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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 20 October 2025 | Viewed by 5532

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Special Issue Editor

Dr. Tomasz Rechciński

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Guest Editor

1st Department of Cardiology, Medical University of Lodz, 91-347 Lodz, Poland
Interests: cardiac rehabilitation; myocardial infarction; heart failure; atherosclerosis

Special Issue Information

Dear Colleagues,

The rapid development of new interventional, pharmacological, and biological methods of treating cardiovascular diseases has meant that, in recent decades, we have seen the extension of human life and the improvement of its quality during therapy. Comprehensive cardiac rehabilitation was first defined by the WHO in 1963; despite the passage of six decades since then, it still does not require redefinition—“it is the coordinated sum of the activities needed to influence favorably the underlying cause of cardiovascular disease, as well as to provide the best possible physical, mental, and social conditions, so that the patients may, by their efforts, preserve or resume best functioning in their community and through improved health behavior, slow or reverse progression of the disease”.

Despite obtaining class I recommendations in the management of patients after acute coronary syndrome or after hospitalization due to heart failure, we still see insufficient use of this method of culminating in-hospital treatment.

In this Special Issue, we want to present the latest achievements in cardiac rehabilitation and create a platform for exchanging experiences between centers conducting this form of treatment. We invite cardiologists, internists, physiotherapists, psychologists, and all specialists involved in the rehabilitation process after the treatment of heart and vascular diseases to send their works, among which original works and review articles are welcome.

Dr. Tomasz Rechciński
Guest Editor

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Keywords

cardiac rehabilitation
kinesiotherapy
psychological support
lifestyle modifications
myocardial infarction
heart failure

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Published Papers (6 papers)

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Research

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11 pages, 752 KB

Open AccessArticle

Effect of Introducing a Mini-Ergometer to the Ward Due to the COVID-19 Pandemic-Imposed Restrictions on Rehabilitation Centers on Physical Function: Cardiac Rehabilitation of Patients with Heart Failure

by Etsuko Mori, Hideki Ishii, Hirotaka Matsuura, Yuji Kono, Yoichiro Aoyagi, Rio Shimizu, Tomoyasu Hiratsuka, Yoshihiro Sobue, Eiichi Watanabe and Hitoshi Kagaya

J. Clin. Med. 2025, 14(17), 5922; https://doi.org/10.3390/jcm14175922 - 22 Aug 2025

Viewed by 359

Abstract

Background/Objectives: The COVID-19 pandemic restrictions had negative effects on cardiac rehabilitation. The difference in the location of cardiac rehabilitation practice during the COVID-19 pandemic decreased the amount of aerobic exercise and the patient’s physical function at discharge. Therefore, we introduced a mini-ergometer to the ward to provide quantitative aerobic exercise. This study aimed to evaluate physical function at discharge after the introduction of a mini-ergometer to the ward in patients with heart failure. Methods: We included a total of 117 consecutive patients who were admitted to a university hospital and underwent a cardiac rehabilitation program for heart failure between June 2020 and September 2022. Patients were divided into two groups: Group A (n = 54), which included those admitted before the introduction of the mini-ergometer, and Group B (n = 63), which included those admitted after the introduction of the mini-ergometer. Data, including age, sex, and functional status, were obtained. Additionally, the duration of each rehabilitation exercise was measured. Results: Group B had a significantly higher 6 min walking distance at discharge than Group A (Group A: 236.0 m vs. Group B: 290.0 m, p = 0.020). Furthermore, Group B had a significantly longer ergometer exercise duration than Group A (Group A: 0 min vs. Group B: 25.0 min, p < 0.001). Conclusions: The results showed that the introduction of the mini-ergometer to the ward could ensure quantitative exercise loads even under restricted access to rehabilitation centers during the COVID-19 outbreak, thereby improving physical function at discharge in patients with heart failure. Full article

(This article belongs to the Special Issue Recent Clinical Advances in Cardiac Rehabilitation)

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14 pages, 1900 KB

Open AccessArticle

Implementation of a Hybrid Cardiac Rehabilitation and Symptom Scoring System in Patients with Inappropriate or Postural Sinus Tachycardia Referred for Sinus Node Sparing Hybrid Ablation

by Marta Kornaszewska, Aleksandra Wilczek-Banc, Anna Ratajska, Ewa Piotrowicz, Bartosz Szkaradek, Mariusz Kowalewski, Piotr Suwalski, Natalia Ogorzelec, Antoni Wileczek, Magdalena Zając, Michał Pastyrzak and Sebastian Stec

J. Clin. Med. 2025, 14(16), 5879; https://doi.org/10.3390/jcm14165879 - 20 Aug 2025

Viewed by 535

Abstract

Background/Objectives: Patients with inappropriate sinus tachycardia (IST) and postural orthostatic tachycardia syndrome (POTS) exhibit complex clinical profiles due to autonomic dysfunction. While sinus node sparing (SNS) hybrid ablation is emerging as a promising therapy, there are no established guidelines worldwide for post-procedure patient management and care is mainly based on telemonitoring. In contrast, our hybrid cardiac rehabilitation (HCR) program integrates inpatient care and home-based telerehabilitation. We aim to evaluate the implementation of the HCR program, patient acceptance and adherence, and the effectiveness of the Malmö POTS scoring system in monitoring disease progression and rehabilitation outcomes. Methods: Patients underwent a personalized HCR program after SNS. The program included early mobilization, psychological support, respiratory therapy, and structured exercise. Clinical outcomes were assessed using symptom burden (Malmö POTS score), ECG parameters, exercise duration, perceived exertion, and rehabilitation adherence. Results: All patients completed the inpatient phase, and 87% completed the home-based phase. In the early postoperative period, pericarditis, anemia, and benign rhythm disturbances were mild and self-limiting. The Malmö POTS score decreased from 65.3 to 25.7. Lower perceived exertion early in the program correlated with clinical improvement. At the 2-month follow-up, 81% of patients no longer met the clinical criteria for IST/POTS without the use of medications. The program was evaluated as safe, feasible, and well-tolerated, with high patient satisfaction. Conclusions: A well-organized hybrid cardiac rehabilitation program after SNS is feasible, safe, and well-tolerated in IST/POTS patients. The Malmö POTS score may support outcome monitoring. The integration of individualized training and telemedicine represents a promising development for patients post-SNS ablation. While this study demonstrates feasibility and potential benefits, further controlled studies are needed to evaluate its impact on long-term recovery and symptom control. Full article

(This article belongs to the Special Issue Recent Clinical Advances in Cardiac Rehabilitation)

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11 pages, 2239 KB

Open AccessArticle

Cardiac Telerehabilitation After Acute Coronary Syndrome Ensures Similar Improvement in Exercise Capacity as Inpatient Rehabilitation, Regardless of the Age Profile of the Compared Groups

by Barbara Bralewska, Julia Wykrota, Małgorzata Kurpesa, Jarosław D. Kasprzak, Urszula Cieślik-Guerra, Ewa Wądołowska and Tomasz Rechciński

J. Clin. Med. 2025, 14(9), 3143; https://doi.org/10.3390/jcm14093143 - 1 May 2025

Viewed by 856

Abstract

Introduction: During the COVID-19 pandemic, the availability of cardiac rehabilitation (CR) was limited. On the other hand, during that period of epidemic restrictions, patients with acute coronary syndrome (ACS) required careful control and monitoring after coronary events. The aim of this study was to assess whether CR conducted during the epidemic restrictions in a remote mode ensured similar improvement in physical performance as CR conducted in a centre-based mode before the COVID-19 pandemic. Material and Methods: In this one-centre study, we compared the demographic and clinical profiles of patients after ACS who completed inpatient CR before the COVID-19 era with those of patients who completed telerehabilitation during the COVID-19 pandemic. We assessed the workload on the initial and final exercise tests (ExT) obtained by patients and compared the values of the differences between the final and initial ExT. The study included 359 patients (pts) participating in inpatient CR before October 2020 (the suspension of centre-based CR) and 60 pts who took part in telerehabilitation after July 2021 (the introduction of the tele-CR programme). Both inpatient and tele-CR were performed according to the guidelines of the Working Group for Cardiac Rehabilitation of the National Cardiac Society. A telemedic platform was used to control ECG, blood pressure and body mass of the pts participating in telerehabilitation. Results: The improvement of physical performance did not differ significantly between the two groups. The pts who completed telerehabilitation were significantly older than those who completed inpatient CR. The values of other parameters, such as the percentage of females, BMI, the percentage of pts with arterial hypertension and type 2 diabetes mellitus, as well as left ventricular ejection fraction did not differ significantly between the compared groups. Nor did the results of initial ExT expressed in METs, the results of final ExT and the improvement of workload understood as the difference between the final and initial results of ExT differ significantly—they were 7.7 ± 3.06 vs. 7.89 ± 2.98 with p = 0.82; 9.08 ± 0.29 vs. 8.98 ± 3.48 with p = 0.84, and 1 [0–2.2] vs. 1.2 [0–1.8] with p = 0.17, respectively. Conclusions: In our centre, telerehabilitation after acute coronary syndrome guaranteed an equally good improvement in physical capacity as that observed in inpatient CR patients, regardless of the difference in the age profile of the compared groups. These results encourage the popularization of telerehabilitation with remote monitoring of ECG, blood pressure and body mass. Full article

(This article belongs to the Special Issue Recent Clinical Advances in Cardiac Rehabilitation)

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18 pages, 1384 KB

Open AccessArticle

Randomized Trial: A Pilot Study Investigating the Effects of Transcendental Meditation and Yoga Through Retinal Microcirculation in Cardiac Rehabilitation

by Adam Saloň, Karin Schmid-Zalaudek, Bianca Steuber, Maximilian Elliot Rudlof, Till Olaf Bartel, Petra Mächler, Andreas Dorr, Rainer Picha, Per Morten Fredriksen, Benedicta Ngwenchi Nkeh-Chungag and Nandu Goswami

J. Clin. Med. 2025, 14(1), 232; https://doi.org/10.3390/jcm14010232 - 3 Jan 2025

Cited by 2 | Viewed by 1758

Abstract

Background/Objectives: Cardiovascular diseases are a leading cause of death, and psychosocial stress is considered a contributing factor to these issues. With the rising number of heart surgeries, proper rehabilitation post-surgery is essential. Previous studies have demonstrated the positive impact of yoga and transcendental meditation on the cardiovascular system. This pilot study aimed to investigate the effects of yoga and transcendental meditation on retinal microcirculation in cardiac patients before (admission), after (discharge), and following (3 weeks after discharge) rehabilitation. Methods: This study examined changes in retinal microcirculation in three rehabilitation groups of patients after heart surgery. The control group received standard exercise therapy, while the meditation group incorporated 20 min of meditation, and the yoga group incorporated 20 min of yoga practice, twice per day for the duration of four weeks of rehabilitation. Retinal images were captured using a non-mydriatic digital retinal camera (Canon CR-2, Canon Medical Systems Europe B.V., Netherlands), and the microcirculation parameters central retinal artery equivalent, central retinal vein equivalent, and artery-to-vein ratio were analyzed using MONA REVA software ((version 2.1.1), VITO, Mol, Belgium). Repeated measures ANOVA was performed to evaluate differences between the three groups in the course of rehabilitation. Results: None of the parameters revealed significant differences in retinal microcirculation between the three rehabilitation groups. Conclusions: The study evaluating changes in retinal microcirculation, as an indicator of central circulation in cardiac patients undergoing rehabilitation, did not observe any significant changes. As yoga and meditation are underestimated approaches in cardiac rehabilitation, this pilot study acts as a basis for providing preliminary information for future studies to encourage the research community to fill the gap in this area. Full article

(This article belongs to the Special Issue Recent Clinical Advances in Cardiac Rehabilitation)

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Review

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14 pages, 1373 KB

Open AccessReview

Impact of Family Involvement in Cardiac Rehabilitation—Insights from a Literature Review

by Gabriela Popescu, Alexandra Maștaleru, Andra Oancea, Alexandru-Dan Costache, Cristina Andreea Adam, Carmen Rîpă, Carmen Marinela Cumpăt and Maria Magdalena Leon

J. Clin. Med. 2025, 14(18), 6468; https://doi.org/10.3390/jcm14186468 (registering DOI) - 13 Sep 2025

Abstract

Conventional medicine relies solely on the interaction between the doctor and the patient, not necessarily including the family in discussions about therapy and diagnosis. Nevertheless, recent research indicates that the presence of a family member during a doctor’s visit improves both communication between the doctor and the patient, as well as the patient’s understanding of information related to their health condition. Additionally, by adopting this approach, family members can better understand what obligations arise at this stage and the patient’s needs. Studies have shown that collaboration with family members has significantly reduced mortality rate and improved their quality of life, as the family strengthened their confidence in their abilities by providing moral and emotional support. Even though family support and involvement seem to be very important, sometimes patients have reported that overly active family involvement becomes intrusive, as it violates their privacy and disrupts their autonomy. That is why it is important for family members directly involved in recovery to learn to respect the boundaries set by the patient. Both the patient and their family experience stressful moments during this recovery period, which necessitate their attention. The involvement of family members in the recovery process reduces their levels of anxiety and stress, as they can closely monitor the patient’s progress. Additionally, integrating family members into the rehabilitation program can provide further benefits for the patient, as the presence of a family member leads to increased comfort and motivation. Full article

(This article belongs to the Special Issue Recent Clinical Advances in Cardiac Rehabilitation)

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25 pages, 2341 KB

Open AccessReview

Mitochondrial Bioenergetics and Cardiac Rehabilitation: Bridging Basic Science and Clinical Practice

by Angela Dziedzic, Klaudia Marek, Piotr Niebrzydowski, Dominika Szalewska, Patrycja Nowak and Elżbieta Miller

J. Clin. Med. 2025, 14(11), 3949; https://doi.org/10.3390/jcm14113949 - 3 Jun 2025

Viewed by 1255

Abstract

Cardiovascular diseases (CVDs) are the leading cause of global morbidity and mortality, underscoring the necessity of long-term secondary prevention strategies such as comprehensive cardiac rehabilitation (CR). CR is a clinically validated, cost-effective intervention that mitigates cardiovascular risk, improves functional capacity, and enhances patient prognosis. Emerging evidence emphasizes the pivotal role of mitochondrial bioenergetics in mediating the systemic benefits of exercise-based CR, particularly through mechanisms involving mitochondrial biogenesis, dynamics, and mitophagy. This review synthesizes molecular insights with clinical guidelines by evaluating four national CR guidelines—from Poland, France, the United States, and Portugal—alongside a comprehensive recommendation issued by the European Society of Cardiology (ESC). The analysis focused on key components of CR, including exercise modalities (aerobic, resistance, and high-intensity interval training) and prescription parameters such as frequency, intensity, and duration. Only guidelines fulfilling predefined inclusion criteria with complete and detailed data were included; documents lacking essential information were excluded from the final synthesis. Full article

(This article belongs to the Special Issue Recent Clinical Advances in Cardiac Rehabilitation)

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