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Hansen D, Abreu A, Ambrosetti M, Cornelissen V, Gevaert A, Kemps H, Laukkanen JA, Pedretti R, Simonenko M, Wilhelm M, Davos CH, Doehner W, Iliou MC, Kränkel N, Völler H, Piepoli M. Exercise intensity assessment and prescription in cardiovascular rehabilitation and beyond: why and how: a position statement from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology. Eur J Prev Cardiol 2022; 29:230-245. [PMID: 34077542 DOI: 10.1093/eurjpc/zwab007] [Citation(s) in RCA: 97] [Impact Index Per Article: 48.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/02/2021] [Accepted: 01/08/2021] [Indexed: 12/12/2022]
Abstract
A proper determination of the exercise intensity is important for the rehabilitation of patients with cardiovascular disease (CVD) since it affects the effectiveness and medical safety of exercise training. In 2013, the European Association of Preventive Cardiology (EAPC), together with the American Association of Cardiovascular and Pulmonary Rehabilitation and the Canadian Association of Cardiac Rehabilitation, published a position statement on aerobic exercise intensity assessment and prescription in cardiovascular rehabilitation (CR). Since this publication, many subsequent papers were published concerning the determination of the exercise intensity in CR, in which some controversies were revealed and some of the commonly applied concepts were further refined. Moreover, how to determine the exercise intensity during resistance training was not covered in this position paper. In light of these new findings, an update on how to determine the exercise intensity for patients with CVD is mandatory, both for aerobic and resistance exercises. In this EAPC position paper, it will be explained in detail which objective and subjective methods for CR exercise intensity determination exist for aerobic and resistance training, together with their (dis)advantages and practical applications.
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Affiliation(s)
- Dominique Hansen
- Department of Cardiology, Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
- UHasselt, Faculty of Rehabilitation Sciences, BIOMED-REVAL-Rehabilitation Research Centre, Hasselt University, Agoralaan, Building A, 3590 Hasselt, Belgium
| | - Ana Abreu
- Cardiology Department, Hospital Universitário de Santa Maria/Centro Académico de Medicina de Lisboa (CAML), Exercise and Cardiovascular Rehabilitation Laboratory, Centro Cardiovascular da Universidade de Lisboa (CCUL), Lisbon, Portugal
| | - Marco Ambrosetti
- Cardiac Rehabilitation Unit, ASST Ospedale Maggiore Crema, Crema, Italy
| | - Veronique Cornelissen
- Research Unit of Cardiovascular Exercise Physiology, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Belgium
| | - Andreas Gevaert
- Research Group Cardiovascular Diseases, GENCOR Department, University of Antwerp, Antwerp, Belgium
- Department of Cardiology, Antwerp University Hospital (UZA), Belgium
| | - Hareld Kemps
- Department of Cardiology, Maxima Medical Centre, Veldhoven, The Netherlands
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jari A Laukkanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Cardiovascular Department, IRCCS MultiMedica, Care and Research Institute, Sesto San Giovanni, Milano, Italy
| | - Roberto Pedretti
- Heart Transplantation Outpatient Department, Cardiopulmonary Exercise Test Research Department, Almazov National Medical Research Centre, St. Petersburg, Russia
| | - Maria Simonenko
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Matthias Wilhelm
- Cardiovascular Research Laboratory, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Constantinos H Davos
- BCRT-Berlin Institute of Health Center for Regenerative Therapies, Department of Cardiology (Virchow Klinikum), Charité - Universitätsmedizin Berlin, Partner Site Berlin, Germany
| | - Wolfram Doehner
- Cardiac Rehabilitation and Secondary Prevention Department, Corentin Celton Hospital, Assistance Publique Hopitaux de Paris Centre Université de Paris, Paris, France
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin D-1220, Germany
| | - Marie-Christine Iliou
- Charité - University Medicine Berlin, Campus Benjamin Franklin, Department of Cardiology, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Nicolle Kränkel
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin D-1220, Germany
- Klinik am See, Rehabilitation Centers for Internal Medicine, Berlin, Germany
| | - Heinz Völler
- Department of Rehabilitation Medicine, University of Potsdam, Potsdam, Germany
- Heart Failure Unit, G. da Saliceto Hospital, AUSL Piacenza and University of Parma, Parma, Italy
| | - Massimo Piepoli
- Heart Failure Unit, G. da Saliceto Hospital, AUSL Piacenza and University of Parma, Parma, Italy
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Gevaert A, Boehm B, Hartmann H, Goovaerts I, Stoop T, Van De Heyning CM, Beckers PJ, Baldassari F, Mueller S, Duvinage A, Wisloff U, Adams V, Pieske B, Halle M, Van Craenenbroeck EM. Effect of exercise training on vascular function and endothelial repair in heart failure with preserved ejection fraction: results from the OptimEx trial. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2693] [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: 11/13/2022] Open
Abstract
Abstract
Background
Exercise training improves peak oxygen uptake (VO2) in heart failure with preserved ejection fraction (HFpEF), but the underlying mechanisms are unknown. In other cardiovascular diseases, exercise training improves vascular function and increases levels of circulating endothelium-repairing cells. We aimed to investigate the effects of moderate continuous training (MCT) and high intensity interval training (HIIT) on vascular function and cellular endothelial repair in HFpEF.
Methods
This was a prespecified subanalysis of the Optimizing Exercise Training in Prevention and Treatment of Diastolic Heart Failure randomized trial. HFpEF patients (n=180) were randomized to HIIT, MCT or attention control. At baseline and after 12 weeks, we measured peak VO2, fingertip arterial tonometry (n=109), brachial artery flow-mediated dilation (n=59), aortic pulse wave velocity (n=94), and flow cytometry (n=136) for endothelial progenitor cells (CD45dimCD34+VEGFR2+) and angiogenic T cells (CD3+CD31+CD184+). Changes in these parameters were compared between groups using linear mixed models. Parameters were correlated using Spearman's rho.
Results
At 3 months, we did not observe significant differences between HIIT, MCT and control group regarding changes in vascular function throughout the vascular tree (fingertip arterial tonometry, brachial artery flow-mediated dilation and central arterial stiffness, Table 1) or levels of circulating endothelium-repairing cells (endothelial progenitor cells and angiogenic T cells, Table 1). Results were similar at 12 months and when restricting analysis to patients with at least 70% adherence to training sessions. Patients with higher peak VO2 at baseline had lower numbers of circulating endothelial progenitor cells (rho=−0.22, p=0.011).
Conclusions
In patients with HFpEF, exercise training did not change vascular function or levels of endothelium-repairing cells. Thus, improved vascular function likely does not contribute to the change in peak VO2 after training. These findings are in contrast with the benefits of exercise on vascular function in heart failure with reduced ejection fraction and coronary artery disease.
Funding Acknowledgement
Type of funding sources: Public grant(s) – EU funding. Main funding source(s): EU Framework Programme 7 Table 1
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Affiliation(s)
- A Gevaert
- University of Antwerp, Research Group Cardiovascular Diseases, GENCOR Department, Antwerp, Belgium
| | - B Boehm
- Technical University of Munich, Department of Preventive Pediatrics, Munich, Germany
| | - H Hartmann
- Charite Universitatsmedizin Berlin, Department Internal Medicine and Cardiology, Campus Virchow Klinikum, Berlin, Germany
| | - I Goovaerts
- University Hospital Antwerp, Department of Cardiology, Antwerp, Belgium
| | - T Stoop
- University Hospital Antwerp, Department of Cardiology, Antwerp, Belgium
| | - C M Van De Heyning
- University of Antwerp, Research Group Cardiovascular Diseases, GENCOR Department, Antwerp, Belgium
| | | | - F Baldassari
- Technical University of Munich, Center for Prevention, Sports Medicine and Sports Cardiology, Munich, Germany
| | - S Mueller
- Technical University of Munich, Center for Prevention, Sports Medicine and Sports Cardiology, Munich, Germany
| | - A Duvinage
- Technical University of Munich, Center for Prevention, Sports Medicine and Sports Cardiology, Munich, Germany
| | - U Wisloff
- Norwegian University of Science and Technology, Trondheim, Norway
| | - V Adams
- Heart Centre Dresden, Dresden, Germany
| | - B Pieske
- Charite Universitatsmedizin Berlin, Department Internal Medicine and Cardiology, Campus Virchow Klinikum, Berlin, Germany
| | - M Halle
- Technical University of Munich, Center for Prevention, Sports Medicine and Sports Cardiology, Munich, Germany
| | - E M Van Craenenbroeck
- University of Antwerp, Research Group Cardiovascular Diseases, GENCOR Department, Antwerp, Belgium
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Ambrosetti M, Abreu A, Cornelissen V, Hansen D, Iliou MC, Kemps H, Pedretti RFE, Voller H, Wilhelm M, Piepoli MF, Beccaluva CG, Beckers P, Berger T, Davos CH, Dendale P, Doehner W, Frederix I, Gaita D, Gevaert A, Kouidi E, Kraenkel N, Laukkanen J, Maranta F, Mazza A, Mendes M, Neunhaeuserer D, Niebauer J, Pavy B, Gil CP, Rauch B, Sarzi Braga S, Simonenko M, Cohen-Solal A, Sommaruga M, Venturini E, Vigorito C. Delphi consensus recommendations on how to provide cardiovascular rehabilitation in the COVID-19 era. Eur J Prev Cardiol 2021; 28:541-557. [PMID: 33624042 PMCID: PMC7717287 DOI: 10.1093/eurjpc/zwaa080] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 02/07/2023]
Abstract
This Delphi consensus by 28 experts from the European Association of Preventive Cardiology (EAPC) provides initial recommendations on how cardiovascular rehabilitation (CR) facilities should modulate their activities in view of the ongoing coronavirus disease 2019 (COVID-19) pandemic. A total number of 150 statements were selected and graded by Likert scale [from -5 (strongly disagree) to +5 (strongly agree)], starting from six open-ended questions on (i) referral criteria, (ii) optimal timing and setting, (iii) core components, (iv) structure-based metrics, (v) process-based metrics, and (vi) quality indicators. Consensus was reached on 58 (39%) statements, 48 'for' and 10 'against' respectively, mainly in the field of referral, core components, and structure of CR activities, in a comprehensive way suitable for managing cardiac COVID-19 patients. Panelists oriented consensus towards maintaining usual activities on traditional patient groups referred to CR, without significant downgrading of intervention in case of COVID-19 as a comorbidity. Moreover, it has been suggested to consider COVID-19 patients as a referral group to CR per se when the viral disease is complicated by acute cardiovascular (CV) events; in these patients, the potential development of COVID-related CV sequelae, as well as of pulmonary arterial hypertension, needs to be focused. This framework might be used to orient organization and operational of CR programmes during the COVID-19 crisis.
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Affiliation(s)
- Marco Ambrosetti
- Department of Cardiac Rehabilitation, ICS Maugeri Care and Research Institute, Via S. Maugeri, 4, 27100 Pavia, Italy.,Cardiac Rehabilitation Unit, ASST Crema, Crema, Italy
| | - Ana Abreu
- Serviço de Cardiologia, Hospital Universitário de Santa Maria/Centro Hospitalar Universitário Lisboa Norte (CHULN), Centro Académico de Medicina de Lisboa (CAML), Centro Cardiovascular da Universidade de Lisboa (CCUL), Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | | | - Dominique Hansen
- REVAL and BIOMED-Rehabilitation Research Center, Hasselt University, Hasselt, Belgium
| | - Marie Christine Iliou
- Department of Cardiac Rehabilitation and Secondary Prevention, Hôpital Corentin Celton, Assistance Publique Hopitaux de Paris Centre-Universite de Paris, Paris, France
| | - Hareld Kemps
- Department of Cardiology, Máxima Medical Centre, Veldhoven, The Netherlands.,Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands
| | | | - Heinz Voller
- Klinik am See, Rehabilitation Center for Internal Medicine, Berlin, Germany.,Department of Rehabilitation Medicine, University of Potsdam, Potsdam, Germany
| | - Mathias Wilhelm
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | | | - Paul Beckers
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, Antwerp University, Crema, Belgium
| | | | - Costantinos H Davos
- Cardiovascular Research Laboratory, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Paul Dendale
- Heart Centre, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium.,Hasselt University, Hasselt, Belgium
| | - Wolfram Doehner
- Department of Cardiology (Virchow Klinikum), German Centre for Cardiovascular Research (DZHK), Berlin, Germany.,BCRT - Berlin Institute of Health Center for Regenerative Therapies, Center for Stroke Research Berlin, Charité Universitätsmedizin, Berlin, Germany
| | - Ines Frederix
- Department of Cardiology, Jessa Hospital, Hasselt, Belgium
| | - Dan Gaita
- Institutul de Boli Cardiovasculare, Universitatea de Medicina si Farmacie Victor Babes din Timisoara, Timisoara, Romania
| | - Andreas Gevaert
- Heart Centre, Jessa Hospital Campus Virga Jesse, Hasselt, Belgium.,Research Group Cardiovascular Diseases, GENCOR Department, University of Antwerp, Antwerp, Belgium
| | - Evangelia Kouidi
- Laboratory of Sports Medicine, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Nicolle Kraenkel
- Charité - University Medicine Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Berlin, Germany
| | - Jari Laukkanen
- Central Finland Health Care District Hospital District, Kuopio, Finland
| | - Francesco Maranta
- Cardiac Rehabilitation Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Antonio Mazza
- Department of Cardiac Rehabilitation, ICS Maugeri Care and Research Institute, Via S. Maugeri, 4, 27100 Pavia, Italy
| | - Miguel Mendes
- Cardiology Department, CHLO-Hospital de Santa Cruz, Karnaxide, Portugal
| | - Daniel Neunhaeuserer
- Sport and Exercise Medicine Division, Department of Medicine, University of Padova,Padova, Italy
| | - Josef Niebauer
- University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University Salzburg, Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Bruno Pavy
- Cardiac Rehabilitation Department, Loire-Vendée-Océan Hospital, Machecoul, France
| | - Carlos Peña Gil
- Department of Cardiology, Complexo Hospitalario Universitario de Santiago de Compostela, CV, SERGAS CIBER, IDIS, Santiago, Spain
| | - Bernhard Rauch
- IHF - Institut für Herzinfarktforschung, Ludwigshafen, Germany
| | - Simona Sarzi Braga
- Department of Cardiac Rehabilitation, ICS Maugeri Care and Research Institute, Tradate, Italy
| | - Maria Simonenko
- Physiology Research and Blood Circulation Department, Cardiopulmonary Exercise Test SRL, Heart Transplantation Outpatient Department, Federal State Budgetary Institution, 'V.A. Almazov National Medical Research Centre' of the Ministry of Health of the Russian Federation, Saint Petersburg, Russian Federation
| | - Alain Cohen-Solal
- Cardiology Department, Hopital Lariboisiere, UMRS-942, Paris University, Paris, France
| | - Marinella Sommaruga
- Psychology Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Camaldoli Institute, Milano, Italy
| | - Elio Venturini
- Cardiac Rehabilitation Unit, Azienda USL Toscana Nord-Ovest, Cecina Civil Hospital, Cecina, Italy
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Gevaert A, Boehm B, Baldassarri F, Goovaerts I, Stoop T, Hartmann H, Mueller S, Duvinage A, Kraigher-Krainer E, Van De Heyning CM, Beckers PJ, Wisloff U, Pieske B, Winzer EB, Halle M, Van Craenenbroeck EM. MICROVASCULAR ENDOTHELIAL FUNCTION DIFFERS BETWEEN HEART FAILURE WITH PRESERVED EJECTION FRACTION PHENOTYPES. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)31334-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Heart failure (HF) is a growing health problem. Despite improved management and outcome, the number of patients with HF is expected to keep rising in the following years. In recent research, adiponectin was shown to exert beneficial effects in the cardiovascular system, but the protein was also implicated in the development and progression of HF. The objective of this review is to provide an overview of current knowledge on the role of adiponectin in HF with reduced ejection fraction. We discuss the cardioprotective and (anti-) inflammatory actions of adiponectin and its potential use in clinical diagnosis and prognosis.
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Affiliation(s)
- Tahnee Sente
- Laboratory for Cellular and Molecular Cardiology, Department of Cardiology, Antwerp University Hospital, Edegem, Belgium.
- Cardiovascular Diseases, Department of Translational Pathophysiological Research, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium.
| | - Andreas Gevaert
- Laboratory for Cellular and Molecular Cardiology, Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
- Cardiovascular Diseases, Department of Translational Pathophysiological Research, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - An Van Berendoncks
- Cardiovascular Diseases, Department of Translational Pathophysiological Research, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Christiaan J Vrints
- Laboratory for Cellular and Molecular Cardiology, Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
- Cardiovascular Diseases, Department of Translational Pathophysiological Research, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Vicky Y Hoymans
- Laboratory for Cellular and Molecular Cardiology, Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
- Cardiovascular Diseases, Department of Translational Pathophysiological Research, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
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Van Craenenbroeck EM, Frederix G, Pattyn N, Beckers P, Van Craenenbroeck AH, Gevaert A, Possemiers N, Cornelissen V, Goetschalckx K, Vrints CJ, Vanhees L, Hoymans VY. Effects of aerobic interval training and continuous training on cellular markers of endothelial integrity in coronary artery disease: a SAINTEX-CAD substudy. Am J Physiol Heart Circ Physiol 2015; 309:H1876-82. [DOI: 10.1152/ajpheart.00341.2015] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [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] [Received: 05/11/2015] [Accepted: 10/07/2015] [Indexed: 12/23/2022]
Abstract
In this large multicenter trial, we aimed to assess the effect of aerobic exercise training in stable coronary artery disease (CAD) patients on cellular markers of endothelial integrity and to examine their relation with improvement of endothelial function. Two-hundred CAD patients (left ventricular ejection fraction > 40%, 90% male, mean age 58.4 ± 9.1 yr) were randomized on a 1:1 base to a supervised 12-wk rehabilitation program of either aerobic interval training or aerobic continuous training on a bicycle. At baseline and after 12 wk, numbers of circulating CD34+/KDR+/CD45dim endothelial progenitor cells (EPCs), CD31+/CD3+/CXCR4+ angiogenic T cells, and CD31+/CD42b− endothelial microparticles (EMPs) were analyzed by flow cytometry. Endothelial function was assessed by flow-mediated dilation (FMD) of the brachial artery. After 12 wk of aerobic interval training or aerobic continuous training, numbers of circulating EPCs, angiogenic T cells, and EMPs were comparable with baseline levels. Whereas improvement in peak oxygen consumption was correlated to improvement in FMD (Pearson r = 0.17, P = 0.035), a direct correlation of baseline or posttraining EPCs, angiogenic T cells, and EMP levels with FMD was absent. Baseline EMPs related inversely to the magnitude of the increases in peak oxygen consumption (Spearman rho = −0.245, P = 0.027) and FMD (Spearman rho = −0.374, P = 0.001) following exercise training. In conclusion, endothelial function improvement in response to exercise training in patients with CAD did not relate to altered levels of EPCs and angiogenic T cells and/or a diminished shedding of EMPs into the circulation. EMP flow cytometry may be predictive of the increase in aerobic capacity and endothelial function.
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Affiliation(s)
- Emeline M. Van Craenenbroeck
- Laboratory of Cellular and Molecular Cardiology, Department of Cardiology, Antwerp University Hospital, Wilrijkstraat 10, Edegem, Belgium
- Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
- Cardiovascular Diseases, Department of Translational Pathophysiological Research, University of Antwerp, Antwerp, Belgium
| | - Geert Frederix
- Laboratory of Cellular and Molecular Cardiology, Department of Cardiology, Antwerp University Hospital, Wilrijkstraat 10, Edegem, Belgium
- Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
| | - Nele Pattyn
- Department of Rehabilitation Sciences, Research Centre for Cardiovascular and Respiratory Rehabilitation, University of Leuven, Leuven, Belgium; and
| | - Paul Beckers
- Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
- Cardiovascular Diseases, Department of Translational Pathophysiological Research, University of Antwerp, Antwerp, Belgium
| | - Amaryllis H. Van Craenenbroeck
- Laboratory of Cellular and Molecular Cardiology, Department of Cardiology, Antwerp University Hospital, Wilrijkstraat 10, Edegem, Belgium
- Department of Nephrology, Antwerp University Hospital, Edegem, Belgium
| | - Andreas Gevaert
- Laboratory of Cellular and Molecular Cardiology, Department of Cardiology, Antwerp University Hospital, Wilrijkstraat 10, Edegem, Belgium
- Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
- Cardiovascular Diseases, Department of Translational Pathophysiological Research, University of Antwerp, Antwerp, Belgium
| | - Nadine Possemiers
- Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
| | - Veronique Cornelissen
- Department of Rehabilitation Sciences, Research Centre for Cardiovascular and Respiratory Rehabilitation, University of Leuven, Leuven, Belgium; and
| | - Kaatje Goetschalckx
- Department of Cardiovascular Diseases, University Hospital of Leuven, Leuven, Belgium
| | - Christiaan J. Vrints
- Laboratory of Cellular and Molecular Cardiology, Department of Cardiology, Antwerp University Hospital, Wilrijkstraat 10, Edegem, Belgium
- Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
- Cardiovascular Diseases, Department of Translational Pathophysiological Research, University of Antwerp, Antwerp, Belgium
| | - Luc Vanhees
- Department of Rehabilitation Sciences, Research Centre for Cardiovascular and Respiratory Rehabilitation, University of Leuven, Leuven, Belgium; and
- Department of Cardiovascular Diseases, University Hospital of Leuven, Leuven, Belgium
| | - Vicky Y. Hoymans
- Laboratory of Cellular and Molecular Cardiology, Department of Cardiology, Antwerp University Hospital, Wilrijkstraat 10, Edegem, Belgium
- Department of Cardiology, Antwerp University Hospital, Edegem, Belgium
- Cardiovascular Diseases, Department of Translational Pathophysiological Research, University of Antwerp, Antwerp, Belgium
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Gevaert A, Smets H, Vercauteren R. Fondaparinux in heparin-induced thrombocytopenia. Acta Cardiol 2013; 68:517-20. [PMID: 24283115 DOI: 10.1080/ac.68.5.2994477] [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] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Heparin-induced thrombocytopenia is a potentiallylife-threatening complication of heparin or low-molecular-weight heparin administration. We describe the case of a patient with heparin-induced thrombocytopenia complicated by pulmonary embolism, successfully treated with fondaparinux, a factor Xa inhibitor. We also review the literature regarding the use of this anticoagulant in heparin-induced thrombocytopenia complicated by thrombosis. Few treatment options are available in Belgium, and there is little evidence regarding newer anticoagulants.
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Affiliation(s)
- Andreas Gevaert
- Dept. of Internal Medicine, University of Antwerp, Wilrijk, Belgium
| | - Hilde Smets
- Dept. of Nephrology, GZA St. Augustinus Hospital, Wilrijk, Belgium
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