1
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Liang Q, Wang Z, Liu J, Yan Z, Liu J, Lei M, Zhang H, Luan X. Effect of Exercise Rehabilitation in Patients With Acute Heart Failure: A Systematic Review and Meta-analysis. J Cardiovasc Nurs 2024; 39:390-400. [PMID: 37487171 DOI: 10.1097/jcn.0000000000001010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
BACKGROUND Exercise rehabilitation is conducive to increasing functional ability and improving health outcomes, but its effectiveness in patients with acute heart failure (AHF) is still controversial. PURPOSE In this study, our aim was to systematically examine the efficacy of exercise rehabilitation in people with AHF. METHODS A search was conducted for randomized controlled trial studies on exercise rehabilitation in patients with AHF up to November 2021. Two investigators conducted literature selection, quality assessments, and data extractions independently. The primary outcome was 6-minute walk distance, and the secondary outcomes were left ventricular ejection fraction, quality of life, Short Physical Performance Battery, readmission, and mortality. RevMan (version 5.3) software was used for the meta-analysis. RESULTS Twelve studies with 1215 participants were included. Exercise rehabilitation significantly improved the 6-minute walk distance (mean difference [MD], 33.04; 95% confidence interval [CI], 31.37-34.70; P < .001; I2 = 0%), quality of life (MD, -11.57; 95% CI, -19.25 to -3.89; P = .003; I2 = 98%), Short Physical Performance Battery (MD, 1.40; 95% CI, 1.36-1.44; P < .001; I2 = 0%), and rate of readmission for any cause (risk ratio, 0.48; 95% CI, 0.26-0.88; P = .02; I2 = 7%), compared with routine care. However, no statistically significant effects on left ventricular ejection fraction (MD, 0.94; 95% CI, -1.62 to 3.51; P = .47; I2 = 0%) and mortality (risk ratio, 1.07; 95% CI, 0.64-1.80; P = .79; I2 = 0%) were observed. CONCLUSIONS Compared with routine care, exercise rehabilitation improved functional ability and quality of life, reducing readmission in patients with AHF.
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2
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Zeng R, Chen J, Wang Y, Liu Q. The effect of functional electrical stimulation of the legs on cardiopulmonary function and quality of life in patients with chronic heart failure: A systematic review and meta-analysis. SAGE Open Med 2024; 12:20503121241245003. [PMID: 38855004 PMCID: PMC11162138 DOI: 10.1177/20503121241245003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 03/18/2024] [Indexed: 06/11/2024] Open
Abstract
Introduction Functional electrical stimulation is important for the rehabilitation of patients with chronic heart failure. This meta-analysis of randomized controlled trials compared the efficacy of functional electrical stimulation versus conventional exercise training or placebo in patients with chronic heart failure. Methods Studies were searched through PubMed, Embase, and the Cochrane Library databases up to 1 November 2023. The outcomes were cardiopulmonary function index (6-minute walking distance), peak oxygen consumption, and Minnesota Heart Failure Life Questionnaire quality of life scores. A subgroup analysis was conducted according to the ejection fraction. The 95% confidence interval and mean difference represented the outcome of the effect size. Results Seventeen studies involving 732 participants were included. Compared with the control, functional electrical stimulation significantly improved peak oxygen consumption (MD = 2.84 ml/kg/min, 95% Cl: 1.99-3.68 ml/kg/min), increased 6-minute walking distance (MD = 49.52 m, 95% Cl: 22.61-76.43 m), and improved the life quality scores (MD = -12.86, 95% Cl: -17.48 to -7.88). Compared with functional electrical stimulation, exercise training also improved peak oxygen consumption (MD = -0.94 ml/kg/min-1, 95% Cl: -1.36 to -0.52 ml/kg/min), and the quality of life (QoL, MD = 0.66, 95% Cl: 0.34-0.98, p < 0.05, I 2 = 38%), but the result of 6-minute walking distance (MD = -6.97 m, 95% Cl: -18.32 to -4.38 m) did not show a difference. Further subgroup analysis showed that outcomes including the above, significantly improved under the functional electrical stimulationfor both HF patients with reduced ejection fraction and HF patients with preserved ejection fraction patients, but difference is insignificant of the results between groups of aerobic exercise and functional electrical stimulationacted on patients with HF patients with reduced ejection fraction. Conclusions Our study demonstrates that compared with placebo, functional electrical stimulation benefits the patients with chronic heart failure on cardiopulmonary function and quality of life. Furthermore, HF patients with reduced ejection fraction patients benefit more from functional electrical stimulation than HF patients with reduced ejection fraction patients. Therefore, functional electrical stimulation is a promising complementary therapy for patients with chronic heart failure.
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Affiliation(s)
- Rui Zeng
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Jun Chen
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yimin Wang
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Qiang Liu
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
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3
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Makita S, Yasu T, Akashi YJ, Adachi H, Izawa H, Ishihara S, Iso Y, Ohuchi H, Omiya K, Ohya Y, Okita K, Kimura Y, Koike A, Kohzuki M, Koba S, Sata M, Shimada K, Shimokawa T, Shiraishi H, Sumitomo N, Takahashi T, Takura T, Tsutsui H, Nagayama M, Hasegawa E, Fukumoto Y, Furukawa Y, Miura SI, Yasuda S, Yamada S, Yamada Y, Yumino D, Yoshida T, Adachi T, Ikegame T, Izawa KP, Ishida T, Ozasa N, Osada N, Obata H, Kakutani N, Kasahara Y, Kato M, Kamiya K, Kinugawa S, Kono Y, Kobayashi Y, Koyama T, Sase K, Sato S, Shibata T, Suzuki N, Tamaki D, Yamaoka-Tojo M, Nakanishi M, Nakane E, Nishizaki M, Higo T, Fujimi K, Honda T, Matsumoto Y, Matsumoto N, Miyawaki I, Murata M, Yagi S, Yanase M, Yamada M, Yokoyama M, Watanabe N, Ito H, Kimura T, Kyo S, Goto Y, Nohara R, Hirata KI. JCS/JACR 2021 Guideline on Rehabilitation in Patients With Cardiovascular Disease. Circ J 2022; 87:155-235. [PMID: 36503954 DOI: 10.1253/circj.cj-22-0234] [Citation(s) in RCA: 64] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Shigeru Makita
- Department of Cardiac Rehabilitation, Saitama Medical University International Medical Center
| | - Takanori Yasu
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center
| | - Yoshihiro J Akashi
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
| | - Hitoshi Adachi
- Department of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Hideo Izawa
- Department of Cardiology, Fujita Health University of Medicine
| | - Shunichi Ishihara
- Department of Psychology, Bunkyo University Faculty of Human Sciences
| | - Yoshitaka Iso
- Division of Cardiology, Showa University Fujigaoka Hospital
| | - Hideo Ohuchi
- Department of Pediatrics, National Cerebral and Cardiovascular Center
| | | | - Yusuke Ohya
- Department of Cardiovascular Medicine, Nephrology and Neurology, Graduate School of Medicine, University of the Ryukyus
| | - Koichi Okita
- Graduate School of Lifelong Sport, Hokusho University
| | - Yutaka Kimura
- Department of Health Sciences, Kansai Medical University Hospital
| | - Akira Koike
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Masahiro Kohzuki
- Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine
| | - Shinji Koba
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Kazunori Shimada
- Department of Cardiology, Juntendo University School of Medicine
| | | | - Hirokazu Shiraishi
- Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine
| | - Naokata Sumitomo
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center
| | - Tetsuya Takahashi
- Department of Physical Therapy, Faculty of Health Science, Juntendo University
| | - Tomoyuki Takura
- Department of Healthcare Economics and Health Policy, Graduate School of Medicine, The University of Tokyo
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | | | - Emiko Hasegawa
- Faculty of Psychology and Social Welfare, Seigakuin University
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
| | - Yutaka Furukawa
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital
| | | | - Satoshi Yasuda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
| | - Sumio Yamada
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine
| | - Yuichiro Yamada
- Center for Diabetes, Endocrinology and Metabolism, Kansai Electric Power Hospital
| | | | | | - Takuji Adachi
- Department of Physical Therapy, Nagoya University Graduate School of Medicine
| | | | | | | | - Neiko Ozasa
- Cardiovascular Medicine, Kyoto University Hospital
| | - Naohiko Osada
- Department of Physical Checking, St. Marianna University Toyoko Hospital
| | - Hiroaki Obata
- Division of Internal Medicine, Niigata Minami Hospital.,Division of Rehabilitation, Niigata Minami Hospital
| | | | - Yusuke Kasahara
- Department of Rehabilitation, St. Marianna University Yokohama Seibu Hospital
| | - Masaaki Kato
- Department of Cardiovascular Surgery, Morinomiya Hospital
| | - Kentaro Kamiya
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University
| | - Shintaro Kinugawa
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | - Yuji Kono
- Department of Rehabilitation, Fujita Health University Hospital
| | - Yasuyuki Kobayashi
- Department of Medical Technology, Gunma Prefectural Cardiovascular Center
| | | | - Kazuhiro Sase
- Clinical Pharmacology and Regulatory Science, Graduate School of Medicine, Juntendo University
| | - Shinji Sato
- Department of Physical Therapy, Teikyo Heisei University
| | - Tatsuhiro Shibata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
| | - Norio Suzuki
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine
| | - Daisuke Tamaki
- Department of Nutrition, Showa University Fujigaoka Hospital
| | - Minako Yamaoka-Tojo
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University
| | - Michio Nakanishi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | | | - Mari Nishizaki
- Department of Rehabilitation, National Hospital Organization Okayama Medical Center
| | - Taiki Higo
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kyushu University
| | - Kanta Fujimi
- Department of Rehabilitation, Fukuoka University Hospital
| | - Tasuku Honda
- Department of Cardiovascular Surgery, Hyogo Brain and Heart Center
| | - Yasuharu Matsumoto
- Department of Cardiovascular Medicine, Shioya Hospital, International University of Health and Welfare
| | | | - Ikuko Miyawaki
- Department of Nursing, Kobe University Graduate School of Health Sciences
| | - Makoto Murata
- Department of Cardiology, Gunma Prefectural Cardiovascular Center
| | - Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | - Masanobu Yanase
- Department of Transplantation, National Cerebral and Cardiovascular Center
| | | | - Miho Yokoyama
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine
| | | | | | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine
| | - Syunei Kyo
- Tokyo Metropolitan Geriatric Medical Center
| | | | | | - Ken-Ichi Hirata
- Department of Internal Medicine, Kobe University Graduate School of Medicine
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4
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Matsuo K, Yoneki K, Tatsuki H, Mibu K, Furuzono K, Kobayashi K, Yasuda S, Tamiya S. Effect of Electrical Muscle Stimulation on the Reduction of Muscle Volume Loss in Acute Heart Failure Patients. Int Heart J 2022; 63:1141-1149. [DOI: 10.1536/ihj.22-207] [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: 12/03/2022]
Affiliation(s)
- Koji Matsuo
- Department of Rehabilitation, Sagamihara Kyodo Hospital
| | - Kei Yoneki
- Department of Rehabilitation, Sagamihara Kyodo Hospital
| | | | - Kazuhiro Mibu
- Department of Rehabilitation, Sagamihara Kyodo Hospital
| | | | | | - Shiori Yasuda
- Department of Rehabilitation, Sagamihara Kyodo Hospital
| | - Seiji Tamiya
- Department of Cardiovascular Medicine, Sagamihara Kyodo Hospital
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5
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Yamazaki Y, Yabe H, Sawano K, Tawara Y, Ohgi S. Effects of exertional dyspnea on early mobilization of patients with acute decompensated heart failure. J Phys Ther Sci 2022; 34:547-553. [PMID: 35937626 PMCID: PMC9345754 DOI: 10.1589/jpts.34.547] [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: 02/16/2022] [Accepted: 05/09/2022] [Indexed: 11/27/2022] Open
Abstract
[Purpose] In this study, we investigated the association between exertional dyspnea and
length of the mobilization program in patients with acute decompensated heart failure.
[Participants and Methods] We recruited all consecutive patients with heart failure who
were hemodynamically stabilized after administration of intravenous medication and were
able to walk >10 m before admission. Exertional dyspnea was evaluated using the visual
analog scale in all patients after the 10-m walk during each session of the mobilization
program. Multiple regression analysis was used to determine the factors associated with
length of the mobilization program. [Results] Our study included 52 patients. Multiple
regression analysis showed that the length of the mobilization program was significantly
associated with the visual analog scale on day 3 and the length before the start of the
mobilization program; however, the length of the mobilization program showed no
significant association with age and blood urea nitrogen levels. The standardized
coefficients for the visual analog scale scores on day 3 and the length before the start
of the mobilization program were 0.49 and 0.33, respectively. [Conclusion] Exertional
dyspnea is a good predictor of the length of the mobilization program. Our findings
highlight the importance of evaluation of exertional dyspnea.
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Affiliation(s)
- Yota Yamazaki
- Department of Rehabilitation Technology, Shizuoka City Shimizu Hospital: 1231 Miyakami, Shimizu-ku, Shizuoka, Shizuoka 424-8636, Japan
| | - Hiroki Yabe
- School of Rehabilitation Sciences, Seirei Christopher University, Japan
| | - Koichi Sawano
- Department of Rehabilitation Technology, Shizuoka City Shimizu Hospital: 1231 Miyakami, Shimizu-ku, Shizuoka, Shizuoka 424-8636, Japan
| | - Yuichi Tawara
- School of Rehabilitation Sciences, Seirei Christopher University, Japan
| | - Shohei Ohgi
- School of Rehabilitation Sciences, Seirei Christopher University, Japan
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6
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Poltavskaya M, Sviridenko V, Giverts I, Patchenskaya I, Kozlovskaya I, Tomilovskaya E, Veliyev GO, Andreev D, Syrkin A, Saner H. In-hospital electrical muscle stimulation for patients early after heart failure decompensation: results from a prospective randomised controlled pilot trial. Open Heart 2022; 9:openhrt-2022-001965. [PMID: 35817498 PMCID: PMC9274513 DOI: 10.1136/openhrt-2022-001965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 05/25/2022] [Indexed: 12/02/2022] Open
Abstract
Background Electrical muscle stimulation (EMS) is being evaluated as a possible alternative to exercise training to improve functional capacity in severely deconditioned patients with heart failure (HF). However, there is insufficient data on delayed effects of EMS starting early after decompensation. The aim of this study was to determine the impact of a short inpatient EMS intervention in severely deconditioned patients with HF on functional capacity and quality of life (QoL) over a follow-up period of 1 month. Methods This is a prospective randomised sham-controlled pilot study. 45 patients hospitalised for decompensated systolic HF (58% men, mean age 66.4±10.2 years) were randomised to EMS (n=22) or sham stimulation (n=23) of lower limbs starting within 3 days after admission. The intervention included 7–10 sessions lasting from 30 to 90 min. The 6-minute walking test distance (6-MWTD), Duke Activity Status Index (DASI) and Minnesota Living with Heart Failure Questionnaire (MLHFQ) were evaluated at baseline, discharge and after 1 month. Results All patients completed the programme with good EMS tolerance. 37 patients were included in the final analysis. At discharge, 6-MWTD improved from 206,1±61,3 to 299.5±91 m, DASI from 12.1±5.6 to 18.3±7.2 and MLHFQ from 55.6±8.5 to 34.2±9 with EMS compared with smaller improvements in the sham group (p<0.05 for all). One month after discharge, improvements in the EMS group remained significant for MLHFQ (p=0.004) and DASI (p=0.042) and statistically non-significant for 6-MWTD compared with the sham group. Conclusions Short-term in-hospital EMS leads to improvements in functional capacity and QoL in selected patients early after HF decompensation that are retained over 1 month after discharge and therefore may serve as initial intervention to improve physical capacity or as a bridge to further conventional exercise training. Larger studies are required to evaluate individual responses to an early initiation of EMS in decompensated HF as well as long-term effects.
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Affiliation(s)
- Maria Poltavskaya
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M.Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Victoria Sviridenko
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M.Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Ilya Giverts
- Rehabilitation, City Clinical Hospital #1, Moscow, Russian Federation
| | - Irina Patchenskaya
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M.Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Inesa Kozlovskaya
- Sensory-Motor Physiology and Countermeasures, Institute of Biomedical Problems RAS, Moscow, Russian Federation
| | - Elena Tomilovskaya
- Sensory-Motor Physiology and Countermeasures, Institute of Biomedical Problems RAS, Moscow, Russian Federation
| | - Gabil Orkhan Veliyev
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M.Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Denis Andreev
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M.Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Abram Syrkin
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M.Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Hugo Saner
- Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M.Sechenov First Moscow State Medical University, Moscow, Russian Federation.,ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
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7
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Tanaka S, Kamiya K, Matsue Y, Yonezawa R, Saito H, Hamazaki N, Matsuzawa R, Nozaki K, Yamashita M, Wakaume K, Endo Y, Maekawa E, Yamaoka-Tojo M, Shiono T, Inomata T, Ako J. Efficacy and Safety of Acute Phase Intensive Electrical Muscle Stimulation in Frail Older Patients with Acute Heart Failure: Results from the ACTIVE-EMS Trial. J Cardiovasc Dev Dis 2022; 9:jcdd9040099. [PMID: 35448075 PMCID: PMC9032621 DOI: 10.3390/jcdd9040099] [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: 02/11/2022] [Revised: 03/15/2022] [Accepted: 03/24/2022] [Indexed: 12/23/2022] Open
Abstract
As frailty in older patients with acute heart failure (AHF) has an adverse effect on clinical outcomes, the addition of electrical muscle stimulation (EMS) to exercise-based early rehabilitation may improve the effects of treatment. Post hoc analysis was performed on a randomized controlled study for clinical outcomes and prespecified subgroups (ACTIVE-EMS: UMIN000019551). In this trial, 31 AHF patients aged ≥ 75 years with frailty (Short Physical Performance Battery [SPPB] score 4–9) were randomized 1:1 to receive treatment with an early rehabilitation program only (n = 16) or early rehabilitation with add-on EMS therapy (n = 15) for 2 weeks. Changes in physical function and cognitive function between baseline and after two weeks of treatment were assessed. There were no adverse events during the EMS period. The EMS group showed significantly greater changes in quadriceps’ isometric strength and SPPB compared to the control group, and EMS therapy showed uniform effects in the prespecified subgroups. There were no significant differences in the changes in other indexes of physical function and cognitive function between groups. There was no significant difference in the rate of heart failure hospitalization at 90 days between groups. In conclusion, older AHF patients with frailty showed greater improvement in lower extremity function with the addition of EMS therapy to early rehabilitation without adverse events.
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Affiliation(s)
- Shinya Tanaka
- Department of Rehabilitation, Nagoya University Hospital, Nagoya 466-8560, Japan;
| | - Kentaro Kamiya
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Yokohama 252-0373, Japan;
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Yokohama 252-0373, Japan;
- Correspondence: ; Tel.: +81-42-778-9693
| | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan; (Y.M.); (H.S.)
| | - Ryusuke Yonezawa
- Department of Rehabilitation, Kitasato University Medical Center, Saitama 364-8501, Japan; (R.Y.); (K.W.)
| | - Hiroshi Saito
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan; (Y.M.); (H.S.)
- Department of Rehabilitation, Kameda Medical Center, Chiba 296-8602, Japan;
| | - Nobuaki Hamazaki
- Department of Rehabilitation, Kitasato University Hospital, Yokohama 252-0375, Japan; (N.H.); (K.N.)
| | - Ryota Matsuzawa
- Department of Physical Therapy, School of Rehabilitation, Hyogo University of Health Sciences, Kobe 650-8530, Japan;
| | - Kohei Nozaki
- Department of Rehabilitation, Kitasato University Hospital, Yokohama 252-0375, Japan; (N.H.); (K.N.)
| | - Masashi Yamashita
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Yokohama 252-0373, Japan;
- Research Fellow of Japan Society for the Promotion of Science, Tokyo 102-0083, Japan
| | - Kazuki Wakaume
- Department of Rehabilitation, Kitasato University Medical Center, Saitama 364-8501, Japan; (R.Y.); (K.W.)
| | - Yoshiko Endo
- Department of Rehabilitation, Kameda Medical Center, Chiba 296-8602, Japan;
| | - Emi Maekawa
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Yokohama 252-0374, Japan; (E.M.); (J.A.)
| | - Minako Yamaoka-Tojo
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Yokohama 252-0373, Japan;
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Yokohama 252-0373, Japan;
| | - Takaaki Shiono
- Department of Cardiovascular Medicine, Kitasato University Medical Center, Saitama 364-8501, Japan;
| | - Takayuki Inomata
- Department of Cardiovascular Medicine, Niigata University School of Medical and Dental Sciences, Niigata 951-8510, Japan;
| | - Junya Ako
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Yokohama 252-0374, Japan; (E.M.); (J.A.)
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8
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Hattori K, Mizuno Y, Ogura Y, Inoue T, Nagaya M, Jobara K, Kurata N, Nishida Y. Effects of Neuromuscular Electrical Stimulation on Lower Limb Muscle Strength After Living Donor Liver Transplant: A Case-Control Study. Transplant Proc 2022; 54:749-754. [DOI: 10.1016/j.transproceed.2022.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/17/2022] [Indexed: 11/27/2022]
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9
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OUP accepted manuscript. Eur J Prev Cardiol 2022; 29:e286-e288. [DOI: 10.1093/eurjpc/zwac022] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/20/2021] [Accepted: 02/01/2022] [Indexed: 11/14/2022]
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10
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Ueno K, Kaneko H, Itoh H, Takeda N, Morita H, Fujiu K, Kamiya K, Komuro I. Effectiveness and Approach of Rehabilitation in Patients With Acute Heart Failure: A Review. Korean Circ J 2022; 52:576-592. [PMID: 35929052 PMCID: PMC9353252 DOI: 10.4070/kcj.2022.0181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 06/30/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Kensuke Ueno
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
- Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
| | - Hidehiro Kaneko
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
- Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan
| | - Hidetaka Itoh
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Norifumi Takeda
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsuhito Fujiu
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
- Department of Advanced Cardiology, The University of Tokyo, Tokyo, Japan
| | - Kentaro Kamiya
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan
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11
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Wang HY, Chen YH, Kuan YC, Huang SW, Lin LF, Chen HC. The effectiveness of functional electrical stimulation of the legs in patients with heart failure: A systematic review and meta-analysis of randomized controlled trials. Clin Rehabil 2021; 36:303-316. [PMID: 34881678 DOI: 10.1177/02692155211056999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate the effectiveness of functional electrical stimulation of the legs in patients with heart failure. METHODS Data were obtained from PubMed, Cochrane Library, and Embase databases until August 12, 2021. We included randomized controlled trials that evaluated the effects of functional electrical stimulation applied to the legs of patients with heart failure, namely changes in cardiopulmonary function, muscle strength, and quality of life. RESULTS In total, 14 randomized controlled trials (consisting of 518 patients) were included in our article. Pooled estimates demonstrated that functional electrical stimulation significantly improved peak oxygen consumption (peak VO2; standardized mean difference = 0.33, 95% confidence interval = 0.07-0.59, eight randomized controlled trials, n = 321), 6-min walking distance (mean difference = 48.03 m, 95% confidence interval = 28.50-67.57 m, 10 randomized controlled trials, n = 380), and Minnesota Living with Heart Failure Questionnaire quality of life score (mean difference = - 8.23, 95% confidence interval = - 12.64 to - 3.83, nine randomized controlled trials, n = 383). Muscle strength of lower extremities was not significantly improved in the functional electrical stimulation group compared with that in the control group (standardized mean difference = 0.26, 95% confidence interval = - 0.18 to 0.71, five randomized controlled trials, n = 218). Furthermore, the subgroup analysis revealed that functional electrical stimulation significantly improved peak VO2, 6-min walking distance, and Minnesota Living with Heart Failure Questionnaire quality of life score in the heart failure with reduced ejection fraction and heart failure with preserved ejection fraction subgroups. CONCLUSION Functional electrical stimulation can effectively improve the cardiopulmonary function and quality of life in patients with heart failure. However, functional electrical stimulation did not significantly improve muscle strength in the legs.
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Affiliation(s)
- Hsun-Yi Wang
- School of Medicine, College of Medicine, Taipei Medical University, Taipei
| | - Yu-Hsuan Chen
- School of Medicine, College of Medicine, Taipei Medical University, Taipei
| | - Yi-Chun Kuan
- Center for Evidence-Based Health Care, 159518Shuang Ho Hospital, Taipei Medical University, New Taipei City.,Department of Neurology, 159518Shuang Ho Hospital, Taipei Medical University, New Taipei City.,Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, 159518Shuang Ho Hospital, Taipei Medical University, New Taipei City.,Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei
| | - Li-Fong Lin
- Department of Physical Medicine and Rehabilitation, 159518Shuang Ho Hospital, Taipei Medical University, New Taipei City.,School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei
| | - Hung-Chou Chen
- Center for Evidence-Based Health Care, 159518Shuang Ho Hospital, Taipei Medical University, New Taipei City.,Department of Physical Medicine and Rehabilitation, 159518Shuang Ho Hospital, Taipei Medical University, New Taipei City.,Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei
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12
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Arenja N, Mueller C, Tomilovskaya E, Koryak Y, Poltavskaya M, Saner H. Real-world experience of feasibility and efficacy of electrical muscle stimulation in elderly patients with acute heart failure: A randomized controlled study. Int J Cardiol 2021; 344:113-119. [PMID: 34627967 DOI: 10.1016/j.ijcard.2021.09.062] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/27/2021] [Accepted: 09/30/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Reduced aerobic capacity and deconditioning contributes to morbidity and mortality in elderly acute heart failure (AHF) patients. Electrical muscle stimulation (EMS) has shown to be a suitable alternative to exercise in AHF. However, feasibility and efficacy are unknown in a real-world setting. METHODS This is a prospective, open label blinded, randomized, controlled study, investigating feasibility and efficacy of high-intensity versus low-intensity EMS versus controls in elderly AHF patients. Patients and investigators were blinded to the intervention. EMS was offered to > 60 years old AHF patients, initiated during hospitalization and continued at home. Outcome measures included changes in 6-min walking test distance (6-MWTD), functional capacity and quality-of-life at 3 and 6 weeks. RESULTS Among 97 consecutive AHF patients (78.1 ± 9.4 years, 42.3% females), 60 (61.9%) were eligible for EMS. Of these, 27 provided written informed consent and were randomly assigned to high-intensity (n = 10), low-intensity EMS (n = 9) and controls (n = 8). 13/27 completed the intervention. Main reason for dropouts was intolerance of the overall intervention burden. MACE occurred in 5 and were not associated with the study. EMS groups showed significant improvement of 6-MWTD (controls vs low-intensity p = 0.018) and of independence in daily living (for both p < 0.05). CONCLUSIONS Changes in 6-MWTD suggest efficacy of EMS. Whereas all tolerated EMS well, the burden of study intervention was too high and resulted in a consent rate of <50% and high dropouts, which limit the interpretability of our data. Less demanding EMS protocols are required to evaluate the full potential of EMS in elderly AHF patients.
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Affiliation(s)
- Nisha Arenja
- Department of Cardiology, Kantonsspital Olten, Solothurner Spitäler AG, Olten, Switzerland.
| | - Christian Mueller
- Cardiovascular Research Institute Basel (CRIB), Department of Cardiology, University Hospital Basel, Basel, Switzerland
| | - Elena Tomilovskaya
- Institute for Biomedical Problems of the Russian Academy of Sciences, Moscow, Russia
| | - Yuri Koryak
- Institute for Biomedical Problems of the Russian Academy of Sciences, Moscow, Russia
| | - Maria Poltavskaya
- I.M. Sechenov, First Moscow State Medical University, Moscow, Russia
| | - Hugo Saner
- I.M. Sechenov, First Moscow State Medical University, Moscow, Russia; Institute for Social and Preventive Medicine and ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
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13
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Effect of exercise training on cardiovascular autonomic and muscular function in subclinical Chagas cardiomyopathy: a randomized controlled trial. Clin Auton Res 2020; 31:239-251. [PMID: 32875456 DOI: 10.1007/s10286-020-00721-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Patients with chronic chagasic cardiomyopathy with preserved ventricular function present with autonomic imbalance. This study evaluated the effects of exercise training (ET) in restoring peripheral and cardiac autonomic control and skeletal muscle phenotype in patients with subclinical chronic chagasic cardiomyopathy. METHODS This controlled trial (NCT02295215) included 24 chronic chagasic cardiomyopathy patients who were randomized www.random.org/lists/ into two groups: those who underwent exercise training (n = 12) and those who continued their usual activities (n = 12). Eight patients completed the exercise training protocol, and 10 patients were clinically followed up for 4 months. Muscular sympathetic nerve activity was measured by microneurography and muscle blood flow (MBF) using venous occlusion plethysmography. The low-frequency component of heart rate variability in normalized units (LFnuHR) reflects sympathetic activity in the heart, and the low-frequency component of systolic blood pressure variability in normalized units reflects sympathetic activity in the vessels. The infusion of vasoactive drugs (phenylephrine and sodium nitroprusside) was used to evaluate cardiac baroreflex sensitivity, and a vastus lateralis muscle biopsy was performed to evaluate atrogin-1 and MuRF-1 gene expression. RESULTS The baroreflex sensitivity for increases (p = 0.002) and decreases (p = 0.02) in systolic blood pressure increased in the ET group. Muscle blood flow also increased only in the ET group (p = 0.004). Only the ET group had reduced resting muscular sympathetic nerve activity levels (p = 0.008) and sympathetic activity in the heart (LFnu; p = 0.004) and vessels (p = 0.04) after 4 months. Regarding skeletal muscle, after 4 months, participants in the exercise training group presented with lower atrogin-1 gene expression than participants who continued their activities as usual (p = 0.001). The reduction in muscular sympathetic nerve activity was positively associated with reduced atrogin-1 (r = 0.86; p = 0.02) and MuRF-1 gene expression (r = 0.64; p = 0.06); it was negatively associated with improved baroreflex sensitivity both for increases (r = -0.72; p = 0.020) and decreases (r = -0.82; p = 0.001) in blood pressure. CONCLUSIONS ET improved cardiac and peripheral autonomic function in patients with subclinical chagasic cardiomyopathy. ET reduced MSNA and sympathetic activity in the heart and vessels and increased cardiac parasympathetic tone and baroreflex sensitivity. Regarding peripheral muscle, after 4 months, patients who underwent exercise training had an increased cross-sectional area of type I fibers and oxidative metabolism of muscle fibers, and decreased atrogin-1 gene expression, compared to participants who continued their activities as usual. In addition, the reduction in MSNA was associated with improved cardiac baroreflex sensitivity, reduced sympathetic cardiovascular tone, and reduced atrogin-1 and MuRF-1 gene expression. TRIAL REGISTRATION ID: NCT02295215. Registered in June 2013.
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14
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Groehs RV, Negrao MV, Hajjar LA, Jordão CP, Carvalho BP, Toschi-Dias E, Andrade AC, Hodas FP, Alves MJNN, Sarmento AO, Testa L, Hoff PMG, Negrao CE, Filho RK. Adjuvant Treatment with 5-Fluorouracil and Oxaliplatin Does Not Influence Cardiac Function, Neurovascular Control, and Physical Capacity in Patients with Colon Cancer. Oncologist 2020; 25:e1956-e1967. [PMID: 32762143 DOI: 10.1634/theoncologist.2020-0225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/21/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Adjuvant chemotherapy with 5-fluorouracil (5-FU) and oxaliplatin increases recurrence-free and overall survival in patients with colon adenocarcinoma. It is known that these drugs have been associated with cardio- and neurotoxicity. We investigated the effects of 5-FU ± oxaliplatin on cardiac function, vascular responses, neurovascular control, and physical capacity in patients with colon cancer. METHODS Twenty-nine patients with prior colectomy for stage II-III adenocarcinoma and clinical indication for adjuvant chemotherapy were allocated to receive 5-FU (n = 12) or 5-FU + oxaliplatin (n = 17), according to the oncologist's decision. All the analyses were performed just before and after the end of chemotherapy. Cardiac function was assessed by echocardiography and speckle tracking, and cardiac autonomic control was assessed by heart rate variability (HRV). Vascular endothelial function was assessed by flow-mediated dilation (FMD). Muscle sympathetic nerve activity (MSNA) was directly recorded by microneurography technique, and muscle blood flow by venous occlusion plethysmography. Physical capacity was evaluated by cardiopulmonary exercise test. RESULTS Chemotherapy (pooled data) did not significantly change left ventricular ejection fraction (58 ± 1 vs. 55 ± 2%, p = .14), longitudinal strain (-18 ± 1 vs. -18 ± 1%, p = .66), and HRV. Likewise, chemotherapy did not significantly change FMD, muscle blood flow, and MSNA (33 ± 2 vs. 32 ± 1 bursts/min, p = .31). Physical capacity was not significantly changed in both groups. Similar findings were observed when the patients were subdivided in 5-FU and 5-FU + oxaliplatin treatment groups. 5-FU and 5-FU + oxaliplatin did not significantly change cardiac function, HRV, vascular responses, MSNA, and physical capacity. CONCLUSION This study provides evidence that adjuvant treatment with 5-FU ± oxaliplatin is well tolerated and does not promote changes compatible with long-term cardiotoxicity. IMPLICATIONS FOR PRACTICE Adjuvant chemotherapy with 5-fluorouracil (5-FU) and oxaliplatin increases recurrence-free and overall survival in patients with colon adenocarcinoma; however, these drugs have been associated with cardio- and neurotoxicity. This study investigated the effects of these drugs on cardiac function, vascular responses, neurovascular control, and physical capacity in patients with colon cancer. It was found that 5-FU and oxaliplatin did not significantly change cardiac function, cardiac autonomic control, vascular endothelial function, muscle sympathetic nerve activity, and physical capacity. This study provides evidence that adjuvant treatment with 5-FU ± oxaliplatin is well tolerated and does not promote changes compatible with long-term cardiotoxicity.
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Affiliation(s)
- Raphaela V Groehs
- Instituto do Coracao (InCor), Universidade de São Paulo, São Paulo, Brasil
- Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Marcelo V Negrao
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ludhmila A Hajjar
- Instituto do Coracao (InCor), Universidade de São Paulo, São Paulo, Brasil
- Cancer Institute of the State of São Paulo do Hospital, Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
| | - Camila P Jordão
- Instituto do Coracao (InCor), Universidade de São Paulo, São Paulo, Brasil
| | - Bruna P Carvalho
- Instituto do Coracao (InCor), Universidade de São Paulo, São Paulo, Brasil
| | - Edgar Toschi-Dias
- Instituto do Coracao (InCor), Universidade de São Paulo, São Paulo, Brasil
| | - Ana C Andrade
- Instituto do Coracao (InCor), Universidade de São Paulo, São Paulo, Brasil
| | - Fabiana P Hodas
- Instituto do Coracao (InCor), Universidade de São Paulo, São Paulo, Brasil
| | - Maria J N N Alves
- Instituto do Coracao (InCor), Universidade de São Paulo, São Paulo, Brasil
| | - Adriana O Sarmento
- Instituto do Coracao (InCor), Universidade de São Paulo, São Paulo, Brasil
| | - Laura Testa
- Cancer Institute of the State of São Paulo do Hospital, Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
- D'Or Institute for Research and Education (IDOR), São Paulo, Brazil
| | - Paulo M G Hoff
- Cancer Institute of the State of São Paulo do Hospital, Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil
- D'Or Institute for Research and Education (IDOR), São Paulo, Brazil
| | - Carlos E Negrao
- Instituto do Coracao (InCor), Universidade de São Paulo, São Paulo, Brasil
- School of Physical Education and Sport, Universidade de São Paulo, São Paulo, Brasil
| | - Roberto Kalil Filho
- Instituto do Coracao (InCor), Universidade de São Paulo, São Paulo, Brasil
- Sírio-Libanês Hospital, São Paulo, Brazil
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15
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Sympathetic neural overdrive in congestive heart failure and its correlates: systematic reviews and meta-analysis. J Hypertens 2020; 37:1746-1756. [PMID: 30950979 DOI: 10.1097/hjh.0000000000002093] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND OBJECTIVES Sympathetic neural activation occurs in congestive heart failure (CHF). However, the small sample size of the microneurographic studies, heterogeneity of the patients examined, presence of comorbidities as well as confounders (including treatment) represented major weaknesses not allowing to identify the major features of the phoenomenon, particularly in mild CHF. This meta-analysis evaluated 2530 heart failure (CHF) patients recruited in 106 microneurographic studies. It was based on muscle sympathetic nerve activity (MSNA) quantification in CHF of different clinical severity, but data from less widely addressed conditions, such as ischemic vs. idiopathic, were also considered. METHODS Assessment was extended to the relationships of MSNA with venous plasma norepinephrine, heart rate (HR) and echocardiographic parameters of cardiac morphology [left ventricular (LV) end-diastolic diameter] and function (LV ejection fraction) as well. RESULTS MSNA was significantly greater (1.9 times, P < 0.001) in CHF patients as compared with healthy controls, a progressive significant increase being observed from New York Heart Association classes I-IV in unadjusted and adjusted analyses. MSNA was significantly greater in both untreated and treated CHF (P < 0.001 for both), related to left ventricular (LV) end-diastolic diameter and to a lesser extent to LV ejection fraction (r = 0.24 and -0.05, P < 0.001 and <0.01, respectively), and closely associated with HR (r = 0.66, P < 0.001) and plasma norepinephrine (r = 0.68, P < 0.001). CONCLUSION CHF is characterized by sympathetic overactivity which mirrors the degree of LV dysfunction independently of the stage of CHF, its cause and presence of confounders or pharmacological treatment. plasma norepinephrine and HR represent potentially valuable surrogate markers of sympathetic activation in the clinical setting.
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16
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Reidel LT, Cecchele B, Sachetti A, Calegari L. Efeitos da eletroestimulação neuromuscular de quadríceps sobre a funcionalidade de idosos frágeis e pré-frágeis hospitalizados: ensaio clínico randomizado. FISIOTERAPIA E PESQUISA 2020. [DOI: 10.1590/1809-2950/18046327022020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Este artigo teve como objetivo avaliar os efeitos da eletroestimulação neuromuscular (EENM) sobre a funcionalidade de idosos frágeis e pré-frágeis hospitalizados. Trata-se de um ensaio clínico randomizado com 17 idosos hospitalizados. Foram avaliados dados antropométricos, socioeconômicos e clínicos, seguido da escala proposta por Fried para identificação da síndrome da fragilidade. Além disso, foram avaliados a perimetria da coxa e a força de membros inferiores pelo Medical Research Council (MRC) e teste de sentar e levantar (TSL). Os pacientes foram randomizados em grupo-controle (GC; n=9), com idade de 67,7±6,9 anos e grupo intervenção (GI; n=8), com idade de 71,2±5,6 anos. Ambos os grupos receberam atendimento de fisioterapia convencional. O protocolo de EENM foi aplicado somente no grupo intervenção. Os grupos foram semelhantes quanto ao perfil sociodemográfico, antropométrico, quanto às características clínicas e quanto ao uso contínuo de medicamentos. Houve efeitos significativos da EENM quando comparados ao GC para perimetria da coxa direita (p=0,03); para o número de repetições no TSL (p=0,004) e para a força muscular do quadríceps (p=0,01), avaliados pela escala MRC. O treinamento muscular de quadríceps com a EENM foi efetivo nos idosos frágeis e pré-frágeis hospitalizados, promovendo aumento da força e do desempenho funcional.
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Affiliation(s)
| | | | | | - Leonardo Calegari
- Faculdade Especializada na Área da Saúde do Rio Grande do Sul, Brasil
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17
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Antunes-Correa LM, Trevizan PF, Bacurau AVN, Ferreira-Santos L, Gomes JLP, Urias U, Oliveira PA, Alves MJNN, de Almeida DR, Brum PC, Oliveira EM, Hajjar L, Kalil Filho R, Negrão CE. Effects of aerobic and inspiratory training on skeletal muscle microRNA-1 and downstream-associated pathways in patients with heart failure. J Cachexia Sarcopenia Muscle 2020; 11:89-102. [PMID: 31743617 PMCID: PMC7015255 DOI: 10.1002/jcsm.12495] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 07/26/2019] [Accepted: 08/12/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The exercise intolerance in chronic heart failure with reduced ejection fraction (HFrEF) is mostly attributed to alterations in skeletal muscle. However, the mechanisms underlying the skeletal myopathy in patients with HFrEF are not completely understood. We hypothesized that (i) aerobic exercise training (AET) and inspiratory muscle training (IMT) would change skeletal muscle microRNA-1 expression and downstream-associated pathways in patients with HFrEF and (ii) AET and IMT would increase leg blood flow (LBF), functional capacity, and quality of life in these patients. METHODS Patients age 35 to 70 years, left ventricular ejection fraction (LVEF) ≤40%, New York Heart Association functional classes II-III, were randomized into control, IMT, and AET groups. Skeletal muscle changes were examined by vastus lateralis biopsy. LBF was measured by venous occlusion plethysmography, functional capacity by cardiopulmonary exercise test, and quality of life by Minnesota Living with Heart Failure Questionnaire. All patients were evaluated at baseline and after 4 months. RESULTS Thirty-three patients finished the study protocol: control (n = 10; LVEF = 25 ± 1%; six males), IMT (n = 11; LVEF = 31 ± 2%; three males), and AET (n = 12; LVEF = 26 ± 2%; seven males). AET, but not IMT, increased the expression of microRNA-1 (P = 0.02; percent changes = 53 ± 17%), decreased the expression of PTEN (P = 0.003; percent changes = -15 ± 0.03%), and tended to increase the p-AKTser473 /AKT ratio (P = 0.06). In addition, AET decreased HDAC4 expression (P = 0.03; percent changes = -40 ± 19%) and upregulated follistatin (P = 0.01; percent changes = 174 ± 58%), MEF2C (P = 0.05; percent changes = 34 ± 15%), and MyoD expression (P = 0.05; percent changes = 47 ± 18%). AET also increased muscle cross-sectional area (P = 0.01). AET and IMT increased LBF, functional capacity, and quality of life. Further analyses showed a significant correlation between percent changes in microRNA-1 and percent changes in follistatin mRNA (P = 0.001, rho = 0.58) and between percent changes in follistatin mRNA and percent changes in peak VO2 (P = 0.004, rho = 0.51). CONCLUSIONS AET upregulates microRNA-1 levels and decreases the protein expression of PTEN, which reduces the inhibitory action on the PI3K-AKT pathway that regulates the skeletal muscle tropism. The increased levels of microRNA-1 also decreased HDAC4 and increased MEF2c, MyoD, and follistatin expression, improving skeletal muscle regeneration. These changes associated with the increase in muscle cross-sectional area and LBF contribute to the attenuation in skeletal myopathy, and the improvement in functional capacity and quality of life in patients with HFrEF. IMT caused no changes in microRNA-1 and in the downstream-associated pathway. The increased functional capacity provoked by IMT seems to be associated with amelioration in the respiratory function instead of changes in skeletal muscle. ClinicalTrials.gov (Identifier: NCT01747395).
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Affiliation(s)
- Ligia M Antunes-Correa
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.,School of Physical Education, University of Campinas (UNICAMP), Campinas, Brazil
| | - Patricia F Trevizan
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Aline V N Bacurau
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | | | - João L P Gomes
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Ursula Urias
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Patricia A Oliveira
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | | | - Dirceu R de Almeida
- Division of Cardiology, Department of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Patricia C Brum
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Edilamar M Oliveira
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Ludhmila Hajjar
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Roberto Kalil Filho
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Carlos Eduardo Negrão
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.,School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
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18
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Cops J, De Moor B, Haesen S, Lijnen L, Wens I, Lemoine L, Reynders C, Penders J, Lambrichts I, Mullens W, Hansen D. Endurance Exercise Intervention Is Beneficial to Kidney Function in a Rat Model of Isolated Abdominal Venous Congestion: a Pilot Study. J Cardiovasc Transl Res 2019; 13:769-782. [PMID: 31848881 DOI: 10.1007/s12265-019-09947-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 12/09/2019] [Indexed: 11/24/2022]
Abstract
In this study, the effects of moderate intense endurance exercise on heart and kidney function and morphology were studied in a thoracic inferior vena cava constricted (IVCc) rat model of abdominal venous congestion. After IVC surgical constriction, eight sedentary male Sprague-Dawley IVCc rats (IVCc-SED) were compared to eight IVCc rats subjected to moderate intense endurance exercise (IVCc-MOD). Heart and kidney function was examined and renal functional reserve (RFR) was investigated by administering a high protein diet (HPD). After 12 weeks of exercise training, abdominal venous pressure, indices of body fat content, plasma cystatin C levels, and post-HPD urinary KIM-1 levels were all significantly lower in IVCc-MOD versus IVCc-SED rats (P < 0.05). RFR did not differ between both groups. The implementation of moderate intense endurance exercise in the IVCc model reduces abdominal venous pressure and is beneficial to kidney function.
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Affiliation(s)
- Jirka Cops
- BIOMED, UHasselt - Universiteit Hasselt, Agoralaan, 3590, Diepenbeek, Belgium. .,Faculty of Medicine and Life Sciences, UHasselt - Universiteit Hasselt, Agoralaan, 3590, Diepenbeek, Belgium.
| | - Bart De Moor
- BIOMED, UHasselt - Universiteit Hasselt, Agoralaan, 3590, Diepenbeek, Belgium.,Department of Nephrology, Jessa Ziekenhuis, 3500, Hasselt, Belgium
| | - Sibren Haesen
- BIOMED, UHasselt - Universiteit Hasselt, Agoralaan, 3590, Diepenbeek, Belgium.,Faculty of Medicine and Life Sciences, UHasselt - Universiteit Hasselt, Agoralaan, 3590, Diepenbeek, Belgium
| | - Lien Lijnen
- BIOMED, UHasselt - Universiteit Hasselt, Agoralaan, 3590, Diepenbeek, Belgium
| | - Inez Wens
- Laboratory of Experimental Hematology, Vaccine & Infectious Disease Institute, Faculty of Medicine and Health Sciences, University of Antwerp, 2000, Antwerp, Belgium
| | - Lieselotte Lemoine
- BIOMED, UHasselt - Universiteit Hasselt, Agoralaan, 3590, Diepenbeek, Belgium.,Department of Surgical Oncology, Ziekenhuis Oost-Limburg, 3600, Genk, Belgium
| | - Carmen Reynders
- Clinical Laboratory, Ziekenhuis Oost-Limburg, 3600, Genk, Belgium
| | - Joris Penders
- BIOMED, UHasselt - Universiteit Hasselt, Agoralaan, 3590, Diepenbeek, Belgium.,Clinical Laboratory, Ziekenhuis Oost-Limburg, 3600, Genk, Belgium
| | - Ivo Lambrichts
- BIOMED, UHasselt - Universiteit Hasselt, Agoralaan, 3590, Diepenbeek, Belgium
| | - Wilfried Mullens
- BIOMED, UHasselt - Universiteit Hasselt, Agoralaan, 3590, Diepenbeek, Belgium.,Department of Cardiology, Ziekenhuis Oost-Limburg, 3600, Genk, Belgium
| | - Dominique Hansen
- BIOMED, UHasselt - Universiteit Hasselt, Agoralaan, 3590, Diepenbeek, Belgium.,REVAL, UHasselt - Universiteit Hasselt, Agoralaan, 3590, Diepenbeek, Belgium.,Heart Centre, Jessa Ziekenhuis, 3500, Hasselt, Belgium
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19
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Kondo T, Yamada S, Tanimura D, Kazama S, Ishihara T, Shimojo M, Iwata E, Kondo S, Hiraiwa H, Kato T, Sano H, Awaji Y, Okumura T, Murohara T. Neuromuscular electrical stimulation is feasible in patients with acute heart failure. ESC Heart Fail 2019; 6:975-982. [PMID: 31461577 PMCID: PMC6816057 DOI: 10.1002/ehf2.12504] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/13/2019] [Accepted: 07/08/2019] [Indexed: 01/17/2023] Open
Abstract
Aims In acute heart failure (AHF), immobilization is caused because of unstable haemodynamics and dyspnoea, leading to protein wasting. Neuromuscular electrical stimulation (NMES) has been reported to preserve muscle mass and improve functional outcomes in chronic disease. NMES may be effective against protein wasting frequently manifested in patients with AHF; however, whether NMES can be implemented safely without any adverse effect on haemodynamics has remained unknown. This study aimed to examine the feasibility of NMES in patients with AHF. Methods and results Patients with AHF were randomly assigned to the NMES or control group. The intensity of the NMES group was set at 10–20% maximal voluntary contraction level, whereas the control group was limited at a visible or palpable level of muscle contraction. The sessions were performed 5 days per week since the day after admission. Before the study implementation, we set the feasibility criteria with following items: (i) change in systolic blood pressure (BP) > ±20 mmHg during the first session; (ii) increase in heart rate (HR) > +20 b.p.m. during the first session; (iii) development of sustained ventricular arrhythmia, atrial fibrillation (AF), and paroxysmal supraventricular tachycardia during all sessions; (iv) incidence of new‐onset AF during the hospitalization period < 40%; and (v) completion of the planned sessions by >70% of patients. The criteria of feasibility were set as follows; the percentage to fill one of (i)–(iii) was <20% of the total subjects, and both (iv) and (v) were satisfied. A total of 73 patients (median age 72 years, 51 men) who completed the first session were analysed (NMES group, n = 34; control group, n = 39). Systolic BP and HR variations were not significantly different between two groups (systolic BP, P = 0.958; HR, P = 0.665). Changes in BP > ±20 mmHg or HR > +20 b.p.m. were observed in three cases in the NMES group (8.8%) and five in the control group (12.8%). New‐onset arrhythmia was not observed during all sessions in both groups. During hospitalization, one patient newly developed AF in the NMES group (2.9%), and one developed AF (2.6%) and two lethal ventricular arrhythmia in the control group. Thirty‐one patients in the NMES group (91%) and 33 patients in the control group (84%) completed the planned sessions during hospitalization. This study fulfilled the preset feasibility criteria. Conclusions NMES is feasible in patients with AHF from immediately after admission.
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Affiliation(s)
- Toru Kondo
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sumio Yamada
- Department of Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Daisuke Tanimura
- Department of Cardiology, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | - Shingo Kazama
- Department of Cardiology, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | | | - Masafumi Shimojo
- Department of Cardiology, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | - Etsuo Iwata
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sayano Kondo
- Department of Cardiology, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | - Hiroaki Hiraiwa
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toshiaki Kato
- Department of Cardiology, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | - Hiroaki Sano
- Department of Cardiology, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | - Yoshifumi Awaji
- Department of Cardiology, Nagoya Ekisaikai Hospital, Nagoya, Japan
| | - Takahiro Okumura
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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20
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Cops J, Haesen S, De Moor B, Mullens W, Hansen D. Exercise intervention in hospitalized heart failure patients, with emphasis on congestion-related complications: a review. Heart Fail Rev 2019; 25:257-268. [DOI: 10.1007/s10741-019-09833-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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21
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Cattadori G, Segurini C, Picozzi A, Padeletti L, Anzà C. Exercise and heart failure: an update. ESC Heart Fail 2018; 5:222-232. [PMID: 29235244 PMCID: PMC5880674 DOI: 10.1002/ehf2.12225] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 08/28/2017] [Accepted: 09/01/2017] [Indexed: 12/20/2022] Open
Abstract
The present update is dedicated to the evolution of the interaction between heart failure (HF) and exercise and how the scientific community has handled it. Indeed, on the one hand, HF is a leading cause of morbidity and mortality with a stable prevalence from 1998 onward varying between 6.3% and 13.3%. On the other hand, exercise is seen as a diagnostic and prognostic tool as well as a therapeutic intervention in chronic HF. More precisely, the knowledge, the clinical application, and the research interest on the mutual interactions between exercise and HF have different phases in disease progression: Before HF onset (past): exercise provides protective benefit in preventing HF (primary prevention). With HF present: exercise improvement with training provides benefits in HF (secondary prevention). The prediction of future in HF patients: exercise impairment, as a leading characteristic of HF, is used as a prognostic factor.
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Affiliation(s)
| | | | | | - Luigi Padeletti
- MultiMedica S.p.A.IRCCSMilanItaly
- University of FlorenceFlorenceItaly
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22
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Oliveira MF, Santos RC, Artz SA, Mendez VMF, Lobo DML, Correia EB, Ferraz AS, Umeda IIK, Sperandio PA. Safety and Efficacy of Aerobic Exercise Training Associated to Non-Invasive Ventilation in Patients with Acute Heart Failure. Arq Bras Cardiol 2018. [PMID: 29538506 PMCID: PMC5967141 DOI: 10.5935/abc.20180039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Exercise training (ET) improves functional capacity in chronic heart failure
(HF). However, ET effects in acute HF are unknown. Objective To investigate the effects of ET alone or combined with noninvasive
ventilation (NIV) compared with standard medical treatment during
hospitalization in acute HF patients. Methods Twenty-nine patients (systolic HF) were randomized into three groups: control
(Control - only standard medical treatment); ET with placebo NIV (ET+Sham)
and ET+NIV (NIV with 14 and 8 cmH2O of inspiratory and expiratory
pressure, respectively). The 6MWT was performed on day 1 and day 10 of
hospitalization and the ET was performed on an unloaded cycle ergometer
until patients' tolerance limit (20 min or less) for eight consecutive days.
For all analyses, statistical significance was set at 5% (p < 0.05). Results None of the patients in either exercise groups had adverse events or required
exercise interruption. The 6MWT distance was greater in ET+NIV (Δ120
± 72 m) than in ET+Sham (Δ73 ± 26 m) and Control
(Δ45 ± 32 m; p < 0.05). Total exercise time was greater
(128 ± 10 vs. 92 ± 8 min; p < 0.05) and dyspnea was lower
(3 ± 1 vs. 4 ± 1; p < 0.05) in ET+NIV than ET+Sham. The
ET+NIV group had a shorter hospital stay (17 ± 10 days) than ET+Sham
(23 ± 8 days) and Control (39 ± 15 days) groups (p < 0.05).
Total exercise time in ET+Sham and ET+NIV had significant correlation with
length of hospital stay (r = -0.75; p = 0.01). Conclusion Exercise training in acute HF was safe, had no adverse events and, when
combined with NIV, improved 6MWT and reduce dyspnea and length of stay.
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Affiliation(s)
- Mayron F Oliveira
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brazil.,Universidade de Fortaleza (UNIFOR) - Centro de Ciências da Saúde, Fortaleza, CE - Brazil
| | - Rita C Santos
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brazil
| | - Suellen A Artz
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brazil
| | | | - Denise M L Lobo
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brazil.,Faculdade Metropolitana da Grande Fortaleza (FAMETRO), Fortaleza, CE - Brazil
| | | | - Almir S Ferraz
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brazil
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23
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Bertuzzi R, Gáspari AF, Trojbicz LR, Silva-Cavalcante MD, Lima-Silva AE, Billaut F, Girard O, Millet GP, Bossi AH, Hopker J, Pandeló DR, Fulton TJ, Paris HL, Chapman RF, Grosicki GJ, Murach KA, Hureau TJ, Dufour SP, Favret F, Kruse NT, Nicolò A, Sacchetti M, Pedralli M, Pinheiro FA, Tricoli V, Brietzke C, Pires FO, Sandford GN, Pearson S, Kilding AE, Ross A, Laursen PB, da Silveira ALB, Olivares EL, de Azevedo Cruz Seara F, Miguel-dos-Santos R, Mesquita TRR, Nelatury S, Vagula M. Commentaries on Viewpoint: Resistance training and exercise tolerance during high-intensity exercise: moving beyond just running economy and muscle strength. J Appl Physiol (1985) 2018; 124:529-535. [PMID: 29480788 DOI: 10.1152/japplphysiol.01064.2017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Romulo Bertuzzi
- Endurance Performance Research Group (GEDAE-USP), University of São Paulo, São Paulo, Brazil
| | - Arthur F. Gáspari
- Endurance Performance Research Group (GEDAE-USP), University of São Paulo, São Paulo, Brazil
| | - Lucas R. Trojbicz
- Endurance Performance Research Group (GEDAE-USP), University of São Paulo, São Paulo, Brazil
| | - Marcos D. Silva-Cavalcante
- Endurance Performance Research Group (GEDAE-USP), University of São Paulo, São Paulo, Brazil,Sport Science Research Group, Federal University of Pernambuco, Pernambuco, Brazil
| | - Adriano E. Lima-Silva
- Sport Science Research Group, Federal University of Pernambuco, Pernambuco, Brazil,Human Performance Research Group, Technological Federal University of Parana, Parana, Brazil
| | | | - Oliver Girard
- Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Grégoire P. Millet
- Faculty of Biology and Medicine, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Arthur Henrique Bossi
- School of Sport and Exercise Sciences University of Kent, Chatham Maritime, Chatham, Kent, England
| | - James Hopker
- School of Sport and Exercise Sciences University of Kent, Chatham Maritime, Chatham, Kent, England
| | - Domingos R. Pandeló
- Federal University of São Paulo Centro de Alta Performance (High Performance Center)
| | | | | | | | - Gregory J. Grosicki
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| | - Kevin A. Murach
- Department of Rehabilitation Sciences and Center for Muscle Biology, University of Kentucky, Lexington, KY
| | - Thomas J. Hureau
- University of Strasbourg Faculty of Medicine, Mitochondria, Oxidative Stress and Muscular Protection Laboratory, Strasbourg, France
| | - Stéphane P. Dufour
- University of Strasbourg Faculty of Medicine, Mitochondria, Oxidative Stress and Muscular Protection Laboratory, Strasbourg, France
| | - Fabrice Favret
- University of Strasbourg Faculty of Medicine, Mitochondria, Oxidative Stress and Muscular Protection Laboratory, Strasbourg, France
| | - Nicholas T. Kruse
- Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa
| | - Andrea Nicolò
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Massimo Sacchetti
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Marinei Pedralli
- Department of Kinesiology & Health Education, Cardiovascular Aging Research Laboratory, The University of Texas at Austin, Austin, TX
| | - Fabiano A. Pinheiro
- Laboratory of Adaptation to Strength Training, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil,Exercise Psychophysiology Research Group, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | - Valmor Tricoli
- Laboratory of Adaptation to Strength Training, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Cayque Brietzke
- Exercise Psychophysiology Research Group, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | - Flávio Oliveira Pires
- Exercise Psychophysiology Research Group, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | - Gareth N. Sandford
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand,High Performance Sport New Zealand, Auckland, New Zealand,Athletics New Zealand, Auckland, New Zealand
| | - Simon Pearson
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand,Queensland Academy of Sport, Nathan, Australia
| | - Andrew E. Kilding
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand
| | - Angus Ross
- High Performance Sport New Zealand, Auckland, New Zealand,Athletics New Zealand, Auckland, New Zealand
| | - Paul B. Laursen
- Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland, New Zealand,High Performance Sport New Zealand, Auckland, New Zealand
| | - Anderson Luiz B. da Silveira
- Laboratory of Physiology and Human Performance, Department of Physical Education and Sports, Federal Rural University of Rio de Janeiro, Brazil
| | - Emerson Lopes Olivares
- Laboratory of Cardiovascular Physiology and Pharmacology, Department of Physiological Sciences, Federal Rural University of Rio de Janeiro, Brazil
| | - Fernando de Azevedo Cruz Seara
- Laboratory of Cardiac Electrophysiology, Carlos Chagas Filho Department of Biophysics, Federal University of Rio de Janeiro, Brazil
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24
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Amiya E, Taya M. Is Exercise Training Appropriate for Patients With Advanced Heart Failure Receiving Continuous Inotropic Infusion? A Review. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2018; 12:1179546817751438. [PMID: 29326534 PMCID: PMC5757424 DOI: 10.1177/1179546817751438] [Citation(s) in RCA: 6] [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: 07/18/2017] [Accepted: 12/07/2017] [Indexed: 12/18/2022]
Abstract
Exercise-based rehabilitation programs have been reported to have beneficial effects for patients with heart failure. However, there is little evidence about whether this is the case in patients with more severe heart failure. In particular, there is a question in the clinical setting whether patients with advanced heart failure and continuous inotropic infusion should be prescribed exercise training. In contrast, many studies conclude that prolonged immobility associated with heart failure profoundly impairs physical function and promotes muscle wasting that could further hasten the course of heart failure. By contrast, exercise training has various effects not only in improving exercise capacity but also on vascular function, skeletal muscle, and autonomic balance. In this review, we summarize the effectiveness and discuss methods of exercise training in patients with advanced heart failure receiving continuous inotropic agents such as dobutamine.
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Affiliation(s)
- Eisuke Amiya
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masanobu Taya
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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25
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Tanaka S, Kamiya K, Matsue Y, Yonezawa R, Saito H, Hamazaki N, Matsuzawa R, Nozaki K, Wakaume K, Endo Y, Maekawa E, Yamaoka-Tojo M, Shiono T, Inomata T, Masuda T, Ako J. Effects of Acute Phase Intensive Electrical Muscle Stimulation in Frail Elderly Patients With Acute Heart Failure (ACTIVE-EMS): Rationale and protocol for a multicenter randomized controlled trial. Clin Cardiol 2017; 40:1189-1196. [PMID: 29247531 DOI: 10.1002/clc.22845] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 10/19/2017] [Accepted: 10/20/2017] [Indexed: 01/09/2023] Open
Abstract
In elderly patients with acute heart failure (AHF), clinical outcome is adversely affected by frailty. Although a number of potentially effective interventions for frailty have been reported, little is known about the effects of rehabilitation programs in frail elderly AHF patients. We postulated that addition of electrical muscle stimulation (EMS), which induces muscle contraction without requiring patient volition, to early rehabilitation would be efficacious in frail elderly AHF patients. The ACTIVE-EMS (Effects of Acute Phase Intensive Electrical Muscle Stimulation in Frail Elderly Patients With AHF; UMIN000019551) trial is a multicenter, randomized controlled trial that will enroll 80 patients from 3 hospitals in Japan. AHF patients age ≥ 75 years positive for frailty, defined as Short Physical Performance Battery score 4 to 9, will be randomly assigned to receive early rehabilitation program only or EMS add-on therapy for 2 weeks. The primary endpoint of the trial is the change in quadriceps isometric strength between baseline and 2 weeks, with changes in physical function and cognitive function, and clinical safety and feasibility of EMS therapy as secondary outcomes. ACTIVE-EMS is the first randomized trial to evaluate the clinical effectiveness of adding EMS therapy to early rehabilitation in frail elderly AHF patients. The results of this study will provide insight for the development of appropriate rehabilitation programs for this high-risk population.
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Affiliation(s)
- Shinya Tanaka
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
| | - Kentaro Kamiya
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Yuya Matsue
- Department of Cardiology, Kameda Medical Center, Chiba, Japan.,Department of Cardiovascular Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Ryusuke Yonezawa
- Department of Rehabilitation, Kitasato University Medical Center, Saitama, Japan
| | - Hiroshi Saito
- Department of Rehabilitation, Kameda Medical Center, Chiba, Japan
| | - Nobuaki Hamazaki
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan.,Department of Rehabilitation, Kitasato University Hospital, Kanagawa, Japan
| | - Ryota Matsuzawa
- Department of Rehabilitation, Kitasato University Hospital, Kanagawa, Japan
| | - Kohei Nozaki
- Department of Rehabilitation, Kitasato University Hospital, Kanagawa, Japan
| | - Kazuki Wakaume
- Department of Rehabilitation, Kitasato University Medical Center, Saitama, Japan
| | - Yoshiko Endo
- Department of Rehabilitation, Kameda Medical Center, Chiba, Japan
| | - Emi Maekawa
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Kanagawa, Japan
| | - Minako Yamaoka-Tojo
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan.,Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Takaaki Shiono
- Department of Cardiovascular Medicine, Kitasato University Medical Center, Saitama, Japan
| | - Takayuki Inomata
- Department of Cardiovascular Medicine, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Takashi Masuda
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan.,Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Junya Ako
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan.,Department of Cardiovascular Medicine, Kitasato University School of Medicine, Kanagawa, Japan
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26
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Exercise therapy and autonomic function in heart failure patients: a systematic review and meta-analysis. Heart Fail Rev 2017; 23:91-108. [DOI: 10.1007/s10741-017-9662-z] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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27
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Antunes-Correa LM, Ueno-Pardi LM, Trevizan PF, Santos MR, da Silva CHP, Franco FGM, Alves MJNN, Rondon MUPB, Negrao CE. The influence of aetiology on the benefits of exercise training in patients with heart failure. Eur J Prev Cardiol 2016; 24:365-372. [DOI: 10.1177/2047487316683530] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
| | - Linda M Ueno-Pardi
- School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | - Patricia F Trevizan
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | - Marcelo R Santos
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | | | - Fábio GM Franco
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
| | | | | | - Carlos E Negrao
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
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