Journal of Cardiopulmonary Rehabilitation and Prevention最新文献

{"title":"Post-Myocardial Infarction Guideline-Recommended Therapy Utilizing Sankey Diagrams Among Medicare Beneficiaries.","authors":"Montika Bush, Sharon Peacock-Hinton, Ross J Simpson","doi":"10.1097/HCR.0000000000000987","DOIUrl":"10.1097/HCR.0000000000000987","url":null,"abstract":"<p><strong>Purpose: </strong>To describe 2-year post-myocardial infarction (MI) longitudinal patterns of guideline- directed medical therapy (GDMT) and cardiac rehabilitation (CR) participation with Sankey diagrams.</p><p><strong>Methods: </strong>Eligible Medicare beneficiaries were aged 66 to 95 years with an acute MI (International Classification of Diseases-9-CM discharge codes of 410.xx excluding 410.x2) hospital admission between January 1, 2014 and September 30, 2015 and ≥1 follow-up CR sessions. We defined GDMT (angiotensin converting enzyme-inhibitor or angiotensin receptor blocker, statin, and β-blocker) use as having at least a 21-day supply available during a 30-day window. We stratified CR participation by days with claims (1-11, 12-23, ≥ 24). Population level trends of 6 GDMT combinations, CR participation, and death were depicted with Sankey diagrams.</p><p><strong>Results: </strong>Study population consisted of 5793 beneficiaries, 72% of whom had ≥1 GDMT pre-MI, 93% had ≥1 GDMT at baseline, and 45% initiated CR by 30 days post-MI. A median 23% of CR participants did not flow from low to moderate CR participation each month. At 1-year post-MI, 37% of beneficiaries without pre-MI GDMT and 33% of beneficiaries with pre-MI GDMT concluded CR early. Between 9% and 16% of beneficiaries without pre-MI GDMT and 2% to 6% beneficiaries with pre-MI GDMT did not have a GDMT fill post-MI. On average, 4% to 5% of beneficiaries switched from β-blocker + statin to another GDMT group post-MI each month.</p><p><strong>Conclusions: </strong>Describing patterns of secondary prevention method utilization with Sankey diagrams can identify intervention populations, such as groups with inconsistent CR participation, primary nonadherence to new medications, and volatile medication persistence.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":"107-114"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145604183","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":"The Efficacy and Safety of Short-Term High- and Moderate-Intensity Interval Training in High-Risk Patients With Cardiovascular Disease.","authors":"Mayila Abudoukelimu, Bingqing Bai, Haofeng Zhou, Shengqing Zhang, Zhaoqin Lin, Guolin Zhang, Xianyuan Chen, Lan Guo, Huan Ma","doi":"10.1097/HCR.0000000000001021","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001021","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the efficacy and safety of short-term high- and moderate-intensity interval training (HIIT and MIIT) in high-risk patients with cardiovascular disease (CVD).</p><p><strong>Methods: </strong>We retrospectively recruited 161 high-risk patients with CVD that completed 4 weeks of exercise training in a cardiac rehabilitation clinic between February 2021 and June 2023; 80 patients underwent HIIT, and 81 underwent MIIT. The MIIT contained 4 sets×8 minutes at a rating of perceived exertion of 12 to 14 on the Borg scale of 6 to 20 with 2 minutes of rest between sets. The HIIT consisted of 20 cycles × 30 seconds at a rating of perceived exertion of 15 to 17 with 30 seconds of rest between cycles.</p><p><strong>Results: </strong>The median age was 54 years, and 65% were male. After 4 weeks, mean peak oxygen uptake (), at the anaerobic threshold, and oxygen pulse in HIIT versus MIIT increased by 2.6 versus 2.8 mL/kg/min, 1.7 versus 1.8 mL/kg/min, and 1.2 versus 0.9 mL/beat, respectively (P <.001). The resting systolic and diastolic blood pressures both decreased after HIIT and MIIT (all P<.05). Few exercise-related mild adverse events (<1%) occurred during HIIT and MIIT, and compliance did not differ between groups (P =.779).</p><p><strong>Conclusions: </strong>Our findings suggested that both HIIT and MIIT demonstrated improvements in , at anaerobic threshold, and oxygen pulse as well as reductions in blood pressure after 4 weeks of exercise training. No serious cardiac events occurred during the exercise training. Both HIIT and MIIT can be considered efficient and safe therapeutic methods for high-risk patients with CVD.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165748","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":"Acute Responses to Arm-Crank Exercise on the Cardiovascular Function of Patients With Peripheral Artery Disease: A RANDOMIZED CROSSOVER TRIAL.","authors":"Gustavo O Silva, Paolo M Cunha, Max D Oliveira, Jéssika K T N F Silva, Breno Q Farah, Nelson Wolosker, Hélcio Kanegusuku, Marilia A Correia, Raphael M Ritti-Dias","doi":"10.1097/HCR.0000000000001018","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001018","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the acute cardiovascular responses to arm-cranking (AC) exercise in patients with peripheral artery disease (PAD), comparing it to walking and a nonexercise control condition.</p><p><strong>Methods: </strong>This study is a randomized crossover trial with single-blind data collection in which 17 patients with PAD and claudication (53% men, 66 ± 7 years old, 26.7 ± 4.4 kg/m 2 body mass index, 0.63 ± 0.12 ankle-brachial index) were included. They performed 3 experimental conditions (walking, AC, and control) in random order. The exercise conditions were composed of 15 bouts of 2 minutes (15 × 2) with an intensity equivalent to 4 to 6 on a modified (1-10) Borg Rating of Perceived Exertion scale. We measured blood pressure (BP), cerebral blood flow, heart rate variability, and brachial and femoral artery flow-mediated dilation before and after the conditions. Generalized estimated equations were used to analyze the acute response among experimental conditions, with P < .05 considered significant.</p><p><strong>Results: </strong>We observed post-exercise hypotension in both AC and walking, with a greater net effect in the AC condition compared with walking (systolic BP: AC = -14 ± 14 mm Hg; walking = -6.7 ± 8.9 mm Hg, P < .001; diastolic BP: AC = -5.8 ± 8.4 mm Hg; walking = -1.2 ± 4.1 mm Hg, P = .011). Brachial and femoral artery flow-mediated dilation, cerebral blood flow, and heart rate variability did not change after any of the conditions.</p><p><strong>Conclusion: </strong>Vascular function, cerebral blood flow, and heart rate variability remained unchanged after AC and walking. However, both walking and AC induced post-exercise hypotension in patients with PAD, with a greater magnitude in the AC condition.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105020","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":"The ACE Equation Gives Equivalent Mortality Risk Estimates to the Duke Treadmill Score and Duke Nomogram.","authors":"Alexander H K Montoye, Morgan R Fonley, Bradford S Westgate, Lars Brudin, Thomas Lindow","doi":"10.1097/HCR.0000000000001009","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001009","url":null,"abstract":"<p><strong>Purpose: </strong>We sought to develop an equation, the Alma College Estimation (ACE) equation, to estimate survival equivalent to the Duke treadmill score (DTS) and Duke nomogram.</p><p><strong>Methods: </strong>Combinations of ST segment deviation (0, 1, 2, 3, and 4 mm), angina (0 = none, 1 = nonlimiting, and 2 = limiting), and metabolic equivalents of task (2-20) were graphed on the Duke nomogram, and the ACE equation was developed to predict annual mortality likelihood from nomogram measurements. Secondary analyses analyzed data from a clinical cohort of 10,673 patients who underwent a graded maximal exercise test at a county hospital in Sweden between 2005 and 2016. Following ACE equation development, survival estimates were compared between the equation to traditional line plotting on the Duke nomogram using mean absolute error and equivalence testing. Also, 5-year survival estimates from the ACE equation, nomogram, and DTS were categorized into low, intermediate, and high risk and compared using percent agreement.</p><p><strong>Results: </strong>The developed ACE equation is a non-linear, exponential function. The 5-year survival estimates (100 - [5 × annual mortality risk]) from the ACE equation were significantly equivalent to within 1% of the nomogram ( P < .001, mean difference 0.1% ± 1.0%), with low mean absolute error (all combinations: 0.7% ± 0.7%, clinical cohort: 0.7% ± 1.0%). Percent agreement in risk categories ranged from 83% to 94%.</p><p><strong>Conclusions: </strong>The ACE equation produced similar survival estimates to the Duke nomogram and DTS. This equation improves precision over the DTS and ease of use over the Duke nomogram, and therefore, may serve as a valuable tool for clinicians assessing prognosis from exercise test findings.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105580","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":"Cardiac Rehabilitation Program-Related Factors Associated With Morbidity Among Patients in Low-Resource Settings: ANALYSIS FROM THE INTERNATIONAL CARDIAC REHABILITATION REGISTRY.","authors":"Sana A Elashie, Sherry L Grace, Farzana A Hashmi, Leong Be Kim, Masoumeh Sadeghi, Gabriela L M Ghisi, Jorge A Lara Vargas, Martin Heine, Manal S Al Shamari, Maria J Sepulveda, Karam I Turk-Adawi","doi":"10.1097/HCR.0000000000001023","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001023","url":null,"abstract":"<p><strong>Purpose: </strong>Cardiovascular disease is a leading cause of morbidity globally, particularly in low-resource settings. The effectiveness of cardiac rehabilitation (CR) is well-established; however, the nature of services in low-resource settings differs. This study sought to investigate program characteristics associated with lower all-cause morbidity among CR participants from low-resource settings.</p><p><strong>Methods: </strong>This was a prospective observational study analyzing the International Council of Cardiovascular Prevention and Rehabilitation's International CR Registry. Programs with annual assessment data at the time of study were included, and their characteristics were assessed in a survey. Self and program-reported patient morbidity included all- and cardiac-cause hospitalization, emergency department visits, cardiovascular disease events, and procedures 1 year from initial assessment. A multilevel modified Poisson regression model was used to account for clustering of patients within CR programs, estimating the adjusted incidence rate ratios (IRR) for morbidity.</p><p><strong>Results: </strong>Of the 690 patients from programs in 6 countries across 4 regions (Colombia, Iran, Malaysia, Mexico, Pakistan, and Qatar), 637 (92%) were retained, of which 479 (75%) had morbidity data. Seven patients died and 93 suffered morbidity; this was most commonly noncardiac hospitalization (29 events) and emergency department visits (18 events). The regression analysis revealed a significantly lower incidence of morbidity associated with the following program factors: higher number of risk factors assessed (IRR = 0.55: 95% CI, 0.39-0.77), greater number of CR health care professionals (IRR = 0.76: 95% CI, 0.65-0.89), and CR located in academic/tertiary care institution (IRR = 0.61: 95% CI, 0.50-0.75).</p><p><strong>Conclusion: </strong>Globally, CR programs could benefit from prioritizing comprehensive risk assessment and strengthening CR teams to potentially reduce morbidity.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105457","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":"Guideline-Directed Medical Therapies Among Patients With Heart Failure Enrolled in Cardiac Rehabilitation.","authors":"Claire H Chang, Tanima Basu, Scott L Hummel, Steven J Keteyian, Todd M Koelling, Brahmajee K Nallamothu, Alexander T Sandhu, Michael P Dorsch, Jessica R Golbus","doi":"10.1097/HCR.0000000000001010","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001010","url":null,"abstract":"<p><strong>Purpose: </strong>Cardiac rehabilitation (CR) could be an important opportunity for optimization of guideline-directed medical therapies (GDMT) for patients with heart failure with reduced ejection fraction (HFrEF). We set out to describe GDMT prescribing among enrollees in CR with HFrEF.</p><p><strong>Methods: </strong>We queried the electronic health record of an academic medical center and identified patients with HFrEF who attended CR between 2016 and 2023. We defined CR cycles as at least 6 CR sessions with fewer than 6 months between sessions. Using a validated algorithm, we generated medication optimization scores (MOS, 0%-100% optimized) at the first and final CR session. The algorithm's input included GDMT, New York Heart Association classification, systolic blood pressure, heart rate, creatinine, potassium, allergies, and race. Wilcoxon Signed-Rank analysis was used to compare MOS.</p><p><strong>Results: </strong>A total of 172 CR cycles were completed by 152 patients (64% male, 78% White, 67.5 ± 12.1 years old). Mean sessions per CR cycle was 26.4 ± 10.6. At the end of CR, 85 (49%) patients were on a beta-blocker, 84 (49%) a renin-angiotensin-aldosterone inhibitor, and 31 (18%) a mineralocorticoid receptor antagonist. Accounting for contraindications, patients were eligible for initiation or uptitration of at least 1 GDMT class after 84% of cycles. Median MOS at the start of CR was 39% (IQR: 14, 57) and 35% (IQR: 14, 57) at the end of CR ( P = .90).</p><p><strong>Conclusion: </strong>GDMT utilization among patients with HFrEF in CR is suboptimal. There is a substantial opportunity to develop and validate strategies to improve GDMT prescribing during CR.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105531","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":"Pulmonary Restriction in Patients With a Fontan Circulation: DETERMINANTS, DETERIORATION OVER TIME, AND CLINICAL IMPLICATIONS.","authors":"Gaston van Hassel, Rolf M F Berger, Eryn T Liem, Elke S Hoendermis, Johannes M Douwes, Marinus A J Borgdorff, Joost P van Melle, Brigitte W M Willemse","doi":"10.1097/HCR.0000000000001020","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001020","url":null,"abstract":"<p><strong>Purpose: </strong>Pulmonary restriction is common in patients with a Fontan circulation and is associated with impaired quality of life. Studies often fail to accurately define pulmonary restriction, and few have investigated its predictors, longitudinal course, and clinical implication. We investigate the prevalence and determinants of pulmonary restriction in patients with a Fontan circulation, the evolution of pulmonary function over time, and the relationship between pulmonary function and exercise capacity.</p><p><strong>Methods: </strong>This longitudinal study included 85 patients with a Fontan circulation who underwent serial pulmonary function measurements and exercise testing over an 11-year period. According to established criteria, pulmonary restriction was defined as a total lung capacity (TLC) z score < -1.645.</p><p><strong>Results: </strong>Mean age ± SD was 20 ± 10 years. Median (IQR) TLC, forced vital capacity (FVC), and diffusing capacity of the lungs for carbon monoxide z scores were -0.98 (-1.98, -0.25), -0.82 (-1.52, -0.19), and -2.30 (-3.04, -1.44). Twenty-eight patients (33%) had pulmonary restriction. A longer time since Fontan completion and undergoing 2 or more thoracotomies increased the odds of developing pulmonary restriction. The FVC z score was associated with log 2 percentage of predicted peak oxygen uptake ( β = .08, P = .025), and FVC z scores declined by 0.06 per year ( P = .009).</p><p><strong>Conclusion: </strong>Pulmonary restriction is prevalent in patients with a Fontan circulation. Multiple thoracotomies and a longer time since Fontan completion predict the development of pulmonary restriction. The FVC, not TLC, is associated with lower exercise tolerance. This emphasizes the importance of muscle-dependent pulmonary ventilation. Finally, FVC z scores are decreased in adolescence and deteriorate faster than in the general population.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105615","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":"Social Inequality in the Comprehensive Cardiac Rehabilitation Pathway: A NATIONWIDE COHORT STUDY ACROSS HOSPITALS AND PRIMARY HEALTH CARE CENTERS.","authors":"Marie Louise Svendsen, Jens Refsgaard, Mette Bredsgaard, Thomas Maribo","doi":"10.1097/HCR.0000000000001019","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001019","url":null,"abstract":"<p><strong>Purpose: </strong>To examine socioeconomic differences in the nonpharmacological cardiac rehabilitation (CR) pathway from hospital discharge to CR completion in hospital and primary care settings.</p><p><strong>Methods: </strong>This nationwide cohort study included patients hospitalized with ischemic heart disease between April 1, 2019, and March 31, 2022. Follow-up continued through December 31, 2022, focusing on nonutilization of 11 CR components, including: delayed CR needs assessment (>14 days) and physical exercise training (>29 days); lack of patient education, physical exercise training, test of cardiorespiratory fitness (CRF), depression screening, improvement in CRF (<10% increase), smoking cessation, and finalizing CR meeting; and completion of <75% of planned exercise sessions and dropout. Socioeconomic differences were analyzed by educational attainment, income, occupation, and cohabitant status.</p><p><strong>Results: </strong>Among 45 497 hospitalized patients with ischemic heart disease, 43% (n = 19 573) participated in CR. Only 25% received a CR needs assessment within 14 days of discharge. Socioeconomic differences were demonstrated throughout the CR pathway, except for the finalizing meeting, improvement in CRF, and smoking cessation. The odds of nonutilization among patients with lower educational attainment ranged between 8% higher odds of delayed CR needs assessment (adjusted OR = 1.08: 95% CI, 1.01-1.15) and 31% higher odds of no CRF test (adjusted OR = 1.31: 95% CI, 1.18-1.45).</p><p><strong>Conclusions: </strong>The observed socioeconomic differences throughout the CR pathway underscore the need for targeted interventions to ensure early assessment of CR needs and participation in specific CR activities among patients with lower socioeconomic positions. This study identifies specific patient characteristics and CR activities as key markers for reducing these inequalities.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105598","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":"Talk Test for the Prescription of Aerobic Exercise in Cardiovascular Disease: WHICH STAGE IS MOST APPROPRIATE?","authors":"Amanda Althoff, Amanda Mohr, Geovana Zimermann, Taina de Souza Lopes, Lucas Santos da Silveira, Marlus Karsten","doi":"10.1097/HCR.0000000000001022","DOIUrl":"https://doi.org/10.1097/HCR.0000000000001022","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to determine which stage of the Talk Test (TT) represents the most appropriate workload for prescribing aerobic exercise in cardiovascular rehabilitation.</p><p><strong>Methods: </strong>Individuals with cardiovascular disease underwent a 3-day evaluation. Day 1: cardiopulmonary exercise test; day 2: 2 incremental TT (conventional and with gas analysis); day 3: 2 constant workload TT (CWTT) based on the intensities of the stages last positive (LPTT) and first equivocal (EQTT). Friedman's test was used to compare the heart rate (HR) and oxygen uptake ( ) from the CWTT with the first and second ventilatory thresholds (VT1 and VT2). The association between HR and of VT and CWTT was analyzed using Spearman's correlation coefficient. Chi-square test was used to analyze the proportion of individuals who reached the moderate intensity zone during the CWTTs, considering HR, HR reserve (HRR), and .</p><p><strong>Results: </strong>Thirty-two individuals (23 male, 61 ± 10 years) were included. Heart rate in LPTT was similar to VT1 and lower than VT2 ( P < .001). The HR in EQTT was higher than the VT1 ( P = .002) and lower than VT2 ( P < .001). The during CWTT was similar to VT1 and lower than VT2 ( P < .001). The EQTT showed a higher proportion of individuals with HR and between the VT (HR: 70% vs 53%, P = .026; : 48% vs 31%, P = .023), as well as with HRR in the moderate intensity zone ( P = .025).</p><p><strong>Conclusions: </strong>Exercise intensity similar to the EQTT promotes HR and responses more consistent with the recommended exercise intensity (moderate). This stage represents the most appropriate workload for aerobic exercise prescription in cardiovascular rehabilitation.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105624","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":"Inspiratory Capacity and Dynamic Hyperinflation During Exercise in Patients With Cardiovascular Disease: A SYSTEMATIC REVIEW.","authors":"Viktoria Ludwig, Annika Freiberger, Jan Müller, Julia Hock, Peter Ewert, Alfred Hager","doi":"10.1097/HCR.0000000000000989","DOIUrl":"10.1097/HCR.0000000000000989","url":null,"abstract":"<p><strong>Purpose: </strong>Expiratory flow limitation (EFL) and dynamic hyperinflation (DH) may significantly impact exercise capacity in patients with heart disease. Although commonly linked to lung diseases, recent evidence highlights their role in cardiovascular disease (CVD), contributing to exercise intolerance. This systematic review examines studies from the past decade on pulmonary function during exercise, measured using inspiratory capacity (IC) maneuvers, in patients with CVD, emphasizing prevalence and clinical significance.</p><p><strong>Review methods: </strong>A systematic literature search in PubMed, Scopus, and Cochrane (January 2014-February 2024) explored pulmonary function during exercise in patients with CVD. Two independent reviewers assessed studies using established Quality Assessment Tools.</p><p><strong>Summary: </strong>Seven studies including 231 patients with CVD (mean age 31-66 yr, predominantly male) used cardiopulmonary exercise testing to evaluate exercise-induced DH or EFL with varying definitions. Study quality was mixed. Patients with myocardial infarction showed EFL at moderate exercise, while patients with stable coronary artery disease exhibited EFL only at high intensities. Up to 50% of patients with pulmonary arterial hypertension have DH during peak exercise (P < .05). In patients with heart failure, 25% experienced DH, while others maintained stable breathing. Patients who are post-Fontan displayed pulmonary inefficiencies without DH. Methodological variability precludes definitive conclusions on DH prevalence in patients with CVD. However, reduced IC during exercise, DH, and EFL occur in a substantial proportion of patients, indicating a lower EFL threshold and earlier ventilatory constraints. Further research into heart-lung integration during exercise is crucial for developing personalized treatments and improving clinical management in those patients.</p>","PeriodicalId":15192,"journal":{"name":"Journal of Cardiopulmonary Rehabilitation and Prevention","volume":"46 1","pages":"16-27"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906121","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}