ISSN:0275-1429    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Twenty‐nine patients with coronary heart disease (CHD) (ten post—myocardial infarction) and very low work capacities were placed on an intensive dietary modification and exercise rehabilitation program for 26 days. Maximal work capacity for the onset of ≥1.0 mm ST depression increased from 3.1 ± 0.2 to 4.3 ± 0.3 METs and occurred at the same heart rate—systolic pressure product. Daily walking increased from 0.83 ± 0.33 to 9.33 ± 1.5 km/day. Serum cholesterol dropped from 236 ± 9 to 179 ± 6 mg/dl, while triglycerides dropped from 174 ± 13 to 147 ± 11 mg/dl. Mean body weight decreased by 3 kg. The decreases in cholesterol and triglycerides were highly correlated with the baseline values but were not related to daily walking or the increase in MET capacity. The correlation between weight loss and changes in cholesterol (r = 0.51) and triglycerides (r = 0.39) were low but statistically significant (P ≤ 0.05). These data show that an intensive, short‐term exercise and dietary program can be effective in lowering serum lipids and significantly increasing maximal work capacity and endurance of patients with CHD and very low work capacities.

ISSN:0275-1429    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;The effect of isoproterenol infusion and exercise on R‐wave magnitude was studied in normal subjects and in patients with coronary artery disease. (Group A) Isoproterenol infusion (2 &mgr;g/min/10 min) decreased R‐wave magnitude in ten normal subjects (‐10.8 ± 1.6%, P < 0.001). R‐wave magnitude remained unchanged when isoproterenol was given after propranolol (160 mg) daily for two days (‐0.9 ± 2%). R‐wave magnitude decreased with exercise (‐8 ± 3%, P < 0.05) in five normal subjects but increased with exercise performed after propranolol (160 mg) daily for two days (+11.5 ± 3.5%, P < 0.05). (Group B) A maximal treadmill exercise test was performed in 25 untreated patients with stable angina and no resting myocardial perfusion defects. R‐wave magnitude increased with exercise in ten patients (+8.2 ± 3%, P < 0.001) and decreased in 16 (‐11.2 ± 3%, P < 0.01). The number of coronary arteries with obstruction greater than 70% was greater for patients in whom the R‐wave magnitude increased with exercise than for patients in whom the R‐wave magnitude decreased (2.1 ± 0.12 vs 1.2 ± 1, P < 0.01). (Group C) In ten patients with coronary artery disease and stable angina in whom R‐wave magnitude decreased before therapy (‐10.0 ± 1.6%, P < 0.01), therapy with propranolol resulted in an increase of postexercise R‐wave magnitude (+7.9 ± 3.2%, P < 0.05). It is concluded that the increase of R‐wave magnitude with exercise may be related to inability of the ischemic myocardium to respond to adrenergic stimulation. Furthermore, changes of R‐wave magnitude cannot be used to diagnose ischemia in patients who are receiving beta‐blocking agents.

ISSN:0275-1429    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;A retrospective analysis of 210,000 Navy and Marine Corps recruits entering training during a four‐year period (1975 to 1978) identified those individuals with a degree of heart disease sufficient to preclude employment in the armed forces as blue‐collar workers. The incidence of heart disease was 0.7 per 1,000 recruits (144/210,000). Congenital heart disease accounted for 72% of cases (104/144), with aortic valve disease being the most common problem (26%). Rheumatic heart disease was observed in 17% (25/144); 10% (15/144) had arrhythmias.With continued progress in the diagnosis and treatment of congenital and rheumatic heart diseases, this population of young adults will increase. However, as this and other studies show, young adults with heart disease are often unprepared to meet successfully the responsibilities of adulthood. Insurability, employment, and resources available for vocational training are discussed.

ISSN:0275-1429    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;The smoking habits of a suburban southern California community were determined as part of a total community heart disease screening survey from 1972 to 1974. The population was affluent, and approximately 40% of the subjects were over age 65. There were high proportions of former smokers compared with other surveys: 50% of men and 25% of women. Twenty‐two percent of the men and 26% of the women were current smokers. To our knowledge these are the lowest rates yet reported for an adult free‐living population, and the first time a population survey has reported more current smokers among women than among men.

ISSN:0275-1429    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;American Heart Association Rehabilitation News is a report to the readers of this journal of events, services, publications, and programs of the American Heart Association, 7320 Greenville Ave., Dallas, Texas 75231.

ISSN:0275-1429    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;The effects of six months of a cardiac rehabilitation program, which included physical conditioning and dietary counseling, upon platelet aggregation at rest and following maximal exercise were evaluated in seven men who had survived a myocardial infarction. In platelet samples drawn at rest, aggregation induced with levoepinephrine (EPI) was strikingly reduced following the conditioning program in all subjects at all concentrations of EPI studied (10‐6M to 10‐3M). At peak EPI concentrations (10‐3M), primary wave aggregation fell from 40% ± 27% (mean ± SD) to 11% ± 5% (P + 0.0058), and secondary wave aggregation was abolished. Total aggregation, including the secondary wave, fell from 50% ± 26% to 11% ± 5% (P = 0.0113). No changes in the maximal extent of primary or secondary wave aggregation in response to adenosine diphosphate (ADP) or to collagen were noted, and there were no effects of a single bout of acute exercise upon platelet aggregation in response to any aggregating agent, either before or after the conditioning program. Possible mechanisms for reduced EPI sensitivity following this intervention include platelet alpha‐receptor desensitization, reduced cholesterol content of platelet membranes, or altered platelet kinetics.

ISSN:0275-1429    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Twenty‐five patients with documented coronary artery disease performed a noninvasive symptom‐limited maximal exercise test on a treadmill. The results obtained were compared with those obtained when subjects performed similar exercise while monitored by Swan‐Ganz and arterial catheters. Excellent correlations between maximal oxygen uptake and maximal heart rate were found. In most cases angina was reproducible, and the ST changes were similar during both tests. The intra‐arterial measurements of systolic blood pressure and mean arterial pressure yielded significantly greater values than the systolic blood pressure value obtained with a sphygmomanometer and the corresponding estimated mean pressure. These differences reflect the techniques for estimation rather than hemodynamic differences between the two tests.

ISSN:0275-1429    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Low‐level exercise stress testing was conducted among 230 patients between August 1976 and December 1978; testing was done an average of three to four weeks after patients had undergone coronary artery bypass surgery. A modified Bruce protocol was utilized and a target of 70% to 75% of maximal age‐predicted heart rate was used as the preferred endpoint. Of the 230 patients, 26 (13%) were women. The average age of the female patients was 55 and of the male patients, 54. Five patients underwent concurrent left ventricular aneurysmectomy or value replacement. One hundred four patients (42%) had suffered an earlier myocardial infarction. Cardiac catheterization documented multivessel coronary artery disease in over 90% of the patients. All patients began participation in an outpatient cardiac rehabilitation program shortly after undergoing exercise testing.There were no deaths or significant complications related to the stress testing procedure. A total of 50 patients (22%) demonstrated significant atrial or ventricular arrhythmias during testing. Nineteen patients (8%) required the immediate institution of an appropriate antiarrhythmic agent. During stress, 20 patients (9%) displayed an ST response consistent with ischemia. In six patients a hypertensive response to stress was noted, and appropriate antihypertensive medication was begun.Low‐level exercise stress testing appears to be a safe and useful tool in the assessment of patients in the early period following coronary artery bypass surgery. Valuable information was gained and therapy altered for 33% of patients tested.

ISSN:0275-1429    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0275-1429    

出版商:OVID    

年代:1981

数据来源: OVID