Recent Innovations in the Management of Cardiac Rehabilitation

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Rehabilitation".

Deadline for manuscript submissions: 30 April 2024 | Viewed by 2406

Special Issue Editor


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Guest Editor
Department of Cardiology, Foundation Don Carlo Gnocchi IRCCS, Institute of Hospitalization and Care, S Maria Nascente, Via Capecelatro 66, 20100 Milan, Italy
Interests: diaphragm; fascia; cardiac rehabilitation; physiotherapy; osteopathic medicine

Special Issue Information

Dear Colleagues,

Cardiac rehabilitation is a fundamental path for a cardiac patient. The objectives of rehabilitation look at the whole person, putting the patient under the lenses of different professional figures: cardiologists, physiotherapists, speech therapists, psychologists, dieticians, osteopaths, and nurses. The type of patient undergoing the rehabilitation process does not respond to a single clinical description, but is extremely heterogeneous; hence, there is the real difficulty of correctly framing the rehabilitation process, which should always be subjective and non-standardized. Rehabilitation encompasses multiple cardiovascular pathologies and dysfunctions: patients who have suffered a myocardial infarction, patients undergoing PTCA and stenting, bypass, valve, and aortic replacements, heart transplantation, permanent or temporary L-VAD implantation, and chronic as well as acute CHF. Heart patients can present with pathologies involving multiple organs, or to prolong life as much as possible. The studies present in the literature take into consideration patients with specific criticalities in order to make the results non-confounding. The problem, however, is that, in rehabilitation wards and hospitalizations, the patient does not necessarily reflect a perfect clinical picture and does not always reflect the type of patient in the various trials. The clinician does not choose which patients to follow, without respecting the inclusion and exclusion criteria of an experimental study. Furthermore, the trials are a synthesis of a small portion of patients compared to the millions of cardiovascular patients; that is, each study is a snapshot of people chosen on the basis of specific statistical criteria. The reality of rehabilitation does not always reflect this picture. The Special Issue "Recent Innovations in the Management of Cardiac Rehabilitation" aims to highlight not only the results of the most recent research, but to highlight further rehabilitation possibilities with respect to the cardiovascular clinical reality through multidisciplinary perspectives.

Dr. Bruno Bordoni
Guest Editor

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Keywords

  • endurance and resistance training
  • thoracic pain
  • respiratory muscles
  • multidisciplinary approach
  • L-VAD
  • myocardial infarction
  • cardiosurgery

Published Papers (2 papers)

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Research

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14 pages, 1404 KiB  
Article
Cardiac Rehabilitation Increases Plasma Klotho Levels
by Ana María Pello Lázaro, Koldo Villelabeitia Jaureguizar, Juan Antonio Franco Peláez, Ana Venegas-Rodriguez, Álvaro Aceña, Andrea Kallmeyer, Ester Cánovas, María Luisa González-Casaus, Nieves Tarín, Carmen Cristóbal, Carlos Gutiérrez-Landaluce, Ana Huelmos, Óscar González-Lorenzo, Joaquín Alonso, Lorenzo López-Bescós, Jesús Egido, Ignacio Mahillo-Fernández, Jairo Lumpuy-Castillo, Óscar Lorenzo and José Tuñón
J. Clin. Med. 2024, 13(6), 1664; https://doi.org/10.3390/jcm13061664 - 14 Mar 2024
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Abstract
Background: Mineral metabolism (MM), mainly fibroblast growth factor-23 (FGF-23) and klotho, has been linked to cardiovascular (CV) diseases. Cardiac rehabilitation (CR) has been demonstrated to reduce CV events, although its potential relationship with changes in MM is unknown. Methods: We performed [...] Read more.
Background: Mineral metabolism (MM), mainly fibroblast growth factor-23 (FGF-23) and klotho, has been linked to cardiovascular (CV) diseases. Cardiac rehabilitation (CR) has been demonstrated to reduce CV events, although its potential relationship with changes in MM is unknown. Methods: We performed a prospective, observational, case-control study, with acute coronary syndrome (ACS) patients who underwent CR and control patients (matched by age, gender, left ventricular ejection fraction, diabetes, and coronary artery bypass grafting), who did not. The inclusion dates were from August 2013 to November 2017 in CR group and from July 2006 to June 2014 in control group. Clinical, biochemical, and MM biomarkers were collected at discharge and six months later. Our objective was to evaluate differences in the modification pattern of MM in both groups. Results: We included 58 CR patients and 116 controls. The control group showed a higher prevalence of hypertension (50.9% vs. 34.5%), ST-elevated myocardial infarction (59.5% vs. 29.3%), and treatment with angiotensin-converting enzyme inhibitors (100% vs. 69%). P2Y12 inhibitors and beta-blockers were more frequently prescribed in the CR group (83.6% vs. 96.6% and 82.8% vs. 94.8%, respectively). After six months, klotho levels increased in CR patients whereas they were reduced in controls (+63 vs. −49 pg/mL; p < 0.001). FGF-23 was unchanged in the CR group and reduced in controls (+0.2 vs. −17.3 RU/dL; p < 0.003). After multivariate analysis, only the change in klotho levels was significantly different between groups (+124 pg/mL favoring CR group; IC 95% [+44 to +205]; p = 0.003). Conclusions: In our study, CR after ACS increases plasma klotho levels without significant changes in other components of MM. Further studies are needed to clarify whether this effect has a causal role in the clinical benefit of CR. Full article
(This article belongs to the Special Issue Recent Innovations in the Management of Cardiac Rehabilitation)
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Review

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15 pages, 2569 KiB  
Review
A Scoping Review of Measurement Tools Evaluating Awareness and Disease-Related Knowledge in Peripheral Arterial Disease Patients
by Carolina Machado de Melo Felix, Danielle Aparecida Gomes Pereira, Maureen Pakosh, Lilian Pinto da Silva and Gabriela Lima de Melo Ghisi
J. Clin. Med. 2024, 13(1), 107; https://doi.org/10.3390/jcm13010107 - 24 Dec 2023
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Abstract
Background: Peripheral arterial disease (PAD) is the third leading cause of atherosclerotic cardiovascular morbidity worldwide, with high prevalence and associated complications, and is often overlooked and undertreated. Research has shown that there is a profound lack of PAD-related knowledge and awareness; additionally, information [...] Read more.
Background: Peripheral arterial disease (PAD) is the third leading cause of atherosclerotic cardiovascular morbidity worldwide, with high prevalence and associated complications, and is often overlooked and undertreated. Research has shown that there is a profound lack of PAD-related knowledge and awareness; additionally, information sources are not often reliable and accessible. The objective of this scoping review was: (1) to identify and critically appraise instruments that measure patients’ disease-related knowledge/awareness about PAD, and (2) to characterize the current state of knowledge/awareness levels among these patients. Methods: This systematic review was conducted and reported in accordance with the PRISMA statement. Six databases (APA PsycInfo, CINAHL Ultimate, Embase, Emcare Nursing, Medline ALL and Web of Science Core Collection) were searched, and search strategies were developed utilizing the PICO framework. Potential studies of any methodological design were considered for inclusion through a snowball hand search. Data from the included articles were extracted by a reviewer, and the extraction accuracy was independently cross-checked by another author. Results: The initial database search yielded 9832 records, of which sixteen studies (thirteen quantitative and three qualitative) were included. Only three questionnaires had their psychometric properties assessed. Questionnaire items focused on the following topics: definition/characteristics, risk factors/causes, treatment, complications, and personal issues regarding the perception/management of the disease. Overall, knowledge/awareness about PAD was low among patients. Conclusions: This study identified major gaps in PAD education, including the lack of availability of a validated measurement tool addressing all educational topics relevant to care and low knowledge/awareness of patients about their condition. Full article
(This article belongs to the Special Issue Recent Innovations in the Management of Cardiac Rehabilitation)
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