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Chen KC, Hsu CN, Wu CH, Lin KL, Chen SM, Lee Y, Hsu CY, Hsu CW, Huang CY, Huang SH, Liao CT, Soong C, Chen PW, Yeh SM, Wu CC, Lin CI, Guo NW, Li YH, Lin TH, Chen CH, Huang CY, Chen SY, Wang YC, Huang WC, Chou W, Chen WJ. 2023 TAMIS/TSOC/TACVPR Consensus Statement for Patients with Acute Myocardial Infarction Rehabilitation. ACTA CARDIOLOGICA SINICA 2023; 39:783-806. [PMID: 38022422 PMCID: PMC10646588 DOI: 10.6515/acs.202311_39(6).20230921a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 09/21/2023] [Indexed: 12/01/2023]
Abstract
Cardiac rehabilitation is a comprehensive intervention recommended in international and Taiwanese guidelines for patients with acute myocardial infarction. Evidence supports that cardiac rehabilitation improves the health-related quality of life, enhances exercise capacity, reduces readmission rates, and promotes survival in patients with cardiovascular disease. The cardiac rehabilitation team is comprehensive and multidisciplinary. The inpatient, outpatient, and maintenance phases are included in cardiac rehabilitation. All patients admitted with acute myocardial infarction should be referred to the rehabilitation department as soon as clinically feasible. Pre-exercise evaluation, including exercise testing, helps physicians identify the risks of cardiac rehabilitation and organize appropriate exercise prescriptions. Therefore, the Taiwan Myocardial Infarction Society (TAMIS), Taiwan Society of Cardiology (TSOC), and Taiwan Academy of Cardiovascular and Pulmonary Rehabilitation (TACVPR) address this consensus statement to assist healthcare practitioners in performing cardiac rehabilitation in patients with acute myocardial infarction.
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Affiliation(s)
- Kuan-Cheng Chen
- Kangze Rehabilitation Clinic, Taoyuan
- Department of Rehabilitation, Far Eastern Memorial Hospital
- Division of Physical Medicine and Rehabilitation, Fu Jen Catholic University Hospital, New Taipei City
| | - Chih-Neng Hsu
- Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin
| | - Cheng-Hsueh Wu
- Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei
| | - Ko-Lung Lin
- Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital
| | - Shyh-Ming Chen
- Department of Cardiology, Kaohsiung Chang-Gung Memorial Hospital, Kaohsiung
| | - Yuchun Lee
- Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung
| | - Chien-Yi Hsu
- Division of Cardiology and Cardiovascular Research Center, Department of Internal Medicine, Taipei Medical University Hospital
- Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei
| | | | - Chi-Yao Huang
- Department of Cardiology, Taichung Veterans General Hospital, Taichung
| | | | - Chia-Te Liao
- Division of Cardiovascular Medicine, Chi Mei Medical Center, Tainan; School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung
| | - Christina Soong
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei
| | - Po-Wei Chen
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Shu-Ming Yeh
- Department of Physical Medicine and Rehabilitation, Lo-Hsu Medical Foundation, Inc., Lotung Poh-Ai Hospital, Yilan
| | - Chang-Cheng Wu
- Department of Physical Medicine and Rehabilitation, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan
| | - Cho-I Lin
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Yunlin Branch, Yunlin
| | - Nai-Wen Guo
- Institue of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan
| | - Yi-Heng Li
- Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Tsung-Hsien Lin
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital
- Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University
| | - Chia-Hsin Chen
- Department of Physical Medicine and Rehabilitation, Kaoshiung Medical University Hospital
- School of Medicine, College of Medicine, Kaoshiung Medical University, Kaoshiung
| | - Chun-Yao Huang
- Division of Cardiology and Cardiovascular Research Center, Department of Internal Medicine, Taipei Medical University Hospital
| | - Ssu-Yuan Chen
- Division of Physical Medicine and Rehabilitation, Fu Jen Catholic University Hospital, New Taipei City
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei
- Fu Jen Catholic University College of Medicine, New Taipei City
| | - Yu-Chen Wang
- Department of Cardiology, Asia University Hospital, Taichung
| | - Wei-Chun Huang
- Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei
- Department of Physical Therapy, Fooyin University, Kaohsiung
| | - Willy Chou
- Department of Rehabilitation, Chi Mei Medical Center, Tainan
| | - Wen-Jone Chen
- Department of Cardiology, Min-Sheng General Hospital, Taoyuan, Taiwan
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Gruenewald T, Seeman TE, Choo TH, Scodes J, Snyder C, Pavlicova M, Weinstein M, Schwartz JE, Mukkamala R, Sloan RP. Cardiovascular variability, sociodemographics, and biomarkers of disease: the MIDUS study. Front Physiol 2023; 14:1234427. [PMID: 37693005 PMCID: PMC10484414 DOI: 10.3389/fphys.2023.1234427] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction: Like heart rate, blood pressure (BP) is not steady but varies over intervals as long as months to as short as consecutive cardiac cycles. This blood pressure variability (BPV) consists of regularly occurring oscillations as well as less well-organized changes and typically is computed as the standard deviation of multiple clinic visit-to-visit (VVV-BP) measures or from 24-h ambulatory BP recordings (ABPV). BP also varies on a beat-to-beat basis, quantified by methods that parse variation into discrete bins, e.g., low frequency (0.04-0.15 Hz, LF). However, beat-to-beat BPV requires continuous recordings that are not easily acquired. As a result, we know little about the relationship between LF-BPV and basic sociodemographic characteristics such as age, sex, and race and clinical conditions. Methods: We computed LF-BPV during an 11-min resting period in 2,118 participants in the Midlife in the US (MIDUS) study. Results: LF-BPV was negatively associated with age, greater in men than women, and unrelated to race or socioeconomic status. It was greater in participants with hypertension but unrelated to hyperlipidemia, hypertriglyceridemia, diabetes, elevated CRP, or obesity. LF-diastolic BPV (DBPV), but not-systolic BPV (SBPV), was negatively correlated with IL-6 and s-ICAM and positively correlated with urinary epinephrine and cortisol. Finally, LF-DBPV was negatively associated with mortality, an effect was rendered nonsignificant by adjustment by age but not other sociodemographic characteristics. Discussion: These findings, the first from a large, national sample, suggest that LF-BPV differs significantly from VVV-BP and ABPV. Confirming its relationship to sociodemographic risk factors and clinical outcomes requires further study with large and representative samples.
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Affiliation(s)
- Tara Gruenewald
- Department of Psychology, Chapman University, Orange, CA, United States
| | - Teresa E. Seeman
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Tse-Hwei Choo
- Mental Health Data Science Division, New York State Psychiatric Institute, New York, NY, United States
| | - Jennifer Scodes
- Mental Health Data Science Division, New York State Psychiatric Institute, New York, NY, United States
| | - Clayton Snyder
- Mental Health Data Science Division, New York State Psychiatric Institute, New York, NY, United States
| | - Martina Pavlicova
- Department of Biostatistics, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, United States
| | | | - Joseph E. Schwartz
- Renaissance School of Medicine, Stony Brook University, New York, NY, United States
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Ramakrishna Mukkamala
- Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, United States
| | - Richard P. Sloan
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
- New York State Psychiatric Institute, New York, NY, United States
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Ding M, Li QF, Peng TH, Wang TQ, Yan HH, Tang C, Wang XY, Guo Y, Zheng L. Early life exercise training and inhibition of apoLpp mRNA expression to improve age-related arrhythmias and prolong the average lifespan in Drosophila melanogaster. Aging (Albany NY) 2022; 14:9908-9923. [PMID: 36470666 PMCID: PMC9831727 DOI: 10.18632/aging.204422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 11/16/2022] [Indexed: 01/03/2023]
Abstract
Cardiovascular disease (CVD) places a heavy burden on older patients and the global healthcare system. A large body of evidence suggests that exercise training is essential in preventing and treating cardiovascular disease, but the underlying mechanisms are not well understood. Here, we used the Drosophila melanogaster animal model to study the effects of early-life exercise training (Exercise) on the aging heart and lifespan. We found in flies that age-induced arrhythmias are conserved across different genetic backgrounds. The fat body is the primary source of circulating lipoproteins in flies. Inhibition of fat body apoLpp (Drosophila apoB homolog) demonstrated that low expression of apoLpp reduced the development of arrhythmias in aged flies but did not affect average lifespan. At the same time, exercise can also reduce the expression of apoLpp mRNA in aged flies and have a protective effect on the heart, which is similar to the inhibition of apoLpp mRNA. Although treatment of UAS-apoLppRNAi and exercise alone had no significant effect on lifespan, the combination of UAS-apoLppRNAi and exercise extended the average lifespan of flies. Therefore, we conclude that UAS-apoLppRNAi and exercise are sufficient to resist age-induced arrhythmias, which may be related to the decreased expression of apoLpp mRNA, and that UAS-apoLppRNAi and exercise have a combined effect on prolonging the average lifespan.
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Affiliation(s)
- Meng Ding
- Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, Hunan Normal University, Changsha, China
| | - Qiu Fang Li
- Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, Hunan Normal University, Changsha, China
| | - Tian Hang Peng
- Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, Hunan Normal University, Changsha, China
| | - Tong Quan Wang
- Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, Hunan Normal University, Changsha, China
| | - Han Hui Yan
- Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, Hunan Normal University, Changsha, China
| | - Chao Tang
- Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, Hunan Normal University, Changsha, China
| | - Xiao Ya Wang
- Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, Hunan Normal University, Changsha, China
| | - Yin Guo
- Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, Hunan Normal University, Changsha, China
| | - Lan Zheng
- Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, Hunan Normal University, Changsha, China
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Dor-Haim H, Horowitz M, Yaakobi E, Katzburg S, Barak S. Intermittent aerobic-resistance interval training versus continues aerobic training: Improvement in cardiac electrophysiologic and anthropometric measures in male patients post myocadiac infarction, a randomized control trial. PLoS One 2022; 17:e0267888. [PMID: 35503787 PMCID: PMC9064084 DOI: 10.1371/journal.pone.0267888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/14/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose Exercise is a valuable intervention modality for patients post-myocardial infarction (MI). Aerobic and resistance training are both commonly used separately in cardiac rehabilitation. However, the effect of aerobic interval exercise combined with alternating sets of resistance training (super-circuit training, SCT) on cardiac electrophysiologic and anthropometric measures had not been thoroughly investigated. Aim The primary objective of this study was to compare the effectiveness of moderate-intensity continuous-aerobic training (CAT) vs. SCT on cardiac electrical measures (resting electrocardiographic, ECG; a nd heart rate variability, HRV) in patients’ post-MI presenting reduced left ventricular function. Second, to examine its effect on anthropometric measures. Material and methods Twenty-nine men post-MI with reduced left ventricular function were assigned randomly to either 12 weeks of CAT (n = 15) or SCT (n = 14). CAT group performed moderate-intensity activity. SCT group performed high-intensity exercise, alternating between resistance and aerobic training. Differences between CAT and SCT groups were done using independent t-tests, paired t-tests and effect size (ES). Results Participants in both groups improved their HRV measures (increase in HFnu; p < 0.05; ES > 0.51) and ECG (reduction in QT-dispersion; p < 0.05; ES > 0.51). Only the SCT group had significant improvements in waist circumference (p < 0.05). Conclusion Exercise improves cardiac electrical measures post-MI. However, in comparison to CAT, SCT may yield greater anthropometric changes. In order to have improvements in cardiac electrical stability, clinicians working with post-MI patients may use both CAT and SCT. However, SCT might result in greater improvements.
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Affiliation(s)
- Horesh Dor-Haim
- O2 Health Promotion and Sports Medicine Department, Givat Ram, Jerusalem, Israel
| | - Michal Horowitz
- The laboratory of Environmental Physiology Department of Physiology, Faculty of Dentistry Hebrew University of Jerusalem, Hadassah Ein Kerem Campus Jerusalem, Jerusalem, Israel
| | - Eldad Yaakobi
- The Sagol Center for Hyperbaric Medicine and Research, Yitzhak Shamir Medical Center, Be’er Ya’akov, Israel
| | - Sara Katzburg
- O2 Health Promotion and Sports Medicine Department, Givat Ram, Jerusalem, Israel
- Department of Developmental Biology and Cancer Research, Israel-Canada Medical Research Institute, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Sharon Barak
- Department of Pediatric Rehabilitation, The Edmond and Lily Safra Children’s Hospital, The Chaim Sheba Medical Center, Ramat Gan, Israel
- Kaye Academic College of Education, Beer-Sheba, Israel
- * E-mail:
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Tian D, Meng J. Exercise for Prevention and Relief of Cardiovascular Disease: Prognoses, Mechanisms, and Approaches. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:3756750. [PMID: 31093312 PMCID: PMC6481017 DOI: 10.1155/2019/3756750] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/01/2019] [Accepted: 03/19/2019] [Indexed: 12/12/2022]
Abstract
This review is aimed at summarizing the new findings about the multiple benefits of exercise on cardiovascular disease (CVD). We pay attention to the prevalence and risk factors of CVD and mechanisms and recommendations of physical activity. Physical activity can improve insulin sensitivity, alleviate plasma dyslipidemia, normalize elevated blood pressure, decrease blood viscosity, promote endothelial nitric oxide production, and improve leptin sensitivity to protect the heart and vessels. Besides, the protective role of exercise on the body involves not only animal models in the laboratory but also clinical studies which is demonstrated by WHO recommendations. The general exercise intensity for humans recommended by the American Heart Association to prevent CVD is moderate exercise of 30 minutes, 5 times a week. However, even the easiest activity is better than nothing. What is more, owing to the different physical fitness of individuals, a standard exercise training cannot provide the exact treatment for everyone. So personalization of exercise will be an irresistible trend and bring more beneficial effects with less inefficient physical activities. This paper reviews the benefits of exercise contributing to the body especially in CVD through the recent mechanism studies.
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Affiliation(s)
- Danyang Tian
- Department of Physiology, Hebei Medical University, Shijiazhuang, China
| | - Jinqi Meng
- Department of Sports, Hebei Medical University, Shijiazhuang, China
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Guasch E, Mont L, Sitges M. Mechanisms of atrial fibrillation in athletes: what we know and what we do not know. Neth Heart J 2018; 26:133-145. [PMID: 29411287 PMCID: PMC5818379 DOI: 10.1007/s12471-018-1080-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Exercise is an emerging cause of atrial fibrillation (AF) in young individuals without coexisting cardiovascular risk factors. The causes of exercise-induced atrial fibrillation remain largely unknown, and conclusions are jeopardised by apparently conflicting data. Some components of the athlete's heart are known to be arrhythmogenic in other settings. Bradycardia, atrial dilatation and, possibly, atrial premature beats are therefore biologically plausible contributors to exercise-induced AF. Challenging findings in an animal model suggest that exercise might also prompt the development of atrial fibrosis, possibly due to cumulative minor structural damage after each exercise bout. However, there is very limited, indirect data supporting this hypothesis in athletes. Age, sex, the presence of comorbidities and cardiovascular risk factors, and genetic individual variability might serve to flag those athletes who are at the higher risk of exercise-induced AF. In this review, we will critically address current knowledge on the mechanisms of exercise-induced AF.
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Affiliation(s)
- E Guasch
- Institut Clinic Cardiovascular, Hospital Clínic de Barcelona; IDIBAPS; Universitat de Barcelona; CIBERCV., 08036, Barcelona, Catalonia, Spain.
| | - L Mont
- Institut Clinic Cardiovascular, Hospital Clínic de Barcelona; IDIBAPS; Universitat de Barcelona; CIBERCV., 08036, Barcelona, Catalonia, Spain
| | - M Sitges
- Institut Clinic Cardiovascular, Hospital Clínic de Barcelona; IDIBAPS; Universitat de Barcelona; CIBERCV., 08036, Barcelona, Catalonia, Spain
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Dor-Haim H, Barak S, Horowitz M, Yaakobi E, Katzburg S, Swissa M, Lotan C. Improvement in cardiac dysfunction with a novel circuit training method combining simultaneous aerobic-resistance exercises. A randomized trial. PLoS One 2018; 13:e0188551. [PMID: 29377893 PMCID: PMC5788332 DOI: 10.1371/journal.pone.0188551] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 11/03/2017] [Indexed: 11/24/2022] Open
Abstract
Introduction Exercise is considered a valuable nonpharmacological intervention modality in cardiac rehabilitation (CR) programs in patients with ischemic heart disease. The effect of aerobic interval exercise combined with alternating sets of resistance training (super-circuit training, SCT) on cardiac patients' with reduced left ventricular function, post-myocardial infarction (MI) has not been thoroughly investigated. Aim of study to improve cardiac function with a novel method of combined aerobic-resistance circuit training in a randomized control trial by way of comparing the effectiveness of continuous aerobic training (CAT) to SCT on mechanical cardiac function. Secondary to compare their effect on aerobic fitness, manual strength, and quality of life in men post MI. Finally, to evaluate the safety and feasibility of SCT. Methods 29 men post-MI participants were randomly assigned to either 12-weeks of CAT (n = 15) or SCT (n = 14). Both groups, CAT and SCT exercised at 60%-70% and 75–85% of their heart rate reserve, respectively. The SCT group also engaged in intermittently combined resistance training. Primary outcome measure was echocardiography. Secondary outcome measures were aerobic fitness, strength, and quality of life (QoL). The effectiveness of the two training programs was examined via paired t-tests and Cohen's d effect size (ES). Results Post-training, only the SCT group presented significant changes in echocardiography (a reduction in E/e' and an increase in ejection fraction, P<0.05). Similarly, only the SCT group presented significant changes in aerobic fitness (an increase in maximal metabolic equivalent, P<0.05). In addition, SCT improvement in the physical component of QoL was greater than this observed in the CAT group. In both training programs, no adverse events were observed. Conclusion Men post-MI stand to benefit from both CAT and SCT. However, in comparison to CAT, as assessed by echocardiography, SCT may yield greater benefits to the left ventricle mechanical function as well as to the patient's aerobic fitness and physical QoL. Moreover, the SCT program was found to be feasible as well as safe.
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Affiliation(s)
- Horesh Dor-Haim
- Hadassah Hebrew University Hospital Heart Institute, Jerusalem, Israel
- * E-mail:
| | - Sharon Barak
- The Edmond and Lily Safra Children's Hospital, the Chaim Sheba Medical Center, Ramat Gan, Israel
- Kaye Academic College of Education, Beer-Sheba, Israel
| | - Michal Horowitz
- Department of Physiology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Eldad Yaakobi
- Hadassah Hebrew University Hospital Heart Institute, Jerusalem, Israel
| | - Sara Katzburg
- Hadassah Hebrew University Hospital Heart Institute, Jerusalem, Israel
| | - Moshe Swissa
- Cardiac Research Center, Kaplan Medical Center, Rehovot, Israel
| | - Chaim Lotan
- Hadassah Hebrew University Hospital Heart Institute, Jerusalem, Israel
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