PMID- 28169556
OWN - NLM
STAT- MEDLINE
DCOM- 20180305
LR  - 20180509
IS  - 2047-4881 (Electronic)
IS  - 2047-4873 (Linking)
VI  - 24
IP  - 8
DP  - 2017 May
TI  - Blood pressure dynamics during exercise rehabilitation in heart failure patients.
PG  - 818-824
LID - 10.1177/2047487317690951 [doi]
AB  - Background Patients suffering from heart failure (HF) may demonstrate an abnormal 
      blood pressure response to exercise (ABPRE), which may revert to a normal one 
      following medical treatment. It is assumed that this change correlates positively 
      with prognosis and functional aspects. The aim of this study was to characterize 
      patients with ABPRE and assess ABPRE normalization and the correlation with 
      clinical and functional outcomes. Methods In the study, 651 patients with HF who 
      underwent cardiac rehabilitation (CR) were examined. Patients who presented an 
      ABPRE during stress testing were identified and divided into those who corrected 
      their initial ABPRE following CR and those who did not. Results 
      Pre-rehabilitation ABPRE was present in 27% of patients, 68% of whom normalized 
      their ABPRE following CR. Two parameters were independently predictive of failure 
      to normalize the blood pressure response: female gender (odds ratio (OR) 3.5; 95% 
      confidence interval (CI) 1.4-9.0) and decreased systolic function (OR 3.2; 95% CI 
      1.0-9.4). Patients with hypertrophic cardiomyopathy demonstrated higher rates of 
      ABPRE normalization than patients with other causes of HF (93% vs. 62%, 
      respectively, P = 0.03). The research population exhibited an average improvement 
      in exercise capacity (4.7 to 6.4 metabolic equivalents (METS), P < .001), 
      ejection fraction (35.4% to 37.7%, P < .001) and percentage of patients with New 
      York Heart Association (NYHA) class 3-4 (50% to 43.4%, P = .123). The group who 
      normalized their ABPRE exhibited greater improvement. Conclusions Amongst a 
      population of patients suffering from HF, an ABPRE was normalized following CR in 
      two thirds of patients. Female gender and a reduced systolic function 
      independently predicted the failure to correct the ABPRE, while patients with 
      hypertrophic cardiomyopathy demonstrated exceptionally high rates of 
      normalization.
FAU - Hecht, Idan
AU  - Hecht I
AD  - 1 Cardiac Rehabilitation Institute, Leviev Heart Center, Sheba Medical Center, 
      Sackler School of Medicine, Tel Aviv University, Israel.
FAU - Arad, Michael
AU  - Arad M
AD  - 2 Heart Failure Institute, Leviev Heart Center, Sheba Medical Center, Sackler 
      School of Medicine, Tel Aviv University, Israel.
FAU - Freimark, Dov
AU  - Freimark D
AD  - 2 Heart Failure Institute, Leviev Heart Center, Sheba Medical Center, Sackler 
      School of Medicine, Tel Aviv University, Israel.
FAU - Klempfner, Robert
AU  - Klempfner R
AD  - 1 Cardiac Rehabilitation Institute, Leviev Heart Center, Sheba Medical Center, 
      Sackler School of Medicine, Tel Aviv University, Israel.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20170207
PL  - England
TA  - Eur J Prev Cardiol
JT  - European journal of preventive cardiology
JID - 101564430
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Blood Pressure
MH  - Cardiac Rehabilitation/*methods
MH  - Cardiomyopathy, 
      Hypertrophic/complications/diagnosis/physiopathology/*rehabilitation
MH  - Chi-Square Distribution
MH  - Exercise Test
MH  - *Exercise Therapy
MH  - Female
MH  - Heart Failure/diagnosis/etiology/physiopathology/*rehabilitation
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Odds Ratio
MH  - Recovery of Function
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Sex Factors
MH  - Systole
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - Heart failure
OT  - blood pressure response to exercise
OT  - cardiac rehabilitation
EDAT- 2017/02/09 06:00
MHDA- 2018/03/06 06:00
CRDT- 2017/02/08 06:00
PHST- 2017/02/09 06:00 [pubmed]
PHST- 2018/03/06 06:00 [medline]
PHST- 2017/02/08 06:00 [entrez]
AID - 10.1177/2047487317690951 [doi]
PST - ppublish
SO  - Eur J Prev Cardiol. 2017 May;24(8):818-824. doi: 10.1177/2047487317690951. Epub 
      2017 Feb 7.