2024 SIAC guidelines on cardiorespiratory rehabilitation in pediatric patients with congenital heart disease.

The 2024 Interamerican Society of Cardiology (SIAC) guidelines on cardiorespiratory rehabilitation (CRR) in pediatric patients with congenital heart disease aim to gather and evaluate all relevant evidence available on the topic to unify criteria and promote the implementation of CRR programs in this population in Latin America and other parts of the world. Currently, there is no unified CRR model for the pediatric population. Consequently, our goal was to create these CRR guidelines adapted to the characteristics of congenital heart disease and the physiology of this population, as well as to the realities of Latin America. These guidelines are designed to serve as a support for health care workers involved in the care of this patient group who wish to implement a CRR program in their workplace. The guidelines include an easily reproducible program model that can be implemented in any center. The members of this Task Force were selected by the SIAC on behalf of health care workers dedicated to the care of pediatric patients with congenital heart disease. To draft the document, the selected experts performed a thorough review of the published evidence.

Spray-Dried Yerba Mate Extract Capsules: Clinical Evaluation and Antioxidant Potential in Healthy Individuals.

The aim of the present study was to evaluate the clinical effects and antioxidant potential of spray-dried yerba mate extract (SDME) capsules in healthy individuals. Fourteen healthy volunteers consumed three capsules of SDME three times daily. Measurements were carried out at the baseline and after 7, 30, and 60 days of SDME capsules intake. Electrocardiogram, hematological, urinary, and biochemical parameters analyzed remained within the normal values during all the study. SDME capsules ingestion increased significantly serum antioxidant capacity (after 7 and 30 days) and reduced glutathione values (after 7 and 60 days), and the superoxide dismutase (after 7, 30, and 60 days), catalase (after 7 and 30 days), and paraoxonase-1 activities (after 7 days); and decreased lipid hydroperoxides (after 30 and 60 days) and thiobarbituric acid reactive substances levels (after 7 and 30 days). No change was observed for glutathione peroxidase activity after SDME capsules intake. The present study showed that SDME capsules ingestion by healthy individuals did not promote clinical changes and promoted an increase of antioxidant biomarkers with a concomitant decrease of lipid peroxidation biomarkers in a short and prolonged manner.

Influence of exercise on oxidative stress in patients with heart failure.

Reactive oxygen species play an important role in the pathophysiology of heart failure (HF). In contrast, regular physical exercise can promote adaptations to reactive oxygen species that are beneficial for patients with HF. We completed a systematic review of randomized controlled trials that evaluate the influence of exercise on oxidative stress in patients with HF. Articles were searched in the PubMed, Cochrane, SciELO, and LILACS databases. The search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The quality of the included studies was assessed using the Physiotherapy Evidence Database scale. We selected 12 studies with a total of 353 participants. The included patients had a left ventricle ejection fraction of < 52% and New York Heart Association functional class II or III disease. A significant increase was observed in peak oxygen consumption (between 10 and 46%) in the group that underwent training (TG). There was an improvement in the oxidative capacity of skeletal muscles in the TG, related to the positive activity of mitochondrial cytochrome c oxidase (between 27 and 41%). An increase in the expression of the enzymes glutathione peroxidase (41%), catalase (between 14 and 42%), and superoxide dismutase (74.5%), and a decrease in lipid peroxidation (between 28.8 and 58.5%) were observed in the TG. Physical training positively influenced the cardiorespiratory capacity and enhanced the benefits of oxidant and antioxidant biomarkers in patients with HF. High-intensity training promoted a 15% increase in the plasma total antioxidant capacity, whereas moderate training had no effect.

The Effect of Chronic Musculoskeletal Pain on Sexual Function and Quality of Life of Cardiac Rehabilitation Patients.

BACKGROUND: Comorbidities are stressors to the body and have a negative impact on quality of life and sexual function. OBJECTIVE: The objective of this study was to investigate the effect of the coexistence of coronary heart disease and chronic musculoskeletal pain on sexual function and quality of life of patients undergoing an exercise-based cardiac rehabilitation program. METHODS: This cross-sectional observational study included 105 patients. Instruments used were the musculoskeletal system assessment inventory, Short-Form Health Survey quality-of-life questionnaire, International Index of Erectile Function, and Female Sexual Function Index. RESULTS: There were no differences in male sexual function compared between participants with and without pain. Participants with pain had lower quality-of-life scores related to socioemotional aspects. CONCLUSIONS: The coexistence of coronary heart disease and musculoskeletal pain does not seem to affect patients' sexual function, but it negatively affects Patients' quality of life. This study emphasizes the importance of a multidisciplinary team working in a cardiac rehabilitation program addressing issues related to pain, sexual function, and quality of life.

Cardiovascular rehabilitation of patients with ischemic heart disease undergoing medical treatment, percutaneous transluminal coronary angioplasty, and coronary artery bypass grafting.

OBJECTIVE: To evaluate the occurrence of death and myocardial infarction in subgroups of coronary artery disease patients with hemodynamically significant coronary stenoses undergoing treatment in a cardiovascular rehabilitation program and considered severely ill for: a) not having undergone intervention treatment; b) presenting signs of myocardial ischemia; c) presenting multivessel occlusive disease. METHODS: Retrospective cohort study of 381 patients presented previous coronary angiography showing hemodynamically significant coronary stenoses, for which, because of the anatomic bias, intervention treatment was indicated. The patients were categorized according to the presence or absence of intervention treatment; presence or absence of ischemia in the exercise test; and number of critical coronary stenoses. Statistical analysis was performed using the Kaplan-Meier and logistic regression methods. RESULTS: Survival probability was not different when patients undergoing medical treatment were compared to those undergoing previous intervention treatment (OR 0.813; 95% CI; 0.366-1.809); with and without evidence of ischemia in the exercise test (OR 0.785; 95% CI; 0.366-1.684); and with one-vessel coronary artery disease and with more-than-one-vessel coronary artery disease (OR 0.824, 95% CI; 0.377-1.798). CONCLUSION: In this cohort study, no unfavorable outcome was observed in the subgroups comprised of medically treated patients, with evidence of myocardial ischemia and with multivessel coronary artery disease.