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Cunha NPD, Aguiar-Ricardo I, Rodrigues T, Silverio Antonio P, Couto Pereira S, Alves Da Silva P, Valente Silva B, Brito J, Pinto R, Lemos Pires M, Borges M, Jordao A, Rodrigues C, Pinto FJ, Abreu A. Left ventricular remodeling: is there a real impact of cardiac rehabilitation? Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
A number of randomized controlled trials have examined the effect of exercise training on left ventricle (LV) remodeling in individuals with cardiovascular disease. However, the results of these trials have been inconclusive.
Purpose
Evaluation of the impact of a cardiac rehabilitation program (CRP) on left ventricle remodelling evaluated by echocardiogram.
Methods
Observational single centre study including consecutive patients, undergoing structured CRP since June 2016 until February 2020. Phase II CRP included 3 months of exercise training, aerobic and strength exercise, individually prescribed, 3 times a week, 60 minutes sessions. All patients were submitted to a clinical evaluation, echocardiogram, and cardiopulmonary exercise test before and after the CRP.
Results
205 patients (62.6 ± 11 years, 83.4% men, 82.3% ischemic disease) were included in a phase II CRP. Most patients had ischemic disease (82.3%) and 23.5% of patients had left ventricular ejection fraction (LVEF) <40%. Of the cardiovascular risk factors, hypertension was the most prevalent (76%), followed by dyslipidaemia (67.4%), active smoking (45.9%) and diabetes (26.9%).
After the CRP, there was a significant improvement of LVEF (from 48.3 ± 13 to 52 ± 11.6 %, p = 0.001) and a significant reduction of LV volumes (LV end-diastolic volume, LVEDV , decreased from 140 ± 81 to 121 ± 57, p = 0.002; LV end-systolic volume , LVESV , reduced from 80 ± 75 to 64 ± 48, p = 0.004). Considering only the patients with LVEF < 40% (n = 38), the improvement was even greater: LVEF increased from 30 ± 8 to 39 ± 13 (p = 0.002); LVEDV reduced from 206 ± 107 to 159 ± 81 (p = 0.001) and LVESV reduced from 142 ± 99 to 101 ± 66 (p = 0.002). 63.6%(n = 14) of these patients improved at least 10% of LVEF and only 1 of them had a cardiac resynchronization therapy device.
Conclusions
A phase II CR program was associated with significant improvements in left ventricular reverse remodelling irrespective of baseline EF classification. Those with reduced baseline EF derived an even greater improvement, highlighting the great importance of CR in this subgroup of patients.
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Affiliation(s)
- NPD Cunha
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - I Aguiar-Ricardo
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - T Rodrigues
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - P Silverio Antonio
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - S Couto Pereira
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - P Alves Da Silva
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - B Valente Silva
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - J Brito
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - R Pinto
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - M Lemos Pires
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - M Borges
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - A Jordao
- Centro Hospitalar Universitário Lisboa Norte, Endocrinology Department, Lisbon, Portugal
| | - C Rodrigues
- Centro Hospitalar Universitário Lisboa Norte, Serviço de Psiquiatria e Saúde Mental, Unidade de Psicologia, Lisbon, Portugal
| | - FJ Pinto
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - A Abreu
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
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Fernandes C, Marini T, Frajacomo F, Jordao A, Garcia S, Kannen V. Frequency and Duration Modulate Anticarcinogenic Effects of a Physical Training in the Colon. Int J Sports Med 2015; 36:710-5. [DOI: 10.1055/s-0034-1398624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- C. Fernandes
- Universidade de Sao Paulo, Pathology and Legal Medicine, Ribeirao Preto, Brazil
| | - T. Marini
- Universidade de Sao Paulo, Pathology and Legal Medicine, Ribeirao Preto, Brazil
| | - F.T. Frajacomo
- University of Sao Paulo, Pathology, Ribeirao Preto, Brazil
| | - A. Jordao
- University of Sao Paulo, Nutrition Division, Ribeirao Preto, United States
| | - S. Garcia
- Universidade de Sao Paulo, Pathology and Legal Medicine, Ribeirao Preto, Brazil
| | - V. Kannen
- University of Sao Paulo, Pathology, Ribeirao Preto, Brazil
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Haddad A, Laicine EM, Fife RS, Jordao A, Pelletier G. Autoradiographic, electrophoretic, and immunocytochemical studies of glycoproteins of the rabbit iris. Exp Eye Res 1991; 53:615-22. [PMID: 1743261 DOI: 10.1016/0014-4835(91)90221-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
L-[3H]fucose was injected either intravitreally or intra-aqueously into adult rabbits which were killed at several time points after injection. SDS-polyacrylamide gel electrophoresis and fluorography of iris extracts revealed that most of the proteins are glycoproteins containing fucose residues. Autoradiography of semi-thin histologic sections demonstrated that glycoprotein synthesis was most prominent in the epithelium of the iris, while little protein synthesis was evident in the stroma of the iris. The results of these experiments indicated that the glycoproteins of the iris undergo renewal. The protein band pattern of the iris extracts was very similar to that of extracts of the ciliary body. The high-molecular-weight cartilage matrix glycoprotein (CMGP), an intrinsic component of the ciliary body, vitreous, and aqueous humor, was detected by immunohistologic studies only in the stroma of the iris. The results of immunohistochemical analyses of the eyes of young rabbits (1-21 days old), in addition to the autoradiographic findings, strongly suggest that CMGP is not an intrinsic glycoprotein of the iris stroma, at least in this species.
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Affiliation(s)
- A Haddad
- Departamento de Morfologia, Faculdade de Medicina de Ribeirão Preto, Brasil
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