Impact of an Outpatient Cardiac Rehabilitation Program on Clinical and Analytical Variables in Cardiovascular Disease

Roca-Rodríguez, M. M.; García-Almeida, José Manuel; Ruiz-Nava, Josefina; Alcaide-Torres, Juan; Saracho-Dominguez, H.; Rioja-Vázquez, Rosalía; García-Fernández, Carlos; Gómez-González, Adela María; Montiel-Trujillo, Angel; Tinahones, Francisco J.

doi:10.1097/hcr.0000000000000026

Cited by 15 publications

(12 citation statements)

References 13 publications

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“…Other studies utilizing a standard CR exercise training protocol provide further evidence that when BWL is delivered in the CR setting 5 to 6 kg of weight loss is accomplished 4, 22–25 (Table 1). In contrast, less than 2 kg of weight loss is observed when a BWL intervention is not employed 26–30 . While demonstrating promise, additional study of the optimal dose of exercise and best methods to deliver BWL programming in the CR setting is still needed.…”

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confidence: 98%

Obesity in coronary heart disease: An unaddressed behavioral risk factor

Ades

Savage

2017

Preventive Medicine

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Obesity is an independent risk factor for the development and progression of coronary heart disease (CHD). Over 80% of patients with CHD are overweight or obese. While obesity is often considered a relatively “minor” CHD risk factor, weight loss is a broadly effective risk-factor intervention. Weight loss can profoundly influence a number of “major” risk factors including: hypertension, dyslipidemia and insulin resistance/type 2 diabetes mellitus. Despite its prominence as a risk factor most cardiac rehabilitation (CR) programs do not have a specific, targeted intervention to assist patients with weight loss. Consequently, the weight loss that occurs during CR is quite small and unlikely to appreciably alter risk factors. Relying on CR associated exercise as a sole intervention is an ineffective strategy to promote weight loss. There is evidence, however, that behavioral weight loss (BWL) interventions can be effectively employed in the CR setting. In contrast to programs that do not offer a targeted intervention, studies show that participants in CR-related BWL programs lose significantly more weight. The additional weight loss from the BWL intervention is associated with greater improvements in insulin sensitivity and other components of the metabolic syndrome such as hypertension and lipid abnormalities. As a means of maximizing CHD risk factor reduction CR programs need to incorporate BWL programs as a standard programming for overweight/obese patients.

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confidence: 98%

Obesity in coronary heart disease: An unaddressed behavioral risk factor

Ades

Savage

2017

Preventive Medicine

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“…In a study on 59 patients who participated in a standard cardiac rehabilitation program and were re-assessed 12 months after completion of the program, it was shown that exercise tolerance time and METs achieved were significantly improved [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of a 6-week and 12-week cardiac rehabilitation program on heart rate recovery

et al. 2020

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Background Cardiac rehabilitation has been shown to reduce cardiac mortality, improve quality of life, and reduce hospitalizations. Cardiac rehabilitation programs are usually performed over a 12-week period. Studies have shown that similar benefits could be achieved with shorter programs. Abnormal heart rate recovery after exercise has been associated with an increased risk of cardiovascular events and mortality. The main aim of this study was to compare the effect of a 6-week phase 2 cardiac rehabilitation program on heart rate recovery to a 12-week one in patients who had recovered from an anterior wall ST segment elevation myocardial infarction. Results This prospective study included 60 patients enrolled in cardiac rehabilitation programs randomized into two equal groups: a 6-week and a 12-week program. Baseline patient demographics, lipid profile, and left ventricular ejection fraction (LVEF) were assessed. METs achieved, total exercise time, resting heart rate, peak heart rate, and heart rate recovery at 1 min were examined. These were re-assessed at the end of each program. Results showed no difference between both groups at the end of each program regarding lipid profile and LVEF. Patients enrolled in the 12-week cardiac rehabilitation program were able to achieve more METs, had a longer exercise time, a higher peak heart rate, and had a lower resting heart rate at the end of the program. Heart rate recovery was slightly higher in patients enrolled in the 6-week program 26.5 ± 6.78 versus 23.17 ± 6.12 bpm (p = 0.051). On comparing the magnitude of change between both programs, those in the 12-week program had more increase in HDL-C levels, METs achieved, and exercise time. Additionally, they had more reduction of resting heart rate. Heart rate recovery was more increased for those in the 6-week program. Conclusion Although heart rate recovery increases after completion of each of a 6-week and 12-week cardiac rehabilitation program compared to their baseline, there is no difference on comparing heart rate recovery between both programs at their end. Patients enrolled in a standard 12-week cardiac rehabilitation program achieve more METs, have a longer exercise time, a higher peak HR, and a lower resting HR at the end of the program compared to those in the 6-week program.

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“…Bioelectrical impedance analysis is valid and reliable for body composition measurement in healthy older women, 19 as well as those with HD, 20,21 and has previously been used to assess changes in body composition during CR. 22,23 In addition, it is recognized as an appropriate diagnostic tool for sarcopenia in older adults. 24 For bioelectrical impedance analysis, participants were asked to lie supine on a flat surface for ≥5 min with all extremities extended, feet apart, and hands away from their sides.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Lean Mass in Women With and Without Heart Disease

Graham

Benton

2021

Journal of Cardiopulmonary Rehabilitation and Prevention

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This proof-of-concept study compared lean mass (LM) between women with heart disease (HD) and without HD. Methods: Fifty-six community-dwelling women were pairmatched by age. Heart disease was defined using criteria from the US Behavioral Risk Factor Surveillance System. Body composition was measured using multifrequency bioelectrical impedance analysis. Relative LM was calculated against height (kg/m 2 ) as the lean mass index (LMI). Sarcopenia was defined as an LMI <15.0 kg/m 2 . Strength was measured with a handgrip dynamometer, arm curl test, and chair stand test. Results: Those with HD had significantly less absolute (38.2 ± 0.8 vs 43.5 ± 1.0 kg; P < .001) and relative (15.3 ± 0.3 vs 16.2 ± 0.3 kg/m 2 , P = .015) LM compared with those without HD. Body mass was significantly greater for those without HD (76.1 ± 2.1 vs 68.4 ± 2.1 kg; P = .013) and there were no differences in fat mass. Upper body strength was significantly less and lower body strength was diminished but not significantly different in those with HD compared to those without HD (handgrip: P = .016; arm curl: P < .001; chair stand: P = .066). Conclusions: In this group of community-dwelling women, those who reported a diagnosis of HD had significantly less LM than those without HD. Although neither group was classified as sarcopenic, women with HD were at greater risk due to lower relative LM. Based on our findings, during cardiac rehabilitation clinicians should counsel women regarding resistance exercise for maintenance of LM in addition to strength.

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Impact of an Outpatient Cardiac Rehabilitation Program on Clinical and Analytical Variables in Cardiovascular Disease

Abstract: Cardiac rehabilitation is an appropriate program for the improvement of clinical and analytical variables, such as functional capacity, carbohydrate and lipid metabolism, anthropometric measures, and diet. However, 12 months later, many of these benefits either remained stable or worsened.

Cited by 15 publications

References 13 publications

Obesity in coronary heart disease: An unaddressed behavioral risk factor

Obesity in coronary heart disease: An unaddressed behavioral risk factor

Effect of a 6-week and 12-week cardiac rehabilitation program on heart rate recovery

Comparison of Lean Mass in Women With and Without Heart Disease

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