https://doi.org/10.4081/monaldi.2015.739
Cardiopulmonary rehabilitation in patiens with heart failure and chronic pulmonary disease
Accepted: May 24, 2016
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Authors
The epidemiology of chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) are well known. Each of these conditions has an important impact on quality of life and functional status and on healthcare consumption. Through shared risk factors and pathophysiological mechanisms CHF and COPD coexist more frequently than expected from the respective populations observed by the pulmonologist or cardiologist. This has important prognostic and therapeutic implications. Several registry-based studies and post-hoc analyses of large randomized controlled trials evaluating COPD as a comorbidity in CHF outpatients have highlighted the negative prognostic impact of the comorbidity in terms of constraint in use of recommended treatments. Among them, the cardiopulmonary rehabilitation may play a significant role. Even in these patients, in fact, a rehabilitative approach focused on physical training programs can positively impact functional autonomy, exercise tolerance and quality of life.
Riassunto
Attraverso i fattori di rischio condivisi e simili meccanismi fisiopatologici scompenso cardiaco cronico (SCC) e malattia ostruttiva cronica polmonare (BPCO) coesistono più frequentemente di quanto previsto dalle rispettive popolazioni osservate rispettivamente dallo pneumologo o dal cardiologo. Ciò ha importanti implicazioni prognostiche e terapeutiche. Diversi studi basati su registri e analisi post-hoc di ampi studi randomizzati controllati che hanno valutato la BPCO come comorbidità in pazienti con SCC hanno messo in evidenza l'impatto prognostico negativo della comorbilità in termini soprattutto di limitazioni all’utilizzo di trattamenti raccomandati. Tra questi un ruolo non trascurabile spetta alla riabilitazione. Anche in questi pazienti infatti un approccio riabilitativo incentrato su programmi di training fisico può impattare favorevolmente sulla autonomia funzionale, sulla tolleranza allo sforzo e sulla qualità della vita.
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