Exercise Training for Cardiac Patients, Why and How to Prescribe It?

Abstract

The benefits of regular physical activity whether in primary- or secondary prevention of cardiovascular disease are now irrefutable. Despite its well proven benefits, exercise training remains underused because of lack of insight and familiarity of the majority of cardiologists. This review offers cardiologists the necessary informations about the pathophysiological mechanisms, effects and limitations of the predominantly used training methods in various kardiovascular diseases.

Was ist wichtig?

Bewegungstraining ist nicht nur für Patienten mit koronarer Herzerkrankung, sondern auch für solche mit Herzinsuffizienz empfohlen.

In Übereinstimmung mit den Empfehlungen und in Anbetracht seines erwiesenen Nutzens sollte Herzpatienten Bewegungstraining idealerweise im Rahmen eines kardiovaskulären Rehabilitationprogramms verschrieben werden.

Die Verbindung von Sicherheitsausdauer- und Widerstandstrainings wird empfohlen.

Das Training muss auf der Grundlage einer Bewertung der körperlichen Fähigkeiten des Patienten individualisiert und regelmäßig an den objektiven Fortschritt angepasst werden.

Key words

physical activity - exercise training - cardiovascular disease - cardiac rehabilitation - primary secondary prevention

• References/Literatur

• 1 Levine SA, Lown B. The chair treatment of acute coronary thrombosis. Trans Ass Amer Physicians 1951; 64: 316
• 2 Sullivan MJ, Higginbotham MB, Cobb FR. Exercise training in patients with severe left ventricular dysfunction. Hemodynamic and metabolic effects. Circulation 1988; 78: 506-515
• 3 Thomas RJ, Beatty AL, Beckie TM. et al. Home-based cardiac rehabilitation: a scientific statement from the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. Circulation 2019; 140: e69-e89
• 4 Ponikowski P, Voors AA, Anker SD. et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 2016; 37: 2129-2200
• 5 Fletcher GF, Ades PA, Kligfield P. et al. Exercise standards for testing and training: a scientific statement from the American Heart Association. Circulation 2013; 128: 873-934
• 6 Long L, Mordi IR, Bridges C. et al. Exercise-based cardiac rehabilitation for adults with heart failure. Cochrane Database Syst Rev 2019; DOI: 10.1002/14651858.CD003331.pub5.
• 7 Anderson L, Thompson DR, Oldridge N. et al. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev 2016; DOI: 10.1002/14651858.CD001800.pub3.
• 8 Long L, Anderson L, Dewhirst AM. et al. xercise-based cardiac rehabilitation for adults with stable angina. Cochrane Database Syst Rev 2018; DOI: 10.1002/14651858.CD012786.pub2.
• 9 Garber CE, Blissmer B, Deschenes MR. et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 2011; 43: 1334-1359
• 10 Wang L, Ai D, Zhang N. Exercise dosing and prescription-playing it safe: dangers and prescription. Adv Exp Med Biol 2017; 1000: 357-387
• 11 Balady GJ, Williams MA, Ades PA. et al. Core components of cardiac rehabilitation/secondary prevention programs: 2007 update: a scientific statement from the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; the Councils on Cardiovascular Nursing, Epidemiology and Prevention, and Nutrition, Physical Activity, and Metabolism; and the American Association of Cardiovascular and Pulmonary Rehabilitation. J Cardiopulm Rehabil Prev 2007; 27: 121-129
• 12 Piepoli MF, Corrà U, Adamopoulos S. et al. Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery: a policy statement from the cardiac rehabilitation section of the European Association for Cardiovascular Prevention & Rehabilitation. Endorsed by the Committee for Practice Guidelines of the European Society of Cardiology. Eur J Prev Cardiol 2014; 21: 664-681
• 13 Price KJ, Gordon BA, Bird SR. et al. A review of guidelines for cardiac rehabilitation exercise programs: Is there an international consensus?. Eur J Prev Cardiol 2016; 23: 1715-1733
• 14 Ballesta García BI, Arias RJÁ, Campo RDJ. et al. High-intensity interval training dosage for heart failure and coronary artery disease cardiac rehabilitation. A systematic review and meta-analysis. Rev Esp Cardiol 2019; 72: 233-243
• 15 Pattyn N, Beulque R, Cornelissen V. Aerobic interval vs. continuous training in patients with coronary artery disease or heart failure: an updated systematic review and meta-analysis with a focus on secondary outcomes. Sports Med 2018; 48: 1189-1205
• 16 Volaklis KA, Tokmakidis SP. Resistance exercise training in patients with heart failure. Sports Med 2005; 35: 1085-1103
• 17 Haykowsky MJ, Daniel KM, Bhella PS. et al. Heart failure: exercise-based cardiac rehabilitation: who, when, and how intense?. Can J Cardiol 2016; 32 (Suppl. 02) S382-S387
• 18 Laoutaris ID. The aerobic/resistance/inspiratory muscle training hypothesis in heart failure. Eur J Prev Cardiol 2018; 25: 1257-1262