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Background: It has been suggested that the autonomic system function and the metabolic syndrome can significantly affect patients' survival. The aim of the current study was to investigate the impact of the CARDIAC REHABILITATION PROGRAM on the autonomic system balance in patients with coronary artery disease.Methods: Patients with a previous diagnosis of coronary artery disease who were referred to the Cardiovascular REHABILITATION Center of Afshar Hospital (Yazd, Iran) between March and November 2011 were enrolled. All the patients participated in REHABILITATION sessions 3 times a week for 12 weeks. Heart rate recovery (HRR) was measured as an indicator of the autonomic system balance. In order to calculate HRR, the maximum heart rate during the exercise test was recorded.At the end of the exercise test, the patients were asked to sit down without having a cooldown period and their heart rate was recorded again after 1 minute. The difference between these 2 measurements was considered as HRR.Results: A total of 108 patients, including 86 (79.6%) men and 22 (20.4%) women, completed the REHABILITATION course.The mean age of the study participants was 58.25 ± 9.83 years. A statistically significant improvement was observed in HRR (p value=0.040). Significant declines were also observed in the patients' waist circumference (p value<0.001) and systolic and diastolic blood pressures (p value=0.018 and 0.003, respectively). A decreasing trend was observed in the patients' body mass index, but it failed to reach statistical significance (p value=0.063). No statistically meaningful changes were noted in fasting blood glucose (p value=0.171), high-density lipoprotein (p value=0.070), or triglyceride concentrations (p value=0.149).Conclusion: The CARDIAC REHABILITATION PROGRAM may help to improve HRR and several components of the metabolic syndrome in patients with coronary heart disease.

Background: Anxiety is one of the most primary and common reactions to a CARDIAC event can lead to hypertension, tachycardia, and high CARDIAC output.Objectives: To investigate the predictors of clinical anxiety aggravation at the end of a CARDIAC REHABILITATION (CR) PROGRAM.Patients and Methods: This retrospective study used a database of a CR ward of a hospital in Iran. The demographic and clinical information of 574 patients participating in the CR PROGRAM from April 2005 through April 2010 were analyzed. In order to determine the predictors of anxiety, binary logistic regression was performed.Results: After adjustment for gender, age and education, the results showed that 16.7% of the patients completed their CR PROGRAM with increased levels of clinical anxiety. The following study variables were independently predictive of increased anxiety at the end of the CR PROGRAM: male gender (OR=2.04, 95% CI=1.11 to 3.33, P=0.048), no history of diabetes (OR=4.24, 95% CI=172 to 10.44, P=0.002), family history of CARDIAC disease (OR=2.63, 95% CI=1.03 to 6.74, P = 0.043), and not quitting smoking (OR=3.29, 95% CI=1.38 to 7.85, P=0.007). These variables could explain 9%-15% of the variance in the dependent variable.Conclusions: It is possible to predict higher anxiety levels at the end of the CR PROGRAM and implement preventive measures to control anxiety by considering certain demographic and clinical variables. Future studies should assess the predictive power of other variables.

Background: Uncompleted CARDIAC REHABILITATION (CR) schedule may lead to recurrence of CARDIAC events and its-related re-hospitalization, decreased quality of life and increased risk of co-morbidities. Current study came to address the effects of a complete exercise-based CR PROGRAM on physical function and CARDIAC parameters to clarify whether different sessions could result in better health condition.Methods: Data were collected prospectively on 16 consecutive patients who underwent coronary artery bypass graft surgery and enrolled in an exercise-based CR PROGRAM. The charts of the patients who attended 10 sessions of CR were reviewed as the case group (n=8) and those who participated in at least 20 sessions of PROGRAM were reviewed as the control group (n=8). Both groups received services of a multi-disciplinary CR and CARDIAC parameters were measured at baseline, as well as at the completion of 10 and 20 sessions.Results: It was revealed significant increases from baseline to follow-up for metabolic equivalents in both groups after attending CR PROGRAMs; however increases of this index were higher following 20 sessions adjusted for baseline characteristics. Resting heart rate was significantly decrease in the group underwent completed CR PROGRAM in the presence of main confounders; however this parameter was significantly unchanged in another group.Conclusion: Participation in complete CR PROGRAM is necessary to make achieving optimal improvement in vital indices such as metabolic equivalents and resting heart rate and therefore incomplete CR sessions may not warrant this efficacy.

Background: CARDIAC REHABILITATION has been recognized as one of the most effective strategies for managing cardiovascular indices as well as controlling the cardiovascular risk profile, in particular after coronary artery bypass graft surgery (CABG).However, the effect of this PROGRAM on right ventricular function following CABG is unclear. The aim of this study was to evaluate the impact of CARDIAC REHABILITATION on the right ventricular (RV) function in a cohort of patients who underwent CABG.Methods: A total of 28 patients who underwent CABG and participated consecutively in an 8-week CARDIAC REHABILITATION PROGRAM at Tehran Heart Center were studied. The control group consisted of 39 patients who refused to attend CARDIAC REHABILITATION and only received postoperative medical treatment after registration in the CARDIAC REHABILITATION Clinic. Two dimensional and Doppler echocardiography was performed to assess the RV function in both groups at the three time points of before surgery, at the end of surgery, and at the end of the REHABILITATION PROGRAM.Results: Significant increase of RV function parameters were observed in both REHABILITATION group (RG) and control group (CG) at the end of the REHABILITATION PROGRAM compared with post-CABG evaluation in terms of tricuspid annular plane systolic execution (RG: 12.50 mm to 14.18 mm, CG: 13.41 mm to 14.56 mm), tricuspid annular peak systolic velocity (RG: 8.55 cm/s to 9.14 cm/s, CG: 9.03 cm/s to 9.26 cm/s), and tricuspid annular late diastolic velocity (RG: 8.93 cm/s to 9.39 cm/s, CG: 9.26 cm/s to 9.60 cm/s). The parameters of the RV function did improve in both groups, but this improvement was not associated with participation in the complete CARDIAC REHABILITATION PROGRAM.Conclusion: The RV function parameters gradually improved after CABG, this progress, however, was independent of the exercise-based CARDIAC REHABILITATION PROGRAM.

Introduction: Chronic Total Coronary Occlusion has a high risk of mortality associated with Acute Coronary Syndrome with significantly ventricular disfunction reflected in functional class patient by intolerance to perform physical effort. The Percutaneous Coronary Intervention is the gold standard approach, but in many patients this procedure is not successful. CARDIAC REHABILITATION and Secondary Prevention PROGRAMs has showed improve the patient's ability to perform physical effort by its positive effect on endothelial function and promote angiogenesis, increasing the ischemic threshold. We evaluate the CARDIAC REHABILITATION and Secondary Prevention PROGRAM effect on myocardial performance and ischemic profile in successful and unsuccessful Chronic Total Occlusion Percutaneous Coronary Intervention patients. Materials and Methods. A non-randomized clinical trial was conducted in patients with CTCO underwent to Percutaneous Coronary Intervention (PCI). Patients were divided into two groups: 1) With successful PCI and 2) With unsuccessful PCI. All patients underwent a Sestamibi-Dipyridamole CARDIAC scan and stress test before and after of CRH&SP. The CARDIAC REHABILITATION PROGRAM considered 4-6 weeks of 5 weekly 30-minute training sessions with aerobic at 70% of Heart Resistance Reserve (HRR), with interspersed 3 weekly strength training sessions, as well as nutritional and Psychiatric group interventions. Results. We evaluated 25 patients with successful PCI (n = 13) and unsuccessful PCI (n = 12). For both groups, the CRH&SP showed significant improvement (p <0. 05) in myocardial performance parameters, ischemic profile, and physical effort tolerance, with a Cohen's Delta ≥,80% in Nuclear Medicine Risk, NYHA functional class, METs reached, oxygen consumption, Myocardial Efficacy Index and Duke Score. Conclusions. The CRH&SP has a high positive effect on ventricular function improvement, myocardial performance, and ischemic profile in patients with Chronic Total Coronary Occlusion.