Treatment of the Aged Patients at a Large Cardiac Rehabilitation Center in the Southern Brazil and Some Aspects of Their Dropout from the Therapeutic Programs.

AIM: This paper aims to assess the dropout rate in different age groups through the example of the large cardiac rehabilitation centre affiliated with the Institute of Sports Medicine, University of Caxias do Sul. MATERIAL AND METHODS: A historic cohort study comprising the following groups: Non-Old < 65 (n = 141); Young-Old 65-74 (n = 128); and Middle-Old 75-84 years old (n = 57). The exercise program lasted 48 sessions and dropout was defined as attendance of 50% of sessions or less. Logistic binominal regression was performed to assess the risk of dropout. For all analyses, a two-tailed P value of < 0.05 was used. RESULTS: The total dropout rate was 38.6%. The Young-Old and Middle-Old groups showed lower dropouts compared to Non-Old patients (p = 0.01). Young-Old has 96% less risk for dropout compared to Non-Old group (adjusted odds ratios = 1.96 [1.16-3.29]). Furthermore, patients underwent the Coronary Artery Bypass Graft showed a lower rate of dropout (p = 0.001). The absence of CABG involved three times more risk of dropout (p = 0.001). CONCLUSION: The Non-Old and the Middle-Old patients showed higher dropout rates compared to Young-Old. To ensure the best possible rehabilitation and to improve patients´ participation in CR, these programs should be adjusted to the needs of patients in terms of their age.

Continuous Aerobic Training and High Intensity Interval Training Increase Exercise Tolerance in Heart Failure Patients: A Retrospective Study

Abstract Background: Conventional aerobic training is the first choice in cardiac rehabilitation for patients with chronic heart failure (CHF). However, high-intensity interval training (HIIT) may be an alternative, although it has little evidence. Objectives: To evaluate the effect of continuous aerobic training (CAT) or HIIT on exercise tolerance in CHF patients. Methods: Retrospective study with 30 patients, of both genders, members of a 10-week CAT or HIIT program. The control group (CON) consisted of patients who did not participate voluntarily in the program. Peak oxygen uptake (VO2peak), thresholds (LV1 and LV2), and ventilatory efficiency in the production of dioxide (VE/VCO2 slope), oxygen uptake efficiency (OUES), and VO2 recovery kinetics were analyzed. A two-way or repeated measures ANOVA was used, followed by Fisher's post-hoc test (p<0.05). Results: After 10 weeks of training, the CAT group increased the treadmill speed at LV1 (p=0.040), while the HIIT increased both the speed (p=0.030) and incline of the treadmill (p<0.001) for VO2peak and LV2, as well as the total time of the cardiopulmonary test. The VE/VCO2 slope was lower than that predicted for CAT (p=0.003) and HIIT (p=0.008). There was no change in VO2peak, recovery of heart rate (HR), and VO2, VE/VCO2, and OUES in both groups. Conclusions: After 10 weeks, both CAT and HIIT increased the tolerance to physical exercise. However, HIIT showed improvement in more parameters, differently from CAT.

Change in Profile of Entrants in a Brazilian Large Cardiovascular Rehabilitation Service.

BACKGROUND: There are references regarding physical activity and cardiovascular disease since the nineteenth century. New evidences support that cardiac rehabilitation is closely related to therapeutic success after major coronary events. Although the benefits of cardiac rehabilitation programs are well established, referencing and enrolment in such services remain low. AIM: The aim of this paper is to describe the profile changes throughout the years in a large cardiac rehabilitation service in Brazil. MATERIAL AND METHODS: This is a retrospective analysis of medical records of all patients referred to cardiac rehabilitation service of the Institute of Sports Medicine, University of Caxias do Sul from March 2003 to July 2014. Data collection was carried out using SPSS software and the statistical analysis with Student's t-test, ANOVA test and chi square test. RESULTS: It has seen a substantial increase of patients, mostly routed via universal health system, also an increase of post-myocardial infarction patients and ex-smokers. Also, it was seen few patients in the 7th and 8th life decades, and men were in majority since the beginning. CONCLUSION: An increase in the number of patients referred by universal health system occurred because there is a governmental interest in this type of program. About tobacco, hospitalizations appear to be influential in the decision of abandonment. There was a substantial increase of patients with more severe disease which is in accordance with the latest guidelines of Cardiovascular and Metabolic Rehabilitation.