Cardiac Rehabilitation for Women

Bittner, Vera

doi:10.1007/978-3-319-77932-4_34

Cited by 16 publications

(6 citation statements)

References 75 publications

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“…Since the efficacy of GDMT on HFmrEF patients has been controversial and HFmrEF might be perceived by clinicians as a 'less severe' form of HFrEF, the implementation of GDMT might be more likely to be biased by miscellaneous factors such as socioeconomic characteristics 22 or a higher likelihood of adverse effects of GDMT in women than in men. [23][24][25] The efficacy of GDMT on HFmrEF patients has not been established since no randomized controlled trials (RCTs) were conducted exclusively on this population.…”

Section: Sex-related Difference In the Association Of Lower Lvef With...mentioning

confidence: 99%

Sex-Related Differences in Long-term Outcomes across the Spectrum of Ejection Fraction in Heart Failure Patients

Kawai,

Nagatomo,

Yukino-Iwashita

et al. 2023

Preprint

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BackgroundRecently, patients with supra-normal left ventricular ejection fraction (snLVEF) are reported to have high risk of adverse outcomes, especially in women. We sought to evaluate sex-related differences in the association between LVEF and long-term outcomes in heart failure (HF) patients.MethodsThe multicenter WET-HF Registry enrolled all patients hospitalized for acute decompensated HF (ADHF). We analyzed 3,943 patients (age 77 years; 59.8% male) registered from 2006 to 2017. According to LVEF the patients were divided into the 3 groups: HF with reduced EF (HFrEF), mildly reduced EF (HFmrEF) and preserved EF (HFpEF). The primary endpoint was defined as the composite of cardiac death and ADHF rehospitalization after discharge.ResultsImplementation of guideline-directed medical therapy (GDMT) such as renin-angiotensin-system inhibitor (RASi), β-blocker and their combination at discharge was significantly lower in women than men in HFmrEF. Lower prescription of RASi + β-blocker combination in female HFmrEF was noted even after adjustment for covariates (p=0.007). There were no such sex-related differences in HFrEF. Female sex was associated with higher incidence of the primary endpoint and ADHF rehospitalization after adjustment for covariates exclusively in HFmrEF. Restricted cubic spline analysis demonstrated a U-shaped relationship between LVEF and the hazard ratio of the primary endpoint in women, but such relationship was not observed in men (pfor interaction=0.037).ConclusionsIn women, not only lower LVEF but also snLVEF were associated with worse long-term outcomes. Additionally, sex-related differences in the GDMT implementation for HFmrEF highlight the need for sex-specific guidelines to optimize HF management.

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Section: Sex-related Difference In the Association Of Lower Lvef With...mentioning

confidence: 99%

Sex-Related Differences in Long-term Outcomes across the Spectrum of Ejection Fraction in Heart Failure Patients

Kawai,

Nagatomo,

Yukino-Iwashita

et al. 2023

Preprint

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“…Overall, 3498 unique records were identified from the search. Four reviews were hand-searched [11,[25][26][27]. No title or abstract was identified in a non-English language which would be considered for full-text review.…”

Section: Study Search and Selectionmentioning

confidence: 99%

Outcomes and cost of women-focused cardiac rehabilitation: A systematic review and meta-analysis

et al. 2022

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“…As stated above, CR programmes are endorsed as part of the standard management strategy of IHD[ 4 , 6 , 7 , 75 ]. Whilst this, data has shown that CR is often underutilized and that even in those who are referred for this intervention, many do not complete the pre-specified programme[ 8 , 13 , 14 , 77 , 78 ]. Notably, while the issue of CR underutilization can affect a substantial number of individuals, as illustrated by data from the ESC-EORP EUROASPIRE V study where less than half of individuals with CAD were referred for CR, this can particularly affect certain subgroups such as women and older patients[ 77 - 81 ].…”

Section: Challenges To Crmentioning

confidence: 99%

Current role and future perspectives of cardiac rehabilitation in coronary heart disease

Vilela¹,

Ladeiras-Lopes²,

João³

et al. 2021

WJC

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Ischaemic heart disease (IHD) is a major cause of morbidity and mortality worldwide. While there have been major advances in this field, these patients are still a higher risk subgroup. As such, strategies to mitigate risk and tailor secondary prevention measures are of the utmost relevance. Cardiac rehabilitation (CR), encompassing several domains including exercise training, cardiovascular risk factor optimization, nutritional and psychological assessments, as well as other ancillary interventions has shown to be one of the pillars in the contemporary management of patients with IHD. Indeed, CR is associated with several benefits in this population, ranging from functional capacity to improvements in outcomes. Whilst this, there are still several issues concerning the optimal application of CR which are still not fully ascertained, such as lack of referral and completion, as well as questions related to programme design (particularly among patients with multiple comorbidities). In this review, we aim at presenting a pragmatic overview on the current role of CR in the management of individuals with IHD, while also discussing some of the caveats in the current data, as well as future concepts which could help improve the uptake and personalization of this pivotal time-tested intervention.

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Cardiac Rehabilitation for Women

Cited by 16 publications

References 75 publications

Sex-Related Differences in Long-term Outcomes across the Spectrum of Ejection Fraction in Heart Failure Patients

Sex-Related Differences in Long-term Outcomes across the Spectrum of Ejection Fraction in Heart Failure Patients

Outcomes and cost of women-focused cardiac rehabilitation: A systematic review and meta-analysis

Current role and future perspectives of cardiac rehabilitation in coronary heart disease

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