RESUMEN
[Purpose] Although cardiac rehabilitation (CR) is recommended for patients with chronic heart failure (CHF), adequate exercise effect cannot be obtained in elderly patients. Administration of amino acids (AA) to CHF patients has been reported to improve exercise capacity, but the changes in AA composition in plasma before and after CR had not been reported. This study aimed to measure plasma levels of AA in CHF patients and compare with values of normal range. In addition the relationship between the change of exercise capacity and AA were examined. [Subjects and Methods] Twelve CHF patients (60% males, aged 68 ± 12â years) were studied. The correction between the rates of changes in exercise capacity parameters and in plasma AA levels was investigated. [Results] Anaerobic threshold (AT) and peak oxygen uptake (VO2) improved significantly after CR. The AA profile showed no specific pattern, and citrulline (Cit) was the amino acid showing a significant positive correlation with exercise capacity (∆Cit vs. ∆AT: r=0.602, ∆Cit vs. ∆AT-work rate (WR): r=0.681, ∆Cit vs. ∆VO2/WR: r=0.635). A tendency of positive correlation was observed between ∆Cit and ∆peak VO2 (r=0.456). [Conclusion] The AA profile showed no specific pattern, but a relationship between change in exercise capacity and Cit were found.
RESUMEN
Although cardiac rehabilitation (CR) has been shown to improve exercise tolerance and prognosis in patients with cardiovascular diseases, there remains low participation in outpatient CR. This may be attributed to the patients' busy schedules and difficulty in visiting the hospital due to distance, cost, avoidance of exercise, and severity of coronary disease. To overcome these challenges, many countries are exploring the possibility of remote CR. Specifically, there is increasing attention on the development of remote CR devices, which allow transmission of vital information to the hospital via a remote CR application linked to a wearable device for telemonitoring by dedicated hospital staff. In addition, remote CR programs can support return to work after hospitalization. Previous studies have demonstrated the effects of remote CR on exercise tolerance. However, the preventive effects of remote CR on cardiac events and mortality remain controversial. Thus, safe and effective remote CR requires exercise risk stratification for each patient, telenursing by skilled staff, and multidisciplinary interventions. Therefore, quality assurance of telenursing and multi-disciplinary interventions will be essential for remote CR. Remote CR may become an important part of cardiac management in the future. However, issues such as cost-effectiveness and insurance coverage still persist.
RESUMEN
OBJECTIVE: Oral health conditions have a significant relationship with diabetes mellitus (DM) as well as dyslipidemia. In this study, we investigated the levels of apolipoprotein B (apoB) and oxidized low-density lipoprotein (oxLDL) in the gingival crevicular fluid (GCF) from patients with DM. METHODS: GCF and blood samples from 18 DM patients and 18 healthy subjects were examined. GCF was collected with paper points without inflicting any harm. The apoB and oxLDL levels were measured by sandwich ELISA assays. RESULTS: The number of teeth with a deep probing pocket depth and the number of teeth with bleeding on probing, two typical periodontal parameters, correlated with the DM parameters, such as hemoglobin A1c. The GCF volume and the concentrations of protein, apoB and oxLDL in GCF were significantly higher in the DM patients than in the healthy subjects. In particular, the apoB concentration in GCF was increased 6-fold in the DM patients. The GCF apoB concentration correlated well with the DM parameters in plasma. CONCLUSION: GCF could be a clinical source for examining not only the oral status of patients, but also certain systemic conditions.