ECSS Paris 2023: OP-MH48
INTRODUCTION: Exercise-based cardiac rehabilitation (CR) is a cornerstone in secondary prevention for coronary artery disease (CAD). While aerobic training (AT) has long been established as the gold standard in rehabilitation, resistance training (RT) has been underutilized in clinical practice due to safety concerns. This study systematically evaluates the efficacy and safety of RT in improving cardiorespiratory fitness, cardiac remodeling, and endothelial function in CAD patients. METHODS: We systematically searched PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang databases for randomized controlled trials (RCTs) comparing RT or combined RT and AT with routine care (UC) or AT in adults with CAD. Primary outcomes included peak oxygen uptake (VO2peak), with secondary outcomes being left ventricular ejection fraction (LVEF) and flow-mediated dilation (FMD). Statistical analysis was performed using R software, with effect sizes reported as standardized mean differences (SMD) or mean differences (MD). RESULTS: A total of 27 RCTs involving 2,423 patients were included. Meta-analysis revealed significant improvements in VO2peak (SMD = 0.62, 95% CI: 0.45 to 0.79, P < 0.001), LVEF (MD = 3.85%, 95% CI: 2.14% to 5.56%, P < 0.001), and FMD (MD = 2.45%, 95% CI: 1.12% to 3.78%, P = 0.002) for RT interventions compared to controls. Subgroup analysis showed the most significant benefit for combined training versus routine care (SMD = 0.88, P < 0.001), with an additive effect when combined with AT (SMD = 0.35, P = 0.003). No serious adverse events related to RT were reported. CONCLUSION: RT, especially when combined with AT, is a safe and effective strategy to enhance cardiorespiratory fitness, cardiac function, and endothelial health in CAD patients. These findings support the inclusion of RT in routine cardiac rehabilitation programs.
Read CV JUNyi LIECSS Paris 2023: OP-MH48
INTRODUCTION: Arterial hypertension and increased blood pressure variability (BPV) are major prognostic determinants in patients with ischemic heart disease (IHD). While exercise training is known to improve blood pressure (BP) control, the effects of different combined exercise modalities on BPV in IHD remain poorly defined. METHODS: This randomized pilot study compared the effects of continuous combined training (CCT; moderate-intensity continuous aerobic exercise plus resistance training) and interval combined training (ICT; high-intensity interval aerobic exercise plus resistance training) on BPV and BP parameters in hypertensive patients with IHD. Thirty-six clinically stable patients with IHD and hypertension were randomized to CCT or ICT for 12 weeks. Outcomes included short-term BPV assessed by 24-hour ambulatory BP monitoring, resting and 24-hour BP, and exercise capacity trough cardiopulmonary test. RESULTS: Short-term systolic BPV significantly decreased in the CCT group but remained un-changed in the ICT group: [adjusted between-group difference −2.1 mmHg (95% CI: −4.1 to −0.1; p 0.029]. Resting systolic BP decreased similarly in both groups, whereas no signifi-cant changes were observed in 24-hour BP values. Peak oxygen uptake improved in both groups with a greater increase in the ICT group [adjusted between-groups difference +1.7 mL·kg⁻¹·min⁻¹ (95% CI: 0.7 to 2.8); p = 0.032). CONCLUSION: These findings suggest that, in patients with IHD, continuous combined training may be more effective than interval combined training in reducing short-term BPV, whereas interval training may confer greater improvements in aerobic capacity. Further adequately powered studies are warranted to confirm these results.
Read CV Giuseppe CaminitiECSS Paris 2023: OP-MH48
INTRODUCTION: Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide (1). Although both aerobic and muscle-strengthening physical activity (PA) are key modifiable factors in individuals with CVD (2), adherence to these recommendations is low (3). While sex differences in the associations between PA and mortality have been reported in healthy populations (4), it remains unclear whether similar patterns exist among individuals with established CVD. This study examined sex-specific associations of aerobic and muscle-strengthening PA with all-cause mortality in adults with CVD. METHODS: Data were obtained from the US National Health Interview Survey (NHIS) cohort, including 48826 adults with pre-existing CVD (myocardial infarction, angina pectoris, coronary heart disease or stroke) interviewed between 1997 and 2018 and followed for mortality through 2019. All-cause mortality was ascertained via linkage to the National Death Index. Leisure-time PA was self-reported and classified according to WHO recommendations as: meeting aerobic PA (≥ 150 min/week of moderate-to-vigorous activity) and meeting muscle-strengthening activity (≥ 2 times/week). Multivariable-adjusted Cox proportional hazards ratio (HR) was used to estimate mortality risk across PA profiles based on guideline recommendations, using those meeting neither recommendation as the reference category. Restricted cubic splines were used to examine dose–response. All analyses were conducted separately in women and men. RESULTS: A total of 23710 women (mean age 66.09 years) and 25116 men (mean age 64.87 years) with CVD were followed for a median of 6.63 years (IQR 3.47-11.22), during which 21132 all-cause deaths occurred. Compared with participants meeting neither recommendation, meeting both was associated with the lowest mortality risk in both women (HR 0.70, 95% CI 0.62–0.81) and men (HR 0.65, 95% CI 0.60–0.70). Meeting aerobic recommendations alone was also associated with lower mortality in women (HR 0.75, 95% CI 0.70–0.80) and men (HR 0.72, 95% CI 0.68–0.76), whereas associations for muscle-strengthening activity alone were weaker and not consistently significant. Patterns were similar in women and men (p for interaction >0.05). Spline analyses indicated non-linear dose–response associations, with mortality risk decreasing up to approximately 300-500 min/week of aerobic PA and plateauing thereafter. For muscle-strengthening activity, the lowest risk was observed at approximately 2–3 times/week. CONCLUSION: Among adults with CVD, meeting both aerobic and muscle-strengthening PA recommendations was associated with the lowest risk of all-cause mortality. These associations did not differ by sex, supporting the importance of promoting combined PA modalities in secondary prevention in both women and men. References: 1. Vaduganathan M, et al. (2022) 2. Cao, Z., et al. (2025) 3. Cassidy, S et al. (2018) 4. Ji, Hongwei et al. (2024)
Read CV Alba HernandezECSS Paris 2023: OP-MH48