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Response to “Racial disparities in trend, clinical characteristics and outcomes in takotsubo syndrome” 对 "Takotsubo 综合征的趋势、临床特征和结果中的种族差异 "的回应。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-04 DOI: 10.1016/j.cpcardiol.2024.102834
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引用次数: 0
Effect of exercise training in patients with chronotropic incompetence and heart failure with preserved ejection fraction: Training-HR study protocol 慢动作不全和射血分数保留型心力衰竭患者运动训练的效果:训练-心率研究方案》。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-04 DOI: 10.1016/j.cpcardiol.2024.102839

Background

Chronotropic incompetence (ChI) is linked with diminished exercise capacity in heart failure with preserved ejection fraction (HFpEF). Although exercise training has shown potential for improving functional capacity, the exercise modality associated with greater functional and chronotropic response (ChR) is not well-known. Additionally, how the ChR from different exercise modalities mediates functional improvement remains to be determined. This study aimed to evaluate the effect of three different exercise programs over current guideline recommendations on peak oxygen consumption (peakVO2) in patients with ChI HFpEF phenotype.

Methods and results

In this randomized clinical trial, 80 stable symptomatic patients with HFpEF and ChI (NYHA class II-III/IV) are randomized (1:1:1:1) to receive: a) a 12-week program of supervised aerobic training (AT), b) AT and low to moderate-intensity strength training, c)AT and moderate to high-intensity strength training, or d) guideline-based physical activity and exercise recommendations. The primary endpoint is 12-week changes in peakVO2. The secondary endpoints are 12-week changes in ChR, 12-week changes in quality of life, and how ChR changes mediate changes in peakVO2. A mixed-effects model for repeated measures will be used to compare endpoint changes. The mean age is 75.1 ± 7.2 years, and most patients are women (57.5 %) in New York Heart Association functional class II (68.7 %). The mean peakVO2, percent of predicted peakVO2, and ChR are 11.8 ± 2.6 mL/kg/min, 67.2 ± 14.7 %, and 0.39 ± 0.16, respectively. No significant baseline clinical differences between arms are found.

Conclusions

Training-HR will evaluate the effects of different exercise-based therapies on peakVO2, ChR, and quality of life in patients with ChI HFpEF phenotype.

Clinical trial registration

ClinicalTrials.gov (NCT05649787).

背景:射血分数保留型心力衰竭(HFpEF)患者的运动能力减弱与嗜铬细胞功能不全(ChI)有关。虽然运动训练已显示出提高功能能力的潜力,但与更大的功能和促时差反应(ChR)相关的运动方式并不为人所知。此外,不同运动模式的ChR如何介导功能改善仍有待确定。本研究旨在评估三种不同的运动项目与现行指南建议相比,对 ChI HFpEF 表型患者峰值耗氧量(peakVO2)的影响:在这项随机临床试验中,80 名症状稳定的 HFpEF 和 ChI(NYHA II-III/IV 级)患者被随机分配(1:1:1:1:1)接受:a)为期 12 周的有氧训练(AT)项目;b)有氧训练和中低强度力量训练;c)有氧训练和中高强度力量训练;或 d)基于指南的体力活动和运动建议。主要终点是峰值血氧量在 12 周内的变化。次要终点是 12 周 ChR 的变化、12 周生活质量的变化以及 ChR 的变化如何介导峰值 VO2 的变化。将采用重复测量的混合效应模型来比较终点变化。平均年龄为 75.1±7.2 岁,大多数患者为女性(57.5%),纽约心脏协会功能分级为 II 级(68.7%)。平均峰值 VO2、预测峰值 VO2 百分比和 ChR 分别为 11.8±2.6 mL/kg/min、67.2±14.7% 和 0.39±0.16。两组之间没有发现明显的基线临床差异:训练-HR将评估不同运动疗法对ChI HFpEF表型患者的峰值VO2、ChR和生活质量的影响:临床试验注册:ClinicalTrials.gov (NCT05649787)。
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引用次数: 0
Characteristics and in-hospital outcomes of female patients presenting with ST-segment-elevation myocardial infarction without standard modifiable cardiovascular risk factors 无标准可改变心血管风险因素的 ST 段抬高型心肌梗死女性患者的特征和院内预后。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-04 DOI: 10.1016/j.cpcardiol.2024.102830

Background

Standard Modifiable Cardiovascular Risk Factors (SMuRF) such as hypertension, diabetes mellitus, hyperlipidemia, and smoking have long been established in the etiology of atherosclerotic disease. We evaluate in-hospital outcomes of female STEMI patients without these risk factors.

Methods

The National Inpatient Sample databases (2016 to 2021) were queried to identify STEMI admissions as a principal diagnosis using ICD 10 codes. Patients with a history of coronary artery disease, myocardial infarction, coronary bypass graft, percutaneous coronary intervention, takotsubo cardiomyopathy, cocaine abuse, and spontaneous coronary dissection and males were excluded from our study population. A final study population aged >18 years was divided into cohorts of SMuRF and SMuRF-less based on the presence of ≥1 risk factor. Multivariate logistic regression model adjusting for baseline characteristics and comorbidities. The primary outcome was in-hospital mortality. The secondary outcomes are STEMI-related complications and the use of mechanical circulatory support devices.

Results

200,980 patients were identified. 187,776 (93.4 %) patients were identified as having ≥1 SMuRF, and 13,205 (6.6 %) patients were SMuRF-less. Compared to SMuRF patients, SMuRF-less patients are more likely to be white (75.6 % vs. 73.1 %, p < 0.01) and older median age (69 years [IQR: 58–78] vs 67 years [IQR: 57–81], p < 0.01). In comparing co-morbidities, SMuRF-less patients were less likely to have heart failure (28.0 % vs. 23.4 %, p < 0.01), atrial fibrillation/flutter (16.1 % vs. 14.6 %, p = 0.03), chronic pulmonary disease (18.9 % vs. 9.5 %, p < 0.01), obesity (20.7 % vs. 9.2 %, p < 0.01) and aortic disease (1.1 % vs. 0.6 %, p < 0.01). They were however more likely to have dementia (6.9 % vs. 5.7 %, p < 0.01). In evaluating outcomes, SMuRF-less patients had higher in-hospital mortality (aOR 3.2 [95 % CI, 2.9–3.6]; p < 0.01), acute heart failure (aOR 1.6 [95 % CI, 1.4–1.8]; p < 0.01), acute kidney injury (aOR 1.8 [95 % CI, 1.7–2.1]; p < 0.01), and Intra-aortic balloon pump (aOR 1.7 [95 % CI, 1.5–1.9]; p < 0.01). Predictors of higher mortality in SMuRF-less patients include chronic liver disease (OR 6.8, CI 2.4–19.4, p < 0.01), and Hispanic race (OR 1.62, CI 1.1–2.5, p < 0.01). We also found that SMuRF-less patients were less likely to undergo coronary angiography (aOR 0.5 [95 % CI, 0.4–0.5]; p < 0.01) and percutaneous coronary intervention (aOR 0.7 [95 % CI, 0.6–0.8]; p < 0.01).

Conclusion

Female SMuRF-less patients presenting with STEMI have worse in-hospital outcomes when compared to patients with ≥1SMuRF.

背景:高血压、糖尿病、高脂血症和吸烟等标准可改变心血管风险因素(SMuRF)早已被认为是动脉粥样硬化疾病的病因。我们对不存在这些风险因素的 STEMI 女性患者的院内预后进行了评估:查询全国住院患者抽样数据库(2016 年至 2021 年),使用 ICD 10 编码确定 STEMI 入院的主要诊断。有冠状动脉疾病、心肌梗死、冠状动脉旁路移植术、经皮冠状动脉介入治疗、塔克次氏体心肌病、可卡因滥用、自发性冠状动脉夹层病史的患者和男性被排除在我们的研究人群之外。根据是否存在≥1个危险因素,将年龄大于18岁的最终研究人群分为SMuRF和无SMuRF人群。多变量逻辑回归模型调整了基线特征和合并症。主要结果是院内死亡率。次要结果是 STEMI 相关并发症和机械循环支持装置的使用。187776名患者(93.4%)被确定为≥1例SMuRF,13205名患者(6.6%)无SMuRF。与SMuRF患者相比,无SMuRF患者更可能是白人(75.6%对73.1%,p结论:与SMuRF≥1的患者相比,无SMuRF的STEMI女性患者的院内预后更差。
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引用次数: 0
Clinical outcomes of patients with heart failure and atrial fibrillation: Experience from an outpatient heart failure clinic in Colombia 心力衰竭合并心房颤动患者的临床疗效:哥伦比亚一家心力衰竭门诊的经验。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-04 DOI: 10.1016/j.cpcardiol.2024.102841

Background

Heart failure (HF) can coexist with atrial fibrillation in up to 60 % of cases, increasing rates of hospitalizations and death. This study analyzed the clinical characteristics, treatment, hospitalization, and mortality of patients with HF and atrial fibrillation based on left ventricular ejection fraction (LVEF).

Methods

A retrospective cohort study included patients from an outpatient HF clinic at Medellín (Colombia) between 2020-2022. Patients were classified into two groups according to LVEF: reduced (LVEF≤40 %) and mildly reduced or preserved ejection fraction (LVEF>40 %). The evaluated outcomes were hospitalization and mortality during follow-up. Values for B-type natriuretic peptide (BNP), LVEF and functional class according to the New York Heart Association (NYHA) were also analyzed at admission and during the last follow-up visit.

Results

The study included 185 patients, with 51.9% being male. The median age of the participants was 80 years (interquartile range [IQR] 74 - 86). There was an overall improvement in the NYHA functional class, BNP levels, and LVEF compared with the baseline values, irrespective of left systolic function. Atrial fibrillation ablation was performed in 3.2 % of patients, and cardiac device implantation with atrioventricular node ablation in 29 %. No statistically significant differences were found in terms of hospitalization and mortality regarding left systolic function.

Conclusion

Compressive optimal treatment for patients with HF and atrial fibrillation requires pharmacological treatment, ablation strategies, cardiac devices, cardiovascular rehabilitation and close follow-up. In this cohort, hospitalization and mortality rates were similar according to LVEF categories and there was improvement in NYHA functional class and BNP level.

背景:多达 60% 的心力衰竭患者会同时伴有心房颤动,从而增加住院率和死亡率。本研究根据左心室射血分数(LVEF)分析了心衰合并心房颤动患者的临床特征、治疗、住院和死亡率:这项回顾性队列研究纳入了 2020-2022 年间麦德林(哥伦比亚)心力衰竭门诊的患者。根据射血分数将患者分为两组:射血分数降低(LVEF≤40%)和射血分数轻度降低或保留(LVEF>40%)。评估结果为随访期间的住院率和死亡率。此外,还分析了入院时和最后一次随访时的B型钠尿肽(BNP)值、LVEF值以及根据纽约心脏病协会(NYHA)划分的功能分级:研究共纳入185名患者,其中51.9%为男性,中位年龄为80岁(IQR:74-86)。与入院时的数值相比,无论左心收缩功能如何,NYHA功能分级、B型钠尿肽水平和LVEF均有整体改善。3.2%的患者接受了心房颤动消融术,29%的患者接受了房室结消融的心脏设备植入术。在左心室射血分数方面,住院率和死亡率没有发现明显的统计学差异:心力衰竭合并心房颤动患者的压缩性最佳治疗需要药物治疗、消融策略、心脏设备、心血管康复和密切随访。在该队列中,不同左心室射血分数的住院率和死亡率相似,NYHA功能分级和BNP水平也有所改善。
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引用次数: 0
Innovations in interventional cardiology: Pioneering techniques for a new era 介入心脏病学的创新:新时代的先锋技术。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-04 DOI: 10.1016/j.cpcardiol.2024.102836

Interventional cardiology is on the cusp of a significant transformation as we approach 2050, driven by emerging trends and groundbreaking technological innovations. This mini review explores the pivotal developments shaping the field, focusing on three key areas: Emerging Trends in Interventional Cardiology, Technological Innovations: The Next Frontier, and the Future Era of Intervention Cardiology from 2024 to 2050. Emerging trends, including advancements in imaging and artificial intelligence, are revolutionizing diagnosis and treatment, allowing for more precise and personalized interventions. Technological innovations, such as robotic-assisted procedures and bioresorbable stents, are redefining the landscape, enhancing procedural accuracy, and expanding access to care through remote interventions. Looking ahead to 2050, we anticipate a future where interventional cardiology is increasingly driven by minimally invasive techniques, AI-driven decision-making, and personalized medicine, offering unprecedented improvements in patient outcomes and reshaping the way cardiovascular diseases are managed.

在新兴趋势和突破性技术创新的推动下,介入心脏病学在临近 2050 年之际迎来了重大变革。这篇微型综述探讨了塑造这一领域的关键发展,重点关注三个关键领域:介入心脏病学的新趋势、技术创新:下一个前沿领域,以及 2024 至 2050 年介入心脏病学的未来时代。包括成像和人工智能在内的新兴趋势正在彻底改变诊断和治疗,使介入治疗更加精确和个性化。机器人辅助手术和生物可吸收支架等技术创新正在重新定义这一领域,提高了手术的准确性,并通过远程介入扩大了医疗的可及性。展望 2050 年,我们预计未来介入心脏病学将越来越多地受到微创技术、人工智能驱动的决策和个性化医疗的推动,为患者的治疗效果带来前所未有的改善,并重塑心血管疾病的管理方式。
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引用次数: 0
Comment on, "Evaluating ChatGPT platform in delivering heart failure educational material: A comparison with the leading national cardiology institutes'' 评论:"评估 ChatGPT 平台在提供心力衰竭教育材料方面的作用:与主要国家心脏病研究所的比较"。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-04 DOI: 10.1016/j.cpcardiol.2024.102831
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引用次数: 0
Sleep apnea is a common and dangerous cardiovascular risk factor 睡眠呼吸暂停是一种常见而危险的心血管风险因素。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-04 DOI: 10.1016/j.cpcardiol.2024.102838
<div><div>Sleep apnea involves almost one billion individuals throughout the world, including 40 million Americans. Of major medical concern is the fact that the prevalence of sleep apnea is significantly increasing due to the epidemic of obesity, physical inactivity, and diabetes mellitus which are important risk factors for the development and persistence of sleep apnea in individuals.</div><div>Sleep apnea is characterized by multiple episodes of apnea or hypopnea during sleep, which cause nocturnal arousals, gasping for breath during the night, daytime sleepiness, irritability, forgetfulness, fatigue and recurrent headaches. Obstructive sleep apnea occurs when upper airway obstruction occurs in an individual during sleep with absent or markedly reduced airflow in the presence of continued activity of inspiratory thoracic and diaphragmatic muscles. Central sleep apnea is defined as the absence or the significant reduction of naso-oral airflow due to the withdrawal during sleep of ponto-medullary respiratory center stimulation of the nerves of the inspiratory thoracic and diaphragmatic muscles and absence of contraction of these muscles during apnea. Complex sleep apnea occurs when an individual exhibits characteristics of both obstructive and central sleep apnea.</div><div>The severity of sleep apnea is measured by polysomnography and the apnea hypopnea index (AHI), which is the average number of apneas and hypopneas per hour of sleep measured by polysomnography. Sleep apnea is mild if the AHI is 5-14/h with no or mild symptoms, moderate if the AHI is 15 to 30/h with occasional daytime sleepiness, and severe if the AHI is >30/h with frequent daytime sleepiness that interferes with the normal activities of daily life.</div><div>Chronic sleep apneas and hypopneas followed by compensatory hyperpneas are associated with significant adverse cardiovascular consequences including: 1) recurrent hypoxemia and hypercarbia; 2) Increased sympathetic nerve activity and decreased parasympathetic nerve activity; 3) oxidative stress and vascular endothelial dysfunction; and 4) cardiac remodeling and cardiovascular disease. Moderate or severe sleep apnea significantly increases the risk of coronary artery disease, congestive heart failure, cerebral vascular events (strokes), and cardiac dysrhythmias, and also increase the morbidity and mortality of these diseases. Nevertheless, sleep apnea is currently underdiagnosed and untreated in many individuals due to the challenges in the prediction and detection of sleep apnea and a lack of well-defined optimal treatment guidelines.</div><div>Chronic continuous positive airway pressure for ≥4 h/night for >70% of nights is beneficial in the treatment of patients with sleep apnea. CPAP Improves sleep quality, reduces the AHI, augments cardiac output and increases oxygen delivery to brain and heart, reduces resistant hypertension, decreases cardiac dysrhythmias, and reduces daytime sleepiness.</div><div>The present
全世界有近十亿人患有睡眠呼吸暂停,其中包括四千万美国人。医学界最关注的问题是,由于肥胖、缺乏运动和糖尿病的流行,睡眠呼吸暂停的发病率正在显著增加,而这些都是导致睡眠呼吸暂停发生和持续存在的重要危险因素。睡眠呼吸暂停的特点是在睡眠过程中多次发生呼吸暂停或低通气,导致夜间唤醒、夜间喘息、白天嗜睡、易怒、健忘、疲劳和反复头痛。阻塞性睡眠呼吸暂停是指睡眠时上气道阻塞,在胸肌和膈肌持续活动的情况下气流消失或明显减少。中枢性睡眠呼吸暂停是指在睡眠过程中,由于髓质呼吸中枢对吸气胸肌和膈肌神经的刺激消失,以及这些肌肉在呼吸暂停时没有收缩,导致鼻-口气流缺失或明显减少。当一个人同时表现出阻塞性和中枢性睡眠呼吸暂停的特征时,就会出现复杂性睡眠呼吸暂停。睡眠呼吸暂停的严重程度通过多导睡眠图和呼吸暂停低通气指数(AHI)来测量,后者是多导睡眠图测量的每小时睡眠中呼吸暂停和低通气的平均次数。如果 AHI 为每小时 5-14 次,且无症状或症状轻微,则为轻度睡眠呼吸暂停;如果 AHI 为每小时 15-30 次,且偶有白天嗜睡,则为中度睡眠呼吸暂停;如果 AHI 超过每小时 30 次,且白天经常嗜睡,影响正常的日常生活活动,则为重度睡眠呼吸暂停。长期睡眠呼吸暂停和低通气,继而出现代偿性高通气,会对心血管造成严重的不良后果,包括1)反复低氧血症和高碳酸血症;2)交感神经活动增加,副交感神经活动减少;3)氧化应激和血管内皮功能障碍;4)心脏重塑和心血管疾病。中度或重度睡眠呼吸暂停会显著增加冠心病、充血性心力衰竭、脑血管事件(中风)和心律失常的风险,并增加这些疾病的发病率和死亡率。然而,由于在预测和检测睡眠呼吸暂停方面存在挑战,且缺乏明确的最佳治疗指南,目前许多人对睡眠呼吸暂停的诊断不足且未得到治疗。对睡眠呼吸暂停患者来说,在 70% 以上的夜晚,每晚持续≥4 小时的慢性气道正压治疗是有益的。CPAP 可改善睡眠质量,降低 AHI,增加心输出量,增加大脑和心脏的供氧量,降低抵抗性高血压,减少心律失常,减少白天嗜睡。本文将讨论阻塞性睡眠呼吸暂停、中枢性睡眠呼吸暂停和复杂性呼吸暂停的诊断。随后,回顾了睡眠呼吸暂停的重要病理生理机制以及这些病理生理机制与动脉粥样硬化性血管疾病的关系。为了降低睡眠呼吸暂停导致的心血管疾病发病率和死亡率,促进睡眠呼吸暂停患者的诊断和长期有效的治疗,心血管专家、肺病专家和呼吸治疗/康复专家必须密切合作。
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引用次数: 0
Expanding horizons in pulmonary hypertension management: A systematic review and meta-analysis of non-pharmacological interventions 拓展肺动脉高压管理的视野:非药物干预的系统回顾和元分析》。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-09-01 DOI: 10.1016/j.cpcardiol.2024.102825

Background

Pulmonary hypertension (PH) is a progressive and life-threatening disorder characterized by elevated pulmonary arterial pressure, leading to right heart failure and reduced exercise capacity. Traditional pharmacological and surgical treatments offer limited efficacy and significant side effects, necessitating the exploration of alternative therapeutic options.

Objective

This systematic review and meta-analysis aimed to evaluate the efficacy and safety of non-pharmacological interventions, including exercise, dietary modifications, and psychosocial therapies, in the management of pulmonary hypertension.

Methods

Comprehensive searches were conducted in PubMed, Cochrane Library, and Scopus up to 2024, identifying randomized controlled trials and observational studies examining non-pharmacological interventions for PH. Primary outcomes assessed included pulmonary arterial pressure, right heart function, exercise capacity, and quality of life, with secondary analysis on safety and adverse effects. Data synthesis was performed using random-effects meta-analysis.

Results

The review included 30 studies, totaling 2000 participants with various forms of PH. Meta-analysis demonstrated significant improvements in exercise capacity as measured by the 6 min walk distance (mean increase of 45 meters, 95 % CI: 30-60, p<0.001), enhanced quality of life scores, and reduction in pulmonary arterial pressure (mean reduction of 5 mmHg, 95 % CI: 3-7, p<0.01). Non-pharmacological therapies also showed a favorable safety profile, with minor adverse effects reported.

Conclusion

Non-pharmacological interventions provide a viable and effective complement to traditional treatments for pulmonary hypertension, significantly improving functional capacity and hemodynamic parameters without severe adverse effects. These findings support the integration of tailored non-pharmacological strategies into the therapeutic regimen for PH patients, emphasizing the need for broader implementation and further research to optimize intervention protocols.

背景:肺动脉高压(PH)是一种渐进性、危及生命的疾病,其特点是肺动脉压力升高,导致右心衰竭和运动能力下降。传统的药物和手术治疗疗效有限且副作用大,因此有必要探索其他治疗方案:本系统综述和荟萃分析旨在评估非药物干预措施(包括运动、饮食调整和社会心理疗法)在治疗肺动脉高压方面的有效性和安全性:在PubMed、Cochrane Library和Scopus上进行了全面检索,截止到2024年,确定了研究肺动脉高压非药物干预措施的随机对照试验和观察性研究。评估的主要结果包括肺动脉压、右心功能、运动能力和生活质量,并对安全性和不良反应进行了二次分析。数据综合采用随机效应荟萃分析法:综述包括 30 项研究,共有 2000 名患有各种 PH 的参与者。荟萃分析表明,以 6 分钟步行距离为衡量标准,运动能力有了显著提高(平均提高 45 米,95% CI:30-60,p 结论:非药物干预可为患者提供更多的选择:非药物干预为肺动脉高压的传统治疗提供了可行且有效的补充,可显著改善功能能力和血液动力学参数,且无严重不良反应。这些研究结果支持将量身定制的非药物疗法纳入肺动脉高压患者的治疗方案中,强调了更广泛实施和进一步研究优化干预方案的必要性。
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引用次数: 0
Exploring cardiopulmonary rehabilitation in the middle east and North Africa region: A narrative review of challenges and opportunities 探索中东和北非地区的心肺康复:挑战与机遇的叙述性回顾。
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-31 DOI: 10.1016/j.cpcardiol.2024.102829

Background and Objectives

Cardiopulmonary Rehabilitation (CR) is crucial for managing conditions like congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), and post-COVID-19 complications. This review examines CR practices in the Middle East and North Africa (MENA) region, exploring challenges, disparities, and emerging trends.

Methods

A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science to identify studies published between date of inception and April 24th, 2024, focusing on CR programs, outcomes, challenges, and strategies specific to the MENA region. Data extraction included study design, population characteristics, CR interventions, and key findings.

Results

CR programs in the MENA region vary widely in scope and execution. While efforts are underway to integrate CR services into national healthcare policies, significant challenges persist, including limited infrastructure, shortages of trained professionals, and cultural barriers. Emerging trends include the use of telehealth and digital monitoring tools to expand access to CR services and policy reforms aimed at improving service delivery and patient access.

Conclusion

CR plays a crucial role in improving the quality of life and health outcomes for cardiopulmonary patients, including those in the MENA region. However, significant challenges hinder the widespread adoption and effectiveness of CR programs. Addressing these challenges requires efforts to increase public education, reduce costs, expand funding, and enhance interprofessional collaboration. Future research should assess virtual rehabilitation, cultural adjustments, and long-term outcomes to tailor interventions to MENA's needs, ultimately enhancing CR accessibility and patient outcomes.

背景和目标:心肺康复 (CR) 对于控制充血性心力衰竭 (CHF)、慢性阻塞性肺病 (COPD) 和 COVID-19 后并发症等疾病至关重要。本综述研究了中东和北非地区(MENA)的 CR 实践,探讨了挑战、差异和新趋势:方法:在 PubMed、Scopus 和 Web of Science 中进行了全面的文献检索,以确定从开始到 2024 年 4 月 24 日之间发表的研究,重点关注中东和北非地区的 CR 项目、结果、挑战和策略。数据提取包括研究设计、人群特征、 CR 干预措施和主要发现:中东和北非地区的 CR 项目在范围和执行方面差异很大。虽然正在努力将 CR 服务纳入国家医疗保健政策,但仍存在重大挑战,包括基础设施有限、训练有素的专业人员短缺以及文化障碍。新出现的趋势包括使用远程医疗和数字监测工具来扩大 CR 服务的可及性,以及旨在改善服务提供和患者可及性的政策改革:CR 在改善心肺疾病患者(包括中东和北非地区的心肺疾病患者)的生活质量和健康状况方面发挥着至关重要的作用。然而,巨大的挑战阻碍了 CR 项目的广泛采用和有效性。要应对这些挑战,就必须努力加强公众教育、降低成本、扩大资金投入并加强跨专业合作。未来的研究应评估虚拟康复、文化调整和长期疗效,以便根据中东和北非地区的需求量身定制干预措施,最终提高 CR 的可及性和患者疗效。
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引用次数: 0
Effectiveness of emotional-focused coping on heart-focused anxiety in patients prior to cardiac catheterization 情绪集中应对法对心导管检查前患者心脏焦虑的影响
IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Pub Date : 2024-08-31 DOI: 10.1016/j.cpcardiol.2024.102819
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引用次数: 0
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Current Problems in Cardiology
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