Dataset Information

The role and outcome of cardiac rehabilitation program in patients with atrial fibrillation.

ABSTRACT:

Background

Atrial fibrillation (AF) is associated with diminished cardiac function, and exercise tolerance.

Hypothesis

We sought to investigate the role of cardiac rehabilitation program (CR) in patients with AF.

Methods

The study included 2165 consecutive patients that participated in our CR program between the years 2009 to 2015. All were evaluated by a standard exercise stress test (EST) at baseline, and upon completion of at least 3 months of training. Participants were dichotomized according to baseline fitness and the degree of functional improvement. The combined primary end point was cardiac related hospitalization or all-cause mortality.

Results

A total of 292 patients had history of AF, with a mean age of 68 ± 9 years old, 76% of which were males. The median predicted baseline fitness of AF patients was significantly lower compared to non-AF patients (103% vs 122%, P < 0.001, respectively). Prominent improvement was achieved in the majority of the patients in both groups (64% among AF patients and 63% among those without AF). Median improvement in fitness between stress tests was significantly higher in patients with AF (124% vs 110%, P < 0.001, respectively). Among AF patients, high baseline fitness was associated with a lower event rates (HR 0.40; 95%CI 0.23-0.70; P = 0.001). Moreover, prominent improvement during CR showed a protective effect (HR 0.83; 95% CI 0.69-0.99; P = 0.04).

Conclusion

In patients with AF participating in CR program, low fitness levels at baseline EST are associated with increased risk of total mortality or cardiovascular hospitalization during long-term follow-up. Improvement on follow-up EST diminishes the risk.

SUBMITTER: Younis A

PROVIDER: S-EPMC6489737 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Publications

The role and outcome of cardiac rehabilitation program in patients with atrial fibrillation.

Younis Arwa A Shaviv Ella E Nof Eyal E Israel Ariel A Berkovitch Anat A Goldenberg Ilan I Glikson Michael M Klempfner Robert R Beinart Roy R

Clinical cardiology 20180920 9

<h4>Background</h4>Atrial fibrillation (AF) is associated with diminished cardiac function, and exercise tolerance.<h4>Hypothesis</h4>We sought to investigate the role of cardiac rehabilitation program (CR) in patients with AF.<h4>Methods</h4>The study included 2165 consecutive patients that participated in our CR program between the years 2009 to 2015. All were evaluated by a standard exercise stress test (EST) at baseline, and upon completion of at least 3 months of training. Participants were ...[more]

PMID: 29934991

Similar Datasets

Project description:Atrial fibrillation (AF) is the most common sustained arrhythmia characterized by rapid and multiple irregular excitations within the atria. AF is associated with serious morbidity and increased mortality, and its prevalence is prospected to increase as society ages. The limited therapeutic efficacy of AF treatment as well as its high socioeconomic burden makes AF a major clinical challenge. Despite our expanding knowledge of individual proteins and pathways involved in the complex pathophysiology of atrial fibrillation (AF), an unbiased overview of proteins and functionally enriched biological processes as well as their crosstalk is lacking. Here, we performed an explorative proteomics analysis to reveal the global abundance of proteins in cardiac tissue of patients, and deciphered functionally grouped gene ontologies (GO) to uncover a perspective of the disease biology driving or driven by AF. A total of 2703 proteins were identified by liquid chromatography coupled to tandem mass spectrometry. Among them, 150 proteins (accounting for 5.6% of 2703) had a significantly altered abundance (100 proteins increased and 50 decreased) in AF. A significant biological connection was found between those (protein-protein interaction enrichment p-value=1.0e-16). GO enrichment analysis showed that these 150 proteins were mainly located in extracellular/cytoplasmic vesicles, mitochondrion, and cytoskeletal compartments. Correspondingly, the 100 proteins increased in AF were significantly enriched in the GO terms related to immune system, metabolic process, iron process, ECM disassembly, mitochondrial translation and apoptotic signaling. Partially clustered proteins with dense functional link were found in immune system and metabolic process, and were respectively annotated in neutrophil degranulation, and oxoacid metabolic process coupled to the subunits of mitochondrial dehydrogenase NADH. Those processes enriched in AF had crosstalk via the proteins involved in neutrophil degranulation. Selected proteins such as LCN2 (neutrophil degranulation), CA3 (immune system), NDUFS2 (complex I) and MYH10 (actin motor protein) were validated by western blot or qPCR in an independent cohort. The 50 proteins decreased in AF were collectively enriched in vesicle-mediated transport and actin filament-based movement. We demonstrate that important biological processes underlying persistent AF as well as their crosstalk via the components of neutrophil degranulation. Our study provides a novel insight for a more efficient targeting strategy for AF treatment.

Dataset Information

The role and outcome of cardiac rehabilitation program in patients with atrial fibrillation.

Background

Hypothesis

Methods

Results

Conclusion

Publications

The role and outcome of cardiac rehabilitation program in patients with atrial fibrillation.

Similar Datasets

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