Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Exercise and stable coronary artery disease
Document related concepts
Heart failure wikipedia , lookup
Quantium Medical Cardiac Output wikipedia , lookup
Remote ischemic conditioning wikipedia , lookup
Saturated fat and cardiovascular disease wikipedia , lookup
Cardiovascular disease wikipedia , lookup
Drug-eluting stent wikipedia , lookup
Cardiac surgery wikipedia , lookup
History of invasive and interventional cardiology wikipedia , lookup
Management of acute coronary syndrome wikipedia , lookup
Dextro-Transposition of the great arteries wikipedia , lookup
Transcript
Coronary artery disease (CAD) Exercise and stable coronary artery disease Reporter: Finco Wu Adviser: Linda Lin In Taiwan, heart disease is the third cause of death About 80% is related to coronary atherosclerotic and occlusion. 9.3 9.5 2004 9.2 9.6 2003 9.1 9.7 26.8 27.2 27.1 0 10 20 30 Coronary artery disease (CAD) occurs when the arteries that supply blood to the heart muscle (the coronary arteries) become hardened and narrowed. The arteries harden and narrow due to buildup of a material called plaque on their inner walls. Formation of the atherosclerotic plaque Epidemiology of CAD 2005 When coronary artery has be narrowed narrowed by fatty deposits, such as cholesterol and triglycerides, then it can’ can’t supply the heart muscle with oxygen and nutrients. 心臟疾病 腦血管疾病 惡性腫瘤 Formation of the atherosclerotic plaque Formation of the atherosclerotic plaque 氧化性低密度脂蛋白 泡沫細胞 Clinical Features of CAD Arrhythmia(心率不整) Angina(心絞痛) Myocardial infraction(心肌梗塞) Heart failure(心臟衰竭) Sudden cardiac death(猝死) 脂肪性線紋 Risk factors of CAD Abnormal cholesterol profile(>200mg/dl) Risk factors of CAD Abnormal stress or resting electrocardiogram Age(♀>55 years ♂ >45 years) triglycerides (TG)(>150mg/dl) Physical inactivity Elevated homocysteine(同半胱氨酸 ) High-sensitivity C-reactive protein (hs-CRP,高 敏感C反應蛋白)(1~3mg/l or more) HDLHDL-C (<40mg/dl) LDLLDL-C (>100mg/dl) Smoking Excessive body fat (♀>30% ♂ >20%) Hypertension(SBP>130mmHg DBP>85mmHg) Personal and Family history of heart disease Diabetes Treatment of CAD Drug treatment Surgical treatment PTCA(percutaneous transluminal coronary angioplasty) Stent CABG(Coronary Artery Bypass Graphy ) Dietary treatment Exercise treatment Aerobic exercise Resistance exercise Treatment of CAD Drug treatment ACEI (angiotensin-converting enzyme inhibitors ) help to lower blood pressure and reduce strain on your heart. Beta blockers slow your heart rate and lower your blood pressure to decrease the workload on your heart. Beta blockers are used to relieve angina and may also reduce the risk of a future heart attack. Aspirin antiplatelet (U.S. Department of Health & Human Services ) Treatment of CAD Drug treatment Calcium channel blockers relax blood vessels (arteries and veins) and lower your blood pressure. These medicines can reduce your heart's workload, help widen coronary arteries, and relieve and control angina. Nitroglycerin widens the coronary arteries, increasing blood flow to the heart muscle and relieving chest pain. Lipid lowering drugs : statin, fibrate help to reduce your cholesterol to a doctor-recommended level. (U.S. Department of Health & Human Services) Treatment of CAD Surgical treatment PTCA Stent CABG Treatment of CAD Dietary treatment low fat low salt low cholesterol(> 200mg/day) nicotinic acid Exercise treatment aerobic exercise resistance exercise Benefit of Exercise treatment Increase cardiorespiratory endurance Decrease and control blood pressure Reduce body fat Lower blood lipids(cholesterol & TG ) Prevent and control diabetes Aerobic exercise of CAD Model:walking, jogging, bike, arm crank Intensity:70%~85%HRmax or 60%~70%HRR Duration:30min(warm up 5~7min & cool down 5~7min ) Frequency:3~5 times/week Clara et al,2002; Clara et al,2003; Savvas et al, 2003; Paul et al, 2005; Thompson, 2005 Benefit of Exercise treatment Decrease low-grade(hidden) inflammation in the body(hs-CRP) Increase and maintain good heart function Motivation toward somking cessation Alleviate tension and stress Counteract a personal history of heart disease Combine exercise of CAD Model:dynamic resistance training Intensity:40%~60 maximum voluntary contraction(MVC) Repetition:15~20 Total time:20min(about 6~8 machine) Frequency:2~3 times/week Clara et al,2002; Clara et al,2003; Savvas et al, 2003; Wehrensa et al, 2004; White et al, 2004; Paul et al, 2005; Thompson, 2005; White et al, 2006 Exercise and hs-CRP Exercise capacity is inversely correlated with CRP level (Rahimi, 2005) The relationship between Exercise and hsCRP is unclear (徐嘉吟，2005) Four weeks aerobic exercise does not reduce CRP level (Kelley,2006)
