Supervisors info:
Νανάς Σεραφείμ, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Ροβίνα Νικολέττα, Επίκουρη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Βασιλειάδης Ιωάννης, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Introduction: Heart Failure (HF) and Acute Coronary Syndrome (ACS) are two modern cardiac diseases (which endemic in our country) with high mortality rates despite optimal drug treatment and multiple social and economic consequences. It has also been proven by numerous studies that the exercise and the participation of patients with HF and ACS in organized rehabilitation programs significantly contributes to better recovery and improved quality of life. Exercise through its muscular strengthening improves respiratory function, while improving endothelial function contributes significantly to the regulation of Hypertension and Diabetes, and finally meliorates the clinical status of patients with HF and ACS.
Purpose: The purpose of this study is to investigate whether modern cardiologists (hospital and private doctors) recommend exercise or organized rehabilitation programs to patients with HF or ACS as a means of recovery in addition to classical medication. Finally, we will record whether and to what extent patients are participating / benefiting from such rehabilitation or exercise programs
Method-Material: Our study included 25 patients with ACS and 25 patients with HF independently ejection fraction (EF) (reduce EF <50% or preserve EF> 50%), age, sex, weight, nationality, and insurance capacity. They were asked to complete a specially designed questionnaire customized to each condition. The 50% of the patients in the study came from hospital clinics and GPs, 25% from private clinics and 25% from Health Centers. Patients who completed the ACS questionnaire and those who received the HF were distinguished after consultation with the clinicians who performed the screening.
Results: After completing the questionnaires, the statistical analysis revealed the following: It was found that physicians doctors recommend rehabilitation and intensive care in patients with OSA and CA at a rate of 26% + 10% = 36% compared to hospital recommendation of only 6 % + 2% = 8% of patients. Of particular concern are the rates where 44% of hospital and 34% of private cardiologists make no recommendation in the field of exercise . It is worth mentioning that the hospital doctors do not recommend exercise at a rate of 52% in the subgroup of patients with HF. While the recommendation rates for participation in rehabilitation programs are 36% of cardiac patients, the 35.7% of them refused to participate, resulting in a final disappointing rate of 18%. The main reasons that discouraged them were lack of time (60%), financial situation (20%), distance (20%), lack of medical attention (20%). On the other hand, the rest of the participants said they were satisfied / benefited by 93.3% as they improved their fitness, their fatigue tolerance, their psychology as well as the feeling of shortness of breath in the effort. From the study of more specialized parameters such as EF (ejection fraction) in HF and ACS subgroups, clinicians recommend primarily exercise in patients with ACS and EF> 50% at rates of 60%, as opossed to the 15,4% of people with ACS and EF <50%.In contrast, physicians recommend exercise primarily in patients with HF and EF <50% at rates to 43%, as opposed to 14.3% of patients with HF and EF> 50%.
Conclusion: The study showed that exercise and rehabilitation are not a top priority in the modern cardiologist's awareness of the treatment of cardiovascular diseases. On the contrary, its prescription rates have proved to be particularly low, mainly in the hospital sector. Much needs to be done at both economic, informational, social and medical levels so that exercise and rehabilitation can be a reference point in the treatment of cardiovascular disease.
Keywords:
Rehabilitation, Exercise, Heart Failure, Acute Coronary Syndromes
