Efectos de un programa interdisciplinar combinado con entrenamiento aeróbico continuo variable y fuerza dinámica en el síndrome coronario agudo / Effects of an interdisciplinary program combining aerobic interval training and dynamic strength in acute coronary syndrome

Antecedentes y objetivo: La rehabilitación cardíaca tiene el máximo nivel de evidencia en las guías médicas de referencia, sin embargo, existen todavía modalidades de entrenamiento poco exploradas. Estudiamos los efectos de un programa interdisciplinar tras síndrome coronario agudo (SCA) en prevención secundaria fase II. Métodos: Entre enero 2008 y diciembre 2018 se incluyeron 439 pacientes con cardiopatía isquémica estable y función sistólica preservada, máximo dos meses después del SCA. Se aplicó un entrenamiento combinado de resistencia aeróbica en método continuo variable de alta intensidad y de tonificación muscular dinámica con sobrecarga y/o lastre, además de asesoramiento nutricional y terapia psicológica-educativa durante 12 semanas. Resultados: Finalizaron 378 pacientes. La capacidad funcional aumentó en la prueba de esfuerzo incremental (1,76 METS; IC 95% 1,59 a 1,96 p < 0,001) y en la prueba de marcha de seis minutos (32,58 m; IC 95% 29,24 a 35,92 p < 0,001). Aumentó la actividad física de ocio en el IPAQ (763,27 min/semana; IC 95% 583,31 a 943,16 p < 0,001) y disminuyó el tiempo sentado entre semana (-28,85 min/día; IC 95% -43,94 a -13,77 p < 0,001). Además, mejoraron los hábitos alimentarios en el PREDIMED (2,58 unidades; IC 95% 1,43 a 3,73 p < 0,001), disminuyó el peso corporal (-0,88 kg; IC 95% -1,26 a -0,49 p < 0,001), el perímetro abdominal (1,57 cm; IC 95% 2,23 a 0,90 p < 0,001) y el tejido adiposo (-0,80%; IC 95% -1,10 a -0,51 p < 0,001). Conclusiones: Un programa interdisciplinar con entrenamiento continuo variable de alta intensidad combinado con tonificación muscular dinámica produce mejorías en la capacidad funcional, en el nivel de actividad física, en la composición corporal y en los hábitos alimentarios en pacientes con SCA.(AU)

Introduction and objectives: Cardiac rehabilitation has the highest level of recognition in medical guideline references, however there are still little-explored training modalities. We study the effects of an interdisciplinary program after acute coronary syndrome (ACS) in phase II secondary prevention. Methods: Between January 2008 and December 2018, 439 patients with stable ischemic heart disease and preserved systolic function were included, as maximum 2 month after the ACS. A combined aerobic resistance training program in a variable continuous method and muscle toning with overload and/or ballast was applied, in addition to nutritional counseling and psychological-educational therapy for 12 weeks. Results: 378 patients finished. The functional capacity increases in the incremental stress test (1.76 METS; CI 95%: 1.59–1.96, p < 0.001) and in the six minutes walking test (32.58 m; CI 95%: 29.24–35.92, p < 0.001). Leisure physical activity in IPAQ increased (763.27 min/week; CI 95%: 583.31–943.16, p < 0.001) and the time sitting during the week decreased (−28.85 min/day; CI 95%: −43.94 to −13.77, p < 0.001). Also, eating habits improved in PREDIMED (2.58 units; CI 95%: 1.43–3.73, p < 0.001), decreased body weight (−0.88 kg; CI 95%: −1.26 to −0.49, p < 0.001), the abdominal perimeter (1.57 cm; CI 95%: 2.23–0.90, p < 0.001) and adipose tissue (−0.80%; CI 95%: −1.10 to −0.51, p < 0.001). Conclusions: An interdisciplinary program with high intensity variable continuous training combined with dynamic muscle toning increases functional capacity, the level of physical activity, improves body composition and eating habits in ACS patients.(AU)

[Effects of an interdisciplinary program combining aerobic interval training and dynamic strength in acute coronary syndrome]. / Efectos de un programa interdisciplinar combinado con entrenamiento aeróbico continuo variable y fuerza dinámica en el síndrome coronario agudo.

INTRODUCTION AND OBJECTIVES: Cardiac rehabilitation has the highest level of recognition in medical guideline references, however there are still little-explored training modalities. We study the effects of an interdisciplinary program after acute coronary syndrome (ACS) in phase II secondary prevention. METHODS: Between January 2008 and December 2018, 439 patients with stable ischemic heart disease and preserved systolic function were included, as maximum 2 month after the ACS. A combined aerobic resistance training program in a variable continuous method and muscle toning with overload and/or ballast was applied, in addition to nutritional counseling and psychological-educational therapy for 12 weeks. RESULTS: 378 patients finished. The functional capacity increases in the incremental stress test (1.76 METS; CI 95%: 1.59-1.96, p < 0.001) and in the six minutes walking test (32.58 m; CI 95%: 29.24-35.92, p < 0.001). Leisure physical activity in IPAQ increased (763.27 min/week; CI 95%: 583.31-943.16, p < 0.001) and the time sitting during the week decreased (-28.85 min/day; CI 95%: -43.94 to -13.77, p < 0.001). Also, eating habits improved in PREDIMED (2.58 units; CI 95%: 1.43-3.73, p < 0.001), decreased body weight (-0.88 kg; CI 95%: -1.26 to -0.49, p < 0.001), the abdominal perimeter (1.57 cm; CI 95%: 2.23-0.90, p < 0.001) and adipose tissue (-0.80%; CI 95%: -1.10 to -0.51, p < 0.001). CONCLUSIONS: An interdisciplinary program with high intensity variable continuous training combined with dynamic muscle toning increases functional capacity, the level of physical activity, improves body composition and eating habits in ACS patients.

Fracaso renal anúrico en paciente con estenosis de arteria renal por displasia fibromuscular / Anuric renal failure in a patient with fibromuscular dysplasia renal artery stenosis

La displasia fibromuscular es una entidad que predomina en mujeres jóvenes. Su manifestación clínica más frecuente es la hipertensión arterial. El diagnóstico de estenosis de arteria renal continúa siendo mediante las técnicas de imagen, y la repermeabilización de arteria renal conlleva una mejora significativa del control tensional y la función renal. Presentamos un caso clínico de estenosis de arteria renal por displasia fibromuscular en un hombre joven al que se diagnostica tras presentar episodios de poliuria-anuria con insuficiencia renal, forma infrecuente de presentación de esta entidad

Fibromuscular dysplasia is an entity that predominates in young women. The most common clinical presentation is hypertension. The diagnosis of renal artery stenosis is based on images and revascularisation of renal artery leads to an improvement in renal function and blood pressure control. A clinical case of renal artery stenosis due to fibromuscular dysplasia in a young male patient is exposed, which first appears as polyuria-anuria and renal failure, a rare way of presentation of this pathologyFibromuscular dysplasia is an entity that predominates in young women. The most common clinical presentation is hypertension. The diagnosis of renal artery stenosis is based on images and revascularisation of renal artery leads to an improvement in renal function and blood pressure control. A clinical case of renal artery stenosis due to fibromuscular dysplasia in a young male patient is exposed, which first appears as polyuria-anuria and renal failure, a rare way of presentation of this pathology