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Xu L, Wei J, Liu J, Feng Y, Wang L, Wang S, Li Q, He S, Chen Y, Peng Y, Bao Y, Yang X, He C, Chen M, Wei Q. Inspiratory muscle training improves cardiopulmonary function in patients after transcatheter aortic valve replacement: a randomized clinical trial. Eur J Prev Cardiol 2023; 30:191-202. [PMID: 36378543 DOI: 10.1093/eurjpc/zwac269] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/04/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022]
Abstract
AIMS Inspiratory muscle training (IMT) can increase the strength or endurance of the diaphragm and accessory muscles of inspiration, yet there is no evidence that endorses the role of IMT in patients of transcatheter aortic valve replacement (TAVR). This study for the first time tested the effects of IMT plus usual cardiac rehabilitation (CR) function in patients after TAVR. METHODS AND RESULTS A double-blinded, randomized controlled, single-centre clinical trial was undertaken. Participants who had a confirmed diagnosis of valve heart disease and were clinically stable after TAVR were recruited and received a CR programme during the hospital stay. A total of 96 patients were recruited and randomly assigned to the IMT + CR group (n = 48) or the CR group (n = 48) in a 1:1 ratio. The group difference in the primary outcome, the 6-min walk distance at the discharge of the hospital, significantly favoured the IMT + CR group (mean difference -33.52, 95% CI: -64.42 to -2.62, P = 0.034). The significant difference was maintained at the 1-month and 3-month follow-ups (mean difference: 41.51, 95% CI: 1.82-81.21, P = 0.041). In addition, the mean hospital stays of subjects in the IMT + CR group was 11 days, which was significantly shorter than the 12.5 days in the CR group (P = 0.016). Sensitivity analysis using per-protocol analysis supported these findings. No adverse treatment-related events were reported. CONCLUSION Compared with usual CR, IMT plus CR can effectively improve exercise endurance, pulmonary ventilation function, and inspiratory muscle strength in patients after TAVR and shorten the length of hospital stay.
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Affiliation(s)
- Lin Xu
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Jiafu Wei
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China
| | - Jiani Liu
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Yuan Feng
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China
| | - Lu Wang
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Shiqi Wang
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Qiao Li
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China
| | - Sen He
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China
| | - Yong Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China
| | - Yong Peng
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China
| | - Yun Bao
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China
| | - Xuemei Yang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China
| | - Chengqi He
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
| | - Mao Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, PR China
| | - Quan Wei
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China
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Marinus N, Vigorito C, Giallauria F, Dendale P, Meesen R, Bokken K, Haenen L, Jansegers T, Vandenheuvel Y, Scherrenberg M, Spildooren J, Hansen D. Frailty Test Battery Development including Physical, Socio-Psychological and Cognitive Domains for Cardiovascular Disease Patients: A Preliminary Study. J Clin Med 2022; 11:jcm11071926. [PMID: 35407534 PMCID: PMC9014815 DOI: 10.3390/jcm11071926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/25/2022] [Accepted: 03/28/2022] [Indexed: 01/23/2023] Open
Abstract
Frailty is an age-related decline in physical, socio-psychological and cognitive function that results in extreme vulnerability to stressors. Therefore, this study aimed to elucidate which tests have to be selected to detect frailty in a comprehensive and feasible manner in cardiovascular disease (CVD) patients based on multivariate regression and sensitivity/specificity analyses. Patients (n = 133, mean age 78 ± 7 years) hospitalised for coronary revascularisation or heart failure (HF) were examined using the Fried and Vigorito criteria, together with some additional measurements. Moreover, to examine the association of frailty with 6-month clinical outcomes, hospitalisations and mortality up to 6 months after the initial hospital admission were examined. Some level of frailty was detected in 44% of the patients according to the Vigorito criteria and in 65% of the patients according to the Fried criteria. Frailty could best be detected by a score based on: sex, Mini Nutritional Assessment (MNA), Katz scale, timed up-and-go test (TUG), handgrip strength, Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS-15) and total number of medications. Frailty and specific markers of frailty were significantly associated with mortality and six-month hospitalisations. We thus can conclude that, in patients with CVD, sex, MNA, Katz scale, TUG, handgrip strength, MMSE, GDS-15 and total number of medications play a key role in detecting frailty, assessed by a new time- and cost-efficient test battery.
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Affiliation(s)
- Nastasia Marinus
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium; (R.M.); (K.B.); (L.H.); (T.J.); (Y.V.); (J.S.); (D.H.)
- BIOMED-Biomedical Research Center, Hasselt University, 3590 Diepenbeek, Belgium; (P.D.); (M.S.)
- Correspondence: ; Tel.: +32-(0)11-269203
| | - Carlo Vigorito
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (C.V.); (F.G.)
| | - Francesco Giallauria
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy; (C.V.); (F.G.)
- Faculty of Science and Technology, University of New England, Armidale, NSW 2350, Australia
| | - Paul Dendale
- BIOMED-Biomedical Research Center, Hasselt University, 3590 Diepenbeek, Belgium; (P.D.); (M.S.)
- Heart Centre Hasselt, Jessa Hospital, 3500 Hasselt, Belgium
| | - Raf Meesen
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium; (R.M.); (K.B.); (L.H.); (T.J.); (Y.V.); (J.S.); (D.H.)
| | - Kevin Bokken
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium; (R.M.); (K.B.); (L.H.); (T.J.); (Y.V.); (J.S.); (D.H.)
| | - Laura Haenen
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium; (R.M.); (K.B.); (L.H.); (T.J.); (Y.V.); (J.S.); (D.H.)
| | - Thomas Jansegers
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium; (R.M.); (K.B.); (L.H.); (T.J.); (Y.V.); (J.S.); (D.H.)
| | - Yenthe Vandenheuvel
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium; (R.M.); (K.B.); (L.H.); (T.J.); (Y.V.); (J.S.); (D.H.)
| | - Martijn Scherrenberg
- BIOMED-Biomedical Research Center, Hasselt University, 3590 Diepenbeek, Belgium; (P.D.); (M.S.)
- Heart Centre Hasselt, Jessa Hospital, 3500 Hasselt, Belgium
| | - Joke Spildooren
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium; (R.M.); (K.B.); (L.H.); (T.J.); (Y.V.); (J.S.); (D.H.)
| | - Dominique Hansen
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium; (R.M.); (K.B.); (L.H.); (T.J.); (Y.V.); (J.S.); (D.H.)
- BIOMED-Biomedical Research Center, Hasselt University, 3590 Diepenbeek, Belgium; (P.D.); (M.S.)
- Heart Centre Hasselt, Jessa Hospital, 3500 Hasselt, Belgium
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