1
|
Neubeck L, Pearsons A, Hanson C. Brain fog and spontaneous coronary artery dissection: a commentary. Eur J Cardiovasc Nurs 2024:zvae109. [PMID: 39132782 DOI: 10.1093/eurjcn/zvae109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2024] [Accepted: 07/24/2024] [Indexed: 08/13/2024]
Affiliation(s)
- Lis Neubeck
- Centre for Cardiovascular Health, Edinburgh Napier University, Room 4B29, Sighthill Campus, Sighthill Court, Edinburgh, EH11 4BN, UK
- School of Health and Social Care, Edinburgh Napier University, Room 4B29, Sighthill Campus, Sighthill Court, Edinburgh, EH11 4BN, UK
| | - Alice Pearsons
- Centre for Cardiovascular Health, Edinburgh Napier University, Room 4B29, Sighthill Campus, Sighthill Court, Edinburgh, EH11 4BN, UK
- School of Health and Social Care, Edinburgh Napier University, Room 4B29, Sighthill Campus, Sighthill Court, Edinburgh, EH11 4BN, UK
| | - Coral Hanson
- Centre for Cardiovascular Health, Edinburgh Napier University, Room 4B29, Sighthill Campus, Sighthill Court, Edinburgh, EH11 4BN, UK
- School of Health and Social Care, Edinburgh Napier University, Room 4B29, Sighthill Campus, Sighthill Court, Edinburgh, EH11 4BN, UK
| |
Collapse
|
2
|
Ishihara K, Izawa KP, Kitamura M, Kanejima Y, Ogawa M, Yoshihara R, Morisawa T, Shimizu I. Effects of cardiac rehabilitation on cognitive function in patients with acute coronary syndrome: A systematic review. Heliyon 2024; 10:e32890. [PMID: 38975067 PMCID: PMC11226889 DOI: 10.1016/j.heliyon.2024.e32890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 06/07/2024] [Accepted: 06/11/2024] [Indexed: 07/09/2024] Open
Abstract
Background Construction of an intervention method for the cognitive dysfunction of patients with acute coronary syndrome (ACS) is needed. Exercise-based comprehensive cardiac rehabilitation is a potentially effective approach that can improve cognitive function in ACS patients. This study aimed to investigate the effect of cardiac rehabilitation on cognitive function in ACS patients through a systematic review. Methods A systematic review was conducted of studies on PubMed, MEDLINE, Web of Science, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) on September 13, 2022, to identify those reporting the effects of cardiac rehabilitation on cognitive function in ACS patients. Data that reported exercise-based comprehensive cardiac rehabilitation and cognitive function (even if not main results and any type of cognitive function assessment was used) were extracted. Results In total, six studies were included that comprised a total of 1085 ACS patients. Overall positive effects of cardiac rehabilitation on cognitive function in ACS patients were reported across the six studies. All studies included aerobic exercise, resistance exercise, and patient education in cardiac rehabilitation. Meta-analysis could not be undertaken because each dataset used different methods to evaluate cognitive function, and the outcomes were different. Conclusions This systematic review showed that cardiac rehabilitation could have positive effects on cognitive function in ACS patients. Our results support the efficacy of cardiac rehabilitation for cognitive function in ACS patients. Additional well-designed clinical trials of exercise-based comprehensive cardiac rehabilitation should be conducted to clarify the true effect on cognitive function in ACS patients.
Collapse
Affiliation(s)
- Kodai Ishihara
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, 2-23 Morikitamachi 6-chome, Higashinada-ku, Kobe, 658-0001, Japan
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome, Suma-ku, Kobe, 654-0142, Japan
- Cardiovascular Stroke Renal Project (CRP), Japan
| | - Kazuhiro P. Izawa
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome, Suma-ku, Kobe, 654-0142, Japan
- Cardiovascular Stroke Renal Project (CRP), Japan
| | - Masahiro Kitamura
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome, Suma-ku, Kobe, 654-0142, Japan
- Cardiovascular Stroke Renal Project (CRP), Japan
- School of Physical Therapy, Faculty of Rehabilitation, Reiwa Health Sciences University, 1-12 Wajirogaoka 2-chome, Higashi-ku, Fukuoka, 811-0213, Japan
| | - Yuji Kanejima
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome, Suma-ku, Kobe, 654-0142, Japan
- Cardiovascular Stroke Renal Project (CRP), Japan
- Department of Rehabilitation, Kobe City Medical Center General Hospital, 1-1 Minatojimaminamicho 2-chome, Chuo-ku, Kobe, 650-0047, Japan
| | - Masato Ogawa
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome, Suma-ku, Kobe, 654-0142, Japan
- Cardiovascular Stroke Renal Project (CRP), Japan
- Department of Rehabilitation, Faculty of Health Sciences, Osaka Health Sciences University, 9-27 Temma 1-chome, Kita-ku, Osaka, 530-0043, Japan
| | - Ryo Yoshihara
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome, Suma-ku, Kobe, 654-0142, Japan
- Cardiovascular Stroke Renal Project (CRP), Japan
- Department of Rehabilitation, Kobe City Medical Center General Hospital, 1-1 Minatojimaminamicho 2-chome, Chuo-ku, Kobe, 650-0047, Japan
| | - Tomoyuki Morisawa
- Department of Physical Therapy, Faculty of Health Sciences, Juntendo University, 2-12 Hongo 3-chome, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Ikki Shimizu
- Department of Diabetes, Sakakibara Heart Institute of Okayama, 5-1 Nakaicho 2-chome, Kita-ku, Okayama, 700-0804, Japan
| |
Collapse
|
3
|
Hollings M, Zhao E, Weddell J, Naismith S, Tofler G, Bauman A, Gallagher R. Lower cardiac rehabilitation enrolment occurs in acute coronary syndrome patients who report low levels of physical activity at four weeks post-event: A prospective observational study using physical activity tracker data. Heart Lung 2024; 64:143-148. [PMID: 38215534 DOI: 10.1016/j.hrtlng.2023.12.007] [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: 09/21/2023] [Revised: 12/19/2023] [Accepted: 12/31/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND Physical activity (PA) and cardiac rehabilitation (CR) attendance are important for recovery and prognosis following acute coronary syndrome (ACS). However, PA patterns early post-ACS are not well known. OBJECTIVES Investigate the level of PA at 4-weeks post-ACS and any potential associations with CR enrolment. METHODS We recruited patients admitted for ACS from cardiac wards and clinics at two hospital sites in Sydney, Australia. PA data were collected using wearable activity trackers worn at 4-weeks post-ACS, and CR enrolment was self-reported. RESULTS Participants (n = 61) were aged 66.7 ± 10.3 years, 74 % male, 61 % were married or partnered, and 33 % were diagnosed with ST-elevation myocardial infarction. Patients engaged in 7514±3355 steps per day and 44.6 ± 37.5 min of moderate-to-vigorous physical activity (MVPA). Patients who enrolled in CR exhibited higher daily step counts (p = 0.044), MVPA minutes (p = 0.001), and were more likely to meet PA guidelines. ACS patients who engaged in higher levels of MVPA were more likely to enrol in CR (odds ratio [OR] 1.46; 95 % confidence interval [CI] 1.08, 1.98). CR enrolment was also positively associated with being married or in an intimate partnership (OR 9.93; 95 % CI 1.83, 53.85) and absence of depressive symptoms (OR 11.86; 95 % CI 1.91, 73.74). CONCLUSION Lower CR enrolment rates were observed among less physically active patients at 4-weeks post-ACS. However, each 10 min increment in MVPA increased the odds of CR enrolment by 46 %. Future research should explore strategies to target this inactive and high-risk group, given the potential for a large prognostic gain with CR participation.
Collapse
Affiliation(s)
- Matthew Hollings
- Faculty of Medicine and Health, University of Sydney, Australia; Charles Perkins Centre, University of Sydney, Australia.
| | - Emma Zhao
- Faculty of Medicine and Health, University of Sydney, Australia; Charles Perkins Centre, University of Sydney, Australia
| | - Joseph Weddell
- Faculty of Medicine and Health, University of Sydney, Australia; Charles Perkins Centre, University of Sydney, Australia
| | - Sharon Naismith
- Charles Perkins Centre, University of Sydney, Australia; Faculty of Science, University of Sydney, Australia
| | - Geoffrey Tofler
- Faculty of Medicine and Health, University of Sydney, Australia; Royal North Shore Hospital, St Leonards, Australia
| | - Adrian Bauman
- Faculty of Medicine and Health, University of Sydney, Australia; Charles Perkins Centre, University of Sydney, Australia
| | - Robyn Gallagher
- Faculty of Medicine and Health, University of Sydney, Australia; Charles Perkins Centre, University of Sydney, Australia; Royal North Shore Hospital, St Leonards, Australia
| |
Collapse
|
4
|
Katz BR, Khadanga S, Middleton WA, Mahoney K, Savage PD, DeSarno M, Ades PA, Gaalema DE. Self-Reported Executive Function in Hospitalized Cardiac Patients and Associations With Patient Characteristics and Cardiac Rehabilitation Attendance. J Cardiopulm Rehabil Prev 2023; 43:433-437. [PMID: 36857090 PMCID: PMC10474250 DOI: 10.1097/hcr.0000000000000785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
PURPOSE Executive function (ExF), the ability to do complex cognitive tasks like planning and refraining from impulsive behavior, is associated with compliance with medical recommendations. The present study identified associations between self-reported ExF and demographics of patients with cardiac disease as well as with cardiac rehabilitation (CR) attendance. METHODS Self-reported ExF impairment was measured using the Behavior Rating Inventory of Executive Function (BRIEF) on 316 individuals hospitalized for CR-qualifying cardiac events. Scores were calculated for a global measure (Global Executive Composite [GEC]) and the two BRIEF indices: Behavioral Regulation Index and Metacognition Index (MCI). Participants were followed up post-discharge to determine CR attendance. Univariate logistic regressions between ExF measures and demographic variables were conducted, as were multiple logistic regressions to identify significant, independent predictors. Analyses were conducted using clinical (T scores ≥ 65) and subclinical (T scores ≥ 60) criteria for significant ExF impairment as outcomes. One-way analyses of variance were performed between ExF impairment and CR attendance. RESULTS Self-reported ExF deficits were relatively rare; 8.9% had at least subclinical scores on the GEC. Using the subclinical criterion for the MCI, having diabetes mellitus (DM) and being male were significant, independent predictors of MCI impairment. No significant relationship was found between ExF and CR attendance. CONCLUSION Using the subclinical criterion only, individuals with DM and males were significantly more likely to have MCI impairment. No significant effect of ExF impairment on CR attendance was found, suggesting that self-reported ExF measured in the hospital may not be an appropriate measure for predicting behavioral outcomes.
Collapse
Affiliation(s)
- Brian R. Katz
- Vermont Center on Behavior and Health, Burlington VT
- University of Vermont Departments of Psychiatry and Psychology, Burlington VT
| | - Sherrie Khadanga
- Vermont Center on Behavior and Health, Burlington VT
- University of Vermont Medical Center Division of Cardiology, Burlington VT
| | - William A. Middleton
- Vermont Center on Behavior and Health, Burlington VT
- University of Vermont Departments of Psychiatry and Psychology, Burlington VT
| | - Katharine Mahoney
- Vermont Center on Behavior and Health, Burlington VT
- University of Vermont Departments of Psychiatry and Psychology, Burlington VT
- MedStar Health Research Institute, Hyattsville, MD
| | - Patrick D. Savage
- Vermont Center on Behavior and Health, Burlington VT
- University of Vermont Medical Center Division of Cardiology, Burlington VT
| | - Michael DeSarno
- Vermont Center on Behavior and Health, Burlington VT
- University of Vermont Department of Medical Biostatistics, Burlington VT
| | - Philip A. Ades
- Vermont Center on Behavior and Health, Burlington VT
- University of Vermont Medical Center Division of Cardiology, Burlington VT
| | - Diann E. Gaalema
- Vermont Center on Behavior and Health, Burlington VT
- University of Vermont Departments of Psychiatry and Psychology, Burlington VT
| |
Collapse
|
5
|
Weddell J, Naismith SL, Bauman A, Tofler G, Zhao E, Redfern J, Buckley T, Gallagher R. Age and Marital Status Predict Mild Cognitive Impairment During Acute Coronary Syndrome Admission: An Observational Study of Acute Coronary Syndrome Inpatients. J Cardiovasc Nurs 2023; 38:462-471. [PMID: 36729065 DOI: 10.1097/jcn.0000000000000964] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Mild cognitive impairment (MCI) has been reported after acute coronary syndrome (ACS), but it is uncertain who is at risk, particularly during inpatient admission. OBJECTIVE In this study, we aimed to explore the prevalence and cognitive domains affected in MCI during ACS admission and determine factors that identify patients most at risk of MCI. METHODS Inpatients with ACS were consecutively recruited from 2 tertiary hospital cardiac wards and screened with the Montreal Cognitive Assessment and the Hopkins Verbal Learning Test. Screening included health literacy (Newest Vital Sign), depressive symptoms (Patient Health Questionnaire-9), and physical activity (Physical Activity Scale for the Elderly). Factors associated with MCI were determined using logistic regression. RESULTS Participants (n = 81) had a mean (SD) age of 63.5 (10.9) years, and 82.7% were male. In total, MCI was identified in 52.5%, 42.5% with 1 screen and 10% with both. Individually, the Montreal Cognitive Assessment identified MCI in 48.1%, and the Hopkins Verbal Learning Test identified MCI in 13.8%. In Montreal Cognitive Assessment screening, the cognitive domains in which participants most frequently did not achieve the maximum points available were delayed recall (81.5%), visuospatial executive function (48.1%), and attention (30.9%). Accounting for education, depression, physical activity, and ACS diagnosis, the likelihood of an MCI positive screen increased by 11% per year of age (odds ratio, 1.11; 95% confidence interval, 1.04-1.18) and by 3.6 times for those who are unmarried/unpartnered (odds ratio, 3.61; 95% confidence interval, 1.09-11.89). CONCLUSION An estimated half of patients with ACS screen positive for MCI during admission, with single and older patients most at risk. Multiple areas of thinking were affected with potential impact on capacity for learning heart disease management.
Collapse
|
6
|
Kasprzak D, Kaczmarek-Majer K, Rzeźniczak J, Klamecka-Pohl K, Ganowicz-Kaatz T, Słomczyński M, Budzianowski J, Pieszko K, Hiczkiewicz J, Tykarski A, Burchardt P. Cognitive Impairment in Cardiovascular Patients after Myocardial Infarction: Prospective Clinical Study. J Clin Med 2023; 12:4954. [PMID: 37568355 PMCID: PMC10420195 DOI: 10.3390/jcm12154954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/18/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
(1) Background: Assessment of cognitive function is not routine in cardiac patients, and knowledge on the subject remains limited. The aim of this study was to assess post-myocardial infarction (MI) cognitive functioning in order to determine the frequency of cognitive impairment (CI) and to identify factors that may influence it. (2) Methods: A prospective study included 468 patients hospitalized for MI. Participants were assessed twice: during the first hospitalization and 6 months later. The Mini-Mental State Examination was used to assess the occurrence of CI. (3) Results: Cognitive dysfunction based on the MMSE was found in 37% (N-174) of patients during the first hospitalization. After 6 months, the prevalence of deficits decreased significantly to 25% (N-91) (p < 0.001). Patients with CI significantly differed from those without peri-infarction deficits in the GFR, BNP, ejection fraction and SYNTAX score, while after 6 months, significant differences were observed in LDL and HCT levels. There was a high prevalence of non-cognitive mental disorders among post-MI patients. (4) Conclusions: There is a high prevalence of CI and other non-cognitive mental disorders, such as depression, sleep disorders and a tendency to aggression, among post-MI patients. The analysis of the collected material indicates a significant impact of worse cardiac function expressed as EF and BNP, greater severity of coronary atherosclerosis expressed by SYNTAX results, and red blood cell parameters and LDL levels on the occurrence of CI in the post-MI patient population.
Collapse
Affiliation(s)
| | - Katarzyna Kaczmarek-Majer
- Stochastic Methods Department, System Research Institute, Polish Academy of Sciences, 01-447 Warsaw, Poland
- Analyx Sp. z o.o. sp.k., 61-887 Poznań, Poland
| | | | | | | | | | - Jan Budzianowski
- Faculty of Medicine and Health Sciences, University of Zielona Góra, 65-417 Zielona Góra, Poland
| | - Konrad Pieszko
- Faculty of Medicine and Health Sciences, University of Zielona Góra, 65-417 Zielona Góra, Poland
| | - Jarosław Hiczkiewicz
- Faculty of Medicine and Health Sciences, University of Zielona Góra, 65-417 Zielona Góra, Poland
| | - Andrzej Tykarski
- Department of Hypertension, Angiology, and Internal Medicine, Poznan University of Medical Sciences, 61-848 Poznań, Poland
| | - Paweł Burchardt
- Department of Cardiology, J. Strus Hospital, 61-285 Poznań, Poland
- Department of Hypertension, Angiology, and Internal Medicine, Poznan University of Medical Sciences, 61-848 Poznań, Poland
| |
Collapse
|
7
|
Gallagher R, Ouyang ML, Tofler G, Bauman A, Zhao E, Weddell J, Naismith SL. Sensitivity and specificity of 5 min cognitive screening tests in patients with acute coronary syndrome. Eur J Cardiovasc Nurs 2023; 22:166-174. [PMID: 35714164 DOI: 10.1093/eurjcn/zvac026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 11/12/2022]
Abstract
AIMS This study aimed to determine the sensitivity and specificity of the National Institute of Neurological Disorders and Stroke (NINDS) and the Canadian Stroke Network (CSN) brief (5 min) screen composed of three items of the Montreal Cognitive Assessment (MoCA), in acute coronary syndrome (ACS) patients during hospital admission, relative to the full MoCA and potential alternative combinations of other items. METHODS AND RESULTS Participants were consecutively recruited during ACS admission and administered the MoCA before discharge. The three NINDS-CSN screen items were extracted, collated and compared to the full MoCA. Receiver operator characteristic (ROC) curves were created to determine the sensitivity, specificity, and appropriate cut-off scores of the screens. The mean age of the sample (n = 81) was 63.49 [standard deviation (SD) 10.85] years and 49.4% screened positive for cognitive impairment. The NINDS-CSN mean score was 9.22 (SD 2.09 of the potential range 0-12). Area under the ROC (AUC) indicated high accuracy levels for screening for cognitive impairment (AUC = 0.89, P < 0.01, 95% confidence interval 0.82, 0.96) with none of the alternative combination screens performing better on both sensitivity and specificity. A cut-off score of ≤10 on the NINDS-CSN protocol provided 83% sensitivity and 80% specificity for classifying cognitive impairment. CONCLUSION The NINDS-CSN protocol presents an accurate, feasible screen for cognitive impairment in patients following ACS for use at the bedside and potentially also for telephone screens. Diagnostic accuracy should be confirmed using a neurocognitive battery.
Collapse
Affiliation(s)
- Robyn Gallagher
- Faculty of Medicine and Health, The University of Sydney, Camperdown Campus, Sydney, NSW 2006, Australia.,Charles Perkins Centre, The University of Sydney, Camperdown Campus, Sydney, NSW 2006, Australia
| | - Meng-Lu Ouyang
- Neurological Program, The George Institute for Global Health, City Road, Darlington, Sydney, NSW 2008, Australia
| | - Geoffrey Tofler
- Faculty of Medicine and Health, The University of Sydney, Camperdown Campus, Sydney, NSW 2006, Australia.,Department of Cardiology, Royal North Shore Hospital, Reserve Road St Leonards, Sydney, NSW 2065, Australia
| | - Adrian Bauman
- Faculty of Medicine and Health, The University of Sydney, Camperdown Campus, Sydney, NSW 2006, Australia.,Charles Perkins Centre, The University of Sydney, Camperdown Campus, Sydney, NSW 2006, Australia
| | - Emma Zhao
- Faculty of Medicine and Health, The University of Sydney, Camperdown Campus, Sydney, NSW 2006, Australia.,Charles Perkins Centre, The University of Sydney, Camperdown Campus, Sydney, NSW 2006, Australia
| | - Joseph Weddell
- Faculty of Medicine and Health, The University of Sydney, Camperdown Campus, Sydney, NSW 2006, Australia.,Charles Perkins Centre, The University of Sydney, Camperdown Campus, Sydney, NSW 2006, Australia
| | - Sharon L Naismith
- Charles Perkins Centre, The University of Sydney, Camperdown Campus, Sydney, NSW 2006, Australia.,Faculty of Science, The University of Sydney, Camperdown Campus, Sydney, NSW 2006, Australia.,Brain & Mind Centre, The University of Sydney, Mallet Street Campus, Sydney, NSW 2006, Australia
| |
Collapse
|
8
|
Predictive Accuracy of Inpatient Cognitive Screening for Correctly Classifying Mild Cognitive Impairment at 4 Months Using A Full Neurocognitive Battery in Acute Coronary Syndrome. J Cardiopulm Rehabil Prev 2023; 43:74-75. [PMID: 36576424 DOI: 10.1097/hcr.0000000000000760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
9
|
Sakamoto M, Suematsu Y, Yano Y, Kaino K, Teshima R, Matsuda T, Fujita M, Tazawa R, Fujimi K, Miura SI. Depression and Anxiety Are Associated with Physical Performance in Patients Undergoing Cardiac Rehabilitation: A Retrospective Observational Study. J Cardiovasc Dev Dis 2022; 9:jcdd9010021. [PMID: 35050231 PMCID: PMC8781943 DOI: 10.3390/jcdd9010021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/07/2022] [Accepted: 01/08/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Cardiac rehabilitation (CR) combined with stress management training has been shown to be associated with fewer clinical events than CR alone. However, there have been no reports on the associations of CR with the psychological condition and detailed physical activities evaluated on the same day. Method: One hundred outpatients who participated in a CR program were graded on the hospital anxiety and depression scale (HADS). We divided them into a high HADS group (n = 32) and a normal HADS group (n = 68) and investigated by whole patients, ischemic heart disease (IHD) patients, and heart failure patients. Results: Overall, the patient age was 70.5 ± 9.6 years, the percentage of males was 73.0%, and the body mass index was 23.4 (21.7–26.0) kg/m2. In the high HADS group, overall functional mobility was poor and the distance in a two-minute walking test was short. Especially in IHD patients, the high HADS group showed high fat mass in body composition and low exercise tolerance and ventilator equivalents in cardiopulmonary exercise test. Conclusions: Depression and anxiety involved poor physical performance in CR outpatients and particularly involved low exercise tolerance in IHD patients. To evaluate accurate physical performance, it is necessary to investigate psychological condition.
Collapse
Affiliation(s)
- Maaya Sakamoto
- Department of Cardiology, School of Medicine, Fukuoka University, Fukuoka 814-0180, Japan; (M.S.); (Y.S.); (Y.Y.); (K.F.)
- Center for Cardiac Rehabilitation, Fukuoka University Hospital, Fukuoka 814-0180, Japan; (K.K.); (R.T.); (T.M.); (M.F.)
| | - Yasunori Suematsu
- Department of Cardiology, School of Medicine, Fukuoka University, Fukuoka 814-0180, Japan; (M.S.); (Y.S.); (Y.Y.); (K.F.)
| | - Yuiko Yano
- Department of Cardiology, School of Medicine, Fukuoka University, Fukuoka 814-0180, Japan; (M.S.); (Y.S.); (Y.Y.); (K.F.)
| | - Koji Kaino
- Center for Cardiac Rehabilitation, Fukuoka University Hospital, Fukuoka 814-0180, Japan; (K.K.); (R.T.); (T.M.); (M.F.)
| | - Reiko Teshima
- Center for Cardiac Rehabilitation, Fukuoka University Hospital, Fukuoka 814-0180, Japan; (K.K.); (R.T.); (T.M.); (M.F.)
| | - Takuro Matsuda
- Center for Cardiac Rehabilitation, Fukuoka University Hospital, Fukuoka 814-0180, Japan; (K.K.); (R.T.); (T.M.); (M.F.)
| | - Masaomi Fujita
- Center for Cardiac Rehabilitation, Fukuoka University Hospital, Fukuoka 814-0180, Japan; (K.K.); (R.T.); (T.M.); (M.F.)
| | - Rie Tazawa
- Division of Nutrition, Fukuoka University Hospital, Fukuoka 814-0180, Japan;
| | - Kanta Fujimi
- Department of Cardiology, School of Medicine, Fukuoka University, Fukuoka 814-0180, Japan; (M.S.); (Y.S.); (Y.Y.); (K.F.)
- Center for Cardiac Rehabilitation, Fukuoka University Hospital, Fukuoka 814-0180, Japan; (K.K.); (R.T.); (T.M.); (M.F.)
| | - Shin-ichiro Miura
- Department of Cardiology, School of Medicine, Fukuoka University, Fukuoka 814-0180, Japan; (M.S.); (Y.S.); (Y.Y.); (K.F.)
- Department of Cardiology, Fukuoka University Nishijin Hospital, Fukuoka 814-8522, Japan
- Correspondence: ; Tel.: +81-92-801-1011
| |
Collapse
|
10
|
Astley CM, Redfern J, Cartledge SH, Briffa T. Engaging Patients in Lifestyle Behaviour Change in Cardiovascular Secondary Prevention: Understanding the Complexity. Heart Lung Circ 2021; 31:1-3. [PMID: 34740539 DOI: 10.1016/j.hlc.2021.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Carolyn M Astley
- College of Nursing and Health Science, Flinders University, Adelaide, SA, Australia.
| | - Julie Redfern
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Susie H Cartledge
- School of Public Health and Prevention Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia
| | - Tom Briffa
- School of Population and Global Health, University Western Australia, Perth, WA, Australia
| |
Collapse
|
11
|
Gaalema DE, Mahoney K, Ballon JS. Cognition and Exercise: GENERAL OVERVIEW AND IMPLICATIONS FOR CARDIAC REHABILITATION. J Cardiopulm Rehabil Prev 2021; 41:400-406. [PMID: 34561368 PMCID: PMC8563446 DOI: 10.1097/hcr.0000000000000644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Performance of endurance exercise is associated with a broad range of cognitive benefits, with notable improvements shown across a wide variety of populations including healthy populations as well as those with impaired cognition. By examining the effects of exercise in general populations, as well in populations where cognitive deficits are pronounced, and critical to self-care, we can learn more about using exercise to ameliorate cognitive issues and apply that knowledge to other patient populations, such as those eligible for cardiac rehabilitation (CR). Cognitive challenges are a concern within CR, as management of a chronic disease is cognitively taxing, and, as expected, deficits in cognition predict worse outcomes, including lower attendance at CR. Some subsets of patients within CR may be particularly at high risk for cognitive challenges including those with heart failure with low ejection fraction, recent coronary bypass surgery, multiple chronic conditions, and patients of lower socioeconomic status. Attendance at CR is associated with cognitive gains, likely through the progressive exercise component, with larger amounts of exercise over longer periods having greater benefits. Programs should identify at-risk patients, who could gain the most from completing CR, and provide additional support to keep those patients engaged. While engaged in CR, patients should be encouraged to exercise, at least at moderate intensity, and transitioned to a long-term exercise regimen. Overall, CR programs are well-positioned to support these patients and make significant contributions to their long-term well-being.
Collapse
Affiliation(s)
- Diann E Gaalema
- University of Vermont, Burlington (Dr Gaalema and Ms Mahoney); and Stanford University, Stanford, California (Dr Ballon)
| | | | | |
Collapse
|
12
|
Ishihara K, Izawa KP, Kitamura M, Ogawa M, Shimogai T, Kanejima Y, Morisawa T, Shimizu I. Impact of mild cognitive impairment on unplanned readmission in patients with coronary artery disease. Eur J Cardiovasc Nurs 2021; 21:348-355. [PMID: 34718506 DOI: 10.1093/eurjcn/zvab091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 09/20/2021] [Indexed: 01/08/2023]
Abstract
AIMS To investigate the effect of mild cognitive impairment (MCI) on unplanned readmission in patients with coronary artery disease (CAD). METHODS AND RESULTS From 2132 CAD patients, MCI was estimated with the Japanese version of the Montreal Cognitive Assessment (MoCA-J) in 243 non-dementia patients who met the study criteria. The primary outcome was unplanned hospital readmission after discharge. The incidence of MCI in this cohort was 33.3%, and 51 patients (21.0%) had unplanned readmission during a mean follow-up period of 418.6 ± 203.5 days. After adjusting for the covariates, MCI (hazard ratio, 2.28; 95% confidence interval: 1.09-4.76; P = 0.03) was independently associated with unplanned readmission in the multivariable Cox proportional hazard regression analysis. In the Kaplan-Meier analysis, the cumulative incidence of unplanned readmission for the MCI group was significantly higher than that for the non-MCI group (log-rank test, P < 0.001). Even after exclusion of the patients readmitted within 30 days of discharge, the main results did not change (log-rank test, P < 0.001). CONCLUSION Mild cognitive impairment was independently associated with unplanned readmission after adjustment for many independent variables in CAD patients. In addition to its short-term effects, the adverse effects of MCI had a persistent, long-term impact on CAD patients. Assessment of cognitive function should be conducted by health professionals prior to hospital discharge and during follow-up. To prevent readmission of CAD patients, it will be necessary to support solutions to the problems that inhibit secondary prevention behaviours based on the assessment of the patients' cognitive function.
Collapse
Affiliation(s)
- Kodai Ishihara
- Department of Rehabilitation, Sakakibara Heart Institute of Okayama, 5-1 Nakaicho 2-chome, Kita-ku, Okayama 700-0804, Japan.,Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome, Suma-ku, Kobe 654-0142, Japan.,Cardiovascular Stroke Renal Project (CRP), 10-2 Tomogaoka 7-chome, Suma-ku, Kobe 654-0142, Japan
| | - Kazuhiro P Izawa
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome, Suma-ku, Kobe 654-0142, Japan.,Cardiovascular Stroke Renal Project (CRP), 10-2 Tomogaoka 7-chome, Suma-ku, Kobe 654-0142, Japan
| | - Masahiro Kitamura
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome, Suma-ku, Kobe 654-0142, Japan.,Cardiovascular Stroke Renal Project (CRP), 10-2 Tomogaoka 7-chome, Suma-ku, Kobe 654-0142, Japan.,Department of Physical Therapy, Fukuoka Wajiro Professional Training College, 1-13 Wajirooka 2-chome, Higashi-ku, Fukuoka 811-0213, Japan
| | - Masato Ogawa
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome, Suma-ku, Kobe 654-0142, Japan.,Cardiovascular Stroke Renal Project (CRP), 10-2 Tomogaoka 7-chome, Suma-ku, Kobe 654-0142, Japan.,Department of Rehabilitation Medicine, Kobe University Hospital, 5-2 Kusunokicho 7-chome, Chuo-ku, Kobe 650-0017, Japan
| | - Takayuki Shimogai
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome, Suma-ku, Kobe 654-0142, Japan.,Cardiovascular Stroke Renal Project (CRP), 10-2 Tomogaoka 7-chome, Suma-ku, Kobe 654-0142, Japan.,Department of Rehabilitation, Kobe City Medical Center General Hospital, 1-1 Minatojimaminamicho 2-chome, Chuo-ku, Kobe 650-0047, Japan
| | - Yuji Kanejima
- Department of Public Health, Graduate School of Health Sciences, Kobe University, 10-2 Tomogaoka 7-chome, Suma-ku, Kobe 654-0142, Japan.,Cardiovascular Stroke Renal Project (CRP), 10-2 Tomogaoka 7-chome, Suma-ku, Kobe 654-0142, Japan.,Department of Rehabilitation, Kobe City Medical Center General Hospital, 1-1 Minatojimaminamicho 2-chome, Chuo-ku, Kobe 650-0047, Japan
| | - Tomoyuki Morisawa
- Department of Physical Therapy, Faculty of Health Sciences, Juntendo University, 1-1 Hongo 2-chome, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Ikki Shimizu
- Department of Diabetes, Sakakibara Heart Institute of Okayama, 5-1 Nakaicho 2-chome, Kita-ku, Okayama 700-0804, Japan
| |
Collapse
|