng Xue
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China
| | - Lin Zhang
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu Province, People’s Republic of China
| |
Collapse
|
16
|
Efficacy of Exercise Rehabilitation in Patients with Atrial Fibrillation after Radiofrequency Ablation: A Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:9714252. [PMID: 36248413 PMCID: PMC9568312 DOI: 10.1155/2022/9714252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 08/24/2022] [Accepted: 09/12/2022] [Indexed: 11/09/2022]
Abstract
Background and Aims Radiofrequency ablation is a commonly used treatment for paroxysmal atrial fibrillation (AF), but postoperative rehabilitation exercises are needed to reverse left ventricular structural and functional abnormalities. This meta-analysis aimed to evaluate the intervention effect of exercise training in patients with AF after radiofrequency ablation. Methods A systematic literature search was conducted to identify articles in PubMed, MEDLINE, EMBASE, and the Cochrane Library from January 1, 2010 to December 1, 2021. The mean difference with 95% CI was pooled for continuous variables. We used Review Manager 5.3 for the standard meta-analysis. This study followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results Ten randomized controlled trials (RCTs) were included, with a total of 892 patients with AF. The quality of one study was grade A, and the rest were grade B. The results of the meta-analysis showed that the improvement of 6 min walking distance (MD = 34.42, 95% CI: 3.20 to 65.63, P=0.03), peak oxygen uptake (MD = 1.96, 95% CI: 1.14 to 2.78, P < 0.001), left ventricular ejection fraction (LVEF) (MD = 0.09, 95% CI:0.01-0.17, P=0.02), resting heart rate (MD = -4.50, 95% CI: -8.85 to -0.14, P=0.04), and physical component summary (PCS) (MD = 3.00, 95% CI: 0.46 to 5.54, P=0.02) in the experimental group was significantly better than that of the control group, and the difference was statistically significant. Conclusion Exercise training can improve the level of exercise endurance and cardiac function in patients. However, the results were limited by the quantity and quality of the studies. Large samples and high-quality studies are still needed to verify its long-term efficacy.
Collapse
|
17
|
Updated Meta-Analysis Assessing Effects of Baduanjin on Cardiopulmonary Functions of Patients with Coronary Heart Disease. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:3913082. [PMID: 36212963 PMCID: PMC9536900 DOI: 10.1155/2022/3913082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/23/2022] [Indexed: 11/17/2022]
Abstract
Background Baduanjin is a kind of moderate-intensity aerobic exercise, but its effect on the cardiac rehabilitation (CR) of patients with coronary heart disease (CHD) is controversial. Furthermore, the small sample size of a single study and the inconsistent selection of evaluation indicators among different studies all promote the necessity of conducting a meta-analysis. Objective This meta-analysis aims to explore whether Baduanjin can effectively improve the cardiopulmonary function in patients with CHD and to assess the extrapolation of the results. Methods Both English and Chinese databases were used for literature retrieval. The Cochrane Collaboration tool was used to evaluate the methodological quality of the included literature. A weighted mean difference and a 95% confidence interval were used to assess the effects of Baduanjin on cardiopulmonary function based on multiple CR indicators. Cochran's Q and I2 tests were used for the heterogeneity test. A funnel plot and an Egger test were used to evaluate publication bias. Results After literature retrieval, a total of 12 literature papers were included in this meta-analysis, but their methodological quality was unsatisfactory. By comparing differences between CHD patients with and without Baduanjin, we found that levels of 6MWT, LVEF, NT-proBNP, VO2, peak VO2, MVV, and VE, AT were significantly improved in the experimental group, but heterogeneity exists among included studies. Results of subgroup analyses were consistent with combined estimates and suggested a significant effect of Baduanjin on LVEF. The Egger test indicated no significant publication bias. Conclusion Baduanjin is beneficial to CR in CHD patients, but multiple region-based high-quality studies are necessary to verify the results.
Collapse
|
18
|
Effect of Early Exercise Rehabilitation on Cardiopulmonary Function and Quality of Life in Patients after Coronary Artery Bypass Grafting. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:4590037. [PMID: 36003994 PMCID: PMC9385281 DOI: 10.1155/2022/4590037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/06/2022] [Accepted: 07/12/2022] [Indexed: 11/21/2022]
Abstract
The purpose of this study was to analyze the effect of early exercise rehabilitation on cardiopulmonary function and quality of life in patients after coronary artery bypass grafting (CABG). Eighty patients with coronary heart disease who underwent CABG from April 2020 to April 2022 were divided into the study group (n = 40) and control group (n = 40). The control group was given conventional treatment and routine care after CABG, and the study group received early exercise rehabilitation according to the control group. The cardiac function indexes, 6-minute walking test (6MWT), and cardiopulmonary function indexes and quality of life of the two groups were compared before and after the intervention, and the length of hospitalization and hospital costs as well as the occurrence of pulmonary complications in both groups were recorded. Left ventricular ejection fraction (LVEF) was significantly higher (P < 0.05), and left ventricular end-diastolic dimension (LVEDD) and left ventricular end-systolic diameter (LVESD) were significantly lower (P < 0.05) in the study group than in the control group after the intervention; 6MWT, maximal oxygen consumption (VO2max), and anaerobic threshold (AT) were significantly higher (P < 0.05) in the study group than in the control group after the intervention; physical function (PF), role physical (RP), general health (GH), and role emotional (RE) dimension scores were significantly higher (P < 0.05) in the study group compared with the control group after the intervention The differences in the scores of the remaining dimensions were not statistically significant (P > 0.05); the total hospitalization time in the test group was significantly shorter than that in the control group (P < 0.05), the hospitalization cost was significantly less than that in the control group (P < 0.05), and the total incidence of pulmonary infection and hypoxemia was significantly lower than that in the control group (P < 0.05). Early exercise rehabilitation can effectively improve cardiopulmonary function and exercise tolerance and improve the quality of life of patients after CABG.
Collapse
|
19
|
Effect of CICARE Communication Mode on Disease Uncertainty, Self-Nursing Ability, and Quality of Life in Patients with Coronary Atherosclerotic Heart Disease after Percutaneous Coronary Intervention. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:8654449. [PMID: 36035303 PMCID: PMC9410929 DOI: 10.1155/2022/8654449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/21/2022] [Accepted: 07/01/2022] [Indexed: 01/09/2023]
Abstract
Objective To study the effect of CICARE (Connect, Introduce, Communicate, Ask, Respond, Exit) communication mode on disease uncertainty, self-nursing ability, and quality of life in patients with coronary atherosclerotic heart disease (CAD) after percutaneous coronary intervention (PCI). Methods From January 2021 to December 2021, 102 patients with CAD after PCI were randomly divided into a research group (n =51) and a control group (n =51). The former received CICARE communication model nursing intervention, and the latter received routine doctor-patient communication nursing. To study the scores of disease uncertainty scale (MUIS), Frankl treatment compliance scale (Frankl), self-care ability scale (exercise of self-care-a), quality of life scale (WHOQOL-BREF), and Newcastle nursing satisfaction scale (NSNS) before and 1 week after nursing. Results After one week of nursing, the MUIS score of the research group was lower than that of the control group, and the score of Frankl treatment compliance scale of the research group was higher than that of the control group. After 1 week of nursing, the ESCA score of the research group was higher compared to the control group (p < 0.05), and the WHOQOL-BREF score of the research group was higher compared to the control group (p < 0.05). After one week of nursing, the NSNS score of the research group was higher compared to the control group (p < 0.05). Conclusion The application value of CICARE communication mode nursing intervention in patients with CAD after PCI is more remarkable, and it is more helpful to reduce patients' disease uncertainty, enhance treatment compliance, promote patients' self-nursing ability, and strengthen quality of life and nursing satisfaction.
Collapse
|
20
|
Meslet JB, Dugué B, Brisset U, Pianeta A, Kubas S. Evaluation of a Hybrid Cardiovascular Rehabilitation Program in Acute Coronary Syndrome Low-Risk Patients Organised in Both Cardiac Rehabilitation and Sport Centres: A Model Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9455. [PMID: 35954810 PMCID: PMC9368004 DOI: 10.3390/ijerph19159455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 07/24/2022] [Accepted: 07/28/2022] [Indexed: 02/04/2023]
Abstract
The aim of the study was to investigate the efficiency, the feasibility, and the safety of a hybrid cardiovascular rehabilitation program in low-risk acute coronary syndrome (ACS) patients. Sixty low-risk patients with stable clinical status who experienced an ACS in the previous 3 months were included in a 3-week rehabilitation program. The patients were randomized either to a group performing the rehabilitation totally in a rehabilitation centre or partially (only the first 5 days) and then in sport centres equipped for supervised adapted physical activities. The sport centres were located in the vicinity of the patient’s home. Both rehabilitation programs entailed endurance and resistance training and educational therapy. Before and after rehabilitation, cardiorespiratory functions were measured. Similar and significant improvements in peak V.O2 and power output were seen in patients after both types of rehabilitation (p < 0.05). No particular complications were associated with both of our programs. We conclude that a hybrid rehabilitation program in low-risk ACS patients is feasible, safe, and as beneficial as a traditional program organised in a rehabilitation centre, at least in a short-term. A longitudinal follow-up should nevertheless be organised to examine the long-term impacts of this hybrid rehabilitation program.
Collapse
Affiliation(s)
- Jean-Baptiste Meslet
- Laboratoire «Mobilité Vieillissement, Exercice (MOVE)-UR 20296», Faculté des Sciences du Sport, Université de Poitiers, 86000 Poitiers, France;
- Centre de Réadaptation Cardiaque de Bois-Gibert, 37510 Ballan-Miré, France; (U.B.); (A.P.); (S.K.)
| | - Benoit Dugué
- Laboratoire «Mobilité Vieillissement, Exercice (MOVE)-UR 20296», Faculté des Sciences du Sport, Université de Poitiers, 86000 Poitiers, France;
| | - Ugo Brisset
- Centre de Réadaptation Cardiaque de Bois-Gibert, 37510 Ballan-Miré, France; (U.B.); (A.P.); (S.K.)
| | - Alain Pianeta
- Centre de Réadaptation Cardiaque de Bois-Gibert, 37510 Ballan-Miré, France; (U.B.); (A.P.); (S.K.)
| | - Sophie Kubas
- Centre de Réadaptation Cardiaque de Bois-Gibert, 37510 Ballan-Miré, France; (U.B.); (A.P.); (S.K.)
| |
Collapse
|
21
|
Nappi RE, Chedraui P, Lambrinoudaki I, Simoncini T. Menopause: a cardiometabolic transition. Lancet Diabetes Endocrinol 2022; 10:442-456. [PMID: 35525259 DOI: 10.1016/s2213-8587(22)00076-6] [Citation(s) in RCA: 66] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/08/2022] [Accepted: 02/17/2022] [Indexed: 12/12/2022]
Abstract
Menopause is often a turning point for women's health worldwide. Increasing knowledge from experimental data and clinical studies indicates that cardiometabolic changes can manifest at the menopausal transition, superimposing the effect of ageing onto the risk of cardiovascular disease. The menopausal transition is associated with an increase in fat mass (predominantly in the truncal region), an increase in insulin resistance, dyslipidaemia, and endothelial dysfunction. Exposure to endogenous oestrogen during the reproductive years provides women with protection against cardiovascular disease, which is lost around 10 years after the onset of menopause. In particular, women with vasomotor symptoms during menopause seem to have an unfavourable cardiometabolic profile. Early management of the traditional risk factors of cardiovascular disease (ie, hypertension, obesity, diabetes, dyslipidaemia, and smoking) is essential; however, it is important to recognise in the reproductive history the female-specific conditions (ie, gestational hypertension or diabetes, premature ovarian insufficiency, some gynaecological diseases such as functional hypothalamic amenorrhoea, and probably others) that could enhance the risk of cardiovascular disease during and after the menopausal transition. In this Review, the first of a Series of two papers, we provide an overview of the literature for understanding cardiometabolic changes and the management of women at midlife (40-65 years) who are at higher risk, focusing on the identification of factors that can predict the occurrence of cardiovascular disease. We also summarise evidence about preventive non-hormonal strategies in the context of cardiometabolic health.
Collapse
Affiliation(s)
- Rossella E Nappi
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
| | - Peter Chedraui
- Instituto de Investigación e Innovación en Salud Integral and Laboratorio de Biomedicina, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Irene Lambrinoudaki
- Menopause Unit, 2nd Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Tommaso Simoncini
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| |
Collapse
|
22
|
Ding Y, Wei Z, Li J, Zhu L. Effects of Metoprolol Succinate Combined with Entresto on Cardiac Function Indexes and Coagulation Function in Patients with Congestive Heart Failure. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9765884. [PMID: 35637842 PMCID: PMC9148243 DOI: 10.1155/2022/9765884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 04/11/2022] [Accepted: 04/19/2022] [Indexed: 11/17/2022]
Abstract
Objective To investigate the effects of metoprolol succinate combined with Entresto (Sacubitril Valsartan Sodium Tablets) on cardiac function and coagulation function in patients with congestive heart failure (CHF). Methods About 120 patients with CHF treated from April 2018 to April 2021 were enrolled in our hospital. The patients were arbitrarily assigned into control group and study group. The control group was cured with metoprolol succinate sustained-release tablets, and the study group was cured with metoprolol succinate sustained-release tablets combined with Entresto. The curative effect, cardiac function, vascular endothelial function, oxidative stress, and coagulation function were compared. Results First of all, we compared the general data, and there exhibited no difference in age, sex, course of disease, hypertension, coronary heart disease, diabetes, atrial fibrillation, and other general data (P > 0.05). Second, we compared the clinical efficacy. The effective rate of the study group (98.33%) was higher (90.00%) (P < 0.05). There exhibited no significant difference in cardiac function indexes before treatment, but after treatment, LVEF increased, LVESD and LVEDD decreased, LVESD and LVEDD in the study group were lower, and LVEF in the study group was higher (P < 0.05). Before treatment, there exhibited no significant difference in vascular endothelial function. However, the levels of CGRP and ET increased and the level of NO decreased, and the level of NO in the study group was lower, while the levels of CGRP and ET in the study group were higher after treatment (P < 0.05). There exhibited no significant difference in oxidative stress indexes before treatment, however, the levels of GSH-Px and SOD increased and the levels of MDA decreased after treatment, while the level of MDA in the study group was lower, while the levels of GSH-Px and SOD in the study group were higher (P < 0.05). Finally, we compared the indexes of blood coagulation function. There exhibited no significant difference before treatment, but after treatment, the levels of APTT, PT, and FIB decreased, and the levels of APTT, PT, and FIB in the study group were lower (P < 0.05). Conclusion Clinical practice demonstrated that LVESD and LVEDD decreased and LVEF increased after treatment with Entresto combined with metoprolol in CHF patients, which can effectively facilitate cardiac function and vascular endothelial function, reduce oxidative stress reaction, and improve blood coagulation indexes, suggesting that Entresto combined with metoprolol can improve ventricular remodeling with good safety.
Collapse
Affiliation(s)
- Yuanyuan Ding
- Hubei Province Huangshi Puren Hospital Cardiovascular Medicine, 435002, China
| | - Zufa Wei
- Hubei Province Huangshi Puren Hospital Cardiovascular Medicine, 435002, China
| | - Jian Li
- Hubei Province Huangshi Puren Hospital Cardiovascular Medicine, 435002, China
| | - Ling Zhu
- Audit Office of Huangshi Central Hospital, Hubei Province, China
| |
Collapse
|
23
|
Zhang Z, Wang L, Zhan Y, Xie C, Xiang Y, Chen D, Wu Y. Clinical value and expression of Homer 1, homocysteine, S-adenosyl-l-homocysteine, fibroblast growth factors 23 in coronary heart disease. BMC Cardiovasc Disord 2022; 22:215. [PMID: 35546659 PMCID: PMC9097103 DOI: 10.1186/s12872-022-02554-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 03/07/2022] [Indexed: 12/17/2022] Open
Abstract
Background This study aimed to explore clinical value and expression of Homer 1, S-adenosyl-l-homocysteine (SAH), homocysteine (Hcy), fibroblast growth factors (FGF) 23 in coronary heart disease (CHD). Methods From March 2020 to April 2021, a total of 137 patients with CHD and 138 healthy subjects who came to our hospital for physical examination and had no cardiovascular disease were retrospectively enrolled, and they were assigned to the CHD group and the control group, respectively. Patients in the CHD group were divided into stable angina pectoris (SAP) group (n = 48), unstable angina pectoris (UAP) group (n = 46), and acute myocardial infarction (AMI) group (n = 43) according to clinical characteristics for subgroup analysis. The degree of coronary artery stenosis was assessed by Gensini score, which is a reliable assessment tool for the severity of coronary artery disease. The levels of Homer 1, SAH, Hcy, and FGF 23 were tested and compared. Spearman correlation analysis was used to analyze the correlation between serum Homer1, SAH, Hcy, FGF23 levels and Gensini score, and multivariate unconditional Logistic regression was used to analyze the risk factors of coronary heart disease. Results Demographic characteristics of each group were comparable (P > 0.05). The body mass index (BMI), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and glucose levels of the SAP group, UAP group and AMI group were significantly higher than those of the control group, and the number of patients with smoking, alcohol consumption, hypertension, and diabetes history was significantly more than that of the control group, respectively (P < 0.05). The level of high-density lipoprotein cholesterol (HDL-C) of each subgroup was significantly lower than the control group (P < 0.05). The above indicators showed no significant difference among three subgroups (P > 0.05). Serum SAH, Hcy, Homer1 and FGF23 levels in each subgroup were significantly higher than those in control group (P < 0.05). And above indicators in SAP group and UAP group were significantly lower than those in AMI group (P < 0.05), and the levels of above indicators in SAP group were significantly lower than those in UAP group (P < 0.05). The results of Spearman correlation analysis showed that serum Homer1, FGF23, SAH, Hcy levels were positively correlated with Gensini score (r = 0.376, 0.623, 0.291, 0.372, all P < 0.01). Multivariate logistic regression analysis showed that smoking, hypertension, diabetes, alcohol consumption, obesity, HDL-C, FGF23, SAH, Hcy, Homer 1 were independent risk factors for coronary heart disease. Conclusion The levels of FGF23, SAH, Hcy, and Homer1 tend to increase in patients with CHD compared with normal population, and the more severe the disease, the higher the levels, which has certain reference value for the clinical diagnosis of CHD and the evaluation and monitoring of the disease.
Collapse
Affiliation(s)
- Zhixin Zhang
- Department of Cardiology, Renmin Hospital, Hubei University of Medicine, No. 39 Chaoyang Middle Road, Shiyan, 442000, Hubei, China
| | - Lin Wang
- Department of Cardiology, Renmin Hospital, Hubei University of Medicine, No. 39 Chaoyang Middle Road, Shiyan, 442000, Hubei, China
| | - Yu Zhan
- Department of Cardiology, Renmin Hospital, Hubei University of Medicine, No. 39 Chaoyang Middle Road, Shiyan, 442000, Hubei, China
| | - Cui Xie
- Department of Cardiology, Renmin Hospital, Hubei University of Medicine, No. 39 Chaoyang Middle Road, Shiyan, 442000, Hubei, China
| | - Yang Xiang
- Department of Cardiology, Renmin Hospital, Hubei University of Medicine, No. 39 Chaoyang Middle Road, Shiyan, 442000, Hubei, China
| | - Dan Chen
- Department of Cardiology, Renmin Hospital, Hubei University of Medicine, No. 39 Chaoyang Middle Road, Shiyan, 442000, Hubei, China
| | - You Wu
- Department of Cardiology, Renmin Hospital, Hubei University of Medicine, No. 39 Chaoyang Middle Road, Shiyan, 442000, Hubei, China.
| |
Collapse
|
24
|
Jin Q, Zhou Y, Yin D, He H, Liu Y, Wu Y. Effects of cluster nursing on cardiac function and quality of life in coronary heart disease patients with chronic heart failure: A protocol of randomized controlled trial. Medicine (Baltimore) 2022; 101:e29091. [PMID: 35446292 PMCID: PMC9276295 DOI: 10.1097/md.0000000000029091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 02/26/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Coronary heart disease (CHD) chronic heart failure has high morbidity and mortality, which poses a serious threat to patients' quality of life and life safety. For the treatment of chronic heart failure of CHD, in addition to drugs, high quality nursing measures are also very important. Cluster nursing is a high-quality nursing model based on evidence-based evidence. There is no clinical study to evaluate the effect of cluster nursing on cardiac function and quality of life of CHD patients with chronic heart failure. METHODS This is a prospective randomized controlled trial to investigate the effects of cluster nursing on cardiac function and quality of life in patients with CHD chronic heart failure. Approved by the Clinical Research Ethics Committee of our hospital, patients will be randomly assigned to either routine nursing or cluster nursing. They will be followed up for 3 months after 4 weeks of treatment. Observation indicators include: The total effective rate of cardiac function improvement, Minnesota Living with Heart Failure Questionnaire, left ventricular ejection fraction, N-terminal pro-brain natriuretic peptide, 6-minute walk test, adverse reaction, etc. Data were analyzed using the statistical software package SPSS version 25.0. DISCUSSION This study will evaluate the effects of cluster nursing on cardiac function and quality of life of CHD patients with chronic heart failure. The results of this study will provide clinical basis for establishing reasonable and effective nursing programs for CHD patients with chronic heart failure.
Collapse
|
25
|
Xie X, Chen H, Fan J, Min Q, Fan D. Effects of Cardiopulmonary Rehabilitation Promotion Mode Intervention Combined with Oxygen Therapy on Cardiopulmonary Function and Blood Gas Analysis Indexes of COPD Patients with Cor Pulmonale. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:8495996. [PMID: 35378941 PMCID: PMC8976654 DOI: 10.1155/2022/8495996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 02/22/2022] [Accepted: 02/26/2022] [Indexed: 11/17/2022]
Abstract
Chronic obstructive pulmonary disease is a common respiratory disease. This paper observes the effects of cardiopulmonary rehabilitation promotion mode intervention combined with oxygen therapy on cardiopulmonary function and blood gas analysis indexes in patients with chronic obstructive pulmonary disease (COPD) complicated with cor pulmonale. A total of 136 COPD patients with cor pulmonale admitted to our hospital from July 2018 to October 2020 were selected as the research objects and divided into two groups by a simple random method. 136 patients are given oxygen therapy while the traditional group and cardiopulmonary rehabilitation group are given traditional mode and cardiopulmonary rehabilitation promotion mode intervention. Cardiopulmonary rehabilitation promotion mode intervention combined with oxygen therapy can improve the cardiopulmonary function of COPD patients with cor pulmonale, regulate the expression of related serum factors, improve self-care ability, and reduce the number of hospitalizations.
Collapse
Affiliation(s)
- Xiangmei Xie
- Chief Superintendent Nurse of the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Huihong Chen
- Chief Superintendent Nurse of the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Jie Fan
- Chief Superintendent Nurse of the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Qin Min
- Chief Superintendent Nurse of the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Donghua Fan
- Chief Superintendent Nurse of the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
| |
Collapse
|
26
|
Vilela EM, Ladeiras-Lopes R, Joao A, Braga J, Torres S, Viamonte S, Ribeiro J, Teixeira M, Nunes JP, Fontes-Carvalho R. Current role and future perspectives of cardiac rehabilitation in coronary heart disease. World J Cardiol 2021; 13:695-709. [PMID: 35070112 PMCID: PMC8716974 DOI: 10.4330/wjc.v13.i12.695] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/08/2021] [Accepted: 11/30/2021] [Indexed: 02/06/2023] Open
Abstract
Ischaemic heart disease (IHD) is a major cause of morbidity and mortality worldwide. While there have been major advances in this field, these patients are still a higher risk subgroup. As such, strategies to mitigate risk and tailor secondary prevention measures are of the utmost relevance. Cardiac rehabilitation (CR), encompassing several domains including exercise training, cardiovascular risk factor optimization, nutritional and psychological assessments, as well as other ancillary interventions has shown to be one of the pillars in the contemporary management of patients with IHD. Indeed, CR is associated with several benefits in this population, ranging from functional capacity to improvements in outcomes. Whilst this, there are still several issues concerning the optimal application of CR which are still not fully ascertained, such as lack of referral and completion, as well as questions related to programme design (particularly among patients with multiple comorbidities). In this review, we aim at presenting a pragmatic overview on the current role of CR in the management of individuals with IHD, while also discussing some of the caveats in the current data, as well as future concepts which could help improve the uptake and personalization of this pivotal time-tested intervention.
Collapse
Affiliation(s)
- Eduardo M Vilela
- Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia 4434-502, Portugal
| | - Ricardo Ladeiras-Lopes
- Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia 4434-502, Portugal
- Department of Surgery and Physiology, Cardiovascular Research Unit (UnIC), Faculty of Medicine, University of Porto, Porto 4200-319, Portugal
| | - Ana Joao
- Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia 4434-502, Portugal
| | - Joana Braga
- Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia 4434-502, Portugal
| | - Susana Torres
- Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia 4434-502, Portugal
| | - Sofia Viamonte
- Centro de Reabilitação do Norte, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia 4405-565, Portugal
| | - José Ribeiro
- Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia 4434-502, Portugal
| | - Madalena Teixeira
- Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia 4434-502, Portugal
| | - José P Nunes
- Faculty of Medicine, University of Porto, Porto 4200-319, Portugal
| | - Ricardo Fontes-Carvalho
- Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia 4434-502, Portugal
- Department of Surgery and Physiology, Cardiovascular Research Unit (UnIC), Faculty of Medicine, University of Porto, Porto 4200-319, Portugal
| |
Collapse
|
27
|
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.
Collapse
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
| |
Collapse
|
28
|
O'Doherty AF, Humphreys H, Dawkes S, Cowie A, Hinton S, Brubaker PH, Butler T, Nichols S. How has technology been used to deliver cardiac rehabilitation during the COVID-19 pandemic? An international cross-sectional survey of healthcare professionals conducted by the BACPR. BMJ Open 2021; 11:e046051. [PMID: 33879492 PMCID: PMC8061561 DOI: 10.1136/bmjopen-2020-046051] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To investigate whether exercise-based cardiac rehabilitation services continued during the COVID-19 pandemic and how technology has been used to deliver home-based cardiac rehabilitation. DESIGN A mixed methods survey including questions about exercise-based cardiac rehabilitation service provision, programme diversity, patient complexity, technology use, barriers to using technology, and safety. SETTING International survey of exercise-based cardiac rehabilitation programmes. PARTICIPANTS Healthcare professionals working in exercise-based cardiac rehabilitation programmes worldwide. MAIN OUTCOME MEASURES The proportion of programmes that continued providing exercise-based cardiac rehabilitation and which technologies had been used to deliver home-based cardiac rehabilitation. RESULTS Three hundred and thirty eligible responses were received; 89.7% were from the UK. Approximately half (49.3%) of respondents reported that cardiac rehabilitation programmes were suspended due to COVID-19. Of programmes that continued, 25.8% used technology before the COVID-19 pandemic. Programmes typically started using technology within 19 days of COVID-19 becoming a pandemic. 48.8% did not provide cardiac rehabilitation to high-risk patients, telephone was most commonly used to deliver cardiac rehabilitation, and some centres used sophisticated technology such as teleconferencing. CONCLUSIONS The rapid adoption of technology into standard practice is promising and may improve access to, and participation in, exercise-based cardiac rehabilitation beyond COVID-19. However, the exclusion of certain patient groups and programme suspension could worsen clinical symptoms and well-being, and increase hospital admissions. Refinement of current practices, with a focus on improving inclusivity and addressing safety concerns around exercise support to high-risk patients, may be needed.
Collapse
Affiliation(s)
- Alasdair F O'Doherty
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - Helen Humphreys
- Sport and Physical Activity Research Centre, Sheffield Hallam University, Sheffield, UK
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Susan Dawkes
- School of Nursing, Midwifery and Paramedic Practice, Robert Gordon University, Aberdeen, Scotland, UK
- British Association for Cardiovascular Prevention and Rehabilitation, London, UK
| | - Aynsley Cowie
- British Association for Cardiovascular Prevention and Rehabilitation, London, UK
- Cardiac Rehabilitation, Lister Centre, University Hospital Crosshouse, Kilmarnock, Scotland, UK
| | - Sally Hinton
- British Association for Cardiovascular Prevention and Rehabilitation, London, UK
| | - Peter H Brubaker
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Tom Butler
- British Association for Cardiovascular Prevention and Rehabilitation, London, UK
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK
| | - Simon Nichols
- Sport and Physical Activity Research Centre, Sheffield Hallam University, Sheffield, UK
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
- British Association for Cardiovascular Prevention and Rehabilitation, London, UK
| |
Collapse
|