Journal of Cardiopulmonary Rehabilitation and Prevention最新文献

{"title":"Heart Rate Variability-Guided Exercise Training Compared With Standard Exercise Training in Patients With Coronary Artery Disease: A RANDOMIZED CLINICAL TRIAL.","authors":"Florent Besnier, Mathieu Gayda, Pierre-Olivier Magnan, Josep Iglesies-Grau, Antoine Bouvard, Nicolas Martin, Sarah Clavet, Maxime Duclos, Anil Nigam, Martin Juneau, Philippe L'Allier, Louis Bherer","doi":"10.1097/HCR.0000000000001017","DOIUrl":"10.1097/HCR.0000000000001017","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to compare heart rate variability-guided (HRV-G) exercise training versus standard exercise training (SET) on peak oxygen uptake (V̇O₂ peak ) in patients experiencing an acute coronary syndrome event.</p><p><strong>Methods: </strong>This randomized controlled trial included 48 patients randomized to HRV-G or SET. Both groups consisted of 3 aerobic exercise sessions per week for 3 months. For the HRV-G group, daily exercise was based on a 5-minute morning heart rate recording and the root mean square of successive differences between normal heartbeats (RMSSD). If RMSSD was within ±0.5 SD from baseline, a high-intensity interval training session was performed; if beyond ±0.5 SD , an active recovery session was prescribed. The SET group did 2 sessions of moderate-intensity continuous exercise and 1 session of high-intensity interval training per week, irrespective of HRV status.</p><p><strong>Results: </strong>The V̇O₂ peak increased significantly in both groups (+1.9 mL·kg -1 ·min -1 , P = .002 for SET and +2.1 mL·kg -1 ·min -1 , P < .001 for HRV-G) with no significant group-by-time interaction ( P = .794). Fifty percent of patients were considered responders (ΔV̇O₂ peak change post-pre >5%) in the SET group versus 75% in the HRV-G group ( P = .111). There was a significant time-by-group interaction for V̇O 2 at the first ventilatory threshold, adjusted for lean body mass, showing greater improvement in the HRV-G group compared with the SET group ( P = .043). The training load was significantly lower in HRV-G.</p><p><strong>Conclusions: </strong>In patients with coronary artery disease, HRV-G exercise training led to similar V̇O₂ peak improvements and prevalence of responders but a larger improvement in V̇O 2 at the first ventilatory threshold adjusted for lean body mass compared with SET, despite a lower training load.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"211-218"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding Pulmonary Rehabilitation Beyond Chronic Obstructive Pulmonary Disease and Long COVID: ITS ROLE IN COMPARATIVE EVIDENCE.","authors":"Tetsuro Maeda, Abebaw Mengistu Yohannes","doi":"10.1097/HCR.0000000000001054","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001054","url":null,"abstract":"","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":"46 3","pages":"155-157"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Contemporary Review of Spontaneous Coronary Artery Dissection: CLINICAL CARE, CARDIAC REHABILITATION, AND FUTURE DIRECTIONS.","authors":"Patricia Carey, Ashley E Battenberg, Sharonne N Hayes, Amanda R Bonikowske, Laura Suarez Pardo, Kathryn F Larson, Marysia S Tweet","doi":"10.1097/HCR.0000000000001016","DOIUrl":"10.1097/HCR.0000000000001016","url":null,"abstract":"<p><strong>Purpose: </strong>Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome predominantly affecting women. Although the knowledge of SCAD has expanded over the past 2 decades, limited evidence exists to guide post-event management and prevention of future adverse events. This review aims to synthesize the current understanding of SCAD and outline considerations for exercise prescription and cardiac rehabilitation (CR) in this unique population.</p><p><strong>Review methods: </strong>A comprehensive literature review was conducted, incorporating original research articles, systematic reviews, meta-analyses, and current clinical guidelines related to SCAD and CR.</p><p><strong>Summary: </strong>Current literature demonstrates that CR is safe in this population and is associated with improvement in measures of physical and mental health. Expert consensus supports reintroduction of exercise and an individualized multidisciplinary CR framework.This review highlights current evidence and expert recommendations for the multidisciplinary outpatient management of patients with SCAD.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"158-167"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146104779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cascade of Cardiac Rehabilitation Referral, Enrollment, and Completion and Its Major Predictors in a Large Hospital System.","authors":"Lena Mathews, Siyu Zou, Lisa R Yanek, Thomas Kaszmetskie, Lisa A Benz Scott, Roger S Blumenthal, Lisa A Cooper, Kerry J Stewart, Chiadi E Ndumele, Kunihiro Matsushita","doi":"10.1097/HCR.0000000000001014","DOIUrl":"10.1097/HCR.0000000000001014","url":null,"abstract":"<p><strong>Purpose: </strong>Cardiac rehabilitation (CR) is an effective but underused secondary prevention strategy. We evaluated where the relative gap in the implementation of CR occurs and characteristics related to CR utilization.</p><p><strong>Methods: </strong>We analyzed electronic health records from a large academic health system (2017-2019). We included patients aged ≥18 years, hospitalized with a cardiac event, with an indication for CR. We evaluated crude proportions and used mixed-effects logistic regression to examine the association of characteristics with referral, enrollment (≥1 session), and completion (≥36 sessions), accounting for multiple admissions.</p><p><strong>Results: </strong>Among 4084 patient encounters (mean age: 65.3 ± 14.6 years, 45% female, and 42% Black), 25% were referred, 29% of those referred, enrolled, and 21% of those enrolled, completed CR. We identified characteristics associated with lower CR referral, for example, Black patients (OR = 0.64: 95% CI, 0.50-0.80), female patients (OR = 0.68: 95% CI, 0.56-0.83), and discharge from noncardiology services (eg, OR = 0.07: 95% CI, 0.05-0.10 for general medicine). Post-discharge outpatient visits were associated with higher CR referrals (eg, OR = 1.94: 95% CI, 1.56-2.41 for cardiology follow-up visits). The pattern was largely similar for enrollment and completion, except for higher enrollment for cardiac surgery and lower enrollment for lower-income patients.</p><p><strong>Conclusions: </strong>In the CR care cascade, significant bottlenecks exist at each step, with the narrowest bottleneck noted at the completion stage. We also identified demographic and health system characteristics related to lower CR utilization, which can guide system- and individual-level efforts to promote CR use.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"219-227"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Rehabilitation Program in Pediatric and Young Adult Patients With Congenital Heart Disease: SINGLE-CENTER 4-YEAR EXPERIENCE.","authors":"Ling Li, Caleb Ross, Michael Randone, Windy W Alonso, Scott Fletcher, Camille Hancock Friesen","doi":"10.1097/HCR.0000000000001006","DOIUrl":"10.1097/HCR.0000000000001006","url":null,"abstract":"","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"E13-E15"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Sternal Precautions on Clinical and Patient-Reported Outcomes in Patients Undergoing Cardiac Surgery via Sternotomy: A SCOPING REVIEW.","authors":"Mitti Blakoe, Rikke Gottlieb, Ida Elisabeth Højskov, Dorte Bæk Olsen, Sune Damgaard, Jan Christensen","doi":"10.1097/HCR.0000000000001025","DOIUrl":"10.1097/HCR.0000000000001025","url":null,"abstract":"<p><strong>Purpose: </strong>Patients undergoing cardiac surgery via sternotomy are typically advised to follow sternal precautions for 8 to 12 weeks post-operatively. These precautions vary across surgical centers, and current recommendations are primarily based on heterogeneous studies and expert opinion. This scoping review aimed to map the impact of upper body movement and sternal precaution strategies on clinical and patient-reported outcomes within 1 year post-operatively in adult patients undergoing cardiac surgery via sternotomy.</p><p><strong>Review methods: </strong>The review was reported based on the PRISMA-ScR (Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Eligible studies included randomized controlled trials; nonrandomized controlled trials; quasi-experimental, prospective, and retrospective cohort studies; mixed methods studies; case studies; case-control studies; and cross-sectional studies. Studies were considered eligible if they included patients ≥18 years undergoing cardiac surgery via sternotomy and examined the relationship between sternal precautions or upper body movement strategies within 12 weeks post-operatively and any clinical or patient-reported outcomes within 1 year post-operatively. The systematic literature search was conducted in March 2025 in 6 databases.</p><p><strong>Summary: </strong>Of 16 464 unique records screened, 12 studies involving 2853 patients were included. These studies found that neither weighted upper body movement strategies nor less restrictive sternal precautions negatively affect sternal wound infections, sternal stability, pain, length of hospital stay, readmissions, or health-related quality of life. Positive improvements were found in functional status and discharge disposition in patients following a less restrictive sternal regimen. The body of evidence indicates that weighted upper body movement strategies and less restrictive sternal precautions do not negatively affect the investigated clinical or patient-reported outcomes post-sternotomy.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"168-175"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cross-Sectional Examination of Sex-Based Differences in Cardiac Rehabilitation Participation From the Behavioral Risk Factor Surveillance System.","authors":"Shweta Gore, Amol M Karmarkar, Lin-Na Chou, Sabrina J Mily, Amit Kumar","doi":"10.1097/HCR.0000000000001011","DOIUrl":"10.1097/HCR.0000000000001011","url":null,"abstract":"<p><strong>Purpose: </strong>Following an acute myocardial infarction (AMI), females often experience worse outcomes than males. However, sex-specific disparities in cardiac rehabilitation (CR) participation, along with the roles of income and education, have not been thoroughly investigated. This study examined sex-specific differences in CR participation following AMI and how education and income mediate this association.</p><p><strong>Methods: </strong>We analyzed cross-sectional data from the Behavioral Risk Factor Surveillance System for adults aged ≥45 years with a history of AMI who responded to a CR participation question in 2009 (n = 1289) and 2017 (n = 1383), across 4 states and Washington, DC. The study outcome was participation in CR following AMI. Mediation and moderation analyses were performed to examine the effects of sex, education, and income on CR participation.</p><p><strong>Results: </strong>Females were significantly less likely to participate in CR than males. Mediation analysis revealed a negative association between sex and CR participation, mediated by income and education ( β = -.135, SE = 0.024, P < .001), along with a significant direct effect ( β = -.383, SE = 0.083, P < .001). Moderation analysis showed that females were less likely to participate in CR across several subgroups: White females compared with White males (OR = 0.70: 95% CI, 0.58-0.85), married females compared with married males (OR = 0.50: 95% CI, 0.38-0.67), and significantly lower among females across both age groups.</p><p><strong>Conclusions: </strong>Female participation in CR remains significantly lower than males, partially mediated by lower education and income levels. These findings underscore the need for targeted strategies to enhance CR awareness, accessibility, and adherence among females.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"204-210"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality and Cardiovascular Outcomes in Relation to Cigarette Smoking and Secondhand Smoke: SALUTARY IMPACT OF SMOKING BANS.","authors":"Barry A Franklin, Hadley T Ninow, Isaac J Wedig, Steven J Elmer","doi":"10.1097/HCR.0000000000001031","DOIUrl":"10.1097/HCR.0000000000001031","url":null,"abstract":"","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"E19-E21"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients Who \"No-Show\" in Cardiac Rehabilitation: CHARACTERISTICS AND ATTENDANCE.","authors":"Anna Cichon, Patrick Schilling, Sumsen Thapa, Karen Riska, Peter K Lindenauer, Quinn R Pack","doi":"10.1097/HCR.0000000000001028","DOIUrl":"10.1097/HCR.0000000000001028","url":null,"abstract":"","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"E16-E18"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Significance of Electrographically Positive Exercise Stress Tests in Patients Attending Cardiac Rehabilitation.","authors":"Andrea Van Damme, Stephanie K Nathanail, Eric C Parent, Yongzhe Hong, Jeevan Nagendran, Nabila Mahdi, Tanis Nelson, Tara C Meyer, Colleen Norris, Gabor T Gyenes, Michael D Kennedy","doi":"10.1097/HCR.0000000000000995","DOIUrl":"10.1097/HCR.0000000000000995","url":null,"abstract":"<p><strong>Purpose: </strong>Exercise stress tests (EST) are used to evaluate functional capacity before cardiac rehabilitation (CR). The prognostic value of EST to understand health outcomes in the year following an EST after participating in CR is not well understood.</p><p><strong>Methods: </strong>We reviewed charts of 488 patients (females, n = 64) who underwent an EST within 100 days of starting CR. The outcomes of revascularization, rehospitalization, mortality, and the combination of revascularization or mortality were compared between patients with positive EST (n = 38), negative EST (n = 123), and nondiagnostic EST (n = 327).</p><p><strong>Results: </strong>The positive EST group displayed significantly higher risk for revascularization or mortality within 1 year post-EST (HR = 13.6: 95% CI, 1.6-119.4; P = .018) compared with the negative EST group. Having a prior coronary artery bypass graft surgery independently increased the hazard of rehospitalization at 1 year (HR = 5.1: 95% CI, 1.9-13.5; P = .001) and the composite endpoint at 1 year (HR = 5.7: 95% CI, 1.6-19.7; P = .006) post-EST. The risk for rehospitalization in females (HR = 2.3: 95% CI, 1.0-5.3; P = .050) was greater than for males at 1 year, warranting future investigation into sex-based differences of long-term health outcomes post cardiac event.</p><p><strong>Conclusions: </strong>The utility of EST for patients referred to CR has been debated, but our results demonstrate that EST may provide valuable information for prognosis and decision-making in cardiac care pathways.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"190-196"},"PeriodicalIF":3.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}