Improved exercise tolerance and quality of life with cardiac rehabilitation of older patients after myocardial infarction: results of a randomized, controlled trial.

Abstract:

BACKGROUND:Whether cardiac rehabilitation (CR) is effective in patients older than 75 years, who have been excluded from most trials, remains unclear. We enrolled patients 46 to 86 years old in a randomized trial and assessed the effects of 2 months of post-myocardial infarction (MI) CR on total work capacity (TWC, in kilograms per meter) and health-related quality of life (HRQL). METHODS AND RESULTS:Of 773 screened patients, 270 without cardiac failure, dementia, disability, or contraindications to exercise were randomized to outpatient, hospital-based CR (Hosp-CR), home-based CR (Home-CR), or no CR within 3 predefined age groups (middle-aged, 45 to 65 years; old, 66 to 75 years; and very old, >75 years) of 90 patients each. TWC and HRQL were determined with cycle ergometry and Sickness Impact Profile at baseline, after CR, and 6 and 12 months later. Within each age group, TWC improved with Hosp-CR and Home-CR and was unchanged with no CR. The improvement was similar in middle-aged and old persons but smaller, although still significant, in very old patients. TWC reverted toward baseline by 12 months with Hosp-CR but not with Home-CR. HRQL improved in middle-aged and old CR and control patients but only with CR in very old patients. Complications were similar across treatment and age groups. Costs were lower for Home-CR than for Hosp-CR. CONCLUSIONS:Post-MI Hosp-CR and Home-CR are similarly effective in the short term and improve TWC and HRQL in each age group. However, with lower costs and more prolonged positive effects, Home-CR may be the treatment of choice in low-risk older patients.

journal_name

Circulation

journal_title

Circulation

authors

Marchionni N,Fattirolli F,Fumagalli S,Oldridge N,Del Lungo F,Morosi L,Burgisser C,Masotti G

doi

10.1161/01.CIR.0000066322.21016.4A

subject

Has Abstract

pub_date

2003-05-06 00:00:00

pages

2201-6

issue

17

eissn

0009-7322

issn

1524-4539

pii

01.CIR.0000066322.21016.4A

journal_volume

107

pub_type

临床试验,杂志文章,随机对照试验
  • Retrograde cerebral perfusion results in flow distribution abnormalities and neuronal damage. A magnetic resonance imaging and histopathological study in pigs.

    abstract:BACKGROUND:In the past few years, although significant efforts have been made to assess flow distribution during retrograde cerebral perfusion with microspheres, dye, or hydrogen clearance, flow distribution in real time is still undefined. We used MR perfusion imaging to monitor flow distribution in the brain during a...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:

    authors: Ye J,Ryner LN,Kozlowski P,Yang L,Del Bigio MR,Sun J,Donnelly M,Summers R,Salerno TA,Somorjai RL,Saunders JK,Deslauriers R

    更新日期:1998-11-10 00:00:00

  • Multifactorial actions of beta-adrenergic blocking drugs in ischemic heart disease: current concepts.

    abstract::It is generally agreed that the conditions leading to myocardial ischemia occur when the oxygen demands of the myocardium exceed the oxygen supply. The major limitations of oxygen supply to the myocardium are atherogenic disease and vasospasm of the coronary arteries. The major hemodynamic determinants of myocardial o...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:

    authors: Frishman WH

    更新日期:1983-06-01 00:00:00

  • Anatomic features in victims of sudden coronary death. Coronary artery pathology.

    abstract::Study of the detailed pathology of the myocardium and coronary arteries in ambulatory subjects dying suddenly of coronary heart disease shows that they can be divided into two groups. In one group, there is atherosclerosis with a new vascular event involving coronary thrombosis, which initiates acute myocardial ischem...

    journal_title:Circulation

    pub_type: 杂志文章,评审

    doi:

    authors: Davies MJ

    更新日期:1992-01-01 00:00:00

  • High-density lipoprotein deficiency and dyslipoproteinemia associated with venous thrombosis in men.

    abstract:BACKGROUND:Although dyslipoproteinemia is associated with arterial atherothrombosis, little is known about plasma lipoproteins in venous thrombosis patients. METHODS AND RESULTS:We determined plasma lipoprotein subclass concentrations using nuclear magnetic resonance spectroscopy and antigenic levels of apolipoprotein...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.104.521344

    authors: Deguchi H,Pecheniuk NM,Elias DJ,Averell PM,Griffin JH

    更新日期:2005-08-09 00:00:00

  • Intravenous pretreatment with A1-selective adenosine analogues protects the heart against infarction.

    abstract:BACKGROUND:Recent data from this laboratory indicate that pretreatment with adenosine can protect the heart against infarction via A1-receptors, but because of systemic hypotension, adenosine had to be given into the coronary circulation. METHODS AND RESULTS:In this study, we tested whether the protection could be ach...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.85.2.659

    authors: Thornton JD,Liu GS,Olsson RA,Downey JM

    更新日期:1992-02-01 00:00:00

  • Collagen-targeting vascular endothelial growth factor improves cardiac performance after myocardial infarction.

    abstract:BACKGROUND:Vascular endothelial growth factor (VEGF) is an important active protein for the induction of angiogenesis and improvement in cardiac function after myocardial ischemia; however, the lack of a delivery system targeted to the injured myocardium reduces the local therapeutic efficacy of VEGF and increases its ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.108.800565

    authors: Zhang J,Ding L,Zhao Y,Sun W,Chen B,Lin H,Wang X,Zhang L,Xu B,Dai J

    更新日期:2009-04-07 00:00:00

  • Aortocaval fistulae: a percutaneous model and treatment with stent grafts in sheep.

    abstract:BACKGROUND:Treatment of aortocaval fistulae (ACFs) by open surgery is known to be a high-risk procedure. In this experimental study, we developed a percutaneous model of ACF to test a new nonsurgical method of treatment of ACF using endovascular stent grafts. METHODS AND RESULTS:An ACF was created percutaneously in ei...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.94.1.108

    authors: Boudghène F,Sapoval M,Bonneau M,Bigot JM

    更新日期:1996-07-01 00:00:00

  • Endothelial beta3-adrenoreceptors mediate nitric oxide-dependent vasorelaxation of coronary microvessels in response to the third-generation beta-blocker nebivolol.

    abstract:BACKGROUND:The therapeutic effects of nonspecific beta-blockers are limited by vasoconstriction, thus justifying the interest in molecules with ancillary vasodilating properties. Nebivolol is a selective beta1-adrenoreceptor antagonist that releases nitric oxide (NO) through incompletely characterized mechanisms. We id...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.104.532960

    authors: Dessy C,Saliez J,Ghisdal P,Daneau G,Lobysheva II,Frérart F,Belge C,Jnaoui K,Noirhomme P,Feron O,Balligand JL

    更新日期:2005-08-23 00:00:00

  • Adiponectin specifically increased tissue inhibitor of metalloproteinase-1 through interleukin-10 expression in human macrophages.

    abstract:BACKGROUND:Vascular inflammation and subsequent matrix degradation play an important role in the development of atherosclerosis. We previously reported that adiponectin, an adipose-specific plasma protein, accumulated to the injured artery and attenuated vascular inflammatory response. Clinically, high plasma adiponect...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000127953.98131.ED

    authors: Kumada M,Kihara S,Ouchi N,Kobayashi H,Okamoto Y,Ohashi K,Maeda K,Nagaretani H,Kishida K,Maeda N,Nagasawa A,Funahashi T,Matsuzawa Y

    更新日期:2004-05-04 00:00:00

  • Mechanisms by which adenosine restores conduction in dormant canine pulmonary veins.

    abstract:BACKGROUND:Adenosine acutely reconnects pulmonary veins (PVs) after radiofrequency application, revealing "dormant conduction" and identifying PVs at risk of reconnection, but the underlying mechanisms are unknown. METHODS AND RESULTS:Canine PV and left-atrial (LA) action potentials were recorded with standard microel...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.109.893107

    authors: Datino T,Macle L,Qi XY,Maguy A,Comtois P,Chartier D,Guerra PG,Arenal A,Fernández-Avilés F,Nattel S

    更新日期:2010-03-02 00:00:00

  • p27kip1-838C>A single nucleotide polymorphism is associated with restenosis risk after coronary stenting and modulates p27kip1 promoter activity.

    abstract:BACKGROUND:The cyclin-dependent kinase inhibitor p27(kip1) is a key regulator of smooth muscle cell and leukocyte proliferation in vascular disease, including in-stent restenosis. We therefore hypothesized that common genetic variations or single nucleotide polymorphisms in p27(kip1) may serve as a useful tool in risk ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.108.842179

    authors: van Tiel CM,Bonta PI,Rittersma SZ,Beijk MA,Bradley EJ,Klous AM,Koch KT,Baas F,Jukema JW,Pons D,Sampietro ML,Pannekoek H,de Winter RJ,de Vries CJ

    更新日期:2009-08-25 00:00:00

  • Valve replacement for aortic stenosis in patients with poor left ventricular function: comparison of early changes with stented and stentless valves.

    abstract:BACKGROUND:Long-standing aortic stenosis causes significant left ventricular (LV) dysfunction, which may progress irreversibly. In many cases, LV function can be salvaged by aortic valve surgery, although debate exists regarding the best valve prosthesis to use. METHODS AND RESULTS:We studied 33 patients retrospective...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.100.suppl_2.ii-1

    authors: Collinson J,Henein M,Flather M,Pepper JR,Gibson DG

    更新日期:1999-11-09 00:00:00

  • Modulation of drug effects by regional sympathetic denervation and supersensitivity.

    abstract:BACKGROUND:Regional sympathetic denervation, such as that produced by a myocardial infarction, causes electrophysiological heterogeneity in the ventricles. The purpose of this study was to test the hypothesis that such denervation could cause drugs to exert heterogeneous myocardial effects. METHODS AND RESULTS:Sympath...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.84.4.1709

    authors: Stanton MS,Zipes DP

    更新日期:1991-10-01 00:00:00

  • Endocardial excision: a new surgical technique for the treatment of recurrent ventricular tachycardia.

    abstract::Twelve patients with medically refractory ventricular tachycardia secondary to ischemic heart disease underwent surgery for cure of their arrhythmia. Preoperatively, the tachycardia could be reproducibly initiated and terminated in each patient by programmed stimulation. In all instances, intraoperative mapping locali...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.60.7.1430

    authors: Josephson ME,Harken AH,Horowitz LN

    更新日期:1979-12-01 00:00:00

  • Regional myocardial blood flow redistribution as a cause of postprandial angina pectoris.

    abstract:BACKGROUND:Postprandial angina pectoris has been recognized for more than two centuries and can be identified in up to 10% of patients with chronic ischemic heart disease. Redistribution of myocardial blood flow, from a region supplied by a severely stenotic coronary artery to those supplied by less diseased or normal ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.97.12.1144

    authors: Baliga RR,Rosen SD,Camici PG,Kooner JS

    更新日期:1998-03-31 00:00:00

  • Effects on coagulation and fibrinolysis with reduced versus full systemic heparinization and heparin-coated cardiopulmonary bypass.

    abstract:BACKGROUND:Extracorporeal circulation with circuits coated with surface-bound heparin has allowed reduced levels of systemic heparinization. Clinical benefits have included reduced postoperative bleeding and less homologous blood usage. However, the effects on the hemostatic and fibrinolytic systems have remained in pa...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.cir.92.9.2579

    authors: Ovrum E,Brosstad F,Am Holen E,Tangen G,Abdelnoor M

    更新日期:1995-11-01 00:00:00

  • Exercise performance after repair of anomalous origin of the left coronary artery from the pulmonary artery.

    abstract::Eleven patients underwent exercise testing after operative repair of anomalous origin of the left coronary artery from the pulmonary artery. Five patients repaired after 2 years of age comprised a childhood surgery group, and six patients repaired before 2 years of age comprised an infant surgery group. All patients w...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.81.4.1287

    authors: Paridon SM,Farooki ZQ,Kuhns LR,Arciniegas E,Pinsky WW

    更新日期:1990-04-01 00:00:00

  • Transcriptomic and proteomic patterns of systemic inflammation in on-pump and off-pump coronary artery bypass grafting.

    abstract:BACKGROUND:Coronary artery bypass grafting (CABG) using cardiopulmonary bypass (CPB) provides controlled operative conditions but induces a whole-body inflammatory response capable of initiating devastating morbidity and mortality. Although technically more demanding, deliberate avoidance of CPB in off-pump surgery att...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.104.531152

    authors: Tomic V,Russwurm S,Möller E,Claus RA,Blaess M,Brunkhorst F,Bruegel M,Bode K,Bloos F,Wippermann J,Wahlers T,Deigner HP,Thiery J,Reinhart K,Bauer M

    更新日期:2005-11-08 00:00:00

  • Cardiac Arrest in Pregnancy: A Scientific Statement From the American Heart Association.

    abstract::This is the first scientific statement from the American Heart Association on maternal resuscitation. This document will provide readers with up-to-date and comprehensive information, guidelines, and recommendations for all aspects of maternal resuscitation. Maternal resuscitation is an acute event that involves many ...

    journal_title:Circulation

    pub_type: 杂志文章,实务指引,评审

    doi:10.1161/CIR.0000000000000300

    authors: Jeejeebhoy FM,Zelop CM,Lipman S,Carvalho B,Joglar J,Mhyre JM,Katz VL,Lapinsky SE,Einav S,Warnes CA,Page RL,Griffin RE,Jain A,Dainty KN,Arafeh J,Windrim R,Koren G,Callaway CW,American Heart Association Emergency Cardio

    更新日期:2015-11-03 00:00:00

  • Efficacy of dopamine, dobutamine, and epinephrine during emergence from cardiopulmonary bypass in man.

    abstract::Hemodynamic effects of dobutamine and dopamine (both 5, 10, 15 microgram/kg/min) and epinephrine (0.04 microgram/kg/min) were studied immediately following cessation of cardiopulmonary bypass in 34 patients with preoperative evidence of left ventricular dysfunction. Significant increases in mean cardiac index were see...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.57.2.378

    authors: Steen PA,Tinker JH,Pluth JR,Barnh;rst DA,Tarhan S

    更新日期:1978-02-01 00:00:00

  • Determinants and prognostic implications of persistent ST-segment elevation after primary angioplasty for acute myocardial infarction: importance of microvascular reperfusion injury on clinical outcome.

    abstract:BACKGROUND:Despite early recanalization of an occluded infarct artery, reperfusion at the level of the microcirculation may remain impaired owing to a process of microvascular reperfusion injury. METHODS AND RESULTS:Microvascular reperfusion injury was studied in 91 patients with acute myocardial infarction (AMI) by e...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.99.15.1972

    authors: Claeys MJ,Bosmans J,Veenstra L,Jorens P,De RaedtH,Vrints CJ

    更新日期:1999-04-20 00:00:00

  • Acute ischemic ventricular septal defect.

    abstract::Thirty-one published reports (366 patients) and 48 consecutive patients treated for postinfarction ventricular septal defect at four institutions in northern California were reviewed. Overall hospital mortality was 43% in the reviewed group and was not affected by age, concomitant myocardial revascularization, date of...

    journal_title:Circulation

    pub_type: 杂志文章,评审

    doi:

    authors: Hill JD,Stiles QR

    更新日期:1989-06-01 00:00:00

  • Comparison of angioplasty and surgery for unoperated coarctation of the aorta.

    abstract:BACKGROUND:The use of balloon coarctation angioplasty instead of surgery as treatment for unoperated coarctation of the aorta is controversial. The efficacy and complications of the two procedures have not been studied before in a prospective fashion. METHODS AND RESULTS:Thirty-six patients were prospectively randomiz...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1161/01.cir.87.3.793

    authors: Shaddy RE,Boucek MM,Sturtevant JE,Ruttenberg HD,Jaffe RB,Tani LY,Judd VE,Veasy LG,McGough EC,Orsmond GS

    更新日期:1993-03-01 00:00:00

  • Bone morphogenic protein-4 induces hypertension in mice: role of noggin, vascular NADPH oxidases, and impaired vasorelaxation.

    abstract:BACKGROUND:Recent in vitro studies have shown that disturbed flow and oxidative conditions induce the expression of bone morphogenic proteins (BMPs 2 and 4) in cultured endothelial cells. BMPs can stimulate superoxide production and inflammatory responses in endothelial cells, raising the possibility that BMPs may play...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.106.611822

    authors: Miriyala S,Gongora Nieto MC,Mingone C,Smith D,Dikalov S,Harrison DG,Jo H

    更新日期:2006-06-20 00:00:00

  • Pulmonary hyperinflation and left ventricular mass: the Multi-Ethnic Study of Atherosclerosis COPD Study.

    abstract:BACKGROUND:Left ventricular (LV) mass is an important predictor of heart failure and cardiovascular mortality, yet determinants of LV mass are incompletely understood. Pulmonary hyperinflation in chronic obstructive pulmonary disease (COPD) may contribute to changes in intrathoracic pressure that increase LV wall stres...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.113.001653

    authors: Smith BM,Kawut SM,Bluemke DA,Basner RC,Gomes AS,Hoffman E,Kalhan R,Lima JA,Liu CY,Michos ED,Prince MR,Rabbani L,Rabinowitz D,Shimbo D,Shea S,Barr RG

    更新日期:2013-04-09 00:00:00

  • Peroxisome proliferator-activated receptor gamma plays a critical role in inhibition of cardiac hypertrophy in vitro and in vivo.

    abstract:BACKGROUND:Peroxisome proliferator-activated receptors (PPARs) are transcription factors of the nuclear receptor superfamily. It has been reported that the thiazolidinediones, which are antidiabetic agents and high-affinity ligands for PPARgamma, regulate growth of vascular cells. In the present study, we examined the ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/hc1002.105225

    authors: Asakawa M,Takano H,Nagai T,Uozumi H,Hasegawa H,Kubota N,Saito T,Masuda Y,Kadowaki T,Komuro I

    更新日期:2002-03-12 00:00:00

  • Stabilization of atherosclerotic plaques by blockade of macrophage migration inhibitory factor after vascular injury in apolipoprotein E-deficient mice.

    abstract:BACKGROUND:Macrophage migration inhibitory factor (MIF), a cytokine that controls cell-mediated inflammatory responses, is upregulated in atherogenesis; however, its functional contribution to lesion development has not been evaluated. METHODS AND RESULTS:We studied the role of MIF on neointima lesion formation after ...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000109201.72441.09

    authors: Schober A,Bernhagen J,Thiele M,Zeiffer U,Knarren S,Roller M,Bucala R,Weber C

    更新日期:2004-01-27 00:00:00

  • Arterial stiffness increases with deteriorating glucose tolerance status: the Hoorn Study.

    abstract:BACKGROUND:Type 2 diabetes (DM-2) and impaired glucose metabolism (IGM) are associated with an increased cardiovascular disease risk. In nondiabetic individuals, increased arterial stiffness is an important cause of cardiovascular disease. Associations between DM-2 and IGM and arterial stiffness have not been systemati...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000065222.34933.FC

    authors: Henry RM,Kostense PJ,Spijkerman AM,Dekker JM,Nijpels G,Heine RJ,Kamp O,Westerhof N,Bouter LM,Stehouwer CD,Hoorn Study.

    更新日期:2003-04-29 00:00:00

  • Implementation of Supervised Exercise Therapy for Patients With Symptomatic Peripheral Artery Disease: A Science Advisory From the American Heart Association.

    abstract::Patients with lower-extremity peripheral artery disease (PAD) have greater functional impairment, faster functional decline, increased rates of mobility loss, and poorer quality of life than people without PAD. Supervised exercise therapy (SET) improves walking ability, overall functional status, and health-related qu...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIR.0000000000000727

    authors: Treat-Jacobson D,McDermott MM,Beckman JA,Burt MA,Creager MA,Ehrman JK,Gardner AW,Mays RJ,Regensteiner JG,Salisbury DL,Schorr EN,Walsh ME,American Heart Association Council on Peripheral Vascular Disease; Council on Cardiovascular

    更新日期:2019-09-24 00:00:00

  • Effect of obesity and insulin resistance on myocardial substrate metabolism and efficiency in young women.

    abstract:BACKGROUND:Obesity is a risk factor for impaired cardiac performance, particularly in women. Animal studies suggest that alterations in myocardial fatty acid metabolism and efficiency in obesity can cause decreased cardiac performance. In the present study, we tested the hypothesis that myocardial fatty acid metabolism...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000127959.28627.F8

    authors: Peterson LR,Herrero P,Schechtman KB,Racette SB,Waggoner AD,Kisrieva-Ware Z,Dence C,Klein S,Marsala J,Meyer T,Gropler RJ

    更新日期:2004-05-11 00:00:00