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Exercise and Cardiovascular Disease in Older Adults
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Exercise and Cardiovascular Disease in Older Adults

A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Epidemiology, Lifestyle, and Cardiovascular Health".

Deadline for manuscript submissions: closed (31 March 2024) | Viewed by 20998

Special Issue Editor

Dr. Akihiro Hirashiki

E-Mail Website
Guest Editor
Department of Cardiology, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
Interests: cardiac rehabilitation; heart failure; exercise; multidisciplinary team

Special Issue Information

Dear Colleagues,

Older adults with chronic cardiac diseases or after an acute cardiac event should be enrolled in a cardiac rehabilitation programme, which has been shown to improve their functional capacity and quality of life. This involves a multidisciplinary approach; prescribed physical activity is a core component in addition to medical assessment and cardiac risk factor management.

Cardiac rehabilitation consists of four phases, starting within five days of admission with close monitoring for cardiac decompensation. The interventions aim to counteract negative effects after a cardiac event, with close monitoring for cardiac decompensation. After discharge, patients are supported in adopting an active lifestyle and commencing activity after hospitalisation. In phase three, individualised exercises are offered with psychological support and continued patient education several weeks after the initial cardiac event. The final phase involves the maintenance of lifestyle changes, including physical activity for cardiac protection and secondary prevention. We discuss how the new techniques for cardiac rehabilitation can improve the management and treatment of older adults with chronic cardiac diseases.

Dr. Akihiro Hirashiki
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Cardiovascular Development and Disease is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • exercise
  • cardiac rehabilitation
  • heart failure
  • multidisciplinary team
  • frailty
  • sarcopenia

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Published Papers (5 papers)

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Research

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12 pages, 547 KiB  
Article
Effects of Water-Based Exercise on Patients Older than 60 Years Undergoing Cardiac Rehabilitation after Coronary Intervention
by Jus Ksela, Jan Kafol, Danijela Vasic and Borut Jug
J. Cardiovasc. Dev. Dis. 2024, 11(5), 151; https://doi.org/10.3390/jcdd11050151 - 15 May 2024
Viewed by 1648
Abstract
Cardiac rehabilitation (CR) plays a crucial role in managing patients who have undergone coronary intervention (CI) following acute myocardial infarction. While water-based exercise is gaining recognition as an exercise modality in this patient population, its impact on the subgroup of older adults remains [...] Read more.
Cardiac rehabilitation (CR) plays a crucial role in managing patients who have undergone coronary intervention (CI) following acute myocardial infarction. While water-based exercise is gaining recognition as an exercise modality in this patient population, its impact on the subgroup of older adults remains unexplored. In this post hoc analysis, we investigated the effects of water-based exercise on adults older than 60 years undergoing CR after CI, comparing it to land-based exercise and a control group. In total, 45 patients aged over 60 participated in 14-day exercise programs, featuring two daily 30-min sessions. We assessed exercise capacity (VO2peak), vascular function (flow-mediated vasodilation (FMD)), heart rate variability (HRV), and blood markers (Interleukins 6, 8, and 10, P-Selectin, ICAM, and High-sensitivity CRP) before and after CR. VO2peak in the water-based group improved significantly after CR in comparison with the land-based group: 1.35 kg/mL/min (95% CI [0.20–2.50], p = 0.022). The significant difference between water-based and land-based groups was observed in several HRV parameters: Total power −1129.20 ms2 (95% CI [−1951.92–−306.49], p = 0.008); peak LF 0.04 Hz (95% CI [0.00–0.08], p = 0.036); SD1 −9.02 millisecond (95% CI [−16.86–−1.18], p = 0.025); and SD2 −19.71 ms (95% CI [−35.08–−4.34], p = 0.013). FMD and blood markers did not vary significantly based on the exercise group. These findings suggest that short-term water-based CR may have potential as an alternative to traditional land-based CR, improving VO2peak and cardiorespiratory fitness among adults over 60 years undergoing CR after CI. Full article
(This article belongs to the Special Issue Exercise and Cardiovascular Disease in Older Adults)
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13 pages, 1262 KiB  
Article
Randomized Controlled Trial of Cardiac Rehabilitation Using the Balance Exercise Assist Robot in Older Adults with Cardiovascular Disease
by Akihiro Hirashiki, Atsuya Shimizu, Takahiro Kamihara, Manabu Kokubo, Kakeru Hashimoto, Ikue Ueda, Kenji Sato, Koki Kawamura, Naoki Itoh, Toyoaki Murohara, Hitoshi Kagaya and Izumi Kondo
J. Cardiovasc. Dev. Dis. 2024, 11(5), 133; https://doi.org/10.3390/jcdd11050133 - 25 Apr 2024
Viewed by 1616
Abstract
Background: Recent studies have investigated the effects of exercise on the functional capacity of older adults; training with a balance exercise assist robot (BEAR) effectively improves posture. This study compared the clinical safety and efficacy of training using BEAR video games to conventional [...] Read more.
Background: Recent studies have investigated the effects of exercise on the functional capacity of older adults; training with a balance exercise assist robot (BEAR) effectively improves posture. This study compared the clinical safety and efficacy of training using BEAR video games to conventional resistance training in older adults with cardiovascular disease (CVD). Methods: Ninety patients (mean age: 78 years) hospitalized due to worsening CVD were randomized to cardiac rehabilitation (CR) Group R (conventional resistance training) or Group B (training using BEAR). After appropriate therapy, patients underwent laboratory testing and functional evaluation using the timed up-and-go test (TUG), short physical performance battery (SPPB), and functional independence measure (FIM) just before discharge and 4 months after CR. The rates of CVD readmission, cardiac death, and fall-related fractures were monitored. Results: BEAR had no adverse effects during exercise. At 4 months, TUG and SPPB improved significantly in both groups, with no significant difference between them. FIM motor and the Geriatric Nutritional Risk Index were significantly improved in Group B versus Group R. There was no significant difference in cardiac events and fall-related fractures between the two groups. Conclusion: CR with BEAR is safe and comparable to conventional resistance training for improving balance in older adults with CVD. Full article
(This article belongs to the Special Issue Exercise and Cardiovascular Disease in Older Adults)
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12 pages, 839 KiB  
Article
The Effects of Exercise Training on Exercise Capacity and Vascular Function after Transcatheter Aortic Valve Implantation—A Pilot Study
by Luka Vitez, Matjaž Bunc and Borut Jug
J. Cardiovasc. Dev. Dis. 2023, 10(8), 343; https://doi.org/10.3390/jcdd10080343 - 12 Aug 2023
Cited by 3 | Viewed by 1697
Abstract
Transcatheter aortic valve implantation (TAVI) improves event-free survival in patients with severe aortic stenosis, but patients’ exercise capacity remains poor after the procedure. Therefore, we sought to compare the effects of a supervised center-based exercise training program and unsupervised exercise routine on exercise [...] Read more.
Transcatheter aortic valve implantation (TAVI) improves event-free survival in patients with severe aortic stenosis, but patients’ exercise capacity remains poor after the procedure. Therefore, we sought to compare the effects of a supervised center-based exercise training program and unsupervised exercise routine on exercise capacity and vascular function in patients after TAVI. Patients were randomized to either center-based exercise training (12–24 sessions of combined aerobic and low-weight resistance training twice weekly for 8–12 weeks) or an unsupervised home-based exercise routine (initial appraisal with detailed recommendations and monthly follow-up). Exercise capacity (cardiopulmonary testing) and vascular function (ultrasonographic measurement of flow-mediated vasodilation (FMD) and arterial stiffness) were assessed at the baseline and after the study period. We included 23 patients (mean age of 81 years, 61% women), with higher-than-expected drop-out rates (41%) because of the coronavirus-19 pandemic outbreak. Exercise capacity improved over time, irrespective of the intervention group: 0.09 mL/min/kg increase in peak oxygen uptake (95% CI [0.01–0.16]; p = 0.02), 8.2 Watts increase in workload (95% CI [0.6–15.8]; p = 0.034), and 47 s increase in cumulative exercise time (95% CI [5.0–89.6]; p = 0.029). A between-group difference in change over time (treatment effect) was detected only for FMD (4.49%; 95% CI [2.35; 6.63], p < 0.001), but not for other outcome variables. Both supervised and unsupervised exercise training improve exercise capacity and vascular function in patients after TAVI, with supervised exercise training possibly yielding larger improvements in vascular function, as determined by FMD. Full article
(This article belongs to the Special Issue Exercise and Cardiovascular Disease in Older Adults)
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14 pages, 2297 KiB  
Article
Increasing Lifestyle Walking by 3000 Steps per Day Reduces Blood Pressure in Sedentary Older Adults with Hypertension: Results from an e-Health Pilot Study
by Elizabeth C. Lefferts, Joseph M. Saavedra, Bong Kil Song, Angelique G. Brellenthin, Linda S. Pescatello and Duck-chul Lee
J. Cardiovasc. Dev. Dis. 2023, 10(8), 317; https://doi.org/10.3390/jcdd10080317 - 27 Jul 2023
Cited by 4 | Viewed by 14844
Abstract
Increasing daily steps by an additional 3000 steps/day on 5 days/week equates to ~150 min/week of aerobic physical activity to meet the physical activity guidelines; however, its effectiveness for blood pressure control in older adults with hypertension is unknown. A 20-week, single-arm, pilot [...] Read more.
Increasing daily steps by an additional 3000 steps/day on 5 days/week equates to ~150 min/week of aerobic physical activity to meet the physical activity guidelines; however, its effectiveness for blood pressure control in older adults with hypertension is unknown. A 20-week, single-arm, pilot e-health lifestyle walking intervention was conducted in 21 sedentary older adults (73 ± 5 years old) with hypertension (13 female, 8 male) to investigate the effectiveness of increasing daily steps by an additional 3000 steps/day for blood pressure control. The intervention consisted of two phases, with behavior change assistance provided during the first active phase (weeks 1–10) to help reach step goals and minimal assistance provided during the second self-maintenance phase (weeks 11–20). Nineteen participants (91%) completed both the 10- and 20-week assessments. The participants wore the pedometer for ≥10 h on 97% of the days over 20 weeks. They significantly increased average steps/day from 3899 ± 2198 at baseline to 6512 ± 2633 at 10 weeks and 5567 ± 2587 at 20 weeks. After 20 weeks, both systolic (137 ± 10 to 130 ± 11 mm Hg, p < 0.001) and diastolic (81 ± 6 to 77 ± 6 mm Hg, p = 0.01) blood pressure improved. The response was consistent in participants with (n = 8) and without (n = 13) anti-hypertensive medication. The results of our lifestyle walking intervention are encouraging for reducing blood pressure in older adults with hypertension; however, larger randomized, controlled trials need to be performed to confirm these findings. Full article
(This article belongs to the Special Issue Exercise and Cardiovascular Disease in Older Adults)
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Review

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21 pages, 2156 KiB  
Review
The Complementary Role of Cardiopulmonary Exercise Testing in Coronary Artery Disease: From Early Diagnosis to Tailored Management
by Simone Pasquale Crispino, Andrea Segreti, Martina Ciancio, Dajana Polito, Emiliano Guerra, Giuseppe Di Gioia, Gian Paolo Ussia and Francesco Grigioni
J. Cardiovasc. Dev. Dis. 2024, 11(11), 357; https://doi.org/10.3390/jcdd11110357 - 5 Nov 2024
Viewed by 559
Abstract
Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide, accounting for over 9 million deaths annually. The prevalence of CAD continues to rise, driven by ageing and the increasing prevalence of risk factors such as hypertension, diabetes, and obesity. [...] Read more.
Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide, accounting for over 9 million deaths annually. The prevalence of CAD continues to rise, driven by ageing and the increasing prevalence of risk factors such as hypertension, diabetes, and obesity. Current clinical guidelines emphasize the importance of functional tests in the diagnostic pathway, particularly for assessing the presence and severity of ischemia. While recommended tests are valuable, they may not fully capture the complex physiological responses to exercise or provide the necessary detail to tailor personalized treatment plans. Cardiopulmonary exercise testing (CPET) offers a comprehensive assessment of the cardiovascular, pulmonary, and muscular systems under stress, potentially addressing these gaps and providing a more precise understanding of CAD, particularly in settings where traditional diagnostics may be insufficient. By enabling more personalized and precise treatment strategies, CPET could play a central role in the future of CAD management. This narrative review examines the current evidence supporting the use of CPET in CAD diagnosis and management and explores the potential for integrating CPET into existing clinical guidelines, considering its diagnostic and prognostic capabilities, cost-effectiveness, and the challenges associated with its adoption. Full article
(This article belongs to the Special Issue Exercise and Cardiovascular Disease in Older Adults)
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