The ESC Handbook of Cardiovascular Rehabilitation 1st Edition by Ana Abreu,Jean Paul Schmid,Massimo Piepoli ISBN 0198849303 978-0198849308

Contributors xv

Reviewers xviii

Acknowledgements xix

Abbreviations xxi

1 Evidence for cardiac rehabilitation in the modern era 1

Summary 1

Introduction 1

The evidence 1

Conclusion 8

References 9

Further reading 10

2 Different settings for cardiac rehabilitation 11

Summary 11

Introduction 11

Organization of cardiac rehabilitation 12

Alternative models of cardiac rehabilitation 12

The core components of home-based cardiac rehabilitation 15

Effects of home-based cardiac rehabilitation compared with hospital- or centre-based cardiac rehabilitation 15

Conclusion 16

References 16

Further reading 17

3 Cardiac rehabilitation: referral and barriers 19

Summary 19

Introduction 19

Barriers to CR uptake 20

Conclusion 24

References 24

Further reading 26

4 Human and material resources, structural, and organizational recommendations 27

Summary 27

Introduction 27

Human resources and organizational issues 28

Organizational aspects, infrastructural and material resources 30

Conclusion 33

References 33

Further reading 33

5 Recovering from acute heart events 35

Summary 35

Introduction 35

Cardiac rehabilitation after acute heart events 36

Conclusion 38

References 38

Further reading 39

6 Early assessment and risk stratification 41

Summary 41

Introduction 41

Early assessment 41

Risk profile 43

Conclusion 46

References 46

Further reading 47

7 Modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular risk factors 49

Summary 49

Introduction 49

Effects of physical activity and exercise training on CVD risk factors 50

How to prescribe exercise for improvement of CVD risk factors 52

Conclusion 55

References 55

Further reading 57

8 Exercise training for low-risk patients 59

Summary 59

Introduction 59

Assessment of low-risk patients 60

Prescription for aerobic endurance training 61

Prescription for dynamic resistance training 65

Precautions and safety in exercise training for low-risk patients 67

Conclusion 68

References 68

9 Exercise training programmes for high-risk and specific groups of patients 71

Summary 71

Introduction 71

Definition of ‘high-risk’ patients 71

Assessment of high-risk patients 72

Determination of exercise intensity 73

Exercise modalities 77

Specific populations (patients with ICD, CRT, and assist devices) 80

Conclusion 83

References 84

Further reading 85

10 Diet and nutritional aspects of cardiac rehabilitation 87

Summary 87

Introduction 87

Diet and nutritional aspects in patients with cardiovascular disease 88

Accounting for comorbidities, diabetes mellitus, and hypertension 90

Nutritional aspects in patients with malnutrition issues 90

Weight management and risk of cachexia and frailty 91

Conclusion 94

References 94

11 Educational intervention 97

Summary 97

Introduction 97

General considerations 97

Conclusion 101

References 101

Further reading 101

12 Intervention for depression, anxiety, and stress in cardiovascular patients 103

Summary 103

Introduction 103

How does depression increase cardiac mortality? 104

How do we diagnose depression in cardiac patients? 104

How do we treat depression? 105

Is treatment of depression in cardiac patients able to reduce mortality? 108

Conclusion 109

References 109

Further reading 110

13 Management of non-conventional risk factors 111

Summary 111

Introduction 111

Uric acid 112

Circulating and urinary biomarkers 112

Genetic markers 113

Vascular damage 113

Kidney dysfunction 114

Conclusion 114

References 114

14 How to improve adherence to medication and lifestyle measures 117

Summary 117

Introduction 117

Factors influencing non-adherence, non-adherence risk groups, and facilitators of adherence 118

How to measure adherence 119

Specific strategies for promoting pharmacological adherence 120

Specific strategies for promoting non-pharmacological adherence 121

Cardiac rehabilitation: secondary prevention programmes and adherence 122

Models and theories of change and adherence 123

Techniques for behavioural change 123

New electronic technologies 124

Conclusion 124

References 125

Further reading 126

15 Cardiac rehabilitation for geriatric and frail patients 127

Summary 127

Introduction 127

Cardiac rehabilitation in the elderly 128

Frailty definition and evaluation 130

Cardiac rehabilitation in frail elderly patients 130

Exercise interventions in frail patients 131

Other components of cardiac rehabilitation interventions in elderly patients 132

Conclusion 133

Case 1 133

Case 2 135

References 136

Further reading 138

16 Return to work 139

Summary 139

Introduction 139

Predictors of return to work 140

Conclusion 143

References 143

Further reading 144

17 Specific issues with physical activity after cardiac rehabilitation 145

Summary 145

Introduction 145

How to promote regular physical activity after phase II cardiac rehabilitation 146

How to prescribe and/or recommend regular physical activity after phase II cardiac rehabilitation 147

Conclusion 149

References 149

Further reading 149

18 Cardiopulmonary exercise test 151

Summary 151

Introduction 151

How to perform a cardiopulmonary exercise test 154

Interpreting the results of cardiopulmonary exercise tests 155

Conclusion 161

References 161

Further reading 162

19 Technological issues 163

Summary 163

Introduction 163

Monitoring in cardiac rehabilitation 164

Digital health 166

Future directions 167

References 168

Further reading 170

20 eHealth in cardiac rehabilitation 171

Summary 171

Introduction 171

How to implement cardiac tele-rehabilitation: organizational aspects 172

How to implement cardiac tele-rehabilitation: practical aspects 173

How to cope with legal frameworks and changing technologies 174

Conclusion 175

References 175

Further reading 176

21 The EXPERT tool: how to make exercise prescription easy 177

Summary 177

Introduction 177

The EXPERT tool: features and functionalities 179

The EXPERT training centre 183

Conclusion 184

Acknowledgement 184

References 184

Further reading 185

Index 187