bluuebunny/crossref_metadata_2025_split huggingface dataset:
The validity and reliability of the 6 minute stepper test in patients with systemic hypertension
Authors: Karaduz B , Ozcan EB , Sener YZ , Calik Kutukcu E , Jabrayilov J , Saglam M , Vardar Yagli N , Inal Ince D , Yildirim T , Tokgozoglu L 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction and Background
6 Minute Stepper Test (6MST) is a valid, reliable and practical field test that evaluates exercise capacity in chronic conditions. There is a need for evaluating the validity and reliability of 6MST in for using evaluation during cardiac rehabilitation.

Purpose
The aim of this study was to evaluate the validity and reliability of 6MST test in patients with systemic hypertension.

Methods
Forty hypertensive individuals (mean age: 47.55 ± 6.55 years, female/male: 24/16) were included in the study. Demographic and clinical characteristics of patients were recorded and echocardiography was conducted. Functional exercise capacity was evaluated with 6MST and step number during 6MST was recorded. Exercise capacity was tested with the six minutes walk test (6MWT) and used for validity.

Results
Clinical and demographic status of patients were presented in Table-1. According to the test-retest ICC (Intraclass correlation coefficient) analysis for the reliability of 6MST test in hypertensive patients; 6MST test score has very good reliability for single measurements (ICC value = 0.896, p &lt;0.001) and mean measurements (ICC value = 0.945, p &lt;0.001). According to the results of pearson correlation analysis to evaluate the criterion validity of 6MST test; 6MST test score showed a high relationship with 6MWT distance as the criterion test (r = 0.689, p&lt;0.001) in patients with systemic hypertension.

Conclusions
6MST can be used as a valid and reliable test to evaluate exercise capacity in patients with hypertension. Because it is practical, tolerable and safe so it may be a new valid field test in cardiac rehabilitation.
Motivational aspects of the cardiac rehabilitation programme
Authors: Coto Morales B , Del Castillo Carnevalli HA , Marti Sanchez D , Gomez Sanchez MI , Basabe Velasco ME , Rodriguez Biedma MF , Molinos AC , Fuentes Pereiro J , Casanova Lopez MP , Marschall AF , Duarte Torres J , Biscotti Rodil MB , Rodriguez Gamero MA , Rodriguez Torres DJ , Alvarez Anton SA 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction/Background
Cardiac rehabilitation programmes have proven to be effective in many ways in patients with cardiovascular disease. In fact, its implementation has acquired a relevant role in the European Clínical Practice Guidelines. The reasons why the programmes are successful are diverse, including motivating patients to improve their lifestyle. But, what specific aspects keep the patient motivated in the cardiac rehabilitation programme?

Method
An anonymous survey was administered to patients who completed cardiac rehabilitation programme and who were considered by their physicians as successul in terms of lifestyle changes. A 13-question questionnaire was distributes (Table 1) including baseline characteristics. Patients were asked to rate from 1 to 5 (being 5 the highets rating) how important each of thes items had been in terms of motivation.

Results
83 questionnaires correct completed were analyzed. Mean age was 66+/- 12 y.o. and 21 women (25%). The mode of studies level was primary school. Mean Value of Question (Q) 5: 4,56, Q6: 4,07 Q7: 4,55 Q8: 4,64, Q9:4,43 Q10: 3,93 Q11:3,96 Q12: 4,34 Q13:4,16.

Conclusions
Although many items were valued similarly, the most popular items were the trust in the information given by healthcare professionals( Q5) and the importance of feeling better and improving self-esteem (Q8), being scored over 4,5. On the other hand, the last popular items were the posibility of having a relapse (Q11) and the impact on social life (Q10). The population who fulfilled the survey considered the programme as valuable in terms of makin them improve their lifestyle, being Q13 scored over 4 (4,16).
Cardiac Rehabilitation during COVID-19
Authors: Desira C , De Gray G , Fleri Soler J , Abela M 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
The global COVID19 pandemic has led to significant morbidity and mortality to millions of cardiac patients across the globe. Inferior clinical standards, modified clinical pathways and limited hospital resources has unfortunately translated to significant premature cardiac deaths. Cardiac rehabilitation has also been hit significantly.
Study Objectives
The aim of this study was to assess the impact of cardiac rehabilitation during COVID-19, comparing the referral, adherence and outcomes with patients admitted a year previously.

Methodology
Patients were divided in two groups. Group 1 were those admitted between March-August 2019 (Pre-COVID). Group 2 included those admitted between March-August 2020 (during COVID). Program completion was defined as adherence to ≥6 sessions (Group 1) or ≥ 4 sessions (Group 2). Data was collected from electronic case summaries and cardiac rehabilitation unit medical records. Data was tabulated in SPSS v23. Categorical variables were presented as percentages. Statistical analysis was computed with SPSS v23. A p value of &lt;0.05 was deemed statistically significant.

Results
710 patients were admitted with a cardiac diagnosis (Group 1 n=360, Group 2 n=350), mean age 66.71 ± 13.21 years, dominant male population (n=548, 77.2%). Both groups had comparable proportions of smoking, hypertension, diabetes and hyperlipidaemia.
The referral rate to cardiac rehabilitation was rather poor in both groups, though better in Group 1 (Group 1 38.3% vs 26.6%, p=0.001), partly because of temporary discontinuation of the rehabilitation program at the start of the pandemic. The completion rate was also unfortunately quite low. It was better in Group 2, possibly because of the shorter program duration (Group 1 23.5% vs Group 2 38.7%, p=0.018).
The 1 year readmission rate was significantly higher in Group 1 (22.8% vs 15.1%, p=0.022)), possibly because patients were more open to seek medical advice before the pandemic. The 30 day death rate was comparable in both groups (5.0% vs 5.7%, p=0.672). The 1 year mortality was also comparable (Group 1 12.5% vs Group 2 10.6%, p=0.481) Cardiac rehabilitation did not impact the 1 year readmission rate, 30 day and 1 year mortality.

Conclusion
The 30 day and 1 year mortality in patients admitted during the first 6 months of the pandemic was comparable to the same timeframe the year before. The 1 year readmission rate was higher in patients admitted before COVID, possibly explained by patients being more inclined to seek medical advice. Referral to cardiac rehabilitation was generally low. Adherence to the program did not impact readmission and mortality.
Efficacy of remotely monitored cardiac rehabilitation in patients after cancer treatment: A pilot study
Authors: Batalik L , Filakova K , Dosbaba F , Pepera G , Papathanasiou J , Felsoci M , Janikova A 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): This research was funded by the Ministry of Health, Czech Republic; conceptual development of research organization (FNBr, 65269705).

Background
Cardiovascular diseases are usually a partial cause of mortality in patients after cancer treatment. The increased cardiovascular risk in cancer patients is obtained from the cumulation of risk factors and the side effects of anticancer therapy. A multimodal model of cardiac rehabilitation (CR) can improve cardiorespiratory fitness (CRF), cardiovascular risk, and prognosis in this population. Despite the benefits of CR, patient participation in CR programs is very low. One of the main reasons for the low utilization and completion is the geographical distance from a specialized CR center. The remotely monitored CR method can solve a fundamental barrier that prevents CR programs' extensive and effective use.

Purpose
To examine the feasibility of remotely monitored CR as an alternative approach in hemato-oncological patients after cancer treatment. We assumed that the 12 weeks of remotely monitored CR would be feasible and improve the CRF.

Methods
From March to September 2021, a 12-week study of remotely monitored CR was performed in hemato-oncology patients after cancer treatment. The intervention was based on the principles of phase II CR and consisted of standardized exercise-based in a home-based model with regular telemonitoring and remote supervision. After a cardiovascular assessment, echocardiogram, troponin, brain natriuretic peptides, cardiopulmonary exercise test-CRF were examined, patients were instructed to perform prescribed exercise 3 times per week, for 30 - 50 minutes, at the target heart rate (HR) zone (70 - 90% HRmax) determined by baseline cardiopulmonary exercise testing. Patients were instructed to record their exercise training intensity using a HR monitor and the Borg scale (level 12 - 14 out of 20).

Results
Eight hemato-oncological patients (50% males; mean age 59.4 ± 12.0 years) enrolled in a remotely monitored CR program. All patients were post-cancer treatment, including cancer systemic chemotherapy-based treatment with recommended supportive care. The analysis showed a statistically significant increase in CRF by 13.7% (∆ 20.5 watts, p &lt; 0.05, Abstract Figure). Overall training adherence was high (33.25 / 36 sessions). No exercise-related adverse events were recorded.

Conclusions
The pilot study results support the feasibility assumption of remotely monitored CR in hemato-oncological patients after cancer treatment. CR could lead to significant improvements in CRF. The study results can be useful for sample size estimation of future controlled studies to explore more significant evidence in this area.
Resistance training during cardiac rehabilitation improves physical performance in patients with coronary artery disease: a randomised controlled trial
Authors: Kambic T , Hadzic V , Sarabon N , Lainscak M 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Slovenian Research Agency

Background
Resistance training (RT) is an adjunct exercise therapy to aerobic training (AT) in cardiac rehabilitation, but it remains unknown whether the dose-dependent relationship between RT load (high load [HL] vs. low load [LL]) and improvement in anthropometry, body composition and physical performance exists in patients with coronary artery disease (CAD).

Purpose
The aim of our study was to investigate the effects of HL-RT and LL-RT on top of AT in comparison to AT on anthropometry, body composition and physical performance in patients with CAD.

Methods
A total of 79 patients with a stable CAD were randomised to HL-RT+AT (n = 21), LL-RT+AT (n = 19) or AT (n = 19) and performed 36 training sessions. Fifty-nine patients with mean (SD) age 61 (8) years and left ventricular ejection fraction 53 (9) % completed the study. AT progressed from 50 % to 80% of peak power output achieved at baseline cardiopulmonary exercise test, and RT progressed from 70% of one repetition maximum (1-RM) to 80% of 1-RM in HL-RT group, and from 35% of 1-RM to 40% of 1-RM in LL-RT group. We measured anthropometry (body mass, waist and hip circumference, and waist to hip circumference ratio), body composition (lean body mass and %, body fat mass and %, and phase angle) and physical performance evaluating upper muscle strength (arm curl and hand grip test) and lower muscle strength (five sit-to stand test, up-and-go test, heel raise test), mobility (gait speed test), flexibility (back scratch test, sit-and-reach test), balance (stork balance test) and submaximal endurance (6 min walk test distance) at baseline and post-training.

Results
Waist circumference and waist-to-hip circumference ratio decreased significantly following LL-RT (both p &lt; 0.01), without post-training differences between training interventions in other anthropometry measures and body composition measures (all p &gt; 0.079). HL-RT and LL-RT induced improvements in all physical performance measures, while AT alone did not improve gait speed, upper limb flexibility and performance of up-and-go test. HL-RT was associated with greater improvement in gait speed (+12 %, p =0.044), arm curl test (+13 %, p = 0.037) and time of Up-and-go test (+9 %, p &lt;0.001) compared to AT group, while LL-RT improved more time of Up-and-Go test (+18 %, p &lt; 0.001) and time of five sit-to-stands (+14 %, p = 0.016) compared to AT. There was no difference between HL-RT and LL-RT in post-training change of physical performance measures.

Conclusions
The addition of RT to AT is associated with greater improvements in submaximal muscle strength and mobility compared to AT and should be encouraged in future multimodal exercise-based cardiac rehabilitation.
Impact of a home-based cardiac rehabilitation program in heart failure during the COVID-19 pandemic
Authors: Schmidt C , Basilio PG , Magalhaes S , Alexandre A , Barreira A , Fernandes P , Ribeiro F , Santos M 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): This work was financially supported by the project POCI-01-0145-FEDER-030011, funded by FEDER, through COMPETE2020-POCI, and by national funds, through FCT/MCTES (PTDC/MEC-CAR/30011/2017). CIAFEL, UnIC and UMIB are supported by national funds through Fundação para a Ciência e Tecnologia, I.P. [(UIDB/00617/2020), (UIDB/00051/2020 and UIDP/00051/2020), and (UIDB/00215/2020 and UIDP/00215/2020), respectively]. CS received an individual grant from CAPES [BEX 0554/14-6].

Introduction
Cardiac rehabilitation (CR) is an evidence-based recommended treatment of heart failure (HF) patients. During the COVID-19 pandemic, the shutdown of CR centers was necessary to limit the infection risk among high-risk patients. The integration of a home-based CR (HBCR) program in CR units can help to improve the delivery of care and improve cardiovascular outcomes of HF patients.

Purpose
To assess the effectiveness of an HBCR program in HF patients.

Methods
This is a sub­study of the EXercise InTervention in Heart Failure trial (EXIT-HF), which include forty-nine HF patients (preserved and reduced ejection fraction). The HBCR program consisted in 12-week combined exercise program (60%-80% of peak oxygen consumption (VO2 peak)), 2 training sessions per week, for a total of 24 sessions. Patients performed 4 supervised training sessions and the remaining sessions at home. All patients performed a cardiopulmonary exercise test (VO2 peak), the 6-minute-walking test (6MWT), collected blood analysis (plasma NT-proBNP), and answered the Minnesota Living with Heart Failure Questionnaire.

Results
Forty-two patients (86%) complete at least 80% of prescribed training sessions (age: 61.1±12; FEVE: 37.1±10.8). The HBCR program improve VO2 peak from 18.3 to 20.1ml/kg/min (+1.8 ml/kg/min; 95%IC:1.4 to 2.4; p&lt;0.001) and the walked distance at the 6MWT from 462 to 512 meters (+49 meters; 95%IC: 38 to 60; p&lt;0.001). In addition, overall quality of life was improved (-13 points; 95%IC:-7.8 to -18.5; p&lt;0.001), as well physical (-6.3 points; 95%IC:-3.5 to -9; p&lt;0.001) and emotional dimension of quality of life (-2.8points ; 95%IC: -0.9 to -4.7; p=0.06). No significant change was found in NT-proBNP levels (820±1220 vs 674±903; p=0.285).

Conclusions
Our results showed that HBCR is feasible and can improve functional capacity and quality of life in HF patients.
Role of Integrated yoga like posture, breathing excercise, music, satvic diet and bhagwad geeta for quit smoking and cardiovascular prevention as compare to still active smokers
Authors: Sen N , Tanwar SONAL , Jain ASHOK , Sen NARESH , Kumar DEEPAK 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Coronary heart disease (CHD) is increasing in young individuals and female also in India due to smoking .The possible effect of smoking on endothelial function has long been revealed and also cause oxidative distress, negatively affects platelet function, fibrinolysis, inflammation and vasomotor function.
Aims & Objectives: Our study was performed to quit smoking for better cardiovascular prevention .

Methods
17655 pre-hypertensive and prediabetic enrolled during 2009- 2011 at different medical centers, male versus female 4: 1 (age 18-50 years), 10660 non-smokers and 6995 smokers at same smoking index. We categorized group A for Integrated yoga like posture, breathing exercise (Pranayama), music, sattvic diet and bhagwad geeta for quit smoking and Group B who were denied for spiritual vedic program. Session were perform with three cycles for 3 months and taken follow up after 5 & 10 years.

Results
Data suggest that quit smoking samples were found in integrated yoga group A, 88 % versus 15 % in normal group B. We compared data and found significant BP, HR, HRV reduction around 2.5 fold higher reduction in integrated yoga group quit smokers as compare to still smokers in normal group B with P value ( 0.002, 0.004, 0.003), 1.5 fold reduction of BMI in group A (p&lt;0.005). Significant two fold decrease of incidence of diabetes type 2 and left ventricular diastolic dysfunction, improvement of treadmill METs value, 6 min walk and pulmonary vital capacity in integrated yoga group after 10 years of follow up. 38% risk reduction of acute myocardial injury and stroke found in integrated yoga quit smoking group A.

Conclusion
Smoking cessation is mandatory to reduce cardiovascular events. Integrated yoga is a master life style intervention for quit smoking without medical side effects in future.
Basic life support and automated external defibrillators in secondary schools
Authors: Abela M , Grech V , Sammut MA 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Sudden cardiac arrest is the leading cause of premature death. Effective cardiopulmonary resuscitation (CPR) and early defibrillation substantially improve survival rates. This has also been replicated in schools, with excellent outcome data in schools who advocated CPR certification together with the availability of onsite automated external defibrillator (AED). Most entities now encourage AED installation in schools.

Objectives
As a follow up to the BEAT-IT cardiac screening program performed across all secondary schools in 2017/2018, the main aim of this study was to evaluate the availability of AEDs in schools across the Maltese archipelago. Information on staff CPR certification was also evaluated.

Methodology
One school administrator in all secondary schools across Malta and Gozo (n=54) were asked to complete an online questionnaire. All data was kept anonymous. Data was tabulated. Categorical variables were presented as percentages. Statistical analysis was performed with SPSS v23.

Results
Most schools (n=40, 74.1%) complied, the majority from the northern harbour region (n=15, 37.5%). Student gender in most schools was mixed (n=23, 57.5%). Two schools (5%) reported a cardiac arrest in one of their pupils over the previous 10 years, one happening during school hours. A minority (n=3, 7.5%) strongly disagreed that preventing sudden cardiac death (SCD) in schools is important. Only 1 (2.5%) had never heard of an AED.
Some schools (n=3, 7.5%) did not have an AED on school premises. The majority had one AED (n=1, 75.0%). Most schools service their AED regularly (n=34, 94.4%). The majority had an AED only on one floor (n=35, 97.2%). Most AEDs were installed in easily accessible areas (n=35, 97.2%), yet the location was not subjected to a risk assessment prior to installation in a significant proportion (n=17, 47.2%). Defibrillators in a third of schools (n=11, 30.6%) were not close to sporting facilities, an area traditionally recognized as a high risk location.
Most schools do not organise onsite CPR certification courses (n=21, 52.5%). Some staff are certified in CPR (n=35, 87.5%), a fifth having more than 5 certified individuals (n=8, 20.0%). The majority have also undergone recertification (n=28, 70.0%). Most were strongly in favour of a systematic cardiac screening program in schools (n=28, 70.0%).

Conclusion
A significant proportion of schools have experienced a cardiac arrest in one of its pupils (5.0%), implying this is an important health concern. Yet some still disagree that SCD prevention in schools is important (7.5%). Despite the majority having an AED on site, a substantial proportion did not have a risk assessment prior to installation (47.2%). Only a small proportion of staff members are certified in CPR. Most schools do not organise on-site CPR courses (52.5%). More education and awareness about cardiac arrest in students and CPR certification is necessary.
Prevalence of exercise-induced arrhythmias in young athletes with fragmented QRS pattern in lead V1
Authors: Quinto G , Vecchiato M , Borasio N , Baioccato V , Gasperetti A , Battista F , Neunhaeuserer D , Ermolao A 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Resting 12-lead electrocardiogram (ECG) in apparently health athletes has specific pattern, typically associate to heart remodelling in response to regular exercise. (1,2) Moreover, these adaptations were correlated to typical ventricular arrhythmias, not associated with underlying cardiac abnormalities.(3) Recently, also fragmented QRS complex in lead V1 (fQRSV1), representing right ventricular (RV) activation, seems related to training-induced RV remodelling in athletes, where its prevalence is greater.(4)

Purpose
Evaluate presence of fQRSV1pattern at resting ECG in a population of young athletes and its relationship with training-associated structural heart adaptations and exercise-induced ventricular arrhythmias.

Methods
This study retrospectively enrolled subjects who consecutively undergo to annual pre-participation screening and also to transthoracic echocardiography assessment, from January 2015 to September 2020. For each participant, medical history, physical examination, resting ECG, maximal standardized exercise test and echocardiographic evaluation were collected. All ECG were reviewed by two independent physicians to evaluate fQRSV1 pattern.

Results
684 young athletes (mean age 14.87±1.96 years, 36% female) were included and the overall prevalence of fQRSV1was 27%. Figure 1 shows an example of fQRSV1 pattern. Principal subject characteristics and evaluations data are shown in Table 1. fQRSV1 subjects presented a significantly wider QRS interval (p=0.004) and lower heart rate at rest (p=0.001). Exercise workload expressed in METs and exercise duration were higher in subjects with fQRSV1 (p=0.002 and p=0.023, respectively). Echocardiographic data showed that subjects with fQRSV1differ in morphological and functional right ventricular (RV) characteristics, especially had a higher indexed RV end diastolic diameter (p=0.019) and higher TAPSE (p=0.013). Patients with fQRSV1did not show an increased occurrence of supraventricular or ventricular arrhythmias, regardless of morphology, neither for isolated nor for repetitive events.

Conclusion
Overall prevalence of fQRSV1 pattern in young athletes is comparable with the one studied in other population of adult athletes in previous studies. Adolescent athletes with fQRSV1 present structural heart characteristic that differ from subjects without this ECG pattern, especially in RV feature. No differences in prevalence of any type of exercise-induced arrhythmias was shown, especially in common ventricular arrhythmias consistent with origin from the right ventricular outflow tract, previously described in healthy athletes.