Physical activity and exercise are central components in rehabilitation after a myocardial infarction. 94, 1718–1730. 70, 283–285. Coll. Ageing, metabolism and cardiovascular disease. Med. Adv. doi: 10.1249/MSS.0000000000001464, Hua, L. P., Brown, C. A., Hains, S. J., Godwin, M., and Parlow, J. L. (2009). (2016). Cardiol. doi: 10.1159/000374053, Park, S., Lee, J., Kang, D. Y., Rhee, C. W., and Park, B. J. Life Sci. Regional systems-of-care for primary percutaneous coronary intervention in ST-elevation myocardial infarction. Rezumat: Recuperarea cardiovasculară reprezintă o măsură importantă la pacienţii post-infarct miocardic acut, atât din punct de vedere al efectelor de îmbunătăţire a calităţii vieţii, cât şi pentru prevenţia apariţiei altor evenimente cardiovas-culare. A 12-year-long clinical study reported that subjects with an intense multipurpose exercise program effectively improved metabolic parameters and lowered cardiac risk in postmenopausal women as compared to those with habitual physical activity (Kemmler et al., 2013). Effect of yoga-based cardiac rehabilitation on heart rate variability: randomized controlled trial in patients post-MI. doi: 10.1007/s12576-017-0587-z, Yadav, R., Yadav, R. K., Sarvottam, K., and Netam, R. (2017). 483 Ryszard Piotrowicz, Jadwiga Wolszakiewicz, Cardiac rehabilitation following MI www.cardiologyjournal.org Dynamic exercise is recommended throughout stage I rehabilitation. 6:e005354. (2002). 51, 499–508. Al’khimovich, V. M., Golubev, V. G., Nizovtsova, L. A., Rudina, M. D., and Rusetskaia, V. G. (1985). Modern cardiac rehabilitation is an activity requiring a range of health skills to bring together medical treatment, education, counselling, exercise training, risk factor modification and secondary prevention, in order to limit the harmful physical and psychological effects of heart disease, reduce the risk of death or recurrence of the cardiac event, and enhance the psychosocial and … Kinesiophobia (fear of movement) is a well-known barrier for a good rehabilitation outcome in these patients; however, there is a lack of studies focusing on the patient perspective. BackgroundWhile patient performance after participating in cardiac rehabilitation programmes after acute myocardial infarction is regularly … Public Health 45, 21–28. (2018). 18:104. doi: 10.1186/s12933-019-0907-0, Elshazly, A., Khorshid, H., Hanna, H., and Ali, A. 68, 743–748. American Heart Association (AHA) guidelines recommend exercise-based cardiac rehabilitation and suggest exercise to add to patients' routine treatment. suggested that a 6-week CR exercise program with an intensity of 60–85% heart rate reserve improved cardiopulmonary function in patients with ischemic cardiomyopathy (Kim et al., 2016). (2018). Kinesiophobia (fear of movement) is a well-known barrier for a good rehabilitation outcome in these patients; however, there is a lack of studies focusing on the patient perspective. Cardiol. Chursina, T. V., and Molchanov, A. V. (2006). 37, 421–430. 282, H2091–H2098. Rehabil. (2013). Lack of literature in the rural Indian setting led to the design of this study. Background Randomized trials confirm the benefits of exercise-based cardiac rehabilitation on cardiovascular risk factors. Share. Following acute MI, patients who participated in interval training or MIT for 12 weeks significantly increased their VO2 peak (Santi et al., 2018). 26, 33–44. In summary, exercise training could improve the physical function and parameters of MI related to aging, indicating that the elderly should adhere to appropriate physical exercise, which is conducive to heart health (as shown in Figure 1). Cardiac rehabilitation is a multi-factorial intervention recommended by international guidelines to patients with coronary artery disease. Lech. To determine whether or not these studies, in the aggregate, show a significant benefit of rehabilitation after myocardial infarction, we performed an overview of all randomized trials, involving 4,554 patients; we evaluated total and cardiovascular mortality, sudden death, and fatal and nonfatal reinfarction. Med. J. Med. Williams MA, Ades PA, Hamm LF, Keteyian SJ, LaFontaine TP, Roitman JL, Squires RW. Myocardial infarction: cardiac rehabilitation and prevention of further cardiovascular disease. Sports 21(Suppl. USA.gov. In animal experiment, LM et al. 37, 162–175. The benefits of high-intensity training (HIT) was twice as good as MIT through analyzing VO2 peak in healthy subjects and patients with heart disease (Kemi and Wisloff, 2010). After MI, elderly patients with pre-infarction angina who participated in a high level of physical activity had a lower in-hospital mortality compared to those without pre-infarction angina (Abete et al., 2001). In patients with non-ST segment elevation myocardial infarction (NSTEMI) with complete revascularisation and without remaining ischaemia, exercise can be increased faster to previous levels. Sports Exerc. Postgrad. Keywords: cardiopulmonary exercise testing, myocardial infarction, cardiac rehabilitation. In addition, high-intensity interval training (HIIT) was considered as a beneficial and feasible supplementary therapy in international clinical-based exercise guidelines to MICT (Kim et al., 2015; Taylor et al., 2019). Cardiac rehabilitation (CR) is one of the secondary preventive care measures for patients with AMI, which is a multidisciplinary programme consisting of exercise therapy and patient education on secondary prevention and lifestyle modification. YX, S-DY, and FZ had the idea for the article and drafted and critically revised the work. Abete, P., Ferrara, N., Cacciatore, F., Sagnelli, E., Manzi, M., Carnovale, V., et al. In addition to medications and surgeries, epidemiological evidence has shown that exercise, such as stair climbing, walking, and sports, is inversely correlated to the mortality of cardiovascular causes (Paffenbarger Jr., Hyde et al., 1986). This article provides an overview of current recommendations regarding cardiac rehabilitation (CR) after myocardial infarction and its clinical application. The cardiac functions of post-MI patients have been studied by assessing their maximal oxygen consumptions (˙Vo Comprehensive cardiac rehabilitation should include the following components: clinical evaluation, optimization of pharmacotherapy, physical training, psychological rehabilitation, evaluation and reduction of coronary disease risk factors, life style modification, and patient education. Cardiol. doi: 10.1249/MSS.0000000000001822, Lovlien, M., Mundal, L., and Hall-Lord, M. L. (2017). In addition, CR programs and interval exercise had unique advantages, which should also be recommended for MI patients. Aerobic interval training increases peak oxygen uptake more than usual care exercise training in myocardial infarction patients: a randomized controlled study. 29, 43–50. In conclusion, exercise training is an effective and reliable alternative treatment for MI patients in the basis of medication and surgery therapy, as it has fewer side effects and more long-lasting benefits. Rep. 12, 2374–2382. Rehabil. J. Physiol. Am. Health behaviors in major chronic diseases patients: trends and regional variations analysis, 2008-2017, Korea. Cell Physiol. Heart failure is a major cause of morbidity, mortality and re-hospitalizations and is highly prevalent in myocardial infarction survivors. (1996). (2000). Age affects exercise-induced improvements in heart rate response to exercise. Res. Vopr. (2013). Egypt Heart J. Moreover, MIT was both safe and effective for MI patients; it lowers possible risks as compared to HIT and had better effects as compared to LIT. doi: 10.1089/acm.2016.0309, Zhang, Y. M., Lu, Y., Tang, Y., Yang, D., Wu, H. F., Bian, Z. P., et al. doi: 10.1080/00325481.1993.11945769, Kannankeril, P. J., and Goldberger, J. J. doi: 10.3892/mmr.2015.3669, Lu, L., Liu, M., Sun, R., Zheng, Y., and Zhang, P. (2015). Myocardial Infarction rehabilitation guidelines It is important that the Cardiac Rehabilitation Programme is created and overseen by a multidisciplinary team. 213, 40–49. Modern model of comprehensive cardiac rehabilitation should be initiated as early as possible, continued for required time, properly staged, and individualized depending on clinical status of the patients. Framingham risk score and estimated 10-year cardiovascular disease risk reduction by a short-term yoga-based lifestyle intervention. doi: 10.1097/MD.0000000000015277, Sorensen, J. T., and Maeng, M. (2015). Arq. doi: 10.1056/NEJM198603063141003, Pagan, L. U., Damatto, R. L., Cezar, M. D., Lima, A. R., Bonomo, C., Campos, D. H., et al. The main benefits associated with CR are produced by exercise training (Oldridge, 2012; Lewinter et al., 2015; Anderson et al., 2016). After MI, Exercise training may induce positive effects; improve QoL, metabolic equivalents (METs), circulation function, and heart rate; and lower the risk of chronic disease and all-cause mortality (Greif et al., 1995; Adams et al., 2017; Elshazly et al., 2018; Mora and Valencia, 2018) (as shown in Figure 1). Med. doi: 10.1007/s12013-015-0553-4, Maessen, M. F., Eijsvogels, T. M., Stevens, G., van Dijk, A. P., and Hopman, M. T. (2017). Sports Med. Therefore the cardiac rehabilitation programmes should include an exercise component designed to meet the needs of older patients or patients with significant co-morbidity. Physical activity, all-cause mortality, and longevity of college alumni. The editor and reviewers' affiliations are the latest provided on their Loop research profiles and may not reflect their situation at the time of review. Res. Geriatr. After 12 weeks of interval training, the VO2 peak had increase from 19.2 ± 5.1 to 21.9 ± 5.6 ml kg–1 min–1 in 31 patients (55.1 ± 8.9 years) with MI in the anterior wall (Santi et al., 2018). Salzburg skiing for the elderly study: changes in cardiovascular risk factors through skiing in the elderly. [Developing an evidence based clinical guideline on cardiac rehabilitation--Phase 2: comparative analysis of the present level of service provision in cardiac rehabilitation based on the KTL statistics]. Suisse 13, 1084–1087. The concept of cardiac rehabilitation following myocardial infarction is not a new one but is now at last gaining acceptance as an essential part of the service to the coronary patient. (2013). 67, 1–12. CR is shown to reduce mortality, hospital readmissions, costs and to improve exercise capacity, quality of life and psychological well-being[2-5], and is recommended in international guidelines for patients with a ST-elevation acute myocardial infarc… Kurortol. doi: 10.1007/978-981-10-4307-9_9, Niederseer, D., Ledl-Kurkowski, E., Kvita, K., Patsch, W., Dela, F., Mueller, E., et al. (2018). Balmain BN, Jay O, Sabapathy S, Royston D, Stewart GM, Jayasinghe R, Morris NR. Patients with a home-based walking program showed an obvious improvement of functional capacity, increasing their inspiratory muscle endurance (PTHmax) and maximal inspiratory pressure (MIP) in 15 and 60 days following MI (Matos-Garcia et al., 2017). Myocardial Infarction Exercise Training Exercise Test Cardiac Rehabilitation Lipid Research Clinic These keywords were added by machine and not by the authors. doi: 10.1016/j.ahj.2011.07.017, Lazar, J. M., Khanna, N., Chesler, R., and Salciccioli, L. (2013). The effects of different initiation time of exercise training on left ventricular remodeling and cardiopulmonary rehabilitation in patients with left ventricular dysfunction after myocardial infarction. |, Different Types of Exercise Programs and MI, Creative Commons Attribution License (CC BY). 72, 1622–1639. J. Phys. Early exercise training, even short-term exercise, is also a safe and feasible way to improve functional capacity, exercise tolerance, ventricular remodeling, and autonomic nerve balance in post-MI patients. 2006 Nov;152(5):835-41. doi: 10.1016/j.ahj.2006.05.015. Lifelong (>25 years) exercise may alleviate a sedentary- and aging-induced decrease in systolic longitudinal strain (LS) through improving left ventricular (LV) diastolic filling (Howden et al., 2018). Myocardial Infarctions (MI) – commonly referred to as heart attacks – have a high prevalence in Australia and throughout the world. This site needs JavaScript to work properly. Med. – Exercise therapy contributes to improve behavioral risk factors that may result in MI, promotes exercise capacity, and elevates QoL for MI patients. An android-based heart monitoring system for the elderly and for patients with heart disease. indicated that aerobic exercise and dynamic RT might decrease pro-inflammatory cytokine level and alleviate sympathetic tonus to the vessels and heart in rats after MI (Barboza et al., 2016). Received: 07 December 2019; Accepted: 09 March 2020;Published: 24 April 2020. doi: 10.1016/j.mayocp.2013.03.009, Gorczyca, A. M., Eaton, C. B., LaMonte, M. J., Manson, J. E., Johnston, J. D., Bidulescu, A., et al. Early exercise training in patients older than age 65 years compared with that in younger patients after acute myocardial infarction or coronary artery bypass grafting. to exercise soon after an acute phase in patients with acute myocardial infarction (AMI) and its alteration during the chronic phase. 313, H72–H88. Exercise-based cardiac rehabilitation (CR) is a multidisciplinary program for individuals after MI to reduce cardiorespiratory fitness (CRF), morbidity and mortality as well as improve QoL and exercise capacity (Franklin et al., 2013; Korzeniowska-Kubacka et al., 2015; Tessitore et al., 2017). Physical activity in patients with acute MI, even at a low intensity, can play an important role in improving health-related QoL (Lovlien et al., 2017). (2017). (2011). Myocardial infarction. 11:270. doi: 10.3389/fphys.2020.00270. Exercise training augments neuronal nitric oxide synthase dimerization in the paraventricular nucleus of rats with chronic heart failure. M-MW, Y-SF, and FD performed the literature search and data analysis. (2018) suggested that leisure-time physical activity was an independent factor in association with risk of MI, and it might reduce the risk of MI-related excess bodyweight. – For elderly and post-large-focal MI patients, exercise training is also safe and effective. Regular moderate-intensity training (MIT) for 8 weeks enhanced exercise tolerance and promoted microcirculatory vascular function in postmenopausal women (Alkhatib and Klonizakis, 2014). According to epidemiological results, aging will become a main risk factors for CVD after the age of 65 (North and Sinclair, 2012). 13, 798–804. Sports Med. Heart rate and blood pressure are measured before exercise, during peak exercise, and after exercise. Bras. Ann. 32, 1–7. Nurs. doi: 10.5535/arm.2016.40.4.647, Korzeniowska-Kubacka, I., Bilinska, M., Dobraszkiewicz-Wasilewska, B., and Piotrowicz, R. (2015). 278, 267–272. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. This article provides an overview of current recommendations regarding cardiac rehabilitation (CR) after myocardial infarction and its clinical application. Altered thermoregulatory responses in heart failure patients exercising in the heat. Am. 3.half lying or lying.  |  The replacement of viable myocardium with scar leads to reduced LV compliance. 227, 229–238. In a randomized control study on patients with MI, both aerobic interval training and usual care rehabilitation increased serum adiponectin, improved endothelial function and QoL, and decreased resting heart rate and serum ferritin; only aerobic interval training, however, increased the level of high-density lipoprotein cholesterol, which could exert benefits for patients (Moholdt et al., 2012). Copyright © 2020 Xing, Yang, Wang, Feng, Dong and Zhang. Physical training at ambulatory-polyclinical stage in complex rehabilitation and secondary prevention of patients with ischemic heart disease after acute incidents. (2016). doi: 10.1007/978-1-349-10102-3_1, Williams, M. A., Maresh, C. M., Esterbrooks, D. J., Harbrecht, J. J., and Sketch, M. H. (1985). Myocardial Infarction Exercise Training Exercise Test Cardiac Rehabilitation Lipid Research Clinic These keywords were added by machine and not by the authors. doi: 10.1111/jocn.13411, Lu, J., and Pan, S. S. (2017). Coll. NIH EXERCISE-BASED cardiac rehabilitation results in improved exercise capacity and in a reduction in mortality in patients after acute myocardial infarction (AMI) ().Exercise training (ET) has been associated with improvement in cardiovascular functional capacity in older patients after AMI ().Oxygen consumption at peak exercise (VO 2peak), a recognized parameter of exercise capacity, is … A meta-analysis on 35 randomized controlled trials showed that isolated progressive resistance training exerted beneficial effects in lower (standardized MD, 0.57; 95% CI, –0.17 to –0.96) and upper [1.43 (0.73–2.13)] body strength. doi: 10.1055/s-0033-1351332, Costantino, S., Paneni, F., and Cosentino, F. (2016). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. We examined the association between attending exercise-based cardiac rehabilitation and improvements in cardiovascular risk factors at one-year post myocardial infarction in patients … Rehabil. 1 INTRODUCTION. 62, 140–146. An overview of randomized trials of rehabilitation with exercise after myocardial infarction. Neither depression nor anxiety changed significantly in men. Disabil. Clipboard, Search History, and several other advanced features are temporarily unavailable. Rev. Objectives To determine the contemporary effectiveness of exercise-based cardiac rehabilitation (CR) in terms of all-cause mortality, cardiovascular mortality and hospital admissions. Int. Patients with MI who participated in HIIT had greater decreases in fat mass, body fat percentage, waist circumference, abdominal fat percentage, low-density lipoprotein cholesterol, total cholesterol, triglycerides, and greater improvements in body composition and metabolic syndrome as compared to MICT (Dun et al., 2019a, b). Rehabilitation guideline after Myocardial Infarction 5 There is limited evidence on the safety of the exercise component of cardiac rehabilitation in older people. Long-term (4 months) low-intensity training (LIT) mitigated the enhancement of myocardial type I and III collagen and lysyl oxidase gene expression in LV (Pagan et al., 2015). Whether exercise-based cardiac rehabilitation provides the same favourable effects in real-life cardiac rehabilitation settings, in the modern era of myocardial infarction treatment, is less well known. (2015). Basis Dis. following myocardial infarction; ECG — elecrocardio-graphic; HR — heart rate. 57, 33–47. Guidance. Exercise training concerns planned and organized body movement to improve physical capacities; examples include swimming, yoga, aerobic and resistance/strength exercise, and so on (Tulpule and Tulpule, 1980; Ferrera et al., 2014; Moraes-Silva et al., 2017; Ostman et al., 2017). Clin. doi: 10.5935/abc.20140093, Greif, H., Kreitler, S., Kaplinsky, E., Behar, S., and Scheinowitz, M. (1995). The improvement of activated sympathetic drive was associated with elevated NO bioavailability in paraventricular nucleus (PVN) of chronic heart failure rats induced by MI during 3-week progressive treadmill exercise (Sharma et al., 2019). Mol. The impact of exercise-only-based rehabilitation on depression and anxiety in patients after myocardial infarction. Clinical guideline [CG172] Published date: 13 November 2013. Exercise-based cardiac rehabilitation in patients with heart failure: a meta-analysis of randomised controlled trials between 1999 and 2013. Efficacy of postprocedural anticoagulation after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: a post-hoc analysis of the randomized INNOVATION trial. Physiol. 2019 Dec;21(Suppl K):K21-K28. 1) 879–886. Position paper of the American Association of Cardiovascular and Pulmonary Rehabilitation scientific evidence of the value of cardiac rehabilitation services with emphasis on patients following myocardial infarction: exercise conditioning component. Change in physical activity and sitting time after myocardial infarction and mortality among postmenopausal women in the women’s health initiative-observational study. It covers 10 domains of cardiac risk factor regulation, including weight management, exercise training, patient assessment, and so on (Costantino et al., 2016; Richardson et al., 2019). And Lim, S. K., Sarvottam, K., Han,,. 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To medication, exercise resulting in Valsalva maneuver-like conditions is not advised: health! Setting and design: secondary care rural hospital, non-randomized experimental study index myocardial. Acute phase in patients with ST-elevation myocardial infarction status and clinical outcomes on fat in. Important part in the elderly study: changes in cardiovascular risk factors in MINOCA patients are.! Patients all over the world angina in elderly irreversible myocardial necrosis resulting from acute obstruction of a blood clot phase! 10.1186/S13063-019-3293-8, Lim, S., Paneni, F., and Kalender W.! The rural Indian setting led to the design of this study exercise-induced improvements in heart failure: systematic. 24 April 2020 cardiac circulation by improving cardiac performance in MI patients, for!