Nadia Abelhad, Sergey Kachur, Alexandra Sanchez, C. Lavie, R. Milani
Cardiac rehabilitation (CR) is a form of prescribed exercise that is a multidisciplinary approach designed to improve cardiac function and quality of life following major adverse cardiovascular events. In this comprehensive overview, we will describe the individual components of exercise training and discuss the preset doses for effective CR based on recent meta-analyses. We will also review the effects of prescribed exercise medicine on outcomes such as psychosocial stress factors, cardiorespiratory fitness, and survival and their individualized impact on special populations.
{"title":"Impact of cardiac rehabilitation on psychological factors, cardiorespiratory fitness, and survival: A narrative review","authors":"Nadia Abelhad, Sergey Kachur, Alexandra Sanchez, C. Lavie, R. Milani","doi":"10.4103/hm.hm_58_22","DOIUrl":"https://doi.org/10.4103/hm.hm_58_22","url":null,"abstract":"Cardiac rehabilitation (CR) is a form of prescribed exercise that is a multidisciplinary approach designed to improve cardiac function and quality of life following major adverse cardiovascular events. In this comprehensive overview, we will describe the individual components of exercise training and discuss the preset doses for effective CR based on recent meta-analyses. We will also review the effects of prescribed exercise medicine on outcomes such as psychosocial stress factors, cardiorespiratory fitness, and survival and their individualized impact on special populations.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48127686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Laina, S. Soulaidopoulos, I. Doundoulakis, P. Arsenos, A. Kordalis, P. Xydis, A. Xintarakou, C. Kalantzis, C. Chrysohoou, P. Dilaveris, S. Archontakis, H. Sotiropoulos, S. Sideris, Lila Gatzouli, K. Tsioufis, K. Gatzoulis
Cardiac rehabilitation (CR) is a complex intervention that improves functional capacity and quality of life in patients with heart failure (HF). Besides exercise training (ET), CR includes aggressive risk factor management, education about medication adherence, stress management, and psychological support. Current guidelines strongly recommend CR as an integral part of chronic and stable HF patient care. However, CR programs are underused for multiple reasons, namely, low physician referral and patient adherence, high cost, and lack of awareness. In this review, we present existing evidence of the beneficial effects of ET and CR in HF with reduced and preserved ejection fraction, the underlying pathophysiologic mechanisms by which exercise might alleviate symptoms, and the different types of exercise that can be used in HF. Current guidelines supporting the use of CR, reasons for its underutilization, and home-based CR as an alternative or adjunct to traditional center-based programs are also described.
{"title":"The therapeutic role of exercise training in heart failure patients: A narrative review","authors":"A. Laina, S. Soulaidopoulos, I. Doundoulakis, P. Arsenos, A. Kordalis, P. Xydis, A. Xintarakou, C. Kalantzis, C. Chrysohoou, P. Dilaveris, S. Archontakis, H. Sotiropoulos, S. Sideris, Lila Gatzouli, K. Tsioufis, K. Gatzoulis","doi":"10.4103/hm.hm_23_22","DOIUrl":"https://doi.org/10.4103/hm.hm_23_22","url":null,"abstract":"Cardiac rehabilitation (CR) is a complex intervention that improves functional capacity and quality of life in patients with heart failure (HF). Besides exercise training (ET), CR includes aggressive risk factor management, education about medication adherence, stress management, and psychological support. Current guidelines strongly recommend CR as an integral part of chronic and stable HF patient care. However, CR programs are underused for multiple reasons, namely, low physician referral and patient adherence, high cost, and lack of awareness. In this review, we present existing evidence of the beneficial effects of ET and CR in HF with reduced and preserved ejection fraction, the underlying pathophysiologic mechanisms by which exercise might alleviate symptoms, and the different types of exercise that can be used in HF. Current guidelines supporting the use of CR, reasons for its underutilization, and home-based CR as an alternative or adjunct to traditional center-based programs are also described.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46827149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/hm.hm-d-23-00005
F. Sanchis-Gomar, C. Pérez-Quilis, Thijs H Eijsvogels, F. L. Guía-Galipienso, J. Christle, MarcoV Perez, C. Lavie
{"title":"Maladaptive versus adaptative cardiovascular phenotype in response to exercise training: Expert opinion of the evidence","authors":"F. Sanchis-Gomar, C. Pérez-Quilis, Thijs H Eijsvogels, F. L. Guía-Galipienso, J. Christle, MarcoV Perez, C. Lavie","doi":"10.4103/hm.hm-d-23-00005","DOIUrl":"https://doi.org/10.4103/hm.hm-d-23-00005","url":null,"abstract":"","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70737123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/hm.hm-d-22-00003
S. Rawat, Anshuman Darbari, Pardeep Kumar, Ajay Kumar
{"title":"A case report of renal dysgenesis with isolated aortic dissection type B: Can it be a chance association?","authors":"S. Rawat, Anshuman Darbari, Pardeep Kumar, Ajay Kumar","doi":"10.4103/hm.hm-d-22-00003","DOIUrl":"https://doi.org/10.4103/hm.hm-d-22-00003","url":null,"abstract":"","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70737398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
George Bazoukis, Cheuk-To Chung, StamatisS Papadatos, Gary Tse
Left ventricular noncompaction cardiomyopathy (LVNC) is characterized by prominent ventricular trabeculations and deep intertrabecular recesses. Patients with LVNC have an increased risk of embolic events. The presence of symptoms at the time of diagnosis can be a risk marker for stroke/embolic events. Left ventricular ejection fraction (LVEF), as measured by transthoracic echocardiography and left atrial diameter, has been found to be a significant predictor of systemic embolism in LVNC patients. Furthermore, CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus and stroke or transient ischemic attack) and CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes, stroke, vascular disease, age 65–74 years and sex category [female]) scores were significantly higher in patients with stroke or embolism. Although the difference was not statistically significant, pediatric patients with LVNC combined with other congenital heart defects had more thromboembolic events compared to patients with isolated LVNC. On the other hand, stroke/transient ischemic attacks did not differ significantly between patients with isolated apical LVNC and mid-basal noncompaction. Furthermore, no differences in the prevalence of stroke between the quantiles of the maximal ratio of noncompacted to compacted myocardium have been revealed. Additionally, current data show no association between N-terminal pro-B-type natriuretic peptide levels and stroke/embolic events. Current evidence suggests anticoagulation treatment in LVNC patients with prior embolic events, atrial fibrillation, presence of left ventricular (LV) thrombus, and/or LV dysfunction. In patients with LVNC without a clear indication for anticoagulation, anticoagulant therapy may be considered in patients with CHADS2 score ≥2. More data are needed to identify patients at higher risk of embolic events who will be benefited from anticoagulation treatment.
{"title":"Noncompaction Cardiomyopathy and Embolic Events: A Mini-Review","authors":"George Bazoukis, Cheuk-To Chung, StamatisS Papadatos, Gary Tse","doi":"10.4103/hm.hm_52_22","DOIUrl":"https://doi.org/10.4103/hm.hm_52_22","url":null,"abstract":"Left ventricular noncompaction cardiomyopathy (LVNC) is characterized by prominent ventricular trabeculations and deep intertrabecular recesses. Patients with LVNC have an increased risk of embolic events. The presence of symptoms at the time of diagnosis can be a risk marker for stroke/embolic events. Left ventricular ejection fraction (LVEF), as measured by transthoracic echocardiography and left atrial diameter, has been found to be a significant predictor of systemic embolism in LVNC patients. Furthermore, CHADS2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus and stroke or transient ischemic attack) and CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes, stroke, vascular disease, age 65–74 years and sex category [female]) scores were significantly higher in patients with stroke or embolism. Although the difference was not statistically significant, pediatric patients with LVNC combined with other congenital heart defects had more thromboembolic events compared to patients with isolated LVNC. On the other hand, stroke/transient ischemic attacks did not differ significantly between patients with isolated apical LVNC and mid-basal noncompaction. Furthermore, no differences in the prevalence of stroke between the quantiles of the maximal ratio of noncompacted to compacted myocardium have been revealed. Additionally, current data show no association between N-terminal pro-B-type natriuretic peptide levels and stroke/embolic events. Current evidence suggests anticoagulation treatment in LVNC patients with prior embolic events, atrial fibrillation, presence of left ventricular (LV) thrombus, and/or LV dysfunction. In patients with LVNC without a clear indication for anticoagulation, anticoagulant therapy may be considered in patients with CHADS2 score ≥2. More data are needed to identify patients at higher risk of embolic events who will be benefited from anticoagulation treatment.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135838827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/hm.hm-d-23-00004
Y. Wu, Hui Zhou, Xiaopei Sun, Xiuli Li
{"title":"Anxiety and depression following percutaneous coronary intervention: A case report and discussion","authors":"Y. Wu, Hui Zhou, Xiaopei Sun, Xiuli Li","doi":"10.4103/hm.hm-d-23-00004","DOIUrl":"https://doi.org/10.4103/hm.hm-d-23-00004","url":null,"abstract":"","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70737509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/hm.hm-d-23-00013
RobertH Schneider, Fred Travis, Tony Nader
{"title":"Addressing clinician burnout: A unifying systems medicine model with meditation as a heart-mind intervention","authors":"RobertH Schneider, Fred Travis, Tony Nader","doi":"10.4103/hm.hm-d-23-00013","DOIUrl":"https://doi.org/10.4103/hm.hm-d-23-00013","url":null,"abstract":"","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135600427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The psychosocial impact of acute cardiovascular disease (CVD) events, including cardiac and stroke events, is gaining increasing recognition, with recommendations regarding an integrated cardiovascular approach coming from organizations such as the European Society of Cardiology Council on Stroke. This study aims to document the similarities and differences between heart disease and stroke in the prevalence, predictors and consequences of, and treatments for, anxiety and depression. This scoping review provides an overview of the evidence of similarity and difference in the mental health impacts of cardiac events and strokes. It found that research into postevent anxiety and depression is generally more advanced in the cardiac area than in the stroke area, with research related to poststroke anxiety prevalence, predictors, and treatment being particularly sparse. Despite these limitations, the review reveals enough similarities in the psychosocial impacts of cardiac and stroke events to warrant investigation of the potential for integrated psychosocial services for CVD patients, paying particular attention to collaborative care models of intervention.
{"title":"An integrated perspective for understanding the psychosocial impact of acute cardiovascular events: A scoping review","authors":"AlunC Jackson, MichelleC Rogerson, BarbaraM Murphy","doi":"10.4103/hm.hm-d-23-00029","DOIUrl":"https://doi.org/10.4103/hm.hm-d-23-00029","url":null,"abstract":"The psychosocial impact of acute cardiovascular disease (CVD) events, including cardiac and stroke events, is gaining increasing recognition, with recommendations regarding an integrated cardiovascular approach coming from organizations such as the European Society of Cardiology Council on Stroke. This study aims to document the similarities and differences between heart disease and stroke in the prevalence, predictors and consequences of, and treatments for, anxiety and depression. This scoping review provides an overview of the evidence of similarity and difference in the mental health impacts of cardiac events and strokes. It found that research into postevent anxiety and depression is generally more advanced in the cardiac area than in the stroke area, with research related to poststroke anxiety prevalence, predictors, and treatment being particularly sparse. Despite these limitations, the review reveals enough similarities in the psychosocial impacts of cardiac and stroke events to warrant investigation of the potential for integrated psychosocial services for CVD patients, paying particular attention to collaborative care models of intervention.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135838565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acute management of stroke with carotid free-floating thrombus (FFT) needs careful monitoring to proactively prevent the additional risk of infarction, and reducing intracranial bleeding is the primary goal. No management guidelines are available for this rare clinical condition. Here we presented a case study of a patient presenting with a carotid FFT with acute left-sided weakness. The patient was managed with anticoagulation alone, and the patient was discharged to return home in stable condition and good functional status with mild disability in the patient's left arm. In conclusion, carotid FFT is a rare clinical condition with underlying heterogeneous etiologies and individual-level bleeding risk stratification. Medical and surgical options are considered on a case-by-case basis.
{"title":"A free-floating internal carotid artery thrombus and acute ischemic stroke: A case report for a rare condition with therapeutic challenges","authors":"Saima Nazish, Rizwana Shahid, Kawther Hadhiah, Aisha Alatrash","doi":"10.4103/hm.hm-d-23-00017","DOIUrl":"https://doi.org/10.4103/hm.hm-d-23-00017","url":null,"abstract":"Acute management of stroke with carotid free-floating thrombus (FFT) needs careful monitoring to proactively prevent the additional risk of infarction, and reducing intracranial bleeding is the primary goal. No management guidelines are available for this rare clinical condition. Here we presented a case study of a patient presenting with a carotid FFT with acute left-sided weakness. The patient was managed with anticoagulation alone, and the patient was discharged to return home in stable condition and good functional status with mild disability in the patient's left arm. In conclusion, carotid FFT is a rare clinical condition with underlying heterogeneous etiologies and individual-level bleeding risk stratification. Medical and surgical options are considered on a case-by-case basis.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135844247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.4103/hm.hm-d-23-00022
Gerard Ngueta, Claudia Blais, Guillaume Foldes-Busque, Denis Hamel, Paul Poirier
Background: Chronic medical diseases and recurrent mental disorders are common and may lead to a negative prognosis in adults with cardiovascular diseases (CVDs). The impact of these overlapping morbidities is likely to be further increased in the critical years following a first acute CVD event such as a stroke or myocardial infarction (MI). Objectives: The objective of this study was to examine associations of preexisting chronic diseases and recent mental disorders with mortality in survivors of a first MI or stroke. Methods: Data from the 48,526 patients (59% men) aged ≥40 years with a first MI or stroke were extracted from the Quebec Integrated Chronic Disease Surveillance System. Cox regression models were used to assess the effect of preexisting cancer, renal disease, diabetes, chronic obstructive pulmonary disease (COPD), and recent mental disorders on the risk of recurrent fatal CVD events and all-cause mortality following the index MI or stroke. Results: An increased risk of CVD mortality was observed at 1, 3, and 4.5 years in women and men with coexisting mental disorders and at 4.5 years in those with chronic, preexisting renal disease. Inversely, cancer and COPD were associated with a lowered risk of CVD mortality during the study period. An increased risk of all-cause mortality at all time points was observed in adults with any of the assessed conditions. Conclusions: Adults with coexisting mental disorders are at increased risk of CVD mortality and all-cause mortality in the years following a first MI or stroke. This increased vulnerability is separate from the extra mortality attributable to preexisting chronic diseases.
{"title":"Risk of mortality associated with preexisting chronic diseases and prior year diagnosis of a mental disorder in survivors of a first myocardial infarction or stroke: A cohort study","authors":"Gerard Ngueta, Claudia Blais, Guillaume Foldes-Busque, Denis Hamel, Paul Poirier","doi":"10.4103/hm.hm-d-23-00022","DOIUrl":"https://doi.org/10.4103/hm.hm-d-23-00022","url":null,"abstract":"Background: Chronic medical diseases and recurrent mental disorders are common and may lead to a negative prognosis in adults with cardiovascular diseases (CVDs). The impact of these overlapping morbidities is likely to be further increased in the critical years following a first acute CVD event such as a stroke or myocardial infarction (MI). Objectives: The objective of this study was to examine associations of preexisting chronic diseases and recent mental disorders with mortality in survivors of a first MI or stroke. Methods: Data from the 48,526 patients (59% men) aged ≥40 years with a first MI or stroke were extracted from the Quebec Integrated Chronic Disease Surveillance System. Cox regression models were used to assess the effect of preexisting cancer, renal disease, diabetes, chronic obstructive pulmonary disease (COPD), and recent mental disorders on the risk of recurrent fatal CVD events and all-cause mortality following the index MI or stroke. Results: An increased risk of CVD mortality was observed at 1, 3, and 4.5 years in women and men with coexisting mental disorders and at 4.5 years in those with chronic, preexisting renal disease. Inversely, cancer and COPD were associated with a lowered risk of CVD mortality during the study period. An increased risk of all-cause mortality at all time points was observed in adults with any of the assessed conditions. Conclusions: Adults with coexisting mental disorders are at increased risk of CVD mortality and all-cause mortality in the years following a first MI or stroke. This increased vulnerability is separate from the extra mortality attributable to preexisting chronic diseases.","PeriodicalId":34653,"journal":{"name":"Heart and Mind","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135844249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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