PHYSICAL AND SEXUAL ACTIVITIES
|
|
- Osborne Randall
- 5 years ago
- Views:
Transcription
1 Forgotten problems in HF PHYSICAL AND SEXUAL ACTIVITIES Massimo F Piepoli, MD, PhD, FESC, FACC Heart Failure Unit, Guglielmo da Saliceto Hospital, Piacenza m.piepoli@alice.it No disclosures Massimo Speaker F Piepoli
2 Physical Activity in CHF: Yesterday Speaker Massimo F Piepoli
3 Heart Failure Physical Activity and Exercise Training Regular, moderate daily activity is recommended for all patients with heart failure Class of recommendation I, level of evidence B Exercise training is recommended to all stable chronic heart failure patients. There is no evidence that exercise training should be limited to any particular HF patient subgroup (aetiology, NYHA class, LVEF or medication). Class of recommendation I, level of evidence A ESC Guidelines for the Diagnosis Speaker and Treatment of Acute and Chronic HF
4 Physical Activities in CHF Vagal Autonomic Sympathetic VO 2 Physical Activity
5 Similarity between Muscular Deconditioning and Heart Failure Haemodynamics Vascular resistance Resting Heart Rate Deconditioning Speaker Heart Failure Function Exercise Tolerance Neuroendocrine/autonomic Renin/angiotensin Sympathetic Vagal Activity Baroreflex sensitivity Skeletal Muscle Muscle Mass /bulk Mitochondrial Enzymes Oxidative Glycholytic Psychological Wellbeing Activity Scores
6 Cardiovascular Benefits of Exercise Anti-atherosclerotic Improved lipids Lower BPs Reduced adiposity Insulin sensitivity Inflammation Anti-thrombotic Platelet adhesiveness Fibrinolysis Fibrinogen Blood viscosity Anti-ischemic Myocardial O 2 demand Coronary flow Endothelial dysfunction Anti-arrhythmic Vagal tone Adrenergic activity HR variability
7 Exercise training and CHF. Increased Survival Reduced Hospitalisation M F Piepoli, Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH). BMJ 2004;328:189 Speaker
8 Exercise training and CHF. ExTraMATCH Piepoli et al. BMJ 2004;328:189 Peak VO2 >15 ml/kg/min <15 ml/kg/min Speaker
9 Secondary prevention through cardiac rehabilitation From Knowledge to Implementation. A Position Paper from the Cardiac Rehabilitation Section of the EACPR Exercise Training Prescriptions in CHF MODALITY: Dynamic aerobic exercise and endurance training regimens (cycling, walking, calisthenics) should be prescribed. Different training modalities (respiratory, strength INTENSITY: range of 60 to 80% of maximal HR or at 50-70% of peak VO2. Low intensity exercise training at 40-60% of peak VO2 TRAINING PERIOD: long-term exercise training periods should be pursued DURATION AND FREQUENCY OF THE TRAINING: The length and intensity of the exercise session should be gradually increased by 1-2 min with a goal of 30 min. In the maintenance phase, exercise is recommended for 20 to 60 min on 3 to 5 days/week. Speaker Piepoli et al. Eur Heart J 2010
10 Fantasy vs reality
11 HF patients undergoing Exercise-based Cardiac Rehabilitation in Europe: <20% ECRIS study. European Cardiac Rehabilitation Inventory Survey. Eur J Cardiov Prev Rehab 2010
12 Managing medical barriers to exercise in HF Cardiologists/GPs Inability to meet intensity and duration exercise requirements Arthritis ICD / CRT placement Following hospitalisation Barbour, Heart Fail Rev 2008
13 Managing non-medical barriers to exercise in HF Costing Lack of time Boredom Work conflicts Motivation Vacation/Holidays Social support Depression Barbour, Heart Fail Rev 2008
14 Physical Activity. Key role of the physician Assessment of physical activity level by history: readiness to change behaviour; self-confidence; barriers to increase physical activity, and social support in making positive changes. Recommend: A least minutes/session of moderately intense aerobic activity, preferable daily, or at least 3-4/week; gradual increases in daily lifestyle activities over time, and how to incorporate it into daily routine Advice individualised physical activity according to age, habits, comorbidities, preferences and goal Speaker Piepoli et al. Eur Heart J 2010
15 Physical Activity. Key role of the physician Reassure regarding the safety of the recommended protocol Encourage the involvement in leisure activities, enjoyable and in group programme Educate on the risk of relapses and the need for its lifelong continuation. Expect outcomes: Improved psychosocial well-being, prevention of disability, improved prognosis Speaker Piepoli et al. Eur Heart J 2010
16 Exercise training and modern treatment options for CHF patients
17 Sexual Activity and Heart Failure
18 Sexual Activity: metabolic and haemodynamic demands In middle age CAD men Peak HR (117 bpm), BP 162/89 mmhg METs: In severe CHF HR increases from 53 to 131 bpm RV Pressure from 38/8 to 101/21 mmhg
19 Sexual Activity and Heart Failure
20 Speaker 2010
21 International Journal of Cardiology 101 (2005) 83-90
22 Exercise training sessions 60 min sessions - 3 times/week x 8 weeks: 15 min stretching movements 45 min cycle work-load (watts): 60% peak VO2
23 International Journal of Cardiology 101 (2005) After 8 training Training Control P Peak VO 2, ml/kg/min 21.8± ± AT VO 2, ml/kg/min 14.1± ± Ventilation, L/min 64.2± ± Peak O 2 pulse, ml/beat 10.8 ± ± DVO 2 /DW, ml/min/w 8.7 ± ± Peak Work Rate, Watts 133±28 92± Resting HR, beats/min 76.4± ± Peak HR, beats/min 137 ± ± Peak SPB Pressure, mmhg 183±35 163±15 <0.001
24 Sexual Activity After 8 week Exercise Training Training Control P Men DOMAIN ±2-0.72± DOMAIN 2 0.8± ± DOMAIN ± ± All 6.17± ±3.2 <0.001 Partners DOMAIN 1 0.8± ± DOMAIN ± ± DOMAIN 3 3.5± ± All 4.87± ±0.3 <0.001 International Journal of Cardiology 101 (2005) DOMAIN 1 = relationship with the partner; DOMAIN 2 = quality of penile erection; DOMAIN 3 = personal wellness. In normal individuals, the sum is 13.
25 % Diameter Change % Diameter Change Changes in the vasomotor response of the brachial artery after Exercise Training 8. *P= * trained control trained control Flow-mediated dilation NTG-mediated dilation International Journal of Cardiology 101 (2005) 83-90
26 D MHL Score Changes in Minnesota HF Living Score after Exercise Training Training 0 * Control -15 Entry International Journal of Cardiology 101 (2005) weeks
27 Sexual Activity and Heart Failure Initial assessment: Medical history [age, overall health motivational state] - Signs and symptoms of HF - Lab findings (chemistry, BNP) Low risk NYHA I, No symptom or cardiac event on sexual activity Most patients in this category Intermediate risk NYHA II, or LVEF <30% Moderate risk of symptom exacerbation with sexual activity High risk NYHA III or IV, severe, unstable High risk of symptom exacerbation with sexual activity Continue routine CHF therapy Advice to continue with sexual activity without testing No contraindication to ED if need Re-stratify into low- or high risk after exercise test [CPX], 6MWT, 2D-Echo Consider Exercise Training Stabilise underlying HF via therapy Advice to abstain from sexual activity. Reassess
28 Summary: Physical and Sexual Activities - Exercise intolerance as hallmark of HF - Benefit of moderate exercise training programme, - Promotion of Physical Exercise as a tool to maintain long term effect - Concerns on sexual activity - Multiple aetiology - Benefit of physical training programme via - increasing exercise capacity, and - endothelial function
29 Grazie Massimo F Piepoli, MD, PhD, FESC, FACC Div. Cardiologia, Ospedale Polichirurgico Guglielmo da Saliceto, Piacenza - m.piepoli@alice.it Speaker
What is established? Risk of Benefit complica comp tion
What s new in exercise training in CHF? Jean-Paul Schmid, MD, FESC Consultant Cardiologist, SpitalNetzBern Tiefenau Hospital, Dept. of Internal Medicine, Cardiology, Bern, Switzerland What is established?
More informationHEART FAILURE AN OMINOUS DISEASE
HEART FAILURE AN OMINOUS DISEASE Conflicts of Interest I Have No Conflicts of Interest to Disclose Objective At the conclusion of this presentation, the participants will be able to identify benefits and
More informationThe Role of Cardiac Rehabilitation. The Role of Cardiac Rehabilitation. in Heart Failure. in Heart Failure. History of Cardiac Rehab.
The Role of Cardiac Rehabilitation The Role of Cardiac Rehabilitation in Heart Failure in Heart Failure Kate Traynor RN MS FAACVPR Financial Disclosures No relevant financial relationship exists. History
More informationValue of cardiac rehabilitation Prof. Dr. L Vanhees
Session: At the interface of hypertension and coronary heart disease haemodynamics, heart and hypertension Value of cardiac rehabilitation Prof. Dr. L Vanhees ESC Stockholm August 2010 Introduction There
More informationThe role of CPX testing in the rehabilitation of cardiac patients.
Cardiopulmonary exercise testing (CPX) for comprehensive cardiac evaluations The role of CPX testing in the rehabilitation of cardiac patients. Viviane M Conraads, MD, PhD Department of Cardiology Cardiac
More informationValue of Cardiac Rehabilitation for Improving Patient Outcomes
Value of Cardiac Rehabilitation for Improving Patient Outcomes Pam R. Taub MD, FACC Director of Step Family Cardiac Wellness and Rehabilitation Center Associate Professor of Medicine UC San Diego Health
More informationCardiac Rehabilitation for Heart Failure Patients. Jia Shen MD, MPH Assistant Professor of Medicine UC San Diego Health System
Cardiac Rehabilitation for Heart Failure Patients Jia Shen MD, MPH Assistant Professor of Medicine UC San Diego Health System Disclosures There are no conflict of interests related to this presentation.
More informationThe Role of Exercise in Management of Patients with Heart Failure
The Role of Exercise in Management of Patients with Heart Failure Pamela B. Morris, MD, FACC, FAHA, FASPC, FNLA Chair, ACC Prevention of Cardiovascular Disease Leadership Council and Section Director,
More informationHigh Intensity Interval Exercise Training in Cardiac Rehabilitation
High Intensity Interval Exercise Training in Cardiac Rehabilitation Prof. Leonard S.W. Li Hon. Clinical Professor, Department of Medicine, The University of Hong Kong Director, Rehabilitation Virtus Medical
More informationRebuilding and Reinvigorating Cardiac Rehabilitation in 2018
Rebuilding and Reinvigorating Cardiac Rehabilitation in 2018 Pam R. Taub MD, FACC Director of Step Family Cardiac Wellness and Rehabilitation Center Associate Professor of Medicine UC San Diego Health
More informationCardiac rehabilitation: a beneficial effect in CHD?
Cardiac rehabilitation: a beneficial effect in CHD? An Van Berendoncks Department of Cardiology Antwerp University Hospital Outline Why exercise training in CHD? Risk and benefits? Feasibility? Why should
More informationCardiac Rehabilitation Program for LVAD Patients. Dr Katherine Fan Consultant Cardiologist Grantham Hospital, Hong Kong SAR
Cardiac Rehabilitation Program for LVAD Patients Dr Katherine Fan Consultant Cardiologist Grantham Hospital, Hong Kong SAR Left Ventricular Assist Devices (LVAD) Improved Survival Following LVAD Implantations
More informationL esercizio fisico e le patologie cardiorespiratorie: dalla valutazione funzionale alla prescrizione. M. Guazzi
La Riabilitazione Interdisciplinare L esercizio fisico e le patologie cardiorespiratorie: dalla valutazione funzionale alla prescrizione M. Guazzi Università di Milano Dipartimento Cardiologia Universitaria
More informationCardiac Rehabilitation:
Cardiac Rehabilitation: supervised physical exercise programme in practice Adam Staron MD, PhD Prince Sultan Cardiac Center, Riyadh DISCLOSURE No conflict of interest Exercise test protocols Treadmill
More informationSubject: Outpatient Phase Ii Cardiac Rehab Individualized Treatment Plan And Exercise Prescription
CARDIAC REHAB POLICY & PROCEDURES Policy #: CR 208 Subject: Outpatient Phase Ii Cardiac Rehab Individualized Treatment Plan And Exercise Prescription Purpose: To establish guidelines for developing and
More informationCurtin University is a trademark of Curtin University of Technology CRICOS Provider Code 00301J
Exercise-based cardiac rehabilitation for people with ventricular assist devices: Associate Professor Andrew Maiorana School of Physiotherapy and Exercise Science, Curtin University; Advanced Heart Failure
More informationPRESENTED BY BECKY BLAAUW OCT 2011
PRESENTED BY BECKY BLAAUW OCT 2011 Introduction In 1990 top 5 causes of death and disease around the world: Lower Respiratory Tract Infections Diarrhea Conditions arising during pregnancy Major Depression
More informationThe importance of follow-up after a cardiac event: CARDIAC REHABILITATION. Dr. Guy Letcher
The importance of follow-up after a cardiac event: CARDIAC REHABILITATION Dr. Guy Letcher The National Medicare Experience Mortality After Angioplasty 225,915 patients Mortality After Bypass Surgery 357,885
More informationThe Failing Heart in Primary Care
The Failing Heart in Primary Care Hamid Ikram How fares the Heart Failure Epidemic? 4357 patients, 57% women, mean age 74 years HFSA 2010 Practice Guideline (3.1) Heart Failure Prevention A careful and
More informationScope
Scope Global burden of heart disease Physical activity trends Overview of CR A happy problem Principles of CR in athletes Classification of sport Existing guidelines Exercise testing & prescription HIIT
More informationSpinal Cord Stimulation Hani N. Sabbah, Ph.D., FACC, FCCP, FAHA Professor of Medicine Wayne State University & Director of Cardiovascular Research
Spinal Cord Stimulation Hani N. Sabbah, Ph.D., FACC, FCCP, FAHA Professor of Medicine Wayne State University & Director of Cardiovascular Research Henry Ford Health System Disclosure Information ESC 2011
More informationThe life after myocardial infarction: a long quiet river?
The life after myocardial infarction: a long quiet river? Cardiac rehabilitation: for whom and how? Dr. Barnabas GELLEN MD, PhD, FESC Poitiers JESFC 2018 - Paris Conflicts of interest Speaker honoraria
More informationCPX and Prognosis in Cardiovascular Disease
CPX and Prognosis in Cardiovascular Disease Anselm K. Gitt, Piergiuseppe Agostoni Herzzentrum Ludwigshafen, Germany Instituto di Cardiologia Università di Milano, Milan, Italy Cardiopulmonary exercise
More informationUniversity of Toronto Rotation Specific Objectives. cardiac rehabilitation
University of Toronto Rotation Specific Objectives Cardiac Rehabilitation For this rotation, please FOCUS the evaluation on the following CanMEDs roles: 1) Medical Expert; 2) Collaborator; 3) Health Advocate
More informationThe Art and Science of Exercise Prescription in Patients with Cardiovascular Disease
The Art and Science of Exercise Prescription in Patients with Cardiovascular Disease Prescribe Exercise FITT Principle Frequency Intensity Time or duration Type or modality Exercise Prescription with or
More informationRED CELL DISTRIBUTION WIDTH
RED CELL DISTRIBUTION WIDTH A NEW MARKER OF EXERCISE INTOLERANCE IN PATIENTS WITH CHRONIC HEART FAILURE Emeline Van Craenenbroeck, Paul Beckers, Nadine Possemiers, Christiaan Vrints, Viviane Conraads Cardiology
More informationRole of Cardiopulmonary Exercise Testing in Exercise Prescription
Role of Cardiopulmonary Exercise Testing in Exercise Prescription Jonathan Myers, PhD VA Palo Alto Health Care System Stanford University There are no conflicts of interest to disclose Role of Cardiopulmonary
More informationPsychological & Physiological Effects of Exercise
Psychological & Physiological Effects of Exercise Jeffrey A Zlotnick MD (CAQ) FAAFP DABFP Residency Educational Director of Sports Medicine Penn State Health / St Joseph s Hospital Family Medicine Residency
More informationMobilization and Exercise Prescription
1 Clinicians can use this job aid as a tool to guide them through mobilization and exercise prescription with patients who have cardiopulmonary conditions. Mobilization and Exercise Prescription Therapy
More informationCardiac devices beyond pacemaker and ICD Prof. Dr. Martin Borggrefe
Cardiac devices beyond pacemaker and ICD Prof. Dr. Martin Borggrefe Mannheim CRT studies Patient selection CRT: NYHA III-IV, EF 35%, SR, QRS 120ms, LVEDD>55mm (25-45)% Non-Responder The Concept: Cardiac
More informationTri-City Cardiology Consultants FIFTH ANNUAL SYMPOSIUM
Tri-City Cardiology Consultants FIFTH ANNUAL SYMPOSIUM Faculty Disclosure Banner Baywood Medical Center -Chief of Staff FIFTH ANNUAL SYMPOSIUM NYHA class III-IV symptoms Clinical signs of fluid retention
More informationCHRONIC HEART FAILURE : WHAT ELSE COULD WE OFFER TO OUR PATIENTS? Cardiac Rehabilitation Society of Thailand
CHRONIC HEART FAILURE : WHAT ELSE COULD WE OFFER TO OUR PATIENTS? Cardiac Rehabilitation Society of Thailand ENHANCED EXTERNAL COUNTER PULSATION Piyanuj Ruckpanich, MD. Cardiac Rehabilitation Center Perfect
More informationCase study approach to exercise prescription: one size does not fit all. Samantha Breen Clinical Lead Physiotherapist Manchester Heart Centre
Case study approach to exercise prescription: one size does not fit all Samantha Breen Clinical Lead Physiotherapist Manchester Heart Centre Aims Explain benefits of exercise training Discuss prescription
More informationDiabetes and Heart Failure
Diabetes and Heart Failure A common and fatal combination A Aspects on epidemiology, prognosis diagnosis and therapy Lars Rydén Department of Medicine Karolinska Institutet Stockholm, Sweden Diabetes and
More informationEndurance training and cardiac arrhythmias
Endurance training and cardiac arrhythmias Myocardial and autonomic alterations under endurance training Federico Lombardi, MD, FESC Cardiologia, Osp. San Paolo D.M.C.O. University of Milan Milan, Italy
More informationCARDIAC REHABILITATION AFTER TRANSCATHETER AORTIC VALVE IMPLANTATION: A SINGLE CENTRE EXPERIENCE
ESC Congress 2011 27 Aug - 31 Aug 2011, Paris - France CARDIAC REHABILITATION AFTER TRANSCATHETER AORTIC VALVE IMPLANTATION: A SINGLE CENTRE EXPERIENCE N.Russo, L.Compostella, T.Setzu, M.Napodano, L.Testolin,
More informationClinical Considerations of High Intensity Interval Training (HIIT)
Clinical Considerations of High Intensity Interval Training (HIIT) Jenna Taylor Exercise Physiologist & Dietitian The Wesley Hospital PhD Candidate The University of Queensland What is High Intensity Interval
More informationFocus on Rehabilitation, Exercise and Surgical Coronary Revascularization
Focus on Rehabilitation, Exercise and Surgical Coronary Revascularization Sam Haddad, MD Kenneth O Reilly, MD Disclosure of Commercial or Pharma Support NTD Learning Objectives At the conclusion of this
More informationExercise after CABG: The Good The Bad and the Ugly
Exercise after CABG: The Good The Bad and the Ugly Ph Meurin. Les Grands Prés (Villeneuve Saint Denis) No conflict of Interest After CABG, the Prognosis is Good.. Age 65 ± 10 Male Gender 80 % Pre-op LVEF
More informationAdvanced Concepts of Personal Training Study Guide Answer Key
Advanced Concepts of Personal Training Study Guide Answer Key Lesson 22 Working with Special Populations LESSON TWENTY TWO Lesson Twenty Two Working with Special Populations WORKING WITH SPECIAL POPULATIONS
More informationChallenging clinical cases in cardiac rehabilitation: one size fits all? - women -
Challenging clinical cases in cardiac rehabilitation: one size fits all? - women - Prof. Dr. Birna Bjarnason-Wehrens Institute for Cardiology and Sports medicine German Sportuniversity Colgne Secondary
More informationIron deficiency in heart failure
Iron deficiency in heart failure Piotr Ponikowski, MD, PhD, FESC Department of Heart Diseases, Wroclaw Medical University Centre for Heart Diseases, Military Hospital, Wroclaw, Poland Objectives Importance
More informationCardiovascular Health Practice Guideline Outpatient Management of Coronary Artery Disease 2003
Authorized By: Medical Management Guideline Committee Approval Date: 12/13/01 Revision Date: 12/11/03 Beta-Blockers Nitrates Calcium Channel Blockers MEDICATIONS Indicated in post-mi, unstable angina,
More informationEuroPRevent 2010 Prevention in Adults: Is it good to Know? No conflict of interest to be disclosured
EuroPRevent 2010 Prevention in Adults: Is it good to Know? Almir Sérgio Ferraz MD, PhD Cardiovascular Rehabilitation Center almirferraz@uol.com.br Institute Dante Pazzanese of Cardiology 1 No conflict
More informationThe Who, How and When of Advanced Heart Failure Therapies. Disclosures. What is Advanced Heart Failure?
The Who, How and When of Advanced Heart Failure Therapies 9 th Annual Dartmouth Conference on Advances in Heart Failure Therapies Dartmouth-Hitchcock Medical Center Lebanon, NH May 20, 2013 Joseph G. Rogers,
More informationThe right heart: the Cinderella of heart failure
The right heart: the Cinderella of heart failure Piotr Ponikowski, MD, PhD, FESC Medical University, Centre for Heart Disease Clinical Military Hospital Wroclaw, Poland none Disclosure Look into the Heart
More informationCardiac Rehabilitation & Exercise Training in Congenital Heart Disease. Jidong Sung Division of Cardiology Sungkyunkwan University School of Medicine
Cardiac Rehabilitation & Exercise Training in Congenital Heart Disease Jidong Sung Division of Cardiology Sungkyunkwan University School of Medicine Cardiac rehabilitation Agency of Health Care Policy
More informationCardiovascular Fitness
Section III: Concept 08 Cardiovascular Fitness Cardiovascular Fitness "Cardio" = heart "Vascular" = vessels A strong heart and healthy vessels (developed from regular physical activity) help to make a
More informationBiological Correlates of Frailty in Older Heart Failure Patients
Biological Correlates of Frailty in Older Heart Failure Patients Dalane W. Kitzman, MD Professor of Internal Medicine: Cardiovascular Medicine and Geriatrics Kermit Glenn Phillips II Chair in Cardiology
More informationCardiac Rehabilitation and Electromyostimulation
CREMS-HF Cardiac Rehabilitation and Electromyostimulation Dr Marie Christine Iliou Dr Bénédicte Vergès CREMS-HF study GERS SFC Déclaration de Relations Professionnelles Disclosure Statement of Financial
More informationNew Scientic Advances in Cardiac Rehabilitation No disclosures
New Scientic Advances in Cardiac Rehabilitation No disclosures Massimo F Piepoli Cardiac Rehabilitation Section, EACPR 1 Section Cardiac Rehabilitation, EACPR promoting cardiac rehabilitation in Europe
More informationAcute heart failure, beyond conventional treatment: persisting low output
Acute heart failure, beyond conventional treatment: persisting low output Alexandre Mebazaa, FESC Hôpital Lariboisière, Université Paris 7 U942 Inserm Conflict of Interest Lecture fee: Orion No other conflicts
More informationRest and Exercise Echocardiography in Hypertrophic Cardiomyopathy: Determinants of Exercise Peak Gradient and Predictors of Outcome
Rest and Exercise Echocardiography in Hypertrophic Cardiomyopathy: Determinants of Exercise Peak Gradient and Predictors of Outcome G. Deswarte, AS. Polge, N. Lamblin, A. Millaire, M. Richardson, C. Bauters,
More informationImaging in dilated cardiomyopathy : factors associated with a poor outcome
Imaging in dilated cardiomyopathy : factors associated with a poor outcome Johan De Sutter, MD, PhD, FESC AZ Maria Middelares Gent and University Gent - Belgium Dilated cardiomyopathy Cardiomyopathy with
More informationTreatment of sleep apnea in heart failure patients after SERVE-HF results
Treatment of sleep apnea in heart failure patients after SERVE-HF results Martin R Cowie Professor of Cardiology National Heart & Lung Institute Imperial College London (Royal Brompton Hospital Campus)
More informationAccuracy of the ST/HR hysteresis and of cardiopulmonary stress testing parameters in the diagnosis of exercise induced myocardial ischemia
G. D ANNUNZIO UNIVERSITY - CHIETI FACULTY OF MEDECINE DEPARTMENT OF CARDIOLOGY Director: Prof. R. De Caterina Accuracy of the ST/HR hysteresis and of cardiopulmonary stress testing parameters in the diagnosis
More informationSurgery and device intervention for the elderly with heart failure: assessing the need. Devices and Technology for heart failure in 2011
Surgery and device intervention for the elderly with heart failure: assessing the need Devices and Technology for heart failure in 2011 Assessing cardiovascular function / prognosis (in the elderly): composite
More informationEvidence of Baroreflex Activation Therapy s Mechanism of Action
Evidence of Baroreflex Activation Therapy s Mechanism of Action Edoardo Gronda, MD, FESC Heart Failure Research Center IRCCS MultiMedica Cardiovascular Department Sesto S. Giovanni (Milano) Italy Agenda
More informationBenefits of Exercise The Reality of How Much Is Enough. Center for Cardiac Fitness Pulmonary Rehab Program The Miriam Hospital
Benefits of Exercise The Reality of How Much Is Enough Center for Cardiac Fitness Pulmonary Rehab Program The Miriam Hospital Physiological Effects of Lung Disease Oxidative Stress = Cumulative damage
More informationAfter modern CABG: Pro.
Is there a role for cardiac rehabilitation in the modern era of PCI and CABG? After modern CABG: Pro. Massimo F. Piepoli, Italy No conflict of interest Modern CABG: MICS CABG (Minimally Invasive Cardiac
More informationPerformance Enhancement. Cardiovascular/Respiratory Systems and Athletic Performance
Performance Enhancement Cardiovascular/Respiratory Systems and Athletic Performance Functions of the Cardiovascular System Deliver oxygen & nutrients to body tissues Carry wastes from the cells Anatomy
More informationObjective: Prepare NBRC candidate for CRT and WRT Content Outline
STRESS TEST AND HEMODYNAMICS Lois Rowland, MS, RRT-NPS, RPFT, FAARC Objective: Prepare NBRC candidate for CRT and WRT Content Outline Perform, evaluate patient response to, interpret results from: Stress
More informationIron Deficiency: New Therapeutic Target in Heart Failure. Stefan D. Anker, MD PhD
Iron Deficiency: New Therapeutic Target in Heart Failure Stefan D. Anker, MD PhD Department of Cardiology, Applied Cachexia Research, Charité Campus Virchow-Klinikum, Universitätsmedizin Berlin, Germany.
More informationThe Role of Cardiac Rehabilitation in Recovery & Secondary Prevention. Loren M Stabile, MS Cardiac & Pulmonary Rehab Program Manager
The Role of Cardiac Rehabilitation in Recovery & Secondary Prevention Loren M Stabile, MS Cardiac & Pulmonary Rehab Program Manager Objectives Core Components of Cardiac Rehab Program CR Indications &
More informationNora Goldschlager, M.D. SFGH Division of Cardiology UCSF
CLASSIFICATION OF HEART FAILURE Nora Goldschlager, M.D. SFGH Division of Cardiology UCSF DISCLOSURES: NONE CLASSIFICATION C OF HEART FAILURE NYHA I IV New paradigm Stage A: Pts at high risk of developing
More informationWomen s Ischemia and cardiac rehabilitation
Women s Ischemia and cardiac rehabilitation Dr. Pallavi Bellamkonda MD, FACC Financial Disclosures: None 1 Objectives Understanding the Unique presentations of Ischemic Disease in Women: Obstructive Coronary
More informationImpact of Exercise on Patients with Diabetes Mellitus. Learning Objectives. Definitions Physical Activity and Health
Impact of Exercise on Patients with Diabetes Mellitus Bret Goodpaster, Ph.D. Exercise Physiologist Assistant Professor of Medicine University of Pittsburgh Division of Endocrinology and Metabolism Learning
More informationTo Correlate Ejection Fraction with 6 Minute Walked Distance and Quality of Life in Patients with Left Ventricular Heart Failure
To Correlate Ejection Fraction with 6 Minute Walked Distance and Quality of Life in Patients with Left Ventricular Heart Failure Pramila S Kudtarkar*, Mariya P Jiandani*, Ashish Nabar** Abstract Purpose
More informationShould I use statins?
I know the trials in heart failure but how do I manage my patient? Should I use statins? Aldo P Maggioni, MD, FESC ANMCO Research Center Firenze, Italy Disclosures Aldo P Maggioni served as a member of
More informationThis educational programme has received unrestricted grants from:
This educational programme has received unrestricted grants from: Schiller Reomed AG DAIICHI SANKYO (SCHWEIZ) AG gsk GlaxoSmithKline The sponsors were not involved in the development of this programme,
More informationBenefits of Combined Aerobic/Resistance/Inspiratory Muscle Training in Patients with Chronic Heart Failure. The Ideal Exercise Program for CHF?
Benefits of Combined Aerobic/Resistance/Inspiratory Muscle Training in Patients with Chronic Heart Failure. The Ideal Exercise Program for CHF? I D. Laoutaris, S Adamopoulos, A Manginas, D B. Panagiotakos,
More informationPreventive Cardiology
Preventive Cardiology 21 Volume The Preventive Cardiology and Rehabilitation Prevention Outpatient Visits 7,876 Program helps patients identify traditional and Phase I Rehab 9,932 emerging nontraditional
More informationLXIV: DRUGS: 4. RAS BLOCKADE
LXIV: DRUGS: 4. RAS BLOCKADE ACE Inhibitors Components of RAS Actions of Angiotensin i II Indications for ACEIs Contraindications RAS blockade in hypertension RAS blockade in CAD RAS blockade in HF Limitations
More informationCombination of renin-angiotensinaldosterone. how to choose?
Combination of renin-angiotensinaldosterone system inhibitors how to choose? Karl Swedberg Professor of Medicine Sahlgrenska Academy University of Gothenburg karl.swedberg@gu.se Disclosures Research grants
More informationLearning Objectives. Impact of Exercise on Patients with Diabetes Mellitus. Definitions: Physical Activity and Health.
Impact of Exercise on Patients with Diabetes Mellitus Bret Goodpaster, Ph.D. Exercise Physiologist Professor of Medicine University of Pittsburgh Division of Endocrinology and Metabolism Learning Objectives
More informationI know the trials in heart failure but how do I manage my patient? Dosing of neurohormones antagonists
I know the trials in heart failure but how do I manage my patient? Dosing of neurohormones antagonists Alessandro Fucili (Ferrara, IT) Massimo F Piepoli (Piacenza, IT) Clinical Case: 82 year old woman
More informationPeripheral Contributions to HFpEF
Peripheral Contributions to HFpEF Greg Lewis MD Heart Failure Section Head MGH Cardiology Division and Pulmonary Critical Care Unit Harvard Medical School March 12, 2018 Pathophysiology of HFpEF vs. HFrEF
More informationExercise Testing and Training in Heart Failure Patients Robert S. McKelvie, MD, PhD, FRCPC, Hamilton Health Sciences - General Division
Exercise Testing and Training in Heart Failure Patients Robert S. McKelvie, MD, PhD, FRCPC, Hamilton Health Sciences - General Division Studies have demonstrated that there is no relationship between left
More informationHeart Failure Unit, Cardiac Department, Guglielmo da Saliceto Hospital, Piacenza, Italy
Review Secondary prevention through cardiac rehabilitation: from knowledge to implementation. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention
More informationGastrocnemius, see Medial gastrocnemius Glucose, see Blood glucose
Subject Index Acute myocardial infarction, see Myocardial infarction Aerobic capacity cardiac patients and Tai Chi training effects 185 heart failure and Tai Chi outcomes 198 200, 202, 205 meta-analysis
More informationExercise Progression for the Cardiac, Pulmonary & PAD Patient
Exercise Progression for the Cardiac, Pulmonary & PAD Patient Thomas P. Mahady MS CSCS CCRP Hackensack University Medical Center Hackensack Meridian Health Learning Objectives The Art of Exercise Prescription.
More informationQuality Payment Program: Cardiology Specialty Measure Set
Quality Payment Program: Cardiology Specialty Set Title Number CMS Reporting Method(s) Heart Failure (HF): Angiotensin- Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for
More informationCardiac Rehabilitation Individualized Healing for Patients with Cardiovascular Disease
Cardiac Rehabilitation Individualized Healing for Patients with Cardiovascular Disease Richard A. Josephson MS, MD FACC, FAHA, FACP, FAACVPR Director of Cardiac Intensive Care Director of Cardiovascular
More informationHeart Rhythm Congress 2016 Chronotropic incompetence in heart failure patients
Heart Rhythm Congress 2016 Chronotropic incompetence in heart failure patients Carel C. de Cock Case report : an Amsterdam taxi driver with recurrent syncope MF Koster History 1994: recurrent syncope with
More informationAcute Circulatory Support Should We or Shouldn t We?
Acute Circulatory Support Should We or Shouldn t We? Navin K. Kapur, MD, FACC, FSCAI Assistant Professor, Division of Cardiology Director, Acute Circulatory Support Program Director, Interventional Research
More informationHeart Failure and COPD: Common Partners, Common Problems. Nat Hawkins Liverpool Heart and Chest Hospital
Heart Failure and COPD: Common Partners, Common Problems Nat Hawkins Liverpool Heart and Chest Hospital Disclosures: No conflicts of interest Common partners, common problems COPD in HF common partners
More informationTitle : Adaptation to exercise
Title : Adaptation to exercise Teacher: Magdalena Gibas MD PhD Coll. Anatomicum, 6 Święcicki Street, Dept. of Physiology I. Exercise physiology 1. The acute and chronic responses to exercise depend upon
More informationPrescription Fitness. Robert M. Pepper, DO, FAAFP. ACOFP 55th Annual Convention & Scientific Seminars
Prescription Fitness Robert M. Pepper, DO, FAAFP 8 ACOFP 55th Annual Convention & Scientific Seminars RX: FITNESS Robert M Pepper, DO, FAAFP Assistant Dean for Predoctoral Clinical Education West Virginia
More informationCho et al., 2009 Journal of Cardiology (2009), 54:
Endothelial Dysfunction, Increased Carotid Artery Intima-media Thickness and Pulse Wave Velocity, and Increased Level of Inflammatory Markers are Associated with Variant Angina Cho et al., 2009 Journal
More informationto exercise (maybe) David Nunan PhD Research Fellow
How to get your patients www.cebm.net to exercise (maybe) David Nunan PhD Research Fellow Department of Primary Care Health Sciences and Centre for Evidence Based Medicine University of Oxford Kingston
More informationBasics of Cardiopulmonary Exercise Test Interpretation. Robert Kempainen, MD Hennepin County Medical Center
Basics of Cardiopulmonary Exercise Test Interpretation Robert Kempainen, MD Hennepin County Medical Center None Conflicts of Interest Objectives Explain what normally limits exercise Summarize basic protocol
More informationNew evidences in heart failure: the GISSI-HF trial. Aldo P Maggioni, MD ANMCO Research Center Firenze, Italy
New evidences in heart failure: the GISSI-HF trial Aldo P Maggioni, MD ANMCO Research Center Firenze, Italy % Improving survival in chronic HF and LV systolic dysfunction: 1 year all-cause mortality 20
More informationDr B. Egger Service de Pneumologie Hôpital de Rolle
Dr B. Egger Service de Pneumologie Hôpital de Rolle Planning COPD/rehabilitation introduction COPD rehabilitation programs : Benefits Components/Modalities COPD and congestive heart failure COPD and ischemic
More informationExercise Intolerance in Heart Failure: Significance of Skeletal Muscle Abnormalities
Exercise Intolerance in Heart Failure: Significance of Skeletal Muscle Abnormalities Hokkaido University Graduate School of Medicine Shintaro Kinugawa Survival rate (%) Peak oxygen uptake and prognosis
More informationExercise Prescription Certificate Course
Exercise Prescription Certificate Course Session 2: Principles and Frameworks for Exercise Prescription Dr. Raymond CHAN Hoi-fai MBChB (DUNDEE), MSc Sports Medicine (Glasg), MScSMHS(CUHK), MSpMed (New
More information호흡재활치료 울산의대서울아산병원 호흡기내과 이상도
호흡재활치료 울산의대서울아산병원 호흡기내과 이상도 Systemic (Extrapulmonary) effects in COPD Skeletal muscle dysfunction Osteoporosis Weight loss Sexual dysfunction Cardiovascular diseases (Gross et al., Curr Opin Pulm Med 2001;7:84)
More informationImportance of CRT team for optimization of the results: a European point of view
Importance of CRT team for optimization of the results: a European point of view Matteo Bertini, MD, PhD Arcispedale S. Anna Azienda Ospedaliero-Universitaria Cona-Ferrara No conflict of interest to declare
More informationThe role of physical activity in the prevention and management of hypertension and obesity
The 1 st World Congress on Controversies in Obesity, Diabetes and Hypertension (CODHy) Berlin, October 26-29 2005 The role of physical activity in the prevention and management of hypertension and obesity
More informationAUTONOMIC FUNCTION IS A HIGH PRIORITY
AUTONOMIC FUNCTION IS A HIGH PRIORITY 1 Bladder-Bowel-AD Tetraplegia Sexual function Walking Bladder-Bowel-AD Paraplegia Sexual function Walking 0 10 20 30 40 50 Percentage of respondents an ailment not
More informationCatheter Based Denervation for Heart Failure
Catheter Based Denervation for Heart Failure David E. Kandzari, MD, FACC, FSCAI Chief Scientific Officer Director, Interventional Cardiology Piedmont Heart Institute Atlanta, Georgia david.kandzari@piedmont.org
More information