Cardiac Changes in Overweight and Obese Patients

Alexescu, Teodora; Cozma, Angela; Sitar-Tăut, Adela; Negrean, Vasile; Handru, Mircea I; Motocu, M; Tohănean, Nicoleta; Lencu, Codruta; Para, Ioana

doi:10.1515/rjim-2016-0022

Cited by 9 publications

(8 citation statements)

References 10 publications

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“…The importance of screening programs is evident, moreover because some studiesshowed that only overweight itself produce early changes in cardiovascular status of the patient by decreasing the left ventricular ejection fraction, thickening the interventricular septum, increasing left ventricular mass and implementing early diastolic dysfunction [42].Thus, one could expect that cardiovascular disease would be particularly prevalent in patients with overlap syndrome, but there are limited data on this relationship.…”

Section: Resultsmentioning

confidence: 99%

Nocturnal Hypoxemia, a Key Parameter in Overlap Syndrome

Budin¹,

Maierean²,

Ianoși³

et al. 2019

Rev. Chim.

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The overlap syndrome (OS) is defined as a synergic relation between obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD). Patients with overlap syndrome present the clinical features of each disorder to a greater or a lesser extend depending on the predominant disease. We assessed the main differences between patients with OS and patients with OSA and we highlight the importance of nocturnal hypoxemia on clinical status and management of the patients with overlap syndrome, in order to simplify OSA screening tests in patients with COPD. The study population included 62 selected patients divided in two groups: the first group � subjects diagnosed with OS and the second group - subjects with OSA, without the diagnostic of COPD. The majority of the patients were male, with a mean age of 55�9.84 years in the OSA group and 65.5�10.32 years in the OS group. The nocturnal hypoxemia was more important in the OS grup, with 276.83 minutes spent at a SpO2 below 90% versus 132.98 minutes in the OSA group. The mean AHI was 57.7�29.244 events/hour of sleep in the OS group and 50.7�26.01 events/hour of sleep in the OSA group. At the diagnosis, the mean daytime SpO2 was 90.9�3.59% in the OS group and 95.9�1.57 % in the OSA group. There were statistically significant differences between the two groups concerning age, AHI, Epworth Slepiness Scale, nocturnal desaturation, medium and minimum SpO2 during sleep, daytime SpO2 at the diagnosis and at 1-year follow-up, the presence of cardiovascular comorbidities such as pulmonary hypertension and heart failure. Our study showed that patients with COPD have OSA predictors that differ from those usually recognise in the general population. In OS patients, the most important parameter is the nocturnal hypoxemia. So, it is very useful that the clinicians be trained to include in the management of selected obese COPD patients, comprehensive sleep history, sleep hygiene and OSA screening because, in clinical practice, OSA is quite often underdiagnosed in these patients.

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Section: Resultsmentioning

confidence: 99%

Nocturnal Hypoxemia, a Key Parameter in Overlap Syndrome

Budin¹,

Maierean²,

Ianoși³

et al. 2019

Rev. Chim.

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“…An interesting, positive correlation was found between 6MWT performance and BMI higher than 30 kg/m 2 [18]. This correlation, even paradoxical, is explained by our previous results showing that obese patients often have a better outcome, even though they are more prone cu to cardiac dysfunction and cardiovascular diseases [19], [20]. Maximal exercise capacity or physical capacity may be evaluated by using cardiopulmonary exercise testing (CPET) with a cycle ergometer following standardised protocols, as described recently by Sibilitz et al [21].…”

Section: Assessment Methosds Of the Cardiac Rehabilitation Protocols mentioning

confidence: 85%

Cardiac rehabilitation protocols outcome in frail patients undergoing transcatheter aortic valve implantation

Mocan¹,

Cluj-Napoca²,

Chiorescu³

et al. 2018

Balneo

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The degenerative aortic stenosis (AS) is the most frequent valvular disease in the elderly (over 75 years), and its severe form is found in 12.4% associated with a low survival rate at 5 years (15-50%). These patients are categorised as frail and the only possible choice of treatment is transcatheter aortic valve implantation (TAVI). When cardiac rehabilitation programs (CRP) were introduced after TAVI, they had a positive impact on clinical outcome, increasing the quality of life and decreasing morbidity and mortality, especially in the elderly with high frailty score. This review underlines the utility of objective and functional frailty assessment in elderly patients with severe AS, before and after TAVI. Inclusion of these patients in complex and individually designed CRP could improve both QoL and short and long term outcome. Apart from exercise recommendation, a complete and ideal CRP should include nutrition counselling, occupational therapy, and psychological counselling to ensure psychosocial health, as well as social worker counselling. CRP could prevent and reduce severity of frailty by improving/increasing mobility, muscle mass and cognitive function. Further studies should aim at appraising long-term effects and prognostic relevance of CRP in frail patients undergoing TAVI.

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“…Because of the COPD comorbidities, like cardiovascular diseases and Obstructive Sleep Apnea (OSA), the importance of screening programs for these pathologies is evident in COPD patients. Some studies showed that only overweight itself produces early changes in cardiovascular status of the patient by decreasing the left ventricular ejection fraction, thickening the interventricular septum, increasing left ventricular mass and implementing early diastolic dysfunction (30). Respiratory muscle training is a part of rehabilitation for stable COPD subjects, as it promotes benefits such as improved pulmonary function and respiratory muscle strength, reduction of dyspnea severity, improved exercise tolerance and enhanced functionality and quality of life.…”

Section: Muscular Training Programmentioning

confidence: 99%

Rehabilitation therapies in stable chronic obstructive pulmonary disease

Alexescu¹,

Maierean²,

Budin³

et al. 2019

Balneo

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Introduction. Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease. The pulmonary rehabilitation (PR) is a mutidisciplinary and comprehensive intervention in symptomatic patients with COPD. Objective. This review aims to synthesize evidence from available studies on the relative efficacies of different methods of rehabilitation therapies in patients with stable COPD. Material and Methods. A search was performed on the databases Pubmed, Embase, ResearchGate. Of the 410 articles retrieved from databases, only 20 met the inclusion criteria. Two reviewers independently reviewed selected eligible studies. Results. Rehabilitation is a multidisciplinary intervention in symptomatic patients with COPD, including speleotherapy, halotherapy, muscular training, soft tissue manual therapy and neuromuscular electrostimulation. All of the case-control studies using speleotherapy reported improved respiratory function to varying degrees and there were improvements in lung functional tests including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV 1), oxygen saturation, partial pressure of oxygen in arterial blood, and partial pressure of carbon dioxide in arterial blood. In addition, halotherapy has been associated with relief of respiratory conditions such as COPD, asthma and cystic fibrosis by its bactericidal effect, improvement of immunity and rheological properties of secretions. Respiratory muscle training is a part of rehabilitation for COPD subjects. In patients who can not perform physical activity, neuromuscular electrostimulation (NMES) increased 6 minute walking distance and time to symptom limitation exercising at a submaximal intensity and reduced the severity of leg fatigue on completion of exercise testing. Conclusion. The management of COPD should include a multidisciplinary therapy, including rehabilitation therapies as an adjuvant to the medical treatment, especially because due to the high prevalence, mortality, and morbidity, COPD will be one of the biggest public health challenges in the next century.

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Cardiac Changes in Overweight and Obese Patients

Cited by 9 publications

References 10 publications

Nocturnal Hypoxemia, a Key Parameter in Overlap Syndrome

Nocturnal Hypoxemia, a Key Parameter in Overlap Syndrome

Cardiac rehabilitation protocols outcome in frail patients undergoing transcatheter aortic valve implantation

Rehabilitation therapies in stable chronic obstructive pulmonary disease

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