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Evidence proves that health care providers should promote cardiac rehabilitation (CR) to patients face-to-face to increase CR enrollment. An online course was designed to promote this at the bedside; it is evaluated herein in terms of reach, effect on knowledge, attitudes, discussion self-efficacy and practices, and satisfaction.

Design was observational, one-group pre- and post-test. Some demographics were requested from learners taking all language versions of the 20-min course English, Portuguese, French, Spanish, and simplified Chinese, available at https//globalcardiacrehab.com/CR-Utilization. Investigator-generated items in the pre- and post-test and evaluation survey administered using Google Forms were based on Kirkpatrick's training evaluation model.

The course was initiated by 522 learners from 33 of 203 (16%) countries; most commonly female (n = 341, 65%) nurses (n = 180, 34%) from high-income countries (n = 259, 57%) completing the English (n = 296, 57%) and Chinese (n = 108, 21%) versions. on. Selleck Vorinostat While testing impact on actual CR use is needed, it should be more broadly disseminated to increase reach, in an effort to increase patient enrollment in CR, to reduce morbidity and mortality.
The objective of this study was to investigate sex and age differences in anxiety and depression among patients with cardiovascular disease at baseline and following aerobic interval training (AIT)-based cardiac rehabilitation (CR) and secondarily to compare dropout rates between sexes and age groups.

Participants were younger (≤44 yr), middle-aged (45-64 yr), and older adults (≥65 yr). The AIT protocol consisted of 4 × 4-min of high-intensity work periods at 85-95% peak heart rate (HR) interspersed with 3 min of lower-intensity intervals at 60-70% peak HR, twice weekly for 10 wk. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale at baseline and following CR.

At baseline, of 164 participants (32% female), 14 (35% female) were younger, 110 (33% female) were middle-aged, and 40 (30% female) were older. Older adults reported lower anxiety levels versus younger (4.4 ± 2.6 vs 7.8 ± 3.4 points, P = .008) and middle-aged adults (4.4 ± 2.6 vs 6.1 ± 3.6 points, P = .05). Baselit rates were highest among younger adults.
Incremental shuttle walk tests (ISWTs) are routinely conducted as outcome measures in pulmonary rehabilitation (PR) assessments and in clinical trials; however, there is a paucity of data describing the impact of simply conducting an exercise test and the change produced in the perceived ability of the individual to perform exercise subsequently, which may in turn influence therapy and study outcomes.

We conducted a prospective observational cohort study at Glenfield Hospital, Leicester, UK (University Hospitals of Leicester NHS Trust). At initial PR assessment, we asked patients pre- and post-practice ISWT to report confidence in three areas (walking at home [Q1], managing breathlessness [Q2], and performing an ISWT [Q3]) based on a visual analog scale (0-10).

A total of 100 patients with chronic respiratory disease (age 68.0 ± 10.3 yr, male 49%, chronic obstructive pulmonary disease 63%, Medical Research Council 2-5) completed visual analog scale confidence questions pre- and post-practice ISWT. Confidence in all questions improved after a practice ISWT (all P < .01 Wilcoxon signed rank). A statistically significant improvement in ISWT distance was noted (practice ISWT 207.3 ± 132.7 m to second ISWT 227.4 ± 142.0 m, mean difference = 20.1 m). No association was found between changes in confidence and changes between walk 1 and walk 2 (r2 = [Q1] -0.04, [Q2] -0.09, [Q3] 0.04, P >.05).

Confidence increased in all areas post-practice ISWT, but this was not related to changes in performance. However, this change may be an important consideration when designing research trials as exercise behaviors (eg, walking at home) may be affected by conducting baseline exercise tests.
Confidence increased in all areas post-practice ISWT, but this was not related to changes in performance. However, this change may be an important consideration when designing research trials as exercise behaviors (eg, walking at home) may be affected by conducting baseline exercise tests.
The objectives of this study were to compare the effects of two different high-intensity interval training (HIIT) programs (low-volume vs high-volume) on chronotropic responses during exercise and recovery, and to contrast the results of the HIIT groups together to only physical activity recommendations in post-myocardial infarction (MI) patients taking β-blockers.

Resting heart rate (HRrest), peak HR (HRpeak), HR reserve (HRreserve = HRpeak-HRrest), HR recovery (HRR) as the difference between HRpeak and post-exercise HR, and chronotropic incompetence were assessed in 70 patients (58 ± 8 yr) following MI with a cardiopulmonary exercise test to peak exertion before and after a 16-wk exercise intervention period. All participants were randomized to either attention control (AC) (physical activity recommendations) or one of the two supervised HIIT groups (2 d/wk).

After the intervention, no significant between-HIIT group differences were observed. The HRpeak increased (P < .05) in low- (Δ= 8 ± 18%) and s a potent and time-efficient exercise strategy that could enhance the sympathovagal balance in this population.
Patients participating in cardiac rehabilitation (CR) following an aortic valve procedure demonstrate improvements in physical capacity and psychological well-being. The primary aim of this study is to evaluate baseline exercise capacity and psychological well-being for mitral valve patients participating in CR and to compare physical and psychological outcomes between mitral valve and aortic valve patients.

The primary endpoint was improvement in 6-min walk test (6MWT) distance. Secondary endpoints included change in exercise min/wk, depression scores (Patient Health Questionnaire-9 [PHQ-9]), anxiety scores (General Anxiety Disorder-7 [GAD-7]), and overall quality of life (Dartmouth Cooperative Functional Assessment [COOP]) scores.

Between January 2015 and December 2019, 94 patients who underwent an aortic valve procedure and 46 patients who underwent mitral valve procedures were enrolled prospectively in CR. At the completion of their CR program, patients had similar improvements in their 6MWT (mitral valve 173 ft [125, 238] vs aortic valve 197 ft [121, 295], P = .42); exercise min/wk (mitral valve 90 min [45, 175] vs aortic valve 80 min [40, 130], P = .44). Changes in anxiety (GAD-7), depression (PHQ-9), and COOP scores were smaller but similar between the two groups.

CR participation resulted in similar improvements in physical activity between patients undergoing mitral valve and aortic valve procedures. Psychological well-being and quality of life scores improved minimally and similarly between the two groups.
CR participation resulted in similar improvements in physical activity between patients undergoing mitral valve and aortic valve procedures. Psychological well-being and quality of life scores improved minimally and similarly between the two groups.
Among patients with chronic kidney disease (CKD), little is known about whether the effect of cardiac rehabilitation (CR) on renal function differs across baseline estimated glomerular filtration rate using the serum concentration of cystatin C (eGFRcys). The aim of this study was to evaluate the effect of CR on renal function in patients with CKD.

We performed a retrospective cohort study of patients with CKD (15 ≤ eGFRcys < 60 mL/min/1.73 m2) who participated in our CR program for cardiovascular disease. First, the patients were divided into three groups according to the baseline severity of the eGFRcys G3a, G3b, and G4 groups. We compared the eGFRcys before and after the CR in each group. Second, to determine the association of baseline eGFRcys with the effect of CR, we fitted a linear regression model using the percent change in the eGFRcys (%ΔeGFRcys) as an outcome.

Of the 203 patients, 122 were in G3a, 60 were in G3b, and 21 were in G4 groups. The mean improvement of eGFRcys in each group was 1.3, 3.1, and 4.8 mL/min/1.73 m2, respectively. The %ΔeGFRcys was larger among patients with lower baseline eGFRcys (0.47% greater improvement of %ΔeGFRcys/one lower baseline eGFRcys; 95% CI, 0.23-0.72%). This association remained significant after adjustment for potential confounders (0.63% greater improvement of %ΔeGFRcys/one lower baseline eGFRcys; 95% CI, 0.35-0.91%).

The effect of CR on renal function was greater in patients with worse renal dysfunction measured by eGFRcys. A CR program could be useful for patients with severe renal dysfunction and it might have a beneficial effect on their renal function.
The effect of CR on renal function was greater in patients with worse renal dysfunction measured by eGFRcys. A CR program could be useful for patients with severe renal dysfunction and it might have a beneficial effect on their renal function.
Many patients with coronary artery disease (CAD) do not achieve the recommended physical activity (PA) levels during and after cardiac rehabilitation (CR). The aim of this study was to analyze moderate to vigorous physical activity (MVPA) levels and the differences between perceived (self-reported) and measured (activity monitor) MVPA in CAD patients during CR. The second aim was to analyze which patient characteristics were associated with this difference.

A two-center observational-sectional study was conducted within the Department of Rehabilitation Medicine of the University Medical Center Groningen between January and April 2018. Adults with CAD, following an outpatient CR program, were included. Perceived MVPA was assessed with the Short Questionnaire to Assess Health-enhancing Physical Activity and compared with ActivPAL3 activity monitor outcomes over a period of 7 d.

Fifty-one patients with CAD (age 59.4 ± 7.1 yr, eight females) were recruited. Four patients (8%) did not achieve the recommended guideline level of ≥150 min/wk of MVPA. Patients spent ≥80% of the week in sedentary activities. Patients overestimated MVPA with a median of 805 (218, 1363) min/wk (P < .001). The selected patient characteristics (age, body mass index, type of CAD, type of CR, social support, and self-efficacy) were not associated with this overestimation.

Most patients with CAD, participating in an outpatient CR program, do achieve MVPA exercise recommendations but spend simultaneously too much time in sedentary activities.
Most patients with CAD, participating in an outpatient CR program, do achieve MVPA exercise recommendations but spend simultaneously too much time in sedentary activities.
To assess the feasibility and clinical utility of coronary artery stent (CAS) in securing pancreatico-jejunal anastomosis (PJ) and avoid stent displacement after pancreatoduodenectomy (PD).

Externalized trans-anastomotic stent (ETS) is a standard mitigation strategy for postoperative pancreatic fistula (POPF) in high-risk patients. However, major morbidity remains extremely elevated, especially in case of ETS malfunction due to displacement.

A pilot series of 72 patients underwent PD and PJ with CAS positioning between January 2016 and December 2019. All patients were at high-risk for POPF (soft pancreatic texture; main pancreatic duct diameter ≤ 3 mm) and underwent a CT-scan at postoperative day 5 and 10 to assess the correct CAS positioning. Postoperative outcomes were analyzed, and displacement rates were compared with a cohort of 141 patients with the same high-risk characteristics, undergoing PD with PJ and externalized trans-anastomotic stent (ETS).

No CAS-related complications were registered in the study group.
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