1,721,162 research outputs found

    Exercise training in patients with chronic heart failure: A new challenge for Cardiac Rehabilitation Community.

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    Exercise training (ET) is strongly recommended in patients with chronic stable heart failure (HF). Moderate-intensity aerobic continuous ET is the best-established training modality in HF patients. In the last decade, however, high-intensity interval exercise training (HIIT) has aroused considerable interest in cardiac rehabilitation community. In HF patients, HIIT exerts larger improvements in exercise capacity compared to moderate-continuous ET. Since better functional capacity translates into symptoms relief and improvement in quality of life in patients with HF, this training modality is collecting growing interest and consensus, not revealing major safety issues. HIIT should not replace other training modalities in HF but should rather complement them. Inspiratory muscle training, another promising training modality in patients with HF, exerts beneficial effect on inspiratory muscle strength and inspiratory endurance, on exercise capacity and quality of life. In conclusion, taking into consideration the complecity of HF syndrome, combining and tailoring different ET modalities according to each patient’s baseline clinical characteristics (i.e., exercise capacity, comorbidity, frailty status, personal needs, preferences and goals) seem the wiliest approach for exercise prescription. The present review aims at discussing the rececent evidences on the effects of exercise training in patients with chronic HF (with both reduced and preserved left ventricular function)

    Prevention of cardioembolic events after intracranial hemorrhage.

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    In high thromboembolic risk patients who experienced hemorrhagic stroke, the prevention of cardioembolic events and recurrence of intracranial bleeding should be guaranteed. The consultant cardiologist should carefully identify the most appropriate therapeutic approach for these patients. Among patients with previous hemorrhagic stroke, only few restart oral anticoagulant therapy (OAT) after cerebral bleeding; however, as reported by some registries, it is likely that resuming OAT exerts a favorable effect on the combined outcome of ischemic stroke/systemic embolism/all-cause death. In these patients, several parameters should be evaluated, such as the type of intracranial bleeding, the presence of a previous thromboembolic event, the global thromboembolic risk, as well as the history of a previous OAT. This review deals with a particularly interesting matter, requiring a number of decision-making turning points, i.e. whether it is appropriate or not to start or resume OAT, what drug class and timing choice in such a case, and the potential valuable alternatives to OAT

    Response to Commentary "efficacy of inspiratory muscle training in chronic heart failure patients"

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    In their letter Plentz and colleagues attempt to highlight discrepancies between their review work and that of Smart et al. Plentz and colleagues suggest that the search by Smart et al. was too narrow. We challenge Plentz and colleagues to find omitted studies that were published in the stipulated time frame as, in addition to the stipulated search, extensive hand searching was conducted. The discrepancy between the previous works and the work of Smart et al. may be explained by the fact that we only recorded papers where we were required to read more than the title (e.g. abstracts or full manuscripts) in order to come to a decision to exclude a study. Second, Plentz and colleagues suggest our review included too many studies, which perhaps contradicts their comment above? We do however acknowledge that journal word limits permitting the inclusion of a sensitivity analysis (e.g. removal of studies of Winkelmann and Laoutaris) may have been helpful in teasing out any effects of heterogenic studies
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