Vol. 12. Núm. 37.
Páginas 2232-2242 (Junio 2017)

Actualización
Actualización en rehabilitación cardíaca y prevención secundaria

Updating in cardiac rehabilitation and secondary prevention

A. Berenguel SenénC. Martín SierraM. Gallango Brejano
Doi : https://10.1016/j.med.2017.06.022
Opciones
Resumen
Introducción

La rehabilitación cardíaca es la principal intervención para implementar la prevención secundaria. El manejo es multidisciplinar, basado en el ejercicio, la educación, el control de los factores de riesgo y el fomento de la adherencia.

Programas de rehabilitación

La enfermedad coronaria es la patología más rehabilitada pero casi todas las cardiopatías son susceptibles de participar en un programa. Disminuyen la mortalidad cardiovascular, mejoran el control de los factores de riesgo, la calidad de vida, la reinserción laboral y todo ello con la relación coste/beneficio más favorable de todos los tratamientos utilizados en cardiópatas

Seguridad

La estratificación de riesgo es clave para alcanzar la máxima eficacia y seguridad. El gran reto es la fase III, con la perpetuación de los hábitos adquiridos durante el resto de la vida. Las nuevas tecnologías pueden ayudar en el futuro para garantizar el éxito a largo plazo.

Palabras clave
Rehabilitación cardíaca
Prevención secundaria
Ejercicio físico
Adherencia
Abstract
Introduction

Cardiac rehabilitation is the principal intervention to implement secondary prevention. Management is multi-disciplinary, based on exercise, education, monitoring risk factors and encouraging adherence.

Rehabilitation programmes

Coronary heart disease has the highest rehabilitation but almost all heart diseases are candidates for participation in a programme. These programmes reduce cardiovascular mortality, improve control of risk factors, quality of life, return to work and have the highest cost-benefit ratio of all treatments used in heart disease.

Safety

Risk stratification is key to achieving maximum efficacy and safety. Phase III poses the greatest challenge, in the maintenance of life-long habits. The new technologies can help in the future to ensure long-term success.

Keywords
Cardiac rehabilitation
Secondary prevention
Physical exercise
Adherence

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Bibliografía
[1]
201707010024172348
M. Nichols, N. Townsend, R. Luengo Fernández, J. Leal, A. Gray, P. Scarborough, European Cardiovascular Disease Statistics 2012., et al.
European Heart Network, Brussels and European Society of Cardiology.
Sophia Antipolis, (2012),
[2]
201707010024172349
I. Ferreira-González.
Epidemiologia de la enfermedad coronaria.
Rev Esp Cardiol., (2014), 67 pp. 139-144
[3]
L.B. Newman, M.F. Andrews, M.O. Koblish, L.A. Baker.
Physical medicine and rehabilitation in acute myocardial infarction.
Arch Intern Med., (1952), 89 pp. 552-561
[4]
J.N. Morris, M.D. Crawford.
Coronary heart disease and physical activity of work.
Brit Med J., (1958), 2 pp. 1485
[5]
2017070100241723410
World Health Organisation, Regional office for europe: The rehabilitaton of patients with cardiovascular disease. Report of a seminar. Copenhagen, EURO 0381. 1969.
[6]
H. Ilarraza, J. Myers, W. Kottmann, H. Rickli, P. Dubach.
An evaluation of training responses using self-regulation in a residential rehabilitation program.
J Cardiopulm Rehabil., (2004), 24 pp. 27-33
[7]
2017070100241723411
2017070100241723412
N.B. Oldridge, G.H. Guyat, M.E. Fischer, A.A. Rimm.
Cardiac rehabilitation after myocardial infarction. Combined experience of randomized clinical trials.
JAMA., (1988), 260 pp. 945-950
[8]
2017070100241723413
2017070100241723414
G.T. O’Connor, J.E. Buring, S. Yusuf, S.Z. Goldhaber, E.M. Olmstead, R.S. Pafenbarger Jr., et al.
An overview of randomized trials of rehabilitation with exercise after myocardial infarction.
Circulation., (1989), 80 pp. 234-244
[9]
2017070100241723415
2017070100241723416
J.M. Maroto, R. Artigao, M.D. Morales, C. de Pablo, V. Abraira.
Rehabilitación cardíaca en pacientes con infarto de miocardio. Resultados tras 10 años de seguimiento.
Rev Esp Cardio., (2005), 58 pp. 1181-1187
[10]
R. Hambrecht, C. Walther, S. Mobius-Winckler, S. Gieler, A. Linke, K. conradi, et al.
Percutaneous coronary angioplasty compared with exercise training in patients with coronary artery disease.
Circulation., (2004), 109 pp. 1371-1378
[11]
2017070100241723417
American Association of Cardiovascuar and Pulmonary Rehabilitation. Guidelines for cardiac rehabilitation and secondary prevention programs. 5ª ed. 2013.
[12]
2017070100241723418
2017070100241723419
J.A. Velasco, J. Cosin, J.M. Maroto, J. Muñiz, J.A. Casasnovas, I. Plaza, et al.
Guías de práctica clínica de la Sociedad Española de Cardiología en prevención cardiovascular y rehabilitación cardíaca.
Rev Esp Cardiol., (2000), 53 pp. 1095-1120
[13]
2017070100241723420
T. Kavanagh, D.J. Mertens, L.F. Hamm, J. Beyene, J. Kennedy, P. Corey, et al.
Prediction of long-term prognosis in 12169 men referred for cardiac rehabilitation.
Circulation., (2002), 106 pp. 666-671
[14]
2017070100241723421
J. Myers, M. Prakash, V. Froelicher, D. Do, S. Partington, J.E. Atwood.
Exercise capacity and mortality among men referred for exercise testing.
N Engl J Med., (2002), 346 pp. 793-801
[15]
2017070100241723422
2017070100241723423
European Association of Cardiovascular Prevention and Rehabilitation Committee for Science Guidelines EACPR, Corrà U, Piepoli MF, Carré F, Heuschmann P, Hoffmann U, Verschuren M, et al. Secondary prevention through cardiac rehabilitation: physical activity counselling and exercise training: key components of the position paper from the Cardiac Rehabilitaton Section of the European Association of Cardiovascular Prevention and Rehabilitation. Eur Heart J.;1; 2010; 31:1967-74.
[16]
J. López Chicharro, A. Fernández Vaquero.
Fisiología del ejercicio.
3rd ed., Editorial Médica Panamericana, (2006),
[17]
2017070100241723424
A. Mezzani, P. Agostoni, A. Cohem-Solal, U. Corrà, A. Jegier, E. Kouidi, et al.
Standards for the use of cardiopulmonary exercise testgingfor the functional evaluation of cardiac patients: a report from the Exercise Phisiology Section of the European Associationfor Cardiovascular Prevention and Rehabilitation.
Eur J Cardiovasc Prev Rehabil., (2009), 16 pp. 249-267
[18]
K. Villelabeitia Jaureguizar, I. Diaz Buschmann, E. Vaquerizo García, J. Castillo Martin, I. Mahillo Fernandez, M. Abeytua Jiménez.
Protocolo Bruce: errores habituales en la evaluación de la capacidad funcional y en el diseño de un entrenamiento físico en la cardiopatía isquémica.
Rehabilitación., (2013), 47 pp. 162-169
[19]
B.E. Jensen, B.J. Fletcher, J.C. Rupp, G.F. Fletcher, J.Y. Lee, A. Oberman.
Training level comparison study. Effect of high and low intensity exercise on ventilatory treshold in men with coronary artery disease.
J Cardiopulm Rehabil., (1996), 16 pp. 227-232
[20]
N.N. Mahieu, P. Mcnair, M. de Muynck, V. Stevens, I. Blanckaert, N. Smits, et al.
Effect of static and ballistic strechting on the muscletendontissue properties.
Med Sci Sports Exerc., (2007), 39 pp. 494-501
[21]
2017070100241723425
W.L. Haskell.
Cardiovascular complications during exercise training of cardiac patients.
Circulation., (1978), 57 pp. 920-924
[22]
2017070100241723426
S.P. Van Camp, R.A. Peterson.
Cardiovascular complications of out patients cardiac rehabilitation programs.
JAMA., (1986), 256 pp. 1160-1163
[23]
K. Rees, R.S. Taylor, S. Singht, A.J. Coats, S. Ebrahhim.
Exercise based rehabilation for heart failure.
Cochrane Database Syst Rev., (2004), 3
CD003331
[24]
L. Vanhees, B. Rauch, M. Piepoli, F. van Buuren, T. Takken, M. Börjesson, et al.
Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular disease (Part III).
Eur J Cardiolvasc Prev Rehabil., (2012), 19 pp. 1333-1356
[25]
2017070100241723427
R. Hambrecht, J. Niebauer, C. Marburger, M. Grunze, B. Kälberer, K. Hauer, et al.
Various intensities of leisure time physical activity in patients with coronary artery disease: effects on cardiorespiratory fitness and progression of coronary atherosclerotic lesions.
J Am Coll Cardiol., (1993), 22 pp. 468-477
[26]
B.S. Cornish.
Interval training for patients with coronary artery disease: a systematic review.
Eur J Appl Physiol., (2010), 10 pp. 1682-1685
[27]
R. Arena, J. Myers, D.E. Forman, C.J. Lavie, M. Guazzi.
Should high intensity aerobic interval training become the clinical standard in heart failure?.
Heart Fail Rev., (2013), 18 pp. 95-105
[28]
2017070100241723428
2017070100241723429
A. Mezzani, L.F. Hamm, A.M. Jones, P.E. Mcbride, Moholdt t, J.A. Stone, et al.
Aerobic exercise intensity assessment and prescription in cardiac rehabilitation: A joint position statement of the European Association for Cardiovascular Prevention and Rehabilitation, the American Association of Cardiovascular and Pulmonary Rehabilitation, and the Canadian Association of Cardiac Rehabilitation.
J Cardiopulm Rehabil Prev., (2012), 32 pp. 327-350
[29]
2017070100241723430
2017070100241723431
F. Fletcher, P.A. Ades, P. Kligfield, R. Arena, G.J. Balady, V.A. Bittner, et al.
Exercise standards for testing and training: a scientific statement from the American Heart Association.
Circulation., (2013), 128 pp. 873-893
[30]
2017070100241723432
Exercise prescription for patients with cardiovascular and cerebrovascular disease.
ACSM's guidelines for exercise testing and prescription, Wolters Kluwer/Lippincott Williams and Wilkins, pp. 236-259
[31]
2017070100241723433
N. Galie, M. Humbert, J.R. Vachiery, S. Gibbs, I. Lang, A. Torbicki, et al.
2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension.
Kardiol Pol., (2015), 73 pp. 1127-1206
[32]
2017070100241723434
2017070100241723435
American Association of Cardiovascular and Pulmonary Rehabilitation; American College of Cardiology Foundation; American Heart Association Task Force on Performance Measures (writing committee to develop clinical performance measures for cardiac rehabilitation), Thomas RJ, King M, Lui K, Oldridge N, Piña Il, Spertus J. AACVPR/ACCF/AHA 2010 Update: Performance Measures on Cardiac Rehabilitation for Referral to Cardiac Rehabilitation/Secondary Prevention Services Endorsed by the American College of Chest Physicians, the American College of Sports Medicine, the American Physical Therapy Association, the Canadian Association of Cardiac Rehabilitation, the Clinical Exercise Physiology Association, the European Association for CardiovascularPrevention and Rehabilitation, the Inter-American Heart Foundation, the National Association of Clinical Nurse Specialists, the Preventive Cardiovascular Nurses Association, and the Society of Thoracic Surgeons. J Am Coll Cardiol. 2010; 56(14):1159-67.
[33]
N.B. Oldridge.
Cardiac rehabilitation exercise programme: compliance and comliance-enhancing strategies.
Sports Med., (1988), 6 pp. 42-55
[34]
R. Currell, C. Urquhart, P. Wainwrigth, R. Lewis.
Telemedicine versus face to face patient care: effects on professional practice and health care outcomes.
Cochrane Database Syst Rev., (2000), 2
CD002098