Standard Cardiac Rehabilitation Program for Heart Failure

was established, and the Japanese Association of Cardiac Rehabilitation (JACR) joined the alliance. The initial focus of coronavirus disease 2019 (COVID-19) was primarily on infectious diseases, especially pneumonia, but it gradually became evident that vascular endothelial injury and thrombosis were significantly related to cardiovascular diseases. A nationwide survey in Japan by the Japanese Circulation Society reported both low clinical case experiences with COVID-19 and restrictions to cardiovascular procedures during the first COVID-19 wave in Japan. 1 COVID-19 has become the global threat, and the number of infected patients in Japan has increased rapidly, particularly in the main urban areas. Although the Japan Cardio-Vascular Alliance was not initially established for COVID-19, it turned out to be a good timing as we were faced with an emergency situation that no one had ever experienced before. The Japanese Society of Cardiology organized a COVID-19 Task Force Mission Team to disseminate prompt information and to suggest collaborations with other departments and hospitals on April 10, 2020. 2,3 The COVID-19 pandemic induced healthcare pro-

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“…This suggests an improved awareness of patients, which was one of the main objectives in ambulatory CR. 12 , 13 …”

Section: Discussionmentioning

confidence: 99%

Nationwide Survey of Japanese Cardiac Rehabilitation Training Facilities During the Coronavirus Disease 2019 Outbreak

et al. 2021

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“…The mobilization program was defined according to the statement of the Japanese Circulation Society as sitting over the edge of the bed, chair sitting, standing, and walking with a physical therapist (Figure 1). 5) Figure 2 shows the clinical course in this case. All catecholamines could be withdrawn on day 9 after Impella 5.0 insertion.…”

Section: Case Reportmentioning

confidence: 95%

Hemodynamic Changes During Neuromuscular Electrical Stimulation and Mobility Therapy for an Advanced Heart Failure Patient with Impella 5.0 Device

Nozaki

Hamazaki

Ikeda³

et al. 2021

Int. Heart J.

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The Impella 5.0 is a catheter-mounted left ventricular assist device that is inserted through the patient's subclavian artery. This device allows patient mobilization. Early mobility improves outcomes, including physical function and exercise tolerance, in critically ill patients and those with heart failure (HF). However, there have been no studies regarding the safety of early mobilization during the period of Impella 5.0 insertion based on hemodynamic assessment.A 39-year-old man with idiopathic dilated cardiomyopathy and cardiogenic shock was transferred to our hospital for Impella 5.0 insertion. We started neuromuscular electrical stimulation (NMES) and mobilization eight days after Impella 5.0 insertion. The safety of NMES and mobilization was assessed based on mean blood pressure, heart rate (HR), and mean pulmonary artery pressure measurements as hemodynamic indicators. Muscle strength was also assessed using the Medical Research Council (MRC) scale. Throughout the interventions, only the HR increased slightly during mobilization, and there were no hemodynamic abnormalities. Also, the MRC scale score improved as mobilization progressed. The results presented here suggest that NMES and mobilization are safe and feasible in patients with Impella 5.0 insertion, and therefore should be widely adopted.

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“…Patients who had received thoracic or open-heart surgery within the last three months or had chronic diseases of respiratory systems were excluded from the study. Comprehensive cardiac rehabilitation consisted of supervised exercise training and education on self-management including medication, nutrition, and physical activity, based on the statement from the Japanese Circulation Society [12]. Blood examinations and echocardiograms at hospital discharge were considered as baseline data.…”

Section: Study Design and Populationmentioning

confidence: 99%

“…All patients received comprehensive cardiac rehabilitation during hospitalization and after hospital discharge for five months. Cardiac rehabilitation was initiated when the HF condition was stabilized from the intensive care unit or general wards [12]. The median duration of cardiac rehabilitation initiation from hospitalization for all of studied patients was three days.…”

Section: Cardiac Rehabilitation Programmentioning

confidence: 99%

“…The median duration of cardiac rehabilitation initiation from hospitalization for all of studied patients was three days. In the acute phase, we facilitated mobilization and/or ambulation under the monitoring of electrocardiogram (ECG) and vital signs [12]. If patients were able to walk approximately 200 m with independence, they proceeded to inpatient exercise training with the low-moderate intensity [19,20].…”

Section: Cardiac Rehabilitation Programmentioning

confidence: 99%

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Changes in Respiratory Muscle Strength Following Cardiac Rehabilitation for Prognosis in Patients with Heart Failure

Hamazaki

Kamiya

Yamamoto

et al. 2020

JCM

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Respiratory muscle weakness, frequently observed in patients with heart failure (HF), is reported as a predictor for poor prognosis. Although increased respiratory muscle strength ameliorates exercise tolerance and quality of life in HF patients, the relationship between changes in respiratory muscle strength and patient prognosis remains unclear. A total of 456 patients with HF who continued a 5-month cardiac rehabilitation (CR) were studied. We measured maximal inspiratory pressure (PImax) at hospital discharge as the baseline and five months thereafter to assess the respiratory muscle strength. Changes in PImax during the 5-month observation period (⊿PImax) were examined. We investigated the composite multiple incidence of all-cause death or unplanned readmission after 5-month CR. The relationship between ⊿PImax and the incidence of clinical events was analyzed. Over a median follow-up of 1.8 years, 221 deaths or readmissions occurred, and their rate of incidence was 4.3/100 person-years. The higher ⊿PImax was significantly associated with lower incidence of clinical event. In multivariate Poisson regression model after adjustment for clinical confounding factors, ⊿PImax remained a significant and independent predictor for all-cause death/readmission (adjusted incident rate ratio for ⊿PImax increase of 10 cmH2O: 0.77, 95% confidence interval: 0.70–0.86). In conclusion, the changes in respiratory muscle strength independently predict the incidence of clinical events in patients with HF.

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Standard Cardiac Rehabilitation Program for Heart Failure

Cited by 53 publications

References 22 publications

Nationwide Survey of Japanese Cardiac Rehabilitation Training Facilities During the Coronavirus Disease 2019 Outbreak

Nationwide Survey of Japanese Cardiac Rehabilitation Training Facilities During the Coronavirus Disease 2019 Outbreak

Hemodynamic Changes During Neuromuscular Electrical Stimulation and Mobility Therapy for an Advanced Heart Failure Patient with Impella 5.0 Device

Changes in Respiratory Muscle Strength Following Cardiac Rehabilitation for Prognosis in Patients with Heart Failure

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