Pubblicazioni recenti - cardiac rehabilitation
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Facility-Based and Virtual Cardiac Rehabilitation in Young Patients with Heart Disease During the COVID-19 Era.
Pediatr Cardiol2023 Jun;():. doi: 10.1007/s00246-023-03202-0.
Aronoff Elizabeth B, Chin Clifford, Opotowsky Alexander R, Mays Wayne A, Knecht Sandra K, Goessling Jennah, Rice Malloree, Shertzer Justine, Wittekind Samuel G, Powell Adam W,
Abstract
Cardiac rehabilitation (CR) is an important tool for improving fitness and quality of life in those with heart disease (HD). Few pediatric centers use CR to care for these patients, and virtual CR is rarely used. In addition, it is unclear how the COVID-19 era has changed CR outcomes. This study assessed fitness improvements in young HD patients participating in both facility-based and virtual CR during the COVID-19 pandemic. This retrospective single-center cohort study included new patients who completed CR from March 2020 through July 2022. CR outcomes included physical, performance, and psychosocial measures. Comparison between serial testing was performed with a paired t test with P?0.05 was considered significant. Data are reported as mean?±?standard deviation. There were 47 patients (19?±?7.3 years old; 49% male) who completed CR. Improvements were seen in peak oxygen consumption (VO, 62.3?±?16.1 v 71?±?18.2% of predicted, p?=?0.0007), 6-min walk (6 MW) distance (401?±?163.8 v 480.7?±?119.2 m, p?=??0.0001), sit to stand (16.2?±?4.9 v 22.1?±?6.6 repetitions; p?=??0.0001), Patient Health Questionnaire-9 (PHQ-9) (5.9?±?4.3 v 4.4?±?4.2; p?=?0.002), and Physical Component Score (39.9?±?10.1 v 44.9?±?8.8; p?=?0.002). Facility-based CR enrollees were less likely to complete CR than virtual patients (60%, 33/55 v 80%, 12/15; p?=?0.005). Increases in peak VO (60?±?15.3 v 70.2?±?17.8% of predicted; p?=?0.002) were seen among those that completed facility-based CR; this was not observed in the virtual group. Both groups demonstrated improvement in 6 MW distance, sit-to-stand repetitions, and sit-and-reach distance. Completion of a CR program resulted in fitness improvements during the COVID-19 era regardless of location, although peak VO improved more for the in-person group.
© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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Exercise attenuates myocardial I/R injury by regulating endoplasmic reticulum stress and mitophagy through M2AChR.
Antioxid Redox Signal2023 Jun;():. doi: 10.1089/ars.2022.0168.
Chen Wei, Ma Mei, Song Yinping, Hua Yijie, Jia Hao, Liu Jiankang, Wang Youhua,
Abstract
AIMS:
Adaptive changes in the heart by exercise have been shown to reduce the risk of cardiovascular disease, and M2 Acetylcholine receptor(M2AChR), a receptor abundantly present on cardiac parasympathetic nerves, is closely associated with the development of cardiovascular disease. The present study intends to investigate whether exercise can regulate endoplasmic reticulum stress and mitophagy through M2AChR to resist myocardial ischemia-reperfusion(I/R) injury and to elucidate its mechanism of action.
RESULTS:
Exercise enhanced parasympathetic nerve function and increased myocardial M2AChR protein expression in I/R rats. In addition, it promoted the protein expression of MFN2 and inhibited the expression of Drp1, Chop, PINK1/Parkin, and PERK/eIF2?/ATF4 signaling pathways, effectively reducing mitophagy, endoplasmic reticulum stress, and apoptosis. At the cellular level, AICAR reduced hypoxia/reoxygenation(H/R)-induced endoplasmic reticulum stress through the downregulated expression of PERK/eIF2?/ATF4 pathway proteins in H9C2 cardiomyocytes. When intervened with M2AChR inhibitors, the levels of endoplasmic reticulum stress(ERs) and phosphorylation levels of the PERK/eIF2?/ATF4 pathway were increased in H/R cells.
INNOVATION AND CONCLUSION:
Exercise intervention activated the parasympathetic state in rats. It inhibited myocardial mitophagy and endoplasmic reticulum stress levels, and reduced myocardial apoptosis through M2AChR, thereby resisting I/R-induced myocardial injury and improving cardiac function.
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Is hybrid cardiac rehabilitation superior to traditional cardiac rehabilitation?
Acta Cardiol2023 Jun;():1-5. doi: 10.1080/00015385.2023.2215610.
Racodon Michaël, Vanhove Pierre, Bolpaire Romain, Masson Philippe, Porrovecchio Alessandro, Secq Amandine,
Abstract
BACKGROUND:
The current COVID-19 pandemic imposes changes in the management of cardiac pathologies. Cardiac rehabilitation needs to define new protocols to welcome patients back. In connection with the observations of the European Association of Preventive Cardiology, the choice of cardiac tele-rehabilitation appeared to be unavoidable.
AIM:
This retrospective research based on data from the Program for the Medicalisation of Information Systems (PMSI) and the electronic medical record analyzes the effect of Hybrid Cardiac Rehabilitation.
METHODS:
One hundred and ninety-two patients (29 females and 163 males) with an average of 56.9?years old (±10.3) were able to benefit from a Hybrid Cardiac Rehabilitation program. The data concerning the Stress Test and the Wall Squat Test were collected.
RESULTS:
We have noticed that patients had improved their cardiorespiratory capacity on the initial and final Stress Test 6.6 (±1.8) MET to 8.2 (±1.9) MET (?0.0001). We also found that patients improved lower limb muscle strength 75.1 (±44.8) seconds to 105.7 (±49.7) seconds (?0.0001).
CONCLUSIONS:
Hybrid Cardiac Rehabilitation protocols can be set up in this pandemic situation. The programme effectiveness appears to be comparable to the traditional model. However, additional studies are needed to determine the effectiveness of this programme in the long term.
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End-tidal oxygen partial pressure is a strong prognostic predictive factor in patients with cardiac disease.
Clin Physiol Funct Imaging2023 Jun;():. doi: 10.1111/cpf.12838.
Ogura Asami, Izawa Kazuhiro P, Tawa Hideto, Wada Masaaki, Kanai Masashi, Kubo Ikko, Makihara Ayano, Yoshikawa Ryohei, Matsuda Yuichi,
Abstract
BACKGROUND:
Cardiopulmonary exercise testing (CPET) variables represent central and peripheral factors and combined factors in the pathology of patients with cardiac disease. The difference in end-tidal oxygen partial pressure from resting to anaerobic threshold (?PETO ) may represent predominantly peripheral factors. This study aimed to verify the prognostic significance of ?PETO for major adverse cardiac and cerebrovascular events (MACCE) in cardiac patients, including comparison with the minute ventilation-carbon dioxide production relationship (VE/VCO slope), and peak oxygen uptake (VO ).
METHODS:
In total, 185 patients with cardiac disease who underwent CPET were consecutively enrolled in this retrospective study. The primary endpoint was 3-year MACCE. The ability of ?PETO , VE/VCO slope, and peak VO to predict MACCE was examined.
RESULTS:
Optimal cut-off values for predicting MACCE were 2.0 mmHg for ?PETO (area under the curve [AUC]: 0.829), 29.8 for VE/VCO slope (AUC: 0.734), and 19.0 mL/min/kg for peak VO (AUC: 0.755). The AUC of ?PETO was higher than those of VE/VCO slope and peak VO . The MACCE-free survival rate was significantly lower in the ?PETO ?2.0 group versus the ?PETO >2.0 group (44.4% vs. 91.2%, P
CONCLUSION:
?PETO was a strong predictor of MACCE independent of and superior to VE/VCO slope and peak VO in patients with cardiac disease. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
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Home-based cardiac rehabilitation: development, implementation and outcome evaluation in patients with coronary artery diseases in Lahore, Pakistan - a mixed-methods study protocol.
BMJ Open2023 Jun;13(6):e073673. doi: 10.1136/bmjopen-2023-073673.
Yaqoob Adnan, Barolia Rubina, Ladak Laila, Hanif Asif, Khan Aamir Hameed, Sahar Wajeeha,
Abstract
INTRODUCTION:
Cardiac rehabilitation (CR) is an important strategy to bring cardiac patients back to a normal life after a cardiac event. The benefits of CR as part of secondary prevention are widely known among people who have undergone myocardial infarction or revascularisation. As evidenced by several systematic reviews and meta-analyses, home-based CR (HBCR) has similar or greater effects on health-related quality of life, health outcomes, physical activity, anxiety and unplanned visits to the emergency department as compared with centre-based CR. The purpose of this study is to develop a contextual HBCR intervention and evaluate its effects on quality of life, health behaviours, bio-physiological parameters and emergency hospital visits of patients with coronary artery diseases in Lahore, Pakistan.
METHODS AND ANALYSIS:
This study will employ a mixed-method exploratory sequential research design. The researchers will invite 15-20 cardiac patients and 12-15 healthcare providers for semi-structured interviews in the qualitative phase of the study. Once the intervention is developed and validated through the qualitative phase, the outcomes will be evaluated through a single-blinded randomised control trial in the quantitative phase. A total of 118 patients with acute coronary syndrome will be recruited through a screening checklist and randomly allocated into the control and intervention groups (59 patients in each group). The inductive coding approach will be used for the thematic analysis of qualitative data, whereas the quantitative data will be analysed through descriptive and inferential statistics using SPSS to see the difference within the groups, between groups and between three intervals.
ETHICS AND DISSEMINATION:
The Ethical Review Committee of Aga Khan University and Mayo Hospital Lahore under the registration number 2023-8282-24191 and No/75749MH have approved this study protocol, respectively. The results of this study will be disseminated to participating patients (in the Urdu language), healthcare professionals and the public by publishing the manuscript in an open-access peer-reviewed journal and presenting it at different conferences.
TRIAL REGISTRATION NUMBER:
Australian New Zealand Clinical Trial Registry (ACTRN12623000049673p).
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
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The pathophysiology of cognitive impairment in individuals with heart failure: a systematic review.
Front Cardiovasc Med2023 ;10():1181979. doi: 1181979.
Ni Reine Sam Shi, Mohamed Raffi Hanis Qarissa, Dong Yanhong,
Abstract
INTRODUCTION:
Heart Failure and Cognitive Impairment are both on the rise and shown to be interlinked. Despite existing reviews delineating a relationship between heart failure and cognitive impairment, the underlying pathophysiology is not researched in great depth. Current literature proposed varying pathophysiological mechanisms and focused heavily on the prevalence of cognitive impairment and treatment interventions such as cardiac rehabilitation. In view of the limitations of previous reviews, this systematic review summarized the best existing evidence concerning different pathophysiological mechanisms behind cognitive impairment in individuals with heart failure.
METHODS:
Eight electronic databases including PubMed, Cochrane Library and EMBASE etc., two grey literatures (ProQuest Theses and Dissertations and Mednar) and hand-searching of references were performed using specific criteria regarding population, exposures and outcomes, before duplicate removal and screening using Endnote and Rayyan respectively. JBI critical appraisal tools for non-randomized studies were used for appraisal. Data extraction was performed using two modified forms from JBI Manual for Evidence Synthesis.
RESULTS:
Narrative synthesis was performed to summarize the data from 32 studies. There were three main themes-cognitive impairment due to changes in the brain: brain atrophy, alterations in grey matter and white matter, cerebral alterations, pathway or axis changes, neuroinflammation and hippocampal gene changes; cognitive impairment due to changes in the heart or systemic circulation: inflammation, oxidative stress and changes in serum biomarkers or proteins and the riser rhythm; cognitive impairment due to changes in both the brain and the heart, with seven studies obtaining negative results. There are some limitations such as having non-human studies and large numbers of cross-sectional studies etc.
DISCUSSION:
Considering the findings, future research should examine the bi-directional relationship between the brain and the heart as most of the existing research is about the effect of the heart on the brain. By understanding the different pathophysiological mechanisms, the management and prognosis of heart failure patients will be ameliorated. Interventions that slow down or even reverse cognitive impairment can be explored so that these two common issues will not add to the already aggravating disease burden.
SYSTEMATIC REVIEW REGISTRATION:
This review is registered under PROSPERO. Identifier: CRD42022381359.
© 2023 Sam, Mohamed Raffi and Dong.
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Virtual Reality and Cardiac Diseases: A Systematic Review of Applications and Effects.
J Healthc Eng2023 ;2023():8171057. doi: 8171057.
Bouraghi Hamid, Mohammadpour Ali, Khodaveisi Taleb, Ghazisaeedi Marjan, Saeedi Soheila, Familgarosian Sahar,
Abstract
INTRODUCTION:
Cardiac diseases have grown significantly in recent years, causing many deaths globally. Cardiac diseases can impose a significant economic burden on societies. The development of virtual reality technology has attracted the attention of many researchers in recent years. This study aimed to investigate the applications and effects of virtual reality (VR) technology on cardiac diseases.
METHODS:
A comprehensive search was carried out in four databases, including Scopus, Medline (through PubMed), Web of Science, and IEEE Xplore to identify related articles published until May 25, 2022. Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guideline for systematic reviews was followed. All randomized trials that investigated the effects of virtual reality on cardiac diseases were included in this systematic review.
RESULTS:
Twenty-six studies were included in this systematic review. The results illustrated that virtual reality applications in cardiac diseases can be classified in three categories of physical rehabilitation, psychological rehabilitation, and education/training. This study revealed that the use of virtual reality in psychological and physical rehabilitation can reduce stress, emotional tension, Hospital Anxiety and Depression Scale (HADS) total score, anxiety, depression, pain, systolic blood pressure, and length of hospitalization. Finally, the use of virtual reality in education/training can enhance technical performance, increase the speed of procedures, and improve the user's skills, level of knowledge, and self-confidence as well as facilitate learning. Also, the most limitations mentioned in the studies included small sample size and lack of or short duration of follow-up.
CONCLUSIONS:
The results showed that the positive effects of using virtual reality in cardiac diseases are much more than its negative effects. Considering that the most limitations mentioned in the studies were the small sample size and short duration of follow-up, it is necessary to conduct studies with adequate methodological quality to report their effects in the short term and long term.
Copyright © 2023 Hamid Bouraghi et al.
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TMEM11 regulates cardiomyocyte proliferation and cardiac repair via METTL1-mediated mG methylation of ATF5 mRNA.
Cell Death Differ2023 Jun;():. doi: 10.1038/s41418-023-01179-0.
Chen Xin-Zhe, Li Xin-Min, Xu Shi-Jun, Hu Shen, Wang Tao, Li Rui-Feng, Liu Cui-Yun, Xue Jun-Qiang, Zhou Lu-Yu, Wang Yun-Hong, Li Pei-Feng, Wang Kun,
Abstract
The mitochondrial transmembrane (TMEM) protein family has several essential physiological functions. However, its roles in cardiomyocyte proliferation and cardiac regeneration remain unclear. Here, we detected that TMEM11 inhibits cardiomyocyte proliferation and cardiac regeneration in vitro. TMEM11 deletion enhanced cardiomyocyte proliferation and restored heart function after myocardial injury. In contrast, TMEM11-overexpression inhibited neonatal cardiomyocyte proliferation and regeneration in mouse hearts. TMEM11 directly interacted with METTL1 and enhanced mG methylation of Atf5 mRNA, thereby increasing ATF5 expression. A TMEM11-dependent increase in ATF5 promoted the transcription of Inca1, an inhibitor of cyclin-dependent kinase interacting with cyclin A1, which suppressed cardiomyocyte proliferation. Hence, our findings revealed that TMEM11-mediated mG methylation is involved in the regulation of cardiomyocyte proliferation, and targeting the TMEM11-METTL1-ATF5-INCA1 axis may serve as a novel therapeutic strategy for promoting cardiac repair and regeneration.
© 2023. The Author(s).
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Feasibility of Aerobic Exercise Training to Mitigate Cardiotoxicity of Breast Cancer Therapy: A Systematic Review and Meta-Analysis.
Clin Breast Cancer2023 May;():. doi: S1526-8209(23)00094-0.
Tsai Yu-Lin, Chuang Ya-Chi, Chen Carl Pc, Lee Yu-Chun, Cheng Yuan-Yang, Ou-Yang Liang-Jun,
Abstract
BACKGROUND:
Current anticancer treatments for breast cancer (BC) may cause cardiotoxicity. This study aimed to investigate the effectiveness of aerobic exercise in mitigating cardiotoxicity caused by BC therapy.
MATERIALS AND METHODS:
PubMed, Embase, Cochrane Library, Web of Science, and the Physiotherapy Evidence Database were searched until February 7, 2023. Clinical trials investigating the effectiveness of exercise training, including aerobic exercise, in BC patients receiving treatments that could cause cardiotoxicity were eligible. Outcome measures included cardiorespiratory fitness (CRF) (peak oxygen consumption, VOpeak), left ventricular ejection fraction, and peak oxygen pulse. Intergroup differences were determined by standard mean differences (SMD) and 95% confidence intervals (CIs). Trial sequential analysis (TSA) was utilized to ensure whether the current evidence was conclusive.
RESULTS:
Sixteen trials involving 876 participants were included. Aerobic exercise significantly improved CRF measured by VOpeak in mL/kg/min (SMD 1.79, 95% CI 0.99-2.59) when compared to usual care. This result was confirmed through TSA. Subgroup analyses revealed that aerobic exercise given during BC therapy significantly improved VOpeak (SMD 1.84, 95% CI 0.74-2.94). Exercise prescriptions at a frequency of up to 3 times per week, an intensity of moderate to vigorous, and a >30-minute session length also improved VOpeak.
CONCLUSION:
Aerobic exercise is effective in improving CRF when compared to usual care. Exercise performed up to 3 times per week, at a moderate-to-vigorous intensity, and having a session length >30 minutes is considered effective. Future high-quality research is needed to determine the effectiveness of exercise intervention in preventing cardiotoxicity caused by BC therapy.
Copyright © 2023 Elsevier Inc. All rights reserved.
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Effects of high intensity interval-based inspiratory muscle training in patients with heart failure: A single-blind randomized controlled trial.
Heart Lung2023 Jun;62():1-8. doi: 10.1016/j.hrtlng.2023.05.011.
Tanriverdi Aylin, Savci Sema, Ozcan Kahraman Buse, Odaman Huseyin, Ozpelit Ebru, Senturk Bihter, Ozsoy Ismail, Baran Agah, Akdeniz Bahri, Acar Serap, Balci Ali,
Abstract
BACKGROUND:
Given the promising effects of inspiratory muscle training (IMT), determining the most appropriate IMT protocol will optimize the training benefits.
OBJECTIVES:
The objective of this study was to determine the effects of high intensity interval-based inspiratory muscle training (H-IMT) on cardiovascular, pulmonary, physical, and psychosocial functions in patients with heart failure and reduced ejection fraction (HFrEF).
METHODS:
Thirty-four patients with HFrEF were randomly assigned to the H-IMT or control group for 3 days/week, 8 weeks training period. The H-IMT group performed IMT at least 70% of the maximal inspiratory pressure, whereas the control group performed unloaded IMT. Each session occurred 7 sets with a total of 21 min consisting of 2-min training and 1-min interval. Heart rate variability (HRV), arterial stiffness, respiratory muscle strength and endurance, diaphragm thickness, quadriceps strength, functional capacity, frailty, dyspnea, fatigue, disease-specific health-related quality of life (HRQoL), and generic HRQoL were evaluated at baseline and after 8 weeks training period by blinded assessors.
RESULTS:
Statistically significant between-group differences were observed in the time domain parameters of HRV, arterial stiffness, inspiratory and quadriceps muscle strength, respiratory muscle endurance, diaphragm thickness, functional capacity, frailty, dyspnea, fatigue, and disease-specific HRQoL in favor of the H-IMT group (p
CONCLUSIONS:
H-IMT is an effective protocol for improving cardiac autonomic function, arterial stiffness, inspiratory and quadriceps muscle strength, respiratory muscle endurance, diaphragm thickness, functional capacity, frailty, dyspnea, fatigue, and disease-specific quality of life in patients with HFrEF.
CLINICAL TRIAL REGISTRATION:
NCT04839211.
Copyright © 2023 Elsevier Inc. All rights reserved.
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A Mobile Health Behavior Change Intervention for Women With Coronary Heart Disease: A RANDOMIZED CONTROLLED PILOT STUDY.
J Cardiopulm Rehabil Prev2023 Jun;():. doi: 10.1097/HCR.0000000000000804.
Beckie Theresa M, Sengupta Avijit, Dey Arup Kanti, Dutta Kaushik, Ji Ming, Chellappan Sriram,
Abstract
PURPOSE:
The aim of this study was to evaluate the effects of a mobile health (mHealth) intervention, HerBeat, compared with educational usual care (E-UC) for improving exercise capacity (EC) and other patient-reported outcomes at 3 mo among women with coronary heart disease.
METHODS:
Women were randomized to the HerBeat group (n = 23), a behavior change mHealth intervention with a smartphone, smartwatch, and health coach or to the E-UC group (n = 24) who received a standardized cardiac rehabilitation workbook. The primary endpoint was EC measured with the 6-min walk test (6MWT). Secondary outcomes included cardiovascular disease risk factors and psychosocial well-being.
RESULTS:
A total of 47 women (age 61.2 ± 9.1 yr) underwent randomization. The HerBeat group significantly improved on the 6MWT from baseline to 3 mo (P = .016, d = .558) while the E-UC group did not (P = .894, d =-0.030). The between-group difference of 38 m at 3 mo was not statistically significant. From baseline to 3 mo, the HerBeat group improved in anxiety (P = .021), eating habits confidence (P = .028), self-efficacy for managing chronic disease (P = .001), diastolic blood pressure (P = .03), general health perceptions (P = .047), perceived bodily pain (P = .02), and waist circumference (P = .008) while the E-UC group showed no improvement on any outcomes.
CONCLUSIONS:
The mHealth intervention led to improvements in EC and several secondary outcomes from baseline to 3 mo while the E-UC intervention did not. A larger study is required to detect small differences between groups. The implementation and outcomes evaluation of the HerBeat intervention was feasible and acceptable with minimal attrition.
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
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A pref-1-controlled non-inflammatory mechanism of insulin resistance.
iScience2023 Jun;26(6):106923. doi: 106923.
Huang Yiheng, Cui Donghong, Chen Liujun, Tong Haibin, Wu Hong, Muller Grace K, Qi Yadan, Wang Shuxia, Xu Jinjie, Gao Xiang, Fifield Kathleen E, Wang Lingyan, Xia Zhengyuan, Vanderluit Jacqueline L, Liu Suixin, Leng Lin, Sun Guang, McGuire John, Young Lawrence H, Bucala Richard, Qi Dake,
Abstract
While insulin resistance (IR) is associated with inflammation in white adipose tissue, we report a non-inflammatory adipose mechanism of high fat-induced IR mediated by loss of Pref-1. Pref-1, released from adipose Pref-1+ cells with characteristics of M2 macrophages, endothelial cells or progenitors, inhibits MIF release from both Pref-1+ cells and adipocytes by binding with integrin ?1 and inhibiting the mobilization of p115. High palmitic acid induces PAR2 expression in Pref-1+ cells, downregulating Pref-1 expression and release in an AMPK-dependent manner. The loss of Pref-1 increases adipose MIF secretion contributing to non-inflammatory IR in obesity. Treatment with Pref-1 blunts the increase in circulating plasma MIF levels and subsequent IR induced by a high palmitic acid diet. Thus, high levels of fatty acids suppress Pref-1 expression and secretion, through increased activation of PAR2, resulting in an increase in MIF secretion and a non-inflammatory adipose mechanism of IR.
© 2023 The Authors.
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Effects of Exercise Training on Cognitive Function in Individuals with Heart Failure: A Meta-Analysis.
Phys Ther2023 Mar;():. doi: pzad027.
Peng Jing-Ya, Chen Yung-Hsin, Yen Ju-Hsin, Huang Wei-Ming, Chen Chiao-Nan,
Abstract
OBJECTIVE:
Cognitive function is critical for disease self-management; however, it is poorer in individuals with heart failure (HF) than in age-matched people who are healthy. Aging and disease progression collectively threaten the cognitive function of individuals with HF. Exercise has been shown to improve the mobility and mortality risk factors of this population, but the effects of exercise on the cognitive function of individuals with HF are unclear. This meta-analysis aimed to examine these potential effects.
METHODS:
A systematic literature search was conducted in PubMed, MEDLINE, CINAHL, Cochrane Library, PEDro, and ClinicalKey on literature published until January 2022. Studies examining the effects of exercise training on cognitive function in individuals with HF were included. Characteristics of participants and details of interventions were extracted. Effects of exercise training on global cognitive function, attention, and executive function were analyzed using the Comprehensive Meta-Analysis software.
RESULTS:
Six studies were included. Individuals with chronic HF were examined in most studies. The average ejection fraction of participants was 23% to 46%. Aerobic exercise was used in most studies. All included studies had exercise frequency of 2 to 3 times per week and a duration of 30 to 60 minutes per session for 12 to 18 weeks. Compared with the control group, exercise training benefited the global cognitive function of individuals with HF and cognitive impairments (standardized mean difference?=?0.44; 95% CI?=?0.01 to 0.87). The attention of individuals with HF improved after exercise training compared to that before the intervention.
CONCLUSION:
Exercise may improve cognitive function in individuals with HF and cognitive impairments. However, due to large heterogeneity in the study design, more studies are needed to support clinical application.
IMPACT:
These findings should raise clinicians' awareness about the role of exercise on the cognitive function of individuals with HF, in addition to benefits in physical domains.
© The Author(s) 2023. Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.
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An unusual presentation of invasive Fusarium aortitis in an immunocompromised patient: a case report.
Int J Infect Dis2023 Jun;():. doi: S1201-9712(23)00619-7.
Furaijat Ghefar, Bettac Lucas, Kächele Martin, Grüner Beate, Skrabal Christian, Barth Thomas F E, Parlak Melih, Hagemann Juergen Benjamin, Peters Lynn, Walther Grit, Kersten Johannes,
Abstract
Fusarium (F.) species are ubiquitous filamentous fungi that may cause various opportunistic infections, especially in immunocompromised patients. A rare manifestation of disseminated fusariosis affects the aortic valve and results in invasive aortitis, which poses a significant challenge for clinicians in diagnosis and treatment. Here, we report a case of a 54-year-old immunocompromised patient presenting initially with Fusarium keratitis and chorioretinitis in both eyes and a new endovascular aortic mass. PET/CT was performed, suggesting aortitis. Transoesophageal echocardiography and ECG-guided CT-angiography confirmed a large intraluminal mass in the ascending aorta. The aortic mass and a part of the ascending aorta were resected surgically, and a filamentous fungus with the microscopic features of the genus Fusarium was isolated from and later identified molecularly as F. petroliphilum. The course of treatment was complicated due to perioperative cerebral embolization and mesenteric ischemia. These complications could be attributed to preoperatively existing occlusion of the superior and inferior mesenteric artery and subtotal stenosis of the celiac trunk. This case report describes a rare manifestation of disseminated fusariosis, frequently characterized by protracted clinical courses with poor prognosis. Fusariosis may manifest at different sites at different times or persist as a long-lasting disease with reactivation. This case highlights the importance of the interdisciplinary approach for effectively treating invasive mycoses.
Copyright © 2023. Published by Elsevier Ltd.
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Measurement properties of utility-based health-related quality of life measures in cardiac rehabilitation: a systematic review protocol.
JBI Evid Synth2023 Jun;():. doi: 10.11124/JBIES-22-00347.
Bulamu Norma B, Hines Sonia, Gebremichael Lemlem G, Mpundu-Kaambwa Christine, Pinero de Plaza Maria Alejandra, Dafny Hila A, Beleigoli Alline, Kaambwa Billingsley, Hendriks Jeroen M, Clark Robyn A,
Abstract
OBJECTIVE:
This review will identify and appraise existing evidence on the measurement properties of utility-based health-related quality of life (HRQoL) measures used in cardiac rehabilitation programs. The review will then map the measure domains against the International Classification of Functioning, Disability and Health and the International Consortium of Health Outcome Measures domains for cardiovascular disease.
INTRODUCTION:
Improving HRQoL is an international key indicator for delivering high-quality and person-centered secondary prevention programs. Many instruments and measures assess HRQoL in individuals undergoing cardiac rehabilitation. Utility-based measures are suitable for calculating quality-adjusted life years, a required outcome metric in cost-utility analysis. Cost-utility analysis requires the use of utility-based HRQoL measures. However, there is no consensus on which utility-based measure is best for populations undergoing cardiac rehabilitation.
INCLUSION CRITERIA:
Eligible studies will include patients aged ? 18 years with cardiovascular disease who are undergoing cardiac rehabilitation. Empirical studies that assess quality of life or HRQoL using a utility-based, health-related, patient-reported outcome measure or a measure accompanied by health state utilities will be eligible. Studies must report at least 1 of the following measurement properties: reliability, validity, responsiveness.
METHODS:
This review will follow the JBI methodology for systematic reviews of measurement properties. The following databases will be searched from inception to the present: MEDLINE, Emcare, Embase, Scopus, CINAHL, Web of Science Core Collection, Informit, PsyclNFO, REHABDATA, and the Cochrane Library. Studies will be critically appraised using the COSMIN risk of bias checklist. The review will be reported in line with the PRISMA guidelines.
SYSTEMATIC REVIEW REGISTRATION NUMBER:
PROSPERO CRD42022349395.
Copyright © 2023 JBI.
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COVID-19-specific adult basic life support guideline strategies for chiropractors and other healthcare providers to maximize the safety and efficacy of resuscitation: a commentary.
Chiropr Man Therap2023 Jun;31(1):16. doi: 16.
Woo Chun-Cheung,
Abstract
BACKGROUND:
The emergence of an unprecedented novel severe acute respiratory syndrome coronavirus-2 (SARS-C0V-2), which causes the coronavirus disease 2019 (COVID-19) pandemic, has created new scenarios in basic life support (BLS) management. According to current evidence, SARS-CoV-2 can be transmitted airborne in aerosol particles during resuscitation. Research evidence found an alarming global increase in out-of-hospital cardiac arrests during the COVID-19 pandemic. Healthcare providers are legally obliged to respond to cardiac arrest as soon as possible. Chiropractors will likely encounter potential exercise-related and non-exercise-related cardiac emergencies at some point in their professional lives. They have a duty of care to respond to emergencies such as cardiac arrest. Chiropractors are increasingly involved in providing care, including emergency care, for athletes and spectators at sporting events. Also, exercise-related cardiac arrest in adult patients may occur during exercise testing or rehabilitation with exercise prescriptions in chiropractic and other healthcare settings. Little is known about the COVID-19 BLS guidelines for chiropractors. Knowledge of the current COVID-19-specific adult BLS guidelines is essential to developing an emergency response plan for the on-field and sideline management of exercise-related cardiac arrest and non-athletic, non-exercise-related cardiac arrest.
MAIN TEXT:
Seven peer-reviewed articles on the COVID-19-specific BLS guidelines, including two updates, were reviewed for this commentary. Responding to the COVID-19 pandemic, the national and international resuscitation organizations recommended interim COVID-19-specific BLS guidelines with precaution, resuscitation, and education strategies. BLS safety is paramount. A precautionary approach with the bare minimum of appropriate personal protective equipment for resuscitation is recommended. There was disagreement among the COVID-19 BLS guidelines on the level of personal protective equipment. All healthcare professionals should also undergo self-directed BLS e-learning and virtual skill e-training. The summarized COVID-19-specific adult BLS guideline strategies and protocols are tabled, respectively.
CONCLUSIONS:
This commentary provides a practical overview and highlights current evidence-based intervention strategies of the COVID-19-specific adult BLS guidelines that may help chiropractors and other healthcare providers reduce BLS-related exposures to SARS-CoV-2 and the risks of SARS-CoV-2 transmission and maximize the efficacy of resuscitation. This study is relevant to and impacts future COVID-19-related research in areas such as infection prevention and control.
© 2023. The Author(s).
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Post Event-Cardiovascular Risk Perception Survey: Validity and Reliability in Cardiac Patients Post Heart Event.
J Nurs Meas2023 Jun;():. doi: JNM-2021-0027.R1.
Prue-Owens Kathy, Lindsay Keston, Graham Helen, Ramesh Mythreyi, Justus Dana, Loy Kelsey, Harding-Isidore Annmarie, Angeles Evelyn, Faulkender Melanie, Sublett Karen, Asakura Yuki,
Abstract
Cardiac risk perception in patients who had a heart event is unknown. Evaluate the validity and reliability of the Post Event-Cardiovascular Risk Perception Survey (PE-CRPS). This is a descriptive, cross-sectional study with a convenient sample of 251 patients who experienced a heart event. Descriptive and exploratory factor analyses was used to analyze the data. Nine of ten items with an oblique (direct oblimin) rotation resulted in two factors extracted, which explained 54% of the variance. The two factors represented perception of medical history variable and a stress/family history variable. Cronbach's ? reliability analyses indicated both factors were reliable; strongly related with a correlation of .69 and .81. Cardiovascular risk perception explained by two factors.
© Copyright 2023 Springer Publishing Company, LLC.
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The effectiveness of blood flow restriction training in cardiovascular disease patients: A scoping review.
J Frailty Sarcopenia Falls2023 Jun;8(2):107-117. doi: 10.22540/JFSF-08-107.
Angelopoulos Pavlos, Tsekoura Maria, Mylonas Konstantinos, Tsigkas Grigorios, Billis Evdokia, Tsepis Elias, Fousekis Konstantinos,
Abstract
Therapeutic exercise is integral to the comprehensive rehabilitation of patients with cardiovascular disease and, as such, is recommended by the American Heart Association as a valuable and effective treatment method for such patients. The type of exercise applied to these patients is aerobic and resistance exercise with mild intensities and loads to avoid overloading the cardiovascular system. Blood flow restriction exercise is a novel exercise modality in clinical settings that has in many studies a similar effect on muscle hypertrophy, strength, and cardiovascular response to training at a 70% strength level without blood flow restriction. Since this exercise mode does not require high-intensity loads, it can be a safe method for improving muscle strength, cardiovascular endurance, and functionality in cardiovascular patients. Given that, the objective of this review is to assess and summarize existing evidence for the use of blood flow restriction in cardiovascular patients. A scoping review of existing clinical trials was conducted. Eleven studies were examined that suggested the use of blood flow restrictions in cardiovascular patients to achieve improvements in muscle strength, functionality, and cardiovascular parameters such as blood pressure decrease.
Copyright: © 2023 Hylonome Publications.
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The effect of curcumin on anthropometric indices, blood pressure, lipid profiles, fasting blood glucose, liver enzymes, fibrosis, and steatosis in non-alcoholic fatty livers.
Front Nutr2023 ;10():1163950. doi: 1163950.
Safari Zahra, Bagherniya Mohammad, Khoram Ziba, Ebrahimi Varzaneh Amrollah, Heidari Zahra, Sahebkar Amirhossein, Askari Gholamreza,
Abstract
BACKGROUND:
Non-alcoholic fatty liver disease (NAFLD) is the most common form of liver disease. Curcumin is a natural polyphenol that may be effective against liver steatosis and steatohepatitis. The present study aimed to evaluate the effects of phytosomal curcumin on lipid profile, fasting blood sugar, anthropometric indices, liver enzymes, fibrosis, and steatosis in non-alcoholic fatty liver patients.
METHODS:
The participants were randomized to the curcumin-phosphatidylserine phytosomal receiving group and the placebo receiving group and were followed up for 12 weeks. Data on anthropometric indices, lipid profile, blood glucose, blood pressure, liver enzymes, hepatic steatosis, and fibrosis were collected at the beginning and the end of the clinical trial.
RESULTS:
Supplementation for 12 weeks with phytosomal curcumin significantly reduced fibrosis and steatosis in the phytosomal curcumin receiving group compared with the placebo group (
CONCLUSION:
Curcumin, at a dose of 250 mg per day, might be effective in treating patients with NAFLD. Further studies are necessary to confirm these findings and to discover the underlying mechanisms.
CLINICAL TRIAL REGISTRATION:
https://www.irct.ir/trial/43730, identifier: IRCT20121216011763N39.
Copyright © 2023 Safari, Bagherniya, Khoram, Ebrahimi Varzaneh, Heidari, Sahebkar and Askari.
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Head cooling wrap could suppress the elevation of core temperature after cardiac surgery during forced-air warming in a pediatric intensive care unit: a randomized clinical trial.
J Anesth2023 Jun;():. doi: 10.1007/s00540-023-03210-7.
Sakai Wataru, Chaki Tomohiro, Nawa Yuko, Oyasu Takayoshi, Ichisaka Yuki, Nawa Tomohiro, Asai Hidetsugu, Ebuoka Noriyoshi, Oba Junichi, Yamakage Michiaki,
Abstract
PURPOSE:
The main aim of the current trial was to explore our hypothesis that cooling head wraps lower the core temperature more effectively than ice packs on the head during forced-air warming after pediatric cardiac surgeries.
METHODS:
This study was a single-center Randomized Controlled Trial. Participants were children with a weight???10 kg and hyperthermia during forced-air warming after cardiac surgeries. When the core temperature reached 37.5 °C, ice packs on the head (group C) or a cooling head wrap (group H) were used as cooling devices to decrease the core temperature. The primary outcome was the core temperature. The secondary outcomes were the foot surface temperature and heart rate. We measured all outcomes every 30 min for 240 min after the patient developed hyperthermia. We conducted two-way ANOVA as a pre-planned analysis and also the Bonferroni test as a post hoc analysis.
RESULTS:
Twenty patients were randomly assigned to groups C and H. The series of core temperatures in group H were significantly lower than those in group C (p?0.0001), and post hoc analysis showed that there was no significant difference in core temperatures at T0 between the two groups and statistically significant differences in all core temperatures at T30-240 between the two groups. There was no difference between the two groups' surface temperatures and heart rates.
CONCLUSIONS:
Compared to ice packs on the head, head cooling wraps more effectively suppress core temperature elevation during forced-air warming after pediatric cardiac surgery.
© 2023. The Author(s) under exclusive licence to Japanese Society of Anesthesiologists.
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