著者
Makoto Murata Saya Yanai Shogo Nitta Yuhei Yamashita Tatsunori Shitara Hiroko Kazama Masanori Ueda Yasuyuki Kobayashi Yoshihisa Namasu Hitoshi Adachi
出版者
The Japanese Circulation Society
雑誌
Circulation Reports (ISSN:24340790)
巻号頁・発行日
pp.CR-23-0040, (Released:2023-05-17)
参考文献数
33
被引用文献数
1

Background: The incidence of heart failure (HF) is increasing, and the mortality from HF remains high in an aging society. Cardiac rehabilitation (CR) programs (CRP) increase oxygen uptake (V̇O2) and reduce HF rehospitalization and mortality. Therefore, CR is recommended for every HF patient. However, the number of outpatients undergoing CR remains low, with insufficient attendance at CRP sessions. In this study we evaluated the outcomes of 3 weeks of inpatient CRP (3w In-CRP) for HF patients.Methods and Results: This study enrolled 93 HF patients after acute-phase hospitalization between 2019 and 2022. Patients participated in 30 sessions of 3w In-CRP (30 min aerobic exercise twice daily, 5 days/week). Before and after 3w In-CRP, patients underwent a cardiopulmonary exercise test, and cardiovascular (CV) events (mortality, HF rehospitalization, myocardial infarction, and cerebrovascular disease) after discharge were evaluated. After 3w In-CPR, mean (±SD) peak V̇O2increased from 11.8±3.2 to 13.7±4.1 mL/min/kg (116.5±22.1%). During the follow-up period (357±292 days after discharge), 20 patients were rehospitalized for HF, 1 had a stroke, and 8 died for any reasons. Proportional hazard and Kaplan-Meier analyses demonstrated that CV events were reduced among patients with a 6.1% improvement in peak V̇O2than in patients without any improvement in peak V̇O2.Conclusions: 3w In-CRP for HF patients improved peak V̇O2and reduced CV events in HF patients with a 6.1% improvement in peak V̇O2.
著者
Takafumi Nakajima Makoto Murata Syogo Nitta Tatsunori Shitara Hiroko Kazama Yukiko Satoh Masayo Takizawa Akemi Mori Yasuyuki Kobayashi Hitoshi Adachi
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-20-1215, (Released:2021-06-22)
参考文献数
41
被引用文献数
7

Background:Many heart failure (HF) guidelines recommend sodium restriction for patients with HF, but the outcome of sodium restriction counseling (SRC) for HF patients is still unknown. We wanted to clarify whether SRC reduces cardiac events in patients with HF.Methods and Results:Overall, 800 patients (77±12 years) who were hospitalized for HF were enrolled. During HF hospitalization, patients received SRC; patients were required to have a salt intake of <6 g/day. After discharge, death or HF rehospitalization events were investigated. During a mean follow-up of 319±252 days, 83 patients died, and 153 patients were rehospitalized for HF. SRC significantly decreased all-cause death (odds ratio, 0.42; 95% confidence interval [CI], 0.23–0.76; P<0.01), especially cardiac death of hospitalized HF patients after discharge. In the multivariate analysis adjusted for age, sex, SRC, body mass index, hypertension, dyslipidemia, β-blockers, and mineralocorticoid receptor antagonist intake, cardiac rehabilitation, and the type of HF, SRC remained a significant predictor of death. Kaplan-Meier analysis showed that SRC significantly reduced deaths and the combined outcome of HF rehospitalization and death. In patients with reduced left ventricular ejection fraction, SRC significantly decreased the mortality rate (odds ratio, 0.27; 95% CI, 0.10–0.71; P<0.01).Conclusions:SRC reduced the mortality rate after discharge of hospitalized HF patients.
著者
Shinichiro Sakurai Makoto Murata Saya Yanai Shogo Nitta Yuhei Yamashita Tatsunori Shitara Hiroko Kazama Masanori Ueda Yasuyuki Kobayashi Yoshihisa Namasu Hitoshi Adachi
出版者
The Japanese Circulation Society
雑誌
Circulation Reports (ISSN:24340790)
巻号頁・発行日
pp.CR-23-0016, (Released:2023-05-19)
参考文献数
32
被引用文献数
1

Background: Heart failure with reduced ejection fraction (HFrEF) has a high mortality rate, and cardiac rehabilitation programs (CRP) reduce HFrEF rehospitalization and mortality rates. Some countries attempt 3 weeks of inpatient CRP (3w In-CRP) for cardiac diseases. However, whether 3w In-CRP reduces the prognostic parameter of the Metabolic Exercise data combined with Cardiac and Kidney Indexes (MECKI) score is unknown. Therefore, we investigated whether 3w In-CRP improves MECKI scores in patients with HFrEF.Methods and Results: This study enrolled 53 patients with HFrEF who participated in 30 inpatient CRP sessions, consisting of 30 min of aerobic exercise twice daily, 5 days a week for 3 weeks, between 2019 and 2022. Cardiopulmonary exercise tests and transthoracic echocardiography were performed, and blood samples were collected, before and after 3w In-CRP. MECKI scores and cardiovascular (CV) events (heart failure rehospitalization or death) were evaluated. The MECKI score improved from a median 23.34% (interquartile range [IQR] 10.21–53.14%) before 3w In-CRP to 18.66% (IQR 6.54–39.94%; P<0.01) after 3w In-CRP because of improved left ventricular ejection fraction and percentage peak oxygen uptake. Patients’ improved MECKI scores corresponded with reduced CV events. However, patients who experienced CV events did not have improved MECKI scores.Conclusions: In this study, 3w In-CRP improved MECKI scores and reduced CV events for patients with HFrEF. However, patients whose MECKI scores did not improve despite 3w In-CRP require careful heart failure management.
著者
Makoto Murata Saya Yanai Shogo Nitta Yuhei Yamashita Tatsunori Shitara Hiroko Kazama Masanori Ueda Yasuyuki Kobayashi Yoshihisa Namasu Hitoshi Adachi
出版者
The Japanese Circulation Society
雑誌
Circulation Reports (ISSN:24340790)
巻号頁・発行日
vol.5, no.6, pp.238-244, 2023-06-09 (Released:2023-06-09)
参考文献数
33
被引用文献数
1

Background: The incidence of heart failure (HF) is increasing, and the mortality from HF remains high in an aging society. Cardiac rehabilitation (CR) programs (CRP) increase oxygen uptake (V̇O2) and reduce HF rehospitalization and mortality. Therefore, CR is recommended for every HF patient. However, the number of outpatients undergoing CR remains low, with insufficient attendance at CRP sessions. In this study we evaluated the outcomes of 3 weeks of inpatient CRP (3w In-CRP) for HF patients.Methods and Results: This study enrolled 93 HF patients after acute-phase hospitalization between 2019 and 2022. Patients participated in 30 sessions of 3w In-CRP (30 min aerobic exercise twice daily, 5 days/week). Before and after 3w In-CRP, patients underwent a cardiopulmonary exercise test, and cardiovascular (CV) events (mortality, HF rehospitalization, myocardial infarction, and cerebrovascular disease) after discharge were evaluated. After 3w In-CPR, mean (±SD) peak V̇O2increased from 11.8±3.2 to 13.7±4.1 mL/min/kg (116.5±22.1%). During the follow-up period (357±292 days after discharge), 20 patients were rehospitalized for HF, 1 had a stroke, and 8 died for any reasons. Proportional hazard and Kaplan-Meier analyses demonstrated that CV events were reduced among patients with a 6.1% improvement in peak V̇O2than in patients without any improvement in peak V̇O2.Conclusions: 3w In-CRP for HF patients improved peak V̇O2and reduced CV events in HF patients with a 6.1% improvement in peak V̇O2.
著者
Tetsuya Takahashi Tatsunori Shitara Megumi Kumamaru Masanobu Taya Hiroko Kazama Jun-ichi Nishikawa Harue Nakano Masami Inokuma Tomoyuki Morisawa Simio Yamada Hikaru Matsuda
出版者
The Society of Physical Therapy Science
雑誌
Journal of Physical Therapy Science (ISSN:09155287)
巻号頁・発行日
vol.23, no.1, pp.21-23, 2011 (Released:2011-04-28)
参考文献数
9

[Purpose] The aim of this study was to determine the lower-limb muscle activities during muscle exercise using an on-the-bed muscle training device that utilizes the intermittent inflation of an oval rubber balloon placed against the sole. [Subjects and Methods] Ten healthy subjects were asked to adopt a semi-recumbent position with a flat oval chloridized polyvinyl balloon placed against the sole. The subjects were asked to extend both their legs when they felt the inflation of the balloon on their plantar surface. This exercise was defined as leg exercise against intermittent sole pressure stimulation (ExISPS). [Results] The root-mean-square (RMS)-EMG values of the vastus medialis during ExISPS in the semi-recumbent position were similar to those when standing up from 45-degree knee flexion and calf-raising. The RMS-EMG values of the biceps femoris showed no significant difference among these exercises. The RMS-EMG values of gastrocnemius medialis during ExISPS in the semi-recumbent position were higher than those when standing up from 45-degree knee flexion and standing up from a chair. [Conclusion] The findings of this study suggest that the muscle activities during ExISPS mimic or are greater than those required of the leg in daily life.