bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiac rehabilitation is associated with lower 1-year all-cause mortality in primary pulmonary hypertension
Authors: Kleinnibbelink G , Buckley BJR , Harrison SL , Williams N , Fazio-Eynullayeya E , Underhill P , Van Dijk APJ , Lip GYH , Thijssen DHJ 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background. Despite introduction of pharmacological therapies to improve outcomes of pulmonary hypertension (PH), poor long-term survival remains present. Cardiac rehabilitation may be an alternative strategy to improve survival. However, no study directly linked CR to mortality in PH patients. Therefore, adopting a retrospective observational study using a large electronic medical record (EMR) database, the objective of this study was to compare mortality between patients with primary PH with CR versus a propensity-matched control group of PH without CR.
Methods. The retrospective analysis was conducted on December 14, 2020 using anonymized data within TriNetX, a global federated health research network with access to EMRs from participating academic medical centres, specialty physician practices, and community hospitals, predominantly in the United States. All patients were aged ≥18 years with primary PH recorded in EMRs at least 18-months before the search date to allow for 1-year follow-up from CR. Using logistic regression, patients with PH with an EMR of CR were 1:1 propensity score-matched with PH patients without CR for age, sex, race, diseases of the respiratory system, disease of the circulatory system, hypertensive disease, heart failure, diabetes mellitus, chronic kidney disease, cerebrovascular disease, cardiovascular procedures and cardiovascular medications.
Results. In total, 70,875 patients with primary PH met the inclusion criteria for the control group and 637 patients with primary PH met the inclusion criteria for the CR and exercise cohort (Table 1). Using the propensity score-matched cohort, and excluding patients with outcomes outside the measurement window, mortality at 1-year from CR was proportionally lower with mortality of 13.9% (n = 87 of 628 patients) in the CR and exercise cohort compared to 21.0% (n = 133 of 632 patients) in the controls (OR 0.60, 95% CI 0.45-0.81).
Conclusion. In conclusion, the present study of 1,264 patients with primary PH suggests that CR is associated with 40% lower odds of 1-year mortality, when compared to propensity score-matched patients without CR or exercise programmes.
Abstract Figure.
Factors associated with return to work after coronary artery bypass grafting (CABG)
Authors: Raynaldo A 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background.
Postoperative CABG patients will generally experience improvement in symptoms and functional capacity. Post-CABG patients are expected to be productive again in order to have a positive impact on both patient and the society socio-economically, in addition to other parameters such as morbidity, mortality and serious adverse events.

Purpose
to determine the factors that associated with return to work in CABG patients in one General Hospital.

Methods.
We analyzed data from Adam Malik Hospital registry of 68 patients who had undergone CR after coronary artery bypass graft (CABG) in 2017-2020. The outcomes assessed were work status in 6 month after CABG. Patients’ characteristics, sociodemographic, clinical parameters of functional capacity using 6 minutes of walk test (6MWT), T2DM, Hypertension and cholesterol level were assessed. Factors associated with return to work were identified using multivariable logistic regression.

Results
We identified 68 patients undergoing isolated CABG (2017–2020). One year after discharge for CABG, 40 (58.8%) patients had returned to the workforce. Factors associated with return to work were identified using bivariate logistic regression. Diabetes mellitus (odds ratio, 10.192; 95% confidence interval, 0.063–0.515).

Conclusion
Almost 2 from 3 patients after CABG returned to work within 6 months. Diabetes mellitus and functional capacity were associated with a lower likelihood of returning to work.
Anxiety and depression; influence on information needs in patients receiving cardiac rehabilitation
Authors: Tenbult - Van Limpt N , Traa SJC , Brouwers R , Kemps HMC 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Educational interventions on healthy lifestyle and cardiovascular risk factors are important elements of Cardiac Rehabilitation (CR), and may increase patients’ self-efficacy, satisfaction and health-promoting behaviour. However, these interventions are often not tailored to individual needs of patients, thereby reducing their effectiveness. In order to tailor educational interventions to individuals, it"s important to identify determinants of information needs. Depression and anxiety are highly prevalent in cardiac patients and negatively influence prognosis. Additionally, depression and anxiety may prevent people from seeking information due to lack of initiative and withdrawal from social situations. Little is known on information needs for anxious and depressed patients entering CR. This study evaluated the influence of anxiety and depression on information needs of patients entering CR.

Methods
Prospective observational study. Patients were asked to complete questionnaires on anxiety and depression and on information needs and information seeking behaviour before start of CR. Primary endpoint was the association between information needs and risk of anxiety and depression.

Results
We included 259 patients, predominantly male (76%), mean age 64.8 ± 10.4 year. Two thirds of patients were diagnosed with MI (68%), 163 patients underwent PCI (63%), 71 patients underwent CABG (27%) and 22 patients were treated by medication only (9%). At baseline 19 patients were current smokers (8%). Patients with moderate to high risk of anxiety or depression more often had questions on mood than patients with low risk of anxiety and depression. Patients with moderate to high anxiety risk also more often had questions on nutrition than low risk patients.

Discussion
In patients entering CR, moderate to high risk of anxiety and depression was associated with higher degree of information needs on mood than their low risk counterparts. This indicates that CR programme and educational interventions should be more specifically tailored to patients’ information needs, taking into account anxiety and depression risk.
Information needs before start CR Anxiety risk Depression risk Low (HADS score 0-7) Moderate to high (HADS score 8-21) p-value Low (HADS score 0-7) Moderate to high (HADS score 8-21) p-value Questions on physical activity 71 (37%) 25 (44%) 0.34 78 (38%) 17 (39%) 0.96 Questions on nutrition 49 (26%) 26 (45%) 0.02 57 (28%) 18 (40%) 0.28 Questions on mood 29 (15%) 37 (65%) &lt;0.001 43 (21%) 23 (52%) &lt;0.001 Questions on smoking 3 (23%) 4 (50%) 0.35 5 (33%) 2 (33%) 1.00
Neuromuscular electrical stimulation in early rehabilitation of patients with postoperative complications after cardiovascular surgery
Authors: Oleinik P , Sumin AN , Bezdenezhnykh AV 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): Federal State Budgetary Scientific Institution Research Institute for Complex Issues of Cardiovascular Diseases

Introduction
The purpose was to evaluate the effectiveness of NMES in patients with complications after cardiac surgery.

Methods
This study was 37 patients who had significant postoperative complications after cardiovascular surgery. Participants were randomly - NMES group, n = 18; control, n = 19. It was not possible to blind the investigator. Analyzed basic clinical data. The dynamometry of the muscles upper and lower extremities was carried out, as well as a 6-minute walk test (6MWT). Also, the thickness of the quadriceps was measured using ultrasound.The patients underwent NMES on the quadriceps femoris muscle, daily from the third postoperative day, until discharge. The duration session was 90 minutes.
Outcomes
No differences were found in the baseline characteristics of the groups, including the results of laboratory and instrumental studies. Groups were comparable in the surgery and perioperative parameteres. The initial strength indicators also had no significant differences in the groups.
At discharge knee extensors strength (KES) was significantly higher in the NMES group. The knee flexor strength (KFS) and handgrip strength (HF) increased the same in both groups. The quadriceps crosssectional area (CSA) muscle increased more in the NEMS group than in the control to the time of discharge. Average KES increased to a greater extent in the NMES group. At the same time, average and maximum KFS increased equally in both groups. A 6MWT before discharge did not show a difference between groups (P=.166). The NMES course did not affect the duration of hospitalisation (P=.429).

Discussion
This pilot study show beneficial effects of NMES on muscle strength in patients with complications after cardiovascular surgery.
Physical tests initially and in dynamics NEMS Group (n = 18) Control group (n = 19) Baseline Discharge Baseline Discharge P-level Right knee extensors strength (kg) 20,3 [17,9; 26,1] 28,05 [23,8; 36,2] * 20,1 [18,6; 25,4] 22,3 [20,1; 27,1] * 0,004 Left knee extensors strength (kg) 17,75 [15,5; 27,0] 27,45 [22,3; 33,1] * 20,8 [17,5; 24,2] 22,5 [20,1; 25,9] * 0,017 Right knee flexors strength (kg) 14,85 [11,7; 19,5] 17,5 [14,1; 23,4] * 16,9 [13,1; 23,8] 19,2 [12,5; 26,4] * 0,971 Left knee flexors strength (kg) 14,7 [12,6; 19,6] 19,75 [15,9; 24,2] * 16,2, [10,4; 25,1] 18,8 [13,1; 27,7] * 0,889 6-MWT (m) 148,5 [108,5; 174,0] 288,0 [242,0; 319,0] * 169,0 [115,0; 217,0] 315,0 [277,0; 400,0] * 0,166 Right handgrip strength (kg) 24,5 [15,0; 33,0] 25,5 [19,0; 36,0] * 27,0 [18,0; 32,0] 30,0 [20,0; 35,0] * 0,795 Left handgrip strength (kg) 17,0 [12,0; 27,0] 21,0 [15,0; 31,0] * 19,0 [14,0; 29,0] 23,0 [16,0; 30,0] * 0,541 * - p-level from baseline data &lt; 0,05 ** - p-level from baseline data ≥ 0,05
Effects of the use neuromuscular electrical stimulation of the lower extremities in the prehabilitation of patients in a before cardiac surgery
Authors: Oleinik P , Sumin AN , Bezdenezhnykh AV 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): Research Institute for Complex Issues of Cardiovascular Diseases
Aim
To evaluate the effects of neuromuscular electrostimulation in the prehabilitation and prevention of muscle weakness in patients awaiting cardiac surgery.

Materials and methods
122 patients waiting for elective cardiac surgery were included. Exclusion criteria: age less than 25 and more than 80 years; emergency and urgent surgical interventions; arthropathies; low pain threshold; rhabdomyolysis and other myopathies; cognitive dysfunction. Routine laboratory and instrumental examinations were performed in all patients upon admission to the hospital, as part of a standard examination. 62 patients were randomly selected for the preoperative NMES group, in addition to the standard preoperative preparation and treatment program. The standard program included 60 control patients. Patients of the NMES group underwent quadriceps stimulation for at least 5 sessions, lasting 90 minutes, daily before surgery.

Results.
The groups were comparable and did not have significant differences in gender and age characteristics, according to the main clinical and anamnestic data and types of operations. Initially, there were no differences in the state of the muscles of the lower extremities, the distance of the six-minute walking test (6MWT), and the strength of the hand grip.
After NMES, there was an increase in muscle strength relative to the control group, both stimulated muscle groups and unstimulated antagonist muscles, as well as a greater 6MWT distance and hand compression force. All the differences were significant.

Conclusions
The course of pre-rehabilitation of NMES before surgery, allowed to maintain, and in some cases improve the condition of the muscle frame of the lower extremities. A positive effect was observed not only in stimulated muscle groups, but also in antagonist muscles
Indicators of muscle status NMES (n = 62) Control group (n = 60) Baseline Discharge Baseline Discharge P-level Right knee extensors strength (kg) 24,4 [18,3; 31,4] 30,4 [23,8; 36,2]* 24,7 [20,1; 33,2] 22,25 [18,9; 30,4] &lt;0,001 Left knee extensors strength (kg) 23,8 [19,3; 31,3] 29,2 [23,6; 35,4]* 25,75 [19,2; 31,3] 22,9 [18,9; 27,8] &lt;0,001 Right knee flexors strength (kg) 18,9 [13,3; 24,0] 21,7 [16,6; 25,1] 19,55 [13,1; 26,0] 16,7 [12,1; 23,3] 0,006 Left knee flexors strength (kg) 19,3 [14,3; 24,5] 21,9 [17,3; 26,7] 19,5 [13,0; 24,3] 18,2 [13,4; 22,2] 0,005 6-MWT (m) 300,0 [261,0; 371,0] 331,0 [280,0; 375,0] 304,5 [253,0; 380,0] 285,5 [246,0; 342,0] 0,006 Right handgrip strength (kg) 28,5 [20,5; 34,0] 31,5 [22,0; 34,0] 29,0 [19,0; 34,0] 27,0 [19,0; 33,0] 0,054 Left handgrip strength (kg) 25,0 [18,0; 31,0] 25,0 [18,0; 32,0] 24,0 [15,0; 31,0] 22,0 [14,0; 28,0] 0,062 * - p-level from baseline data &lt; 0,05
Abstract Figure. dynamics of stimulated muscles
Exercise intensity is associated with progression of coronary artery calcification in middle-aged and older athletes: findings from the MARC-2 study
Authors: Aengevaeren V , Mosterd A , Braber TL , Sharma S , Nathoe HM , Velthuis BK , Eijsvogels TMH 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Dutch Heart Foundation
Background
Recent studies have reported increased coronary artery calcification (CAC) in middle-aged male athletes, which is related to the amount and intensity of lifelong exercise. However, previous studies are limited by their cross-sectional study design.
Purpose
We prospectively assessed progression of CAC and its association to exercise volume and intensity in middle-aged and older athletes.
Methods
318 asymptomatic middle-aged and older men were recruited in the Measuring Athlete’s Risk of Cardiovascular events (MARC) study between 2012-2014 and invited for follow-up (MARC-2) between 2019-2020. During both study visits, computed tomography imaging was performed to assess CAC. Exercise characteristics during follow-up were used to calculate exercise volumes (Metabolic equivalent of task [MET]-hours/week), whereas intensities were classified as moderate (3-6 MET), vigorous (6-9 MET) and very vigorous (&gt;9 MET). For linear regression analyses, CAC scores were transformed (Ln delta CAC score + 1) and analyses were adjusted for baseline confounders, CAC at baseline and time between CT scans. Exercise intensities were assessed as proportion of MET-hrs/week and separately included, while adjusting for exercise volume.
Results
We included 289 men (54.9 ± 6.4 years) for MARC-2, with a follow-up of 6.3 ± 0.5 years. Participants exercised for 41 [25-57] MET-hrs/week, of which the median percentage was 0% [interquartile range 0-19] at moderate, 44% [0-84] at vigorous and 34% [0-80] at very vigorous intensity. At baseline, CAC was present in 151 (52%) men, and increased to 205 (71%) men at follow-up. CAC scores increased from 1 [0-32] to 31 [0-132]. Delta CAC score (26 [0-104]) was not associated with overall exercise volume. However, delta CAC score was negatively associated with vigorous intensity exercise and positively associated with very vigorous intensity exercise (Table).
Conclusion
Progression of CAC was not associated with overall exercise volume during 6-year follow-up. However, the degree of vigorous intensity exercise was associated with attenuated CAC progression, whereas very vigorous intensity exercise was associated with accelerated CAC progression.
Linear regression analyses Progression of CAC (Ln Delta CAC score +1) B (95% CI) P-Value Exercise volume (MET-hours/week) .001 (-.005 - .008) .70 Exercise Intensity Moderate intensity (%) -.002 (-.009 - .005) .65 Vigorous intensity (%) -.005 (-.009 - .000) .03 Very vigorous intensity (%) .005 (.001 - .009) .02
Left ventricular remodelling in a large cohort of strength competitive athletes: not so common and differs by sex
Authors: Chumakova O , Isaeva M , Drobyazko O , Alekhin M , Zateyshchikov D 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This research was supported by FMBA of Russia
Background. There are still very limited data about physiological cardiac adaptation in strength athletes.
Purpose. To describe structural and functional features of left ventricular (LV) in a large cohort of healthy strength athletes.
Methods. A total of 673 Caucasian athletes (weight-lifting, males/females = 238/157, and Martial Arts, males/females = 200/78) competing in Russian National and International level events were recruited within 2010-2017. Data of standard 2D echocardiography (Echo) and comprehensive medical history were analyzed. Data are presented as median (IQR) and compared by nonparametric tests (table). To assess LV geometry all athletes were divided into 6 groups according to 4-tiered classification based on mass index, concentricity and end-diastolic volume (EDV) index of LV (Figure).
Results. Both absolute and indexed values of LV structural features were higher in males. Females exhibited higher functional parameters. Only 54 (8%) athletes had elevated LV mass (no sex difference), 23 (3.4%) – LV wall ≥ 12mm (only males) and 78 (11.6%) – changes in LV geometry. There was a prevalence of females in eccentric non-dilated LV hypertrophy (LVH) group (p = 0.088), which was previously accepted as a benign pattern of LV remodelling in non-athlete populations. Males had more often concentric types of LV remodelling (36 of 54 athletes). Among dilated types of LVH, there was a prevalence of males (p = 0.070).
Conclusions. LV remodelling is not common in strength athletes and differs by sex with a more favourable profile in females.
Clinical and Echo parameters Total n = 673 males n = 438 females n = 235 males vs females p-value Age, years 20(4) 20(4) 20(5) 0.06 BSA, m&sup2; 1.84(0.39) 1.96(0.39) 1.66(0.25) &lt;0.001 Sports practice, years 10(6) 10(7) 10(6) 0.12 LV EDD, mm 49(6) 50(5) 46(4) &lt;0.001 LV EDD/(BSA)^0.5 35.8(3) 35.9(3) 35.6(3) 0.017 LV EDV, ml 108(38) 118(32) 92(24) &lt;0.001 LV EDV/(BSA)^1.5 42.8(9) 42.9(10) 42.3(9) 0.14 Maximal LV WT, mm 10(1) 10(2) 9(1) &lt;0.001 LV mass/BSA, g/m&sup2; 86(24) 91(22) 75(16) &lt;0.001 LV Concentricity, g/(ml)^0.67 6.9(1.6) 7.4(1.6) 6.2(1.4) &lt;0.001 LV EF, % 60(5) 60(4) 62(4) &lt;0.001 Mitral E velocity, cm/sec 87(19) 85(19) 89(19) &lt;0.001 BSA - body surface area; EDD - end-diastolic dimension; WT - wall thickness
Abstract Figure. Types of LV geometry in athletes
Cardiovascular risks awareness in coaches and amateur athletes
Authors: Markovich A , Mironova O 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Background
Regular physical activity is an important component of therapy for most сardiovascular diseases and is associated with reduced cardiovascular and all-cause mortality. The promotion of the physical activity and regular exercise is an important preventive measure that affects the prognosis.
Purpose
To assess the awareness of the prevalence of cardiovascular disease in exercising population and its influence on the safety of the patients and healthy adults among coaches and people actively engaged in sports activities.
Methods
An open non-randomized observation was conducted. The questionnaire created by our team included 45 questions about cardiovascular diseases and sport. 111 athletes and coaches aged from 19 to 46 were enrolled in the study. 61,5% (68) are men and 38,5% (42) of the respondents are women.
30,3% (33) of the respondents are coaches. 45,5% (15) of them have over 5 years of coaching experience. 44% (48) of all respondents prefer endurance sport, 25,7% (28) train strength exercise.
63,6% (70) train 3-8 hours per week, 12,7% (14 [7 women and 7 men]) train more than 8 hours each week.
Results
18,5% (20 [6 women and 14 men]) think that ECG is enough for screening for cardiovascular diseases. 20% (4) of them are coaches. Only 69,5% (77) of all respondents know about treadmill test. And 41,6% (32/77) of them know about the necessary screening for arrhythmogenic condition. 13% (10/77) of them train more than 8 hours per week. And only 27,3% (21/77) of people who know about treadmill test, passed it themselves. Also 21,6% (24) of all respondents think that any episode of arrhythmia is the contraindication for any sport. But 96,4% (107) of the respondents know that it is necessary to regularly screen the cardiovascular system, even in the absence of complaints. 9% (10) of the interviewed think that diet is not important for people with cardiovascular diseases. And 18,9% (21) of the respondents don’t know about the effect of electrolytes on the body and the work of the heart muscle. Only 53,2% (59 [21 women and 38 men]) of the respondents trust the doctors more than coaches or themselves. And this is one of the reasons why it is necessary to talk about the basic principles of sports cardiology not only to doctors. 8,1% (9) of the respondents have never heard about any cases of sudden death of an athlete during training or at competitions due to «heart problems». 63,6% (21) of the coaches would not train a person who has suffered a heart attack. 71,8% (56) of the sportsmen would like to return to training after a heart attack.
Conclusions
Despite the fact that most people prefer a sedentary lifestyle, high-intensity fitness and long-distance endurance sport is getting more popular. Our survey proves the relatively low level of education about the underlying health conditions and possible risks associated with sports not only among athletes but professional coaches as well.
There are no conflicts of interest to declare.
Communication based on partnership: experiences of lifestyle counselling by patients and caregivers in primary care
Authors: Loennberg L , Damberg M , Revenas A 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Despite the knowledge of the effect of lifestyle changes in preventing cardiovascular disease, a large proportion of people have unhealthy lifestyle habits. To enhance the care of patients at high cardiovascular risk we started a one-year, structured lifestyle program in primary care.

Purpose
To explore patients´ at high cardiovascular risk and community health nurses´ experiences of lifestyle counselling after participation in a lifestyle program.

Methods
A qualitative explorative design was used to collect data on participants ‘experiences and an inductive content analysis was performed. Sixteen patients (eight men and eight women, aged 51 – 75 years) diagnosed with either type 2 diabetes mellitus or hypertension and three community health nurses were interviewed.

Results
The participants emphasised that lifestyle counselling should be based on partnership where patients and community health nurses collaborates to reach the set treatment and behavioural goals. Five categories describe this partnership; "Collaboration based on respect and mutual interest", "Enable understanding of illness and lifestyle habits", "Measurements and goalsetting are valuable tools", "The value of continuous support" and "Organisation structure should support lifestyle counselling".

Conclusion
Our results indicate that a trustful relationship, increased knowledge on lifestyle habits and how they effect illness, repeated measurements and recurrent support are important for successful lifestyle counselling. Additionally, the organisation of the structured lifestyle counselling needs to be supported by the primary care unit.