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Technological Advancement for Cardiovascular Disease Exercise, Monitoring and Disease Management

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Digital Health".

Deadline for manuscript submissions: closed (30 January 2021) | Viewed by 19279

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Dr. Kazuhiro P. Izawa

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Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka Suma, Kobe 654-0142, Japan
Interests: exercise; adherence; physical activity; disease management; sedentary behavior; health related quality of life; mortality; mobidity; environment; cost effectiveness
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Dear Colleagues,

Cardiovascular diseases are rapidly increasing due to the spread of lifestyle diseases in the world. In particular, along with the aging population is the increase in the number of elderly patients with cardiovascular diseases.
These patients with cardiovascular diseases may be forced to restrict their activities of daily living and lower health-related quality of life due to sedentary behaviour, together with lower physical function and physical activity. In addition, environmental factors may also be related to these factors.

The improvement of these several abilities in cardiovascular disease patients may contribute not only to the improvement of their exercise capacity and life prognosis but also to their health-related quality of life. Also, these improvements will not only prevent cognitive dysfunction, but will also may lead to improvement of mild cognitive impairment, and may actively promote nursing care prevention. Moreover, these are very important in controlling the re-hospitalization rate and eventually in suppressing the increasing medical expenses.

The focus lies on exercise, monitoring, disease management, and their prevention, but other related topics may also be considered. This Special Issue is not only looking for papers reporting original data from epidemiologic studies, but also systematic reviews and meta-analyses are welcome.

Dr. Kazuhiro P. Izawa
Guest Editor

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Keywords

exercise
adherence
physical activity
disease management
sedentary behavior
health-related quality of life
mortality
morbidity
environment
cost-effectiveness

Published Papers (6 papers)

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10 pages, 808 KiB

Open AccessArticle

Relationship among Activities of Daily Living, Nutritional Status, and 90 Day Readmission in Elderly Patients with Heart Failure

by Masahiro Kitamura, Kazuhiro P. Izawa, Masakazu Yaekura, Yumi Mimura, Yuichi Ikeda, Hitomi Nagashima and Peter H. Brubaker

Int. J. Environ. Res. Public Health 2019, 16(24), 5068; https://doi.org/10.3390/ijerph16245068 - 12 Dec 2019

Cited by 10 | Viewed by 3443

Abstract

Purpose: This investigation aimed to examine the relationship among activities of daily living (ADL), nutritional status and 90-day hospital readmission in elderly heart failure (HF) patients. Methods: Participants were selected from 634 HF patients consecutively hospitalized at one institution. We investigated patient characteristics, ADL (motor and cognitive items of Functional Independence Measure (FIM)) and nutritional status (Geriatric Nutritional Risk Index (GNRI)). Data were analyzed using unpaired t-test, χ² test, Cox proportional hazard model, and Kaplan-Meier method. Results: The 169 participants that met inclusion criteria were divided into two groups based on hospital readmission within 90 days of discharge. Body mass index (BMI) (p = 0.03), hemoglobin (p = 0.047), GNRI (p = 0.02) and motor-FIM (p = 0.007) were significantly different between the readmission (n = 31) and non-readmission (n = 138) groups. After Cox proportional hazard model analysis, GNRI (HR: 0.96; p = 0.048) and motor-FIM (HR: 0.97; p = 0.03) scores remained statistically significant. Participants were then classified into four groups based on a previous study’s cut-off values of prognosis for GNRI and motor-FIM. Readmission avoidance rate was significantly lower (p = 0.002) in the group with GNRI <92 and motor FIM <75. Conclusions: This study showed that motor-FIM and GNRI scores for hospitalized elderly HF patients were predictors of readmission within 90 days of discharge. Full article

(This article belongs to the Special Issue Technological Advancement for Cardiovascular Disease Exercise, Monitoring and Disease Management)

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10 pages, 737 KiB

Open AccessArticle

Increased Heart Rate during Walk Test Predicts Chronic-Phase Worsening of Renal Function in Patients with Acute Myocardial Infarction and Normal Kidney Function

by Asami Ogura, Kazuhiro P. Izawa, Hideto Tawa, Fumie Kureha, Masaaki Wada, Masashi Kanai, Ikko Kubo, Ryohei Yoshikawa and Yuichi Matsuda

Int. J. Environ. Res. Public Health 2019, 16(23), 4785; https://doi.org/10.3390/ijerph16234785 - 29 Nov 2019

Viewed by 2454

Abstract

Chronic-phase worsening renal function (WRF) in patients with acute myocardial infarction (AMI) has been associated with poor prognosis. However, there is no consensus on either the method of prevention or the cause. The aim of this study was to determine factors predictive of chronic-phase WRF from the viewpoint of circulatory dynamics response to exercise during hospitalization of AMI patients without renal dysfunction on admission. We studied 186 consecutively AMI patients who underwent the 200-m walk test. Chronic-phase WRF was defined as a 20% decrease in estimated glomerular filtration rate (eGFR) from baseline to 8–10 months after AMI onset. Heart rate (HR) and systolic blood pressure recorded during the 200-m walk test were evaluated as circulatory dynamics responses. In total, 94 patients were enrolled. Multiple linear regression analysis showed that ΔHR (peak-rest) associated significantly with ΔeGFR (β = 0.427, p = 0.018). The receiver operating characteristic curve of ΔHR to predict chronic-phase WRF showed an area under the curve of 0.77, with a cut-off value of 22.0 bpm having a 95% sensitivity and 55% specificity. Among circulatory dynamics responses during exercise in the acute phase after AMI, ΔHR was an independent predictor of chronic-phase WRF. Full article

(This article belongs to the Special Issue Technological Advancement for Cardiovascular Disease Exercise, Monitoring and Disease Management)

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9 pages, 629 KiB

Open AccessFeature PaperArticle

Factors Affecting Discharge to Home of Medical Patients Treated in an Intensive Care Unit

by Takayuki Shimogai, Kazuhiro P. Izawa, Minoru Kawada and Akira Kuriyama

Int. J. Environ. Res. Public Health 2019, 16(22), 4324; https://doi.org/10.3390/ijerph16224324 - 06 Nov 2019

Cited by 8 | Viewed by 2943

Abstract

The purpose of this study was to examine the factors affecting the discharge to home of medical patients treated in an intensive care unit, including elements of in-hospital rehabilitation and prehospital movement ability. The participants of this retrospective cohort study were medical patients treated in an intensive care unit (ICU) and who began rehabilitation in ICU. We assessed the participants in the ICU and analyzed data on patient background, hospitalization, and rehabilitation status. There were 155 ICU patients available for analysis. A multivariable logistic regression model identified the four variables of age (OR 1.06, 95% CI 1.02–1.09), APACHE II score (OR 1.12, 95% CI 1.04–1.24), independence in home life before admission (OR 7.10, 95% CI 1.65–30.44), and standing within 5 days of admission (OR 6.58, 95% CI 2.60–16.61) as factors significantly related to discharge from hospital to home. Independence of home life before admission and early start of standing were identified as factors strongly related to discharge to home. The degree of independence in living before hospital admission and progress toward early mobilization are helpful when considering an ICU patient’s discharge destination. Full article

(This article belongs to the Special Issue Technological Advancement for Cardiovascular Disease Exercise, Monitoring and Disease Management)

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8 pages, 284 KiB

Open AccessArticle

Association of Perceived Built Environment Attributes with Objectively Measured Physical Activity in Community-Dwelling Ambulatory Patients with Stroke

by Masashi Kanai, Kazuhiro P. Izawa, Hiroki Kubo, Masafumi Nozoe, Kyoshi Mase, Mohammad Javad Koohsari, Koichiro Oka and Shinichi Shimada

Int. J. Environ. Res. Public Health 2019, 16(20), 3908; https://doi.org/10.3390/ijerph16203908 - 15 Oct 2019

Cited by 15 | Viewed by 3887

Abstract

There is little evidence on how perceptions of the built environment may influence physical activity among post-stroke patients. This study aimed to explore the associations between perceived built environment attributes and objectively measured physical activity outcomes in community-dwelling ambulatory patients with stroke. This cross-sectional study recruited patients who could walk outside without assistance. We assessed both objectively measured physical activity outcomes such as number of steps and duration of moderate-to-vigorous physical activity (MVPA) with an accelerometer and the patients’ perceived surrounding built environment with the International Physical Activity Questionnaire Environmental Module. Sixty-one patients (67.0 years old) were included. The multiple linear regression analysis showed significant associations of the presence of sidewalks (β = 0.274, p = 0.016) and access to recreational facilities (β = 0.284, p = 0.010) with the number of steps taken (adjusted R² = 0.33). In contrast, no significant associations were found between perceived built environment attributes and MVPA. These findings may help to suggest an approach to promote appropriate physical activity in patients with stroke depending on their surrounding built environment. Full article

(This article belongs to the Special Issue Technological Advancement for Cardiovascular Disease Exercise, Monitoring and Disease Management)

12 pages, 621 KiB

Open AccessArticle

Effects of αβ-Blocker Versus β1-Blocker Treatment on Heart Rate Response During Incremental Cardiopulmonary Exercise in Japanese Male Patients with Subacute Myocardial Infarction

by Shinji Nemoto, Yusuke Kasahara, Kazuhiro P. Izawa, Satoshi Watanabe, Kazuya Yoshizawa, Naoya Takeichi, Kentaro Kamiya, Norio Suzuki, Kazuto Omiya, Atsuhiko Matsunaga and Yoshihiro J. Akashi

Int. J. Environ. Res. Public Health 2019, 16(16), 2838; https://doi.org/10.3390/ijerph16162838 - 08 Aug 2019

Cited by 2 | Viewed by 3462

Abstract

A simplified substitute for heart rate (HR) at the anaerobic threshold (AT), i.e., resting HR plus 30 beats per minute or a percentage of predicted maximum HR, is used as a way to determine exercise intensity without cardiopulmonary exercise testing (CPX) data. However, difficulties arise when using this method in subacute myocardial infarction (MI) patients undergoing beta-blocker therapy. This study compared the effects of αβ-blocker and β1-blocker treatment to clarify how different beta blockers affect HR response during incremental exercise. MI patients were divided into αβ-blocker (n = 67), β1-blocker (n = 17), and no-β-blocker (n = 47) groups. All patients underwent CPX one month after MI onset. The metabolic chronotropic relationship (MCR) was calculated as an indicator of HR response from the ratio of estimated HR to measured HR at AT (MCR-AT) and peak exercise (MCR-peak). MCR-AT and MCR-peak were significantly higher in the αβ-blocker group than in the β1-blocker group (p < 0.001, respectively). Multiple regression analysis revealed that β1-blocker but not αβ-blocker treatment significantly predicted lower MCR-AT and MCR-peak (β = −0.432, p < 0.001; β = −0.473, p < 0.001, respectively). Based on these results, when using the simplified method, exercise intensity should be prescribed according to the type of beta blocker used. Full article

(This article belongs to the Special Issue Technological Advancement for Cardiovascular Disease Exercise, Monitoring and Disease Management)

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5 pages, 525 KiB

Open AccessBrief Report

Relationship between Serum Vitamin D and Leg Strength in Older Adults with Pre-Dialysis Chronic Kidney Disease: A Preliminary Study

by Akira Saito, Koji Hiraki, Yuhei Otobe, Kazuhiro P. Izawa, Tsutomu Sakurada and Yugo Shibagaki

Int. J. Environ. Res. Public Health 2020, 17(4), 1433; https://doi.org/10.3390/ijerph17041433 - 23 Feb 2020

Cited by 3 | Viewed by 2441

Abstract

Active vitamin D (calcitriol, or 1.25 (OH) 2 D) is associated with muscle weakness, falls, and fracture in community-dwelling older people. This study aimed to investigate the relationship between a serum active vitamin D level and lower extremity muscle strength in elderly patients with pre-dialysis chronic kidney disease (CKD). This cross-sectional study included 231 patients with CKD treated conservatively as outpatients. We analyzed patient background factors, including age, sex, body mass index (BMI), intact parathyroid hormone (PTH), phosphorus, calcium, albumin, serum calcitriol level as an indicator of active vitamin D, and estimated glomerular filtration rate (eGFR) collected from medical records. As an index of lower extremity muscle strength, the isometric knee extension muscle strength-to-weight ratio (kgf/kg) was calculated. The mean patient age was 75.9 ± 6.1 years (68.8% male), and the BMI was 24.1 ± 3.8 kg/m². A significant correlation was observed between knee extensor muscle strength and serum calcitriol level (r = 0.32, p < 0.01), age (r = –0.30, p < 0.01), BMI (r = −0.31, p < 0.01), intact PTH (r = −0.22, p < 0.01), phosphorus (r = −0.29, p < 0.01), albumin (r = −0.28, p < 0.01), and eGFR (r = 0.25, p < 0.01). Multiple regression analysis showed calcitriol to be significantly associated with knee extensor muscle strength (β: 0.14, 95% confidence interval: 0–0.002, p = 0.04) after adjustment for covariates. These results suggest that the serum active vitamin D level is associated with lower extremity muscle strength in older adults with pre-dialysis CKD. It is necessary to verify whether vitamin D supplementation increases lower extremity muscle strength in pre-dialysis CKD patients. Full article

(This article belongs to the Special Issue Technological Advancement for Cardiovascular Disease Exercise, Monitoring and Disease Management)

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