ADMA. See Asymmetric dimethyl arginine
Adrenocorticotropic hormone (ACTH), 236
Advanced Cardiac Life Support (ACLS), 463
Aerobic energy balance, 73 Aerobic energy metabolism, 73 Aerobic exercise, 148
AGREE. See European Appraisal of Guidelines Research and Evaluation
AHA. See American Heart Association AI. See Aortic insufficiency Alcohol, 198
blood pressure and, 209 CHF and, 398
diabetes and, 196 moderate intake of, 185 recommended intake of, 185 SCD and, 185
sex and, 333
Aldosterone receptor antagonists, 446
All cause mortality, 14 Allograft vasculopathy, 408 American Association of
Cardiovascular and Pulmonary Rehabilitation (AACVPR), 38
American College of Sports Medicine (ACSM), 4, 38, 77 American Heart Association
(AHA), 4, 38 AMI. See Acute myocardial
infarction
Anabolic-catabolic balance, 73 A
AACVPR. See American Association of Cardiovascular and Pulmonary Rehabilitation ABI. See Ankle-brachial index Abnormal exercise test, 113 ACE inhibitors, 387, 446 Acetylsalicylic acid (ASA), 440 ACLS. See Advanced Cardiac Life
Support
ACSM. See American College of Sports Medicine ACTH. See Adrenocorticotropic
hormone Acupuncture, 243
Acute coronary syndrome, 16 Acute myocardial infarction
(AMI), 182, 232, 347 heart failure risk of, following,
186–187 smoking and, 232
Acute thrombolytic therapy, 129 Adaptation(s), 143
cardiac, 73 cardiovascular, 384
fitness improvements and, 145 neurohormonal, 73
skeletal muscle, 73 vascular, 73
Adapted programs, 357–359 Addiction
pharmacological mechanism of, 235
smoking and, 225, 235–238 Adherence
health care provider, 297–298 strategies, 297
Anaerobic exercise, 148 Anaerobic threshold, 102 Anemia, 395
Anger, 35 Angina
cognitive behavioral
rehabilitation of, 302–303, 338–341
evidence for, 339–340 lesion/disability relation, 339 pectoris, 5, 113, 261, 444 protocol for group CB CR
program for, 340–341 educational sessions, 340 exercise program, 340 goal setting, 340
relaxation/stress management, 340–341
psychological factors in production of, 339 unstable, 16, 93–94 Angiotensin, 311
Angiotensin II receptor blockers, 446
Ankle-brachial index (ABI), 53, 422 ANS. See Autonomic nervous
system Antagonists, 446
Antiarrhythmic drugs, 445, 448 Antiarrhythmic effects, 184 Anticoagulation, 176–177 Antidepressants, 243 Antihypertensive drugs, 439
compelling indications of, 441 Anti-ischemic drugs, 444–445 Antioxidant, 184
Antiplatelet drugs, 440–442 Aortic insufficiency (AI), 114–115
Index
503
Aortic regurgitation (AR), 156, 172 Aortic stenosis (AS), 107, 112, 172
criteria for abnormal exercise ECG in patients with, 113 exercise testing in, 112–113 psychological stress testing in,
114
Aortic valve disease, 371 Aortic valve replacement, 20, 158 Aortic valve surgery, 159 Aorto-coronary bypass graft
surgery (CABG), 324–326 returning to work after,
324–326
medical factors, 324–325 rate and delay, 324 socio-professional factors,
325–326
AR. See Aortic regurgitation Arbitrary inference, 286
ARIC. See Atherosclerosis Risk in Communities
Arrhythmias, 21–22, 174–175, 419, 447–448
Arrhythmogenic conditions, 175 Arterial septal defect, 21 Arteriovenous oxygen (AVO2),
103–104
ARVD. See Right ventricular dysplasia
AS. See Aortic stenosis ASA. See Acetylsalicylic acid Asian vegetarian diet, 182 Assist devices, 416–417 Asymmetric dimethyl arginine
(ADMA), 68 Atherosclerosis, 422–423
subclinical, 250 Atherosclerosis Risk in
Communities (ARIC), 423 Atherosclerotic disease, 68–72
CAD and, noninvasive detection of, 52–55
functional tests for early detection of, 53 ABI, 53
endothelial
dysfunction/forearm blood flow testing, 53
imaging for early detection, 53–55
carotid ultrasound, 53–54 IMT, 54
MRI, 54
plague characteristics, 54 ultrafast CT imaging, 54–55 noninvasive detection of, 52–55 Atherothrombosis, 422–423 Athlete(s)
cardiovascular mortality of, 166
diastolic function and, 166 long-term heart effects of, 164 preventative cardiology with,
164
rhythm disorders and, 164–166 sudden deaths in, 164, 165 Atrial fibrillation, 174, 396, 430,
447–448 Atrial flutter, 175
Atrial septal defect (ASD), 171 Atrioventricular block, 174 Audit, 436, 489–493
Automatic referral to phase II cardiac rehabilitation, 436
Autonomic nervous system (ANS), 347
AVO2. See Arteriovenous oxygen
B
Backward failure, 67
Balanced hypocaloric diet, 203 Balloon valvuloplasty, 115 Basal oxygen uptake, 93 Basic Life Support (BLS), 463 Basic outcome report, 491 Beck Depression Inventory, 276 Behavioral support, 245–248 Beta-blockers, 94, 311, 387, 446 Biventricular pacemaker, 16 Blood pressure. See also
Antihypertensive drugs alcohol and, 209
CVP and, 484 CVPR and, 482
exercise training and, 125–126 reduction of, 28
response to, 105 telemedicine, 312 Blood velocity, 105 BLS. See Basic Life Support BMI. See Body mass index Body mass index (BMI), 481 Bread, 197
The British Association of Cardiac Rehabilitation, 305 Bruce protocol, 99
C
CA. See Circulatory arrest CABG. See Aorto-coronary bypass
graft surgery; Coronary artery bypass grafting Cachexia, 396
CACR. See Canadian Association of Cardiac Rehabilitation CAD. See Coronary artery disease Calcium scoring, 58–59
Canada, cardiac rehabilitation in, 37–40
Canadian Association of Cardiac Rehabilitation (CACR), 37 Cancer, 228–229, 256
Carbohydrate(s), monounsaturated fat balance, 196
Carbohydrates, 195, 204, 209 Cardiac adaptations, 73 Cardiac allograft vasculopathy
(CAV), 411, 412 Cardiac catheterization, 95 Cardiac drug therapy, 15–16 Cardiac illness, 34
Cardiac interventions, 123–124, 170–177
Cardiac misconception, 338 Cardiac patients
educating, 279–284
sexual counseling of, 330–336 problem of, 330–331 Cardiac prevention program
(CVP), 483–485 aim, 483
family approach, 484 health promotion workshop
program, 485 lifestyle intervention, 484 managing patients/families to
target blood pressure/
cholesterol/glucose, 484 Cardiac rehabilitation (CR), 19–23,
34–36, 263–264, 321–322, 431, 435
after cardiac transplantation, 358, 407–416
central limitations to exercise tolerance, 407–408 exercise training, 409–410 nutritional counseling, 413 peripheral limitation to
exercise tolerance, 408–409 psychosocial management,
413–414
risk factor management, 410–412
after heart valve surgery, 157 age-related functional changes
in, 383–384
age-related structural changes in, 383
angina protocol with, 340–341 audit, 489
in Australia, 41–42 current states/future
directions in, 42 evolution of, 41 factors influencing
development in, 41–42 automatic referral, 469–475 in Canada, 37–40
program content of, 38–39 program safety of, 39–40 program staffing, 38 program structure of, 37–38 care/support models, 352–356 in China, 48–51
evolution of, 48–49 program
structure/staffing/content, 49
research, 49–51
in chronic heart failure, 358, 393–404
cardiac rehabilitation team, 403–404
core components of, 393 multidisciplinary programs
for, 401–403 components of, 34 comprehensive, 1, 3–7
in congenital heart disease, 358, 361–374
content of rehabilitation, 369
family-oriented, 368 goals, 365
motor development improvement, 372–373 need for, 367–368 physical activity and, 370 rehabilitation phase, 365–367 required preliminary
examinations, 372 in corporate setting, 359,
428–434
Adidas employee, 431–432 background to, 428–429
cardiac rehabilitation corporate facility, 432–433 corporate CV risk, 429–430 lifestyle/exercise studies, 430 new wellness/cardiac
rehabilitation professional, 433
current concepts with, 5–6 definition of, 3
developing services for, 460–464 diagnostic groups suitable for,
19–20
economic evaluation of, 437, 494–500
categories of, 495–496 decision theory modeling,
498
randomized controlled trials, 498–499
reference case analysis of, 495 effectiveness of, 10
effectiveness of psychology based, 12
in elderly patients, 22, 358, 383–390
benefits, 389–390
educational programs, 389 main goals of, 388
pharmacological interventions in secondary prevention, 387–388
entry assessment for, 19 in Europe, 30–32
evidence base for, 1–2, 9–18 evidence hierarchy for, 9–10 exercise recommended to, 35 experience-based, 10–12 family support with, 280 gender issues in, 358, 376–381 guidelines for, 470–474 home-based, 17 HRQoL and, 263–264 indications for, 2 information for, 282 long-term maintenance
programs, 347–350 modalities, 456–457
myocardial infarction, 321–322 large, 23
objective of, 3
particular interventions within, 13–15
patients more/less effective for, 16–17
in patients with implantable devices, 358–359, 416–420 phase II, 31
communication, 469–475 practice worldwide, 2, 6–7 professional training of, 461–464 programs, 1
psychology-based, 17 psychosocial elements of,
249–253 in PVD, 359, 422–427
recommendations for, 283–284 communication, 283 family support, 283 teamwork, 283–284 referrals of, 282–283 role of, 322
RTW and, 321–322
safety aspects of, 436, 465–467 contraindications, 466 dynamic exercise training, 465 hydrotherapy, 466
resistance training, 465–466 screenings for, 283
secondary prevention measures and, 15–16
with serious arrhythmias, 21–22 service development, 461 social support meaning in,
281–282
in South Africa, 44–46
contemporary programs in, 45 historical perspective of,
44–45
influence shift in, 45–46 sports and, 177
team, 403–404 training for, 462–464 in United States, 34–36
typical lengths of, 34 vocational counseling, 322–323 for women, 379–381
Cardiac rehabilitation corporate facility, 432–433
Cardiac resynchronization therapy, 416
Cardiac surgery, 263–264 Cardiac transplantation
cardiac rehabilitation after, 358, 407–416
central limitations to exercise tolerance, 407–408 exercise training, 409–410 nutritional counseling, 413
Cardiac transplantation (cont.) peripheral limitation to
exercise tolerance, 408–409 psychosocial management,
413–414
risk factor management, 410–412
nutritional counseling, 413 Cardiac valvular surgery, 5 Cardiomyopathies, 172–173 Cardiopulmonary exercise testing
(CPX), 66
anaerobic threshold, 102 arm exercise in, 100 calibration of system, 101 in CHF, 99–108
equipment for, 100–101 evolution of oxygen uptake,
101–102
indications for in CPX, 106–108 peak exercise VO2, 102
protocols for, 99–100
Cardio-rehabilitation service, 32 Cardiovascular adaptations, 384 Cardiovascular disease (CVD), 26,
65–66, 352, 439 competitive sports and, 170 exercise and, 68–72
exercise intolerance in, 67–68 fitness and, 163
food choices for, 27 goals for patients with, 27 habitual exercise and, 127–128 smoking burden on, 225,
227–233
Cardiovascular health, 77–80 Cardiovascular morbidity, 127 Cardiovascular mortality, 166 Cardiovascular prevention and
rehabilitation program (CVPR), 479–483 aim, 479
dietary intervention, 481 family approach, 479–480 health promotion workshop, 482 initial family assessment, 480 lifestyle intervention, 480 managing patients/families to
targeting blood pressure/cholesterol/
glucose, 482
personal support pack, 483 physical activity intervention,
481–482
reassessment, 482–483 smoking cessation, 480–481 Cardiovascular risk factors,
384–387
Cardioverter defibrillators, 22 CARDS. See Collaborative
Atorvastatin Diabetes Study Care/Support models
internet/eHealth, 354–355 lay advice/support, 354 lay-led self-care management
programs, 353–354 new, 352–356
nurse-led multidisciplinary care, 352–353
nurse-led self-care management programs, 353
Carinex survey, 30 Caring support, 301–303 Carotid ultrasound, 53–54 Catabolism, 145
Catastrophic thinking, 286 CAV. See Cardiac allograft
vasculopathy CB. See Cognitive behavioral CDC. See Centers for Disease Control and Prevention Centers for Disease Control and
Prevention (CDC), 77 CHF. See Chronic heart failure CHG. See Children’s heart group Children’s heart group (CHG), 367 China, cardiac rehabilitation in,
48–51 evolution of, 48–49 program
structure/staffing/content, 49
research, 49–51
CHIPs. See Community Health Intervention Programmes Cholesterol, 163. See also
Hypercholesterolemia CVP and, 484
CVPR and, 482
individual’s knowledge/feelings about, 220
lowering, SCD and, 185–186 Chronic aortic insufficiency, 115 Chronic heart failure (CHF), 67,
122, 142, 358 alcohol and, 398 anemia and, 395 atrial fibrillation, 396
cachexia and, 396 cardiac rehabilitation in,
393–404, 458
clinical assessment of patients with, 393–394
contraindications, 146 counseling and education for,
397–398 CPX in, 99–108 depression and, 395 dietary recommendations
alcohol, 398
weight reduction, 399 drug effects on, 397
exercise, clinical effects with, 150 exercise test sites in, 72–74 exercise training in, 72–74,
145–146, 401, 405 hemodynamic profile in, 395 lifestyle for
contraceptive advice, 398 smoking, 398
vaccination, 398
performance measures for, 404 pharmacological approaches to,
396–397
physical inactivity/exercise training, 399
prognosis/life expectancy, 400 rehabilitation, organization
aspects in, 401–404 related disease of, 394–395 renal insufficiency and, 395–396 self-monitoring, 400–401 sexual difficulties/coping
strategies, 399 sleep disorders, 396 smoking and, 398 symptoms of, 394 Chronic incompetence, 407 Circulatory arrest (CA), 363 Clarification, 289–290
COA. See Coarctation of the Aorta COACH. See Coaching Patients on Achieving Cardiovascular Health
Coaching Patients on Achieving Cardiovascular Health (COACH), 42
Coarctation of the Aorta (COA), 171–172
Cochrane Collaboration, 425 Cochrane Library, 10
Cognitive behavioral (CB), 302
Cognitive behavioral
rehabilitation, 302–303, 338–341
Cognitive interventions, 290–291 Collaborative Atorvastatin
Diabetes Study (CARDS), 442
Communication CR, 283
phase II, 469–475
Community Health Intervention Programmes (CHIPs), 46 Community rehabilitation
network, 50
Compensated heart failure, 22–23 Competitive sports, cardiovascular
disease and, 170 Complex lesions, 172 Comprehensive cardiac
rehabilitation, 1, 3–7 Comprehensive rehabilitation
programs, 22–23
Congenital heart disease, 361–374 cardiac rehabilitation in, 358,
361–374 classification of, 362 differentiated illustration of
therapy areas involved in, 369
digitalis glycosides, 446–447 family-oriented rehabilitation of,
368
frequently diagnosed, 362 GUCH, 170
motor development
improvement and, 372–373 organization/phases of, 366 physical activity and, 370–372 possible complications with,
361–362
possible consequences of, 363–364
family consequences, 364 patient consequences, 363–364 rehabilitation content, 369 rehabilitation goals with, 365 rehabilitation need, 367–368 rehabilitation phase, 365–367 require preliminary
examinations and, 372 Congestive heart failure, 445–447
ACE inhibitors, 446 aldosterone receptor
antagonists, 446
angiotensin II receptor blockers, 446
beta-blockers, 446 diuretics, 446 Coronary angioplasty, 5
return to work after, 326–327 medical factors, 327 rehabilitation’s role, 327 socio-professional, 327 Coronary artery bypass grafting
(CABG), 10, 95, 263, 325, 476
Coronary artery disease (CAD), 2, 45–46, 67
atherosclerotic disease, noninvasive detection of, 52–55
early diagnosis of, 2
early diagnosis of, new concepts for, 52–60
exercise testing in, 88–97 imaging modalities in, 90–91 meta-analyses to, 128–129 physical activity
recommendations for, 133–135
pretest probability by age/gender/symptoms, 89 Coronary bypass surgery, 335
sexual dysfunction and, 331 Coronary heart disease (CHD),
10–12, 247, 376
depressive disorders and, 379 exercise testing in, 66, 88–97 exercise training in, 125–135 gender differences in, 377–378 high risk individuals and, 55,
58–59
as inflammatory disease, 190 lipid oxidation theory of,
190–191
prevention guidelines for, 26–28
psychological reactions to, 280–281
psychosocial factors and, 250–251
smoking and, 225
Coronary interventions, RTW after, 302, 324–328
Coronary patients, 26–28 Coronary syndrome, 16 Coronary thrombolytic, 5 Coronary vasomotion, 68–71
Corporate cardiac rehabilitation, 431
Corporate cardiovascular risk, 429–430
Corporate seamless care, 429 Corporate setting, 428
cardiac rehabilitation in, 428–434
Cost minimization analysis, 496 Cost-benefit analysis, 496 Cost-utility analysis (CUA), 496 Counseling. See also Nutritional
counseling; Sexual counseling for CHF, 397–398 vocational, 322–323 CPX. See Cardiopulmonary
exercise testing CR. See Cardiac rehabilitation Craving, 237
pharmacological mechanism of, 235
C-reactive protein (CRP), 186 CRP. See C-reactive protein CUA. See Cost-utility analysis CVD. See Cardiovascular disease CVP. See Cardiac prevention
program
CVPR. See Cardiovascular prevention and rehabilitation program Cytokines, 73
D
Dairy products, 198
DART. See Diet and Reinfarction Trial
DCM. See Dilated cardiomyopathy Decision theory modeling, 498 Defibrillator(s)
cardioverter, 22
implantable, 175, 336, 358–359, 417
intercardiac, 16
internal cardioverter, 151 Denervated heart, 412 Dependency, 225, 235–238
factors influencing development of, 237–238
treatment of, 239–244 Depression, 35, 246–247, 251
CHF and, 395 disorders, 379 following MI, 269–276
Depression (cont.)
evidence review of, linking, 270–275
evidence summary concerning, 274–275 experimental studies of, 274 observational studies
assessing relationship between, 271–272 study/prognosis differences
of, 273 prevalence of, 270 Device failure, 151–152
DHA. See Docosahexaenoic acid Diabetes, 28, 69
alcohol and, 196
exercise training combined with blood glucose control, 140 nutrition counseling for,
194–199
nutritional guidelines for, 195–197
pharmacotherapy for, 449–450 special considerations for,
196–197 type 1/type 2, 195 type 2, 138 Diabetes mellitus
exercise training, 121–122, 138–141
peripheral vascular disease and, 424
therapeutic strategies for, 140 treatment, 424
Diabetes prevention program (DPP), 208
Diastolic dysfunction, 408 Diastolic function, 166 Diet(s)
Asian vegetarian, 182 balanced hypocaloric, 203 low-calorie, 203–204 low-carbohydrate, 204 low-fat, 204
Mediterranean type, 182 very low calorie, 203–204 Diet and Reinfarction Trial
(DART), 181 Dietary behaviors, 221 Dietary intervention, 481 Digitalis glycosides, 446–447 Dilated cardiomyopathy (DCM),
172 Disability, 339
Disease(s). See also Atherosclerotic disease; Cardiovascular disease; Congenital heart disease; Coronary artery disease; Coronary heart disease; Heart disease;
Peripheral arterial disease;
Peripheral vascular disease;
Valvular heart disease aortic valve, 371
CDC, 77
from CHF, 394–395 FRISC, 94
functionally biventricular, 364 GUCH, 170
IHD, 52, 173–174, 252 mitral valve, 20 PAOD, 71
peripheral vascular, 422–427 Diuretic therapy management, 400 Diuretics, 446
DLCO. See Pulmonary diffusing capacity
Docosahexaenoic acid (DHA), 183 Documented mitral valve prolapse,
156
Doppler echocardiography, 110 DPP. See Diabetes prevention
program Drug(s)
antiarrhythmic, 445, 448 antihypertensive, 439, 441 anti-ischemic, 444–445 antiplatelet, 440–442 on CHF, 397
cholesterol lowering, 186 therapy, 15–16
Duke Treadmill Score, 39 Dynamic exercise training, 465
E
ECG. See Electrocardiograph Echocardiographic parameters, 116 Echocardiography, 90–91
Doppler, 110
Economic evaluation, 437, 494–500 ED. See Erectile dysfunction Education, 306
Educational programs, 389 Effective nutritional counseling,
221–222 eHealth, 354–355
EHN. See European Heart Network Eicosapentaenoic acid (EPA), 183
Elderly patients, 22, 152
age-related functional changes in, 383–384
age-related structural changes in, 383
cardiac rehabilitation in, 358, 383–390
benefits from, 389 educational programs, 389 main goals of, 388 physical activity programs,
388–389
cardiovascular adaptations in, 384
cardiovascular risk factors in, 384–387
nutrition, 385
physical activity, 385–386 smoking cessation, 385 complications with, 384 exercise testing, 97
pharmacological interventions in secondary prevention, 387–388
ACE inhibitors, 387 beta-blockers, 387 statins, 387–388 psychological aspects of,
386–387 strength loss of, 386
Electrocardiograph (ECG), 4, 88, 113
Endocarditis, 20, 176 Endothelial activation, 191 Endothelial dysfunction, 53, 69, 138 Endothelial function, 131–132 Endothelial nitric oxide synthase
(eNOS), 68–71, 132 Endothelial progenitor cells
(EPCs), 65, 68, 70, 131–132 Endothelium-derived NO, 132 Endurance, 148–149
Energy balance, 195
aerobic, 73 content, 203
metabolism, aerobic, 73 eNOS. See Endothelial nitric oxide
synthase
EPA. See Eicosapentaenoic acid EPCs. See Endothelial progenitor
cells
Epidemiological studies, 214 Erectile dysfunction (ED), 332
EU. See European Union EuroAction project, 476–487, 477
objectives of, 477–478 principles of, 485–487 priority patients/families,
478–479
general practices, 478–479 hospitals, 478
studies of, 478
Europe, cardiac rehabilitation in, 30–32
European Appraisal of Guidelines Research and Evaluation (AGREE), 37
European Heart Network (EHN), 303, 342–345
case studies, 343–345 Finnish Heart Association,
343–344
Swiss Heart Association, 344–345
EU developments on patient mobility, 343
introduction to, 342–343 European lifestyle targets, 478 European Organization for
Research on the Treatment of Cancer (EORTC), 256 European Society of Cardiology
Guidelines, 432 European Union (EU), 343 Evaluation, 435–437 Event-stress process, 287
Exercise, 3, 77–86, 102, 113. See also Cardiopulmonary exercise testing; Fitness
aerobic, 148
aerobic/anaerobic, 148 recommendations for, 160 application, systemic/regional,
149 arm, 100 benefits of, 84 capacity, 106, 127
cardiac rehabilitation and, 35 cardiac transplantation and,
407–409
cardiovascular diseases, 68–72 cardiovascular risk of, 164 CHF and, 72–74, 150 control, supervised/non-
supervised, 149 endothelial function and,
131–132
evaluation training of, 159 and fitness, 65–66 habitual, 127–128
hemodynamics, 116–118, 135 after valve surgery, 159 history of, 1
intolerance, in cardiovascular disease, 67–68
levels of, 80
lifestyle/exercise studies, 430 on lipids/weight, 130–131 mechanism promoting
cardiovascular protection by, 130–132
method,
continuous/intermittent, 149
MI and, 130
molecular base of, 65, 67–75 new concepts regarding
physiologic benefits of, 85 organ-specific adaptations to, in
cardiovascular diseases, 68–72
peak, VO2, 102
practice worldwide of, 6–7 prescription, 425–426
for PAD, 425–426 psychological benefits of, 84 risk factors change from, 84 therapy, 424–425
tolerance, 407–409 treadmill, 112 Exercise program(s)
for angina, 340
long-term maintenance, 348–349 Exercise testing. See also
Cardiopulmonary exercise testing
in AS, 112–113 abnormal, 113
after myocardial infarction, 94–95
after valve surgery, 116 in AI, 114–115
for asymptomatic persons without known, 91–92 baseline information obtained
prior to, 111
before/after revascularization, 95–96
for CAD, imaging modalities in, 90–91
in CHD, 66, 88–97
CHF patients and, 72 components of, 88 contraindications to, 89 for diagnosis/testing of CAD,
91–92
further indications for, 111 general overview of, 88–90 in heart disease, 65–125 with implantable devices,
418–419
indications for terminating, 89 in MR, 116
in MS, 115
in patients with acute coronary symptoms, 93–94
in patients with symptoms/prior history of CAD, 92–93 reasons for, 111
in special groups, 96–97 elderly, 97
women, 96–97
in valvular heart disease, 66, 110–118
results of, 112–113
special test requirements for, 111
type of, 112
Exercise training, 1, 3–7, 399 after cardiac transplantation,
409–410
after valve surgery, 157–158 benefits of, 126
for blood glucose control for diabetes, 140
blood pressure and, 125–126 CHD and, 125–135
in CHF, 72–74, 145–146, 401, 405
complications of, 158–159 in coronary heart disease, 121,
125–135
metal analyses of, 128–129 newer randomized studies,
129–130
current concepts with, 5–6 in diabetes mellitus, 121–122,
138–141 dynamic, 465 effects of, 410
in heart failure, 122, 142–153 differences in physical
responses to exercise in health and disease, 144–145
Exercise training (cont.) future perspectives in, 153 optimal training protocol,
148–149
risk stratification/patient screening, 146–148 time course of training
adaptations in, 143–144 with implantable devices,
419–420
with implanted pacemakers, 21 ischemia and, 126–127 LV and, 127
patient selection for, 145 on peak oxygen consumption,
143
recommendations for, 160 risks of, 130, 133, 146 start of, 160–161
in valvular heart disease, 122, 156–162
Exercise-induced ischemia, 93 Exertional dyspnea, 106 Experience-based cardiac
rehabilitation, 10–12
F
FAAT. See Fatty Acid Anti- Arrhythmic Trial Facilitating action, 290 Family consequences, 364 Family support, with CR, 280, 283 Fat, 196, 198, 204
Fatty Acid Anti-Arrhythmic Trial (FAAT), 183
Fatty acids combination, 184 dietary, 188–189 n-3, 181–183 n-6, 183–185 PUFA, 182 saturated, 183–185 trans, 183, 196
Finnish Heart Association, 343–344 Fish, 181–183
Fitness, 77–86
cardiovascular disease and, 163 cardiovascular health and, 77–80 gradients of, 78
hypercholesterolemia and, 163 hypertension and, 163 Fluid intake, 400 Flutter, 174
Forearm blood flow testing, 53
Fragmin During Instability in Coronary Artery Disease (FRISC), 94
Framingham Risk Score (FSR), 39 Frank-Starling curve, 383 Frequency control, 447 FRISC. See Fragmin During
Instability in Coronary Artery Disease Fruit, 197–198
FSR. See Framingham Risk Score Functional class, 325
Functional Limitations Profile, 258–259
Functionally biventricular disease, 364
G
Gaol setting, 290 Gender issues
CAD and, 89 in CR, 358, 376–381 pharmacotherapy and, 448 Gene polymorphisms, 69 Global Mood Scale (GMS), 264 Glucose, 140, 208, 482, 484 Glutathione peroxidase, 187 GMS. See Global Mood Scale Grains, 197
Grown up congenital heart disease (GUCH), 170
GUCH. See Grown up congenital heart disease
H
Habitual exercise, 127–128 HCM. See Hypertrophic
cardiomyopathy HDL. See High-density
lipoprotein Health care provider
adherence, 297–298 non-adherence, 295–296 Health care system, 296 Health economic data, 491 Health Education and Risk
Reduction Training (HEART), 430
Health promotion workshop, 482 Health recommendations, 293–299
adherence strategies, 297 cardiac context adherence, 293 interventions of, 296–298 introduction/definitions of, 293
non-adherence consequences, 294
problem of non-adherence, 293–294
strategy summaries, 298 Health related quality of life
(HRQoL), 11, 246 in cardiac
conditions/interventions, 261–264
angina pectoris, 261
cardiac rehabilitation, 263–264 cardiac surgery, 263
heart failure, 262 myocardial infarction,
261–262 PCI, 262–263
in cardiac patients, 256–264 cardiac populations, roles of in,
257
cardiac rehabilitation, 263–264 defining, 256–257
instruments’ typology of, 257 measurement instruments for,
257–261
dimension-specific measures, 259–260
generic measure, 258–259 heart-disease-specific
measure, 259
individual measures, 260 utility measures, 260–261 role of, 257
Healthy balance program, 429 HEART. See Health Education and
Risk Reduction Training Heart disease, 2
exercise testing in, 65–125 prevention guidelines for, 2 rheumatic, 4
sexual dysfunction from, 330 Heart failure (HF), 9, 12–13, 176,
262, 335–336 AMI and, 186–187 compensated, 22–23 congestive, 445–447 exercise training and, 122,
142–153 seriousness of, 311
sexual dysfunction and, 331 training in, 142–143 Heart failure programs
advantages/disadvantages of, 312 nurse-based, 311–315
care relations, 313 content definition of, 314 economic/organizational
frameworks, 331 goals/key components of,
312–313
nurse’s role/responsibilities, 315
patient population, 313–314 staff recruitment/education,
314–315
telemonitoring programs of, 312
Heart failure rehabilitation, 302, 311–315
Heart rate, 125–126 Heart surgery, 176 Heart transplant, 176 Heart transplant recipients
(HTRs), 407 Heart valve replacement, 20 Heart valve surgery, 157 Hemeostasis, 68
Hemodynamics, 116–118, 395 after valve surgery, 159 deterioration, 149 HF. See Heart Failure High risk individual(s), 55
calcium scoring for, 58–59 CHD and, 55, 58–59 imaging methods for, 58–59 traditional identification of,
56–58
High-density lipoprotein (HDL), 131
Home-based cardiac rehabilitation, 17
Hormones, 236
Hospital Anxiety and Depression Scale, 276
Hospital phase, 318
HRQoL. See Health related quality of life
HTRs. See Heart transplant recipients
Hydrotherapy, 466
Hypercholesterolemia, 69, 186 fitness and, 163
Hyperglycemia, 138 Hyperlipidemia, 30, 138
PVD and, 423–424 Hypertension, 4, 30, 69, 138
fitness and, 163 LVH and, 188
peripheral vascular disease and, 424
sports and, 173
Hypertrophic cardiomyopathy (HCM), 21, 172 Hypertrophy, 156. See also Left
ventricular hypertrophy (LVH)
Hypnosis, 243 Hypoperfusion, 22 Hypotension, 95
Hypoxic impairments, 361
I
ICD. See Implantable cardioverter defibrillator
ICER. See Incremental cost- effectiveness ratio IGT. See Impaired glucose
tolerance
IHD. See Ischemic heart disease Illness factors, 294–295 Imaging
atherosclerotic disease, 53–55 for high risk individuals, 58–59 MRI, 52, 54, 97
myocardial perfusion, 90 nuclear perfusion, 91 ultrafast CT, 54–55 Imaging modalities, 90–91 Immunosuppressants, 411 Impaired glucose tolerance (IGT),
208
Implantable cardioverter
defibrillator (ICD), 151, 175, 358–359, 417
Implantable defibrillators, 331 Implantable device(s), 358–359. See
also Defibrillator(s) assist/pacemaker devices,
416–417
exercise testing, 418–419 exercise training with, 419–420 implantable cardioverter
defibrillators, 417
psychological aspects/quality of life, 417
rehabilitation for patients with, 416–420
Implanted pacemaker, 21, 175 IMT. See Intima-Media Thickness Incremental cost-effectiveness
ratio (ICER), 495 Inflammation, 189–191
Information requirements, 306–307 Initial family assessment, 480 Inotropic stimulants, 447 Instrumental support, 281–282 Intercardiac defibrillator, 16 Internet, 354–355
Intervention(s), 214, 240–241 behavioral, 291
cardiac, 123–124, 170–177 CHIPs, 46
cognitive, 290–291 coronary, 302–324–328 with CR, 13–15 dietary, 481
health recommendations and, 296–298
HRQoL and, 261–264 intensive, 241 lifestyle, 480, 484
multifactorial risk factor, 139 one-off/brief, 240–241 PCI, 96, 129, 262–263 pharmacological, 387–388 physical activity, 481–482 RTW and, 321
Intima-Media Thickness (IMT), 54 Intravascular ultrasound (IVUS),
52 Ischemia
exercise training, 126–127 exercise-induced, 93
Ischemic heart disease (IHD), 52, 173–174, 252
Ischemic tissue, 132 Isolation, 35
IVUS. See Intravascular ultrasound
J
Job demand, 250 Job latitude, 250
K
Kansas City Cardiomyopathy Questionnaire (KCCQ), 262 KCCQ. See Kansas City
Cardiomyopathy Questionnaire
L
Large myocardial infarction, 23 L-arginine, 68–69, 70
Laser therapy, 243 Lay advice, 354 Lay support, 354
Lay-led self-care management programs, 353–354 Left ventricular (LV), 127 Left ventricular hypertrophy
(LVH), 110, 188–189 athletes and, 166 hypertension and, 188 Left ventricular systolic
dysfunction (LVSD), 352 Lesions, 172, 339
Life expectancy, 400 Life years gained (LYG), 495 Lifestyle intervention
CVP, 484 CVPR, 480
Life-years saved (LYS), 495 Lipid(s), 130–131, 195–196. See also
Hyperlipidemia control, 140
exercise and, 130–131 lowering drugs, 439, 442–443 oxidation theory, 190–191 Lipid Research Clinics (LRC), 79 Local inflammation, 73
Long-term maintenance programs, 303, 347–350
approach of, 348 CR maintenance phase
difficulties, 347–348 education/risk factor control,
349–350
exercise program/safety, 348–349 healthy lifestyle programs
adherence, 350 Low-calorie diet, 203–204 Low-carbohydrate diet, 204 Low-density lipoprotein (LDL), 28,
131, 190
Low-dose dobutamine infusion, 90 Low-energy food, 205
Low-fat diet, 204
LRC. See Lipid Research Clinics Lung cancer, 228–229
LV. See Left ventricular LVH. See Left ventricular
hypertrophy
LVSD. See Left ventricular systolic dysfunction
LYG. See Life years gained LYS. See Life-years saved
M
Macronutrient composition, 204 Magnetic resonance imaging
(MRI), 52, 54, 97
Malignancies, 412
Malignant ventricular arrhythmias, 419
Malignant ventricular tachycardias, 175
Marfan syndrome, 124, 172 Meat, 198
Medical Outcomes Study (MOS), 39 Medication adherence, 400–401 Mediterranean type diet, 182, 191 Men
CHD in, 377–378
smoking frequency of, 227 Menopause, 377
Mesolimbic dopamine system, 237 Metabolic syndrome (MetS), 180,
201, 206–209 carbohydrates and, 209 definition of, 206
management objectives of, 207 nutritional counseling for
patients with, 207 Meta-regression, 13
MetS. See Metabolic syndrome MI. See Myocardial infarction Micronutrients, 187–188 Microrheology, 68 Milk, 198
Mineral density, 409 Minerals, 196
Minimal clinical priority dietary program, 191–192 Minnesota Living With Heart
Failure (MLHF), 262 Mitral regurgitation (MR), 116,
156, 172
Mitral stenosis (MS), 107, 115, 172 Mitral valve disease, 20
Mitral valve replacement, 20–21 Mitral valve surgery, 159–160 MLHF. See Minnesota Living With
Heart Failure
MOS. See Medical Outcomes Study Motivational readiness, 283 MR. See Mitral regurgitation MRI. See Magnetic resonance
imaging MS. See Mitral stenosis Multidisciplinary approach, 307 Multidisciplinary rehabilitation,
30–31
Multifactorial risk factor intervention, 139 Multisite atherothrombosis,
422–423
Muscular tension, 288 Myocardial infarction (MI), 2,
261–262, 335, 476. See also Acute myocardial infarction acute, 52
CR and, 321–322
depression following, 269–276 exercise and, 130
exercise testing after, 94–95 large, 23
relevant factors from period before, 317–318 post-MI period, 318
relevant factors from hospital phase, 318
RTW literature of, 318–321 returning to work after, 302,
317–323
sexual counseling and, 335 sexual dysfunction and, 331 Myocardial oxygen delivery, 126 Myocardial oxygen demand, 445 Myocarditis, 172, 173
N
n-3 fatty acids, 181–183 n-6 fatty acids, 183–185 National Cardiac Society, 307 National cholesterol education
program (NCEP), 214 National Heart Foundation (NHF),
41–42, 303, 342–345 National Institute for Health and
Clinical Excellence (NICE), 494
NCEP. See National cholesterol education program Neurohormonal adaptations, 73 New York Heart Association
(NYHA), 9
NGOs. See Non-governmental organizations NHF. See National Heart
Foundation
NHP. See Nottingham Health Profile
NICE. See National Institute for Health and Clinical Excellence Nicotine levels, 236
prolonged exposure to, 237 Nicotine pharmacodynamics, 236 Nicotine pharmacokinetics, 235–236 Nicotine replacement therapy
(NRT), 242–243, 449
Nitric oxide (NO), 70, 71, 138 NO. See Nitric oxide Non-adherence, 293–296
causes of, 294–296
health care provider, 295–296 health care system, 296 illness/treatment factor,
294–295
patient-related factors, 295 Non-governmental organizations
(NGOs), 283 Nonsustained ventricular
tachycardia (NSVT), 175 Nottingham Health Profile (NHP),
258
NRT. See Nicotine replacement therapy
NSVT. See Nonsustained ventricular tachycardia Nuclear perfusion imaging, 91 Nursed-based rehabilitation,
311–315
Nurse-led multidisciplinary care, 352–353
Nurse-led self-care management programs, 353
Nurses, 302
heart failure rehabilitation and, 311–315
heart failure rehabilitation program based with, 312–315
change of care relations, 313 economic/organizational
frameworks, 313 goals/key components,
312–313
patient population, 313–314 program content defined, 314 role/responsibilities, 315 staff/recruitment staff,
314–315
phase I rehabilitation, 306–307 phase II rehabilitation, 307–308
physical, 307–308 psychological aspects, 308 phase III rehabilitation, 308 prevention programs of, 305–309 Nutrition, 180, 385
for diabetic patients, 180, 194–199
practical recommendations, 197–198
useful tips for, 198–199 over patient counseling, 180
for overweight patients/patients with metabolic syndrome, 201–210
on risk of fatal complications, 181–192
sudden death and, 181 Nutritional counseling, 212–222,
413
after cardiac transplantation, 413 for diabetes, 194–199
effective, 221–222
European/North American guidelines of, 215 from evidence-based medicine
to recommendations, 212–214
health professionals in, 215–216 organizational issues in,
216–217
patient’s psychological state, 218 practical modalities in, 217 practice recommendations for,
214–221
Nutritional guidelines, for diabetes, 195–197
NYHA. See New York Heart Association
O
Obesity, 44 definition of, 202 juvenile, 123 MetS and, 207
objectives in management of, 202
rise in, 201 Oil, 198
Oleic acid, 183–185 Omega-3 consumption, 182 Omega-3 deficiency, 181–192 Opioid, 235
Optimal training protocol, 148–149 Organization, 435–437
Outcome measurement, 436, 489–493
Over-generalization, 286 Overload, 143
Oxygen pulse, 103 Oxygen uptake, 101–102
Oxygen uptake efficiency slope, 103
P
Pacemaker devices, 16, 21, 175, 416–417
PAD. See Peripheral arterial disease
PAH. See Polycyclic aromatic hydrocarbons PAOD. See Peripheral arterial
occlusive disease
Paradoxical vasoconstriction, 132, 139
Paroxysmal supraventricular tachycardia, 123, 174 Partial pressure of CO2(PCO2), 103 Passive smoking, 231–232
Patent foramen ovale (PFO), 124 Patient screening, 146–148 Patient-related factors, 295 PCI. See Percutaneous coronary
intervention
PCO2. See Partial pressure of CO2
PDA. See Persistent ductus arteriosus
Peak exercise VO2, 102, 107 Peak oxygen consumption, 143 Peak oxygen uptake, 142
Percutaneous coronary intervention (PCI), 96, 129, 262–263 Percutaneous transluminal
coronary angioplasty (PCTA), 53, 384 Pericarditis, 173
Peripheral arterial disease (PAD), 26 exercise prescription, 425–426 hyperlipidemia and, 423–424 mechanisms of action with,
426–427
Peripheral arterial occlusive disease (PAOD), 71 Peripheral vascular disease (PVD)
cardiac rehabilitation for, 359, 422–427
diabetes mellitus and, 424 intermittent claudication/clinical
aspects, 422–423 ankle-brachial index, 422 definition, 422
multisite atherothrombosis, 422–423
modification of risk factors diabetes mellitus treatment,
424
hyperlipidemia treatment, 423–424
hypertension treatment, 424 smoking cessation, 423 non-pharmacological therapy
for claudication, 424–427 exercise therapy, 424–425 therapy goals, 424
