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Aims Emerging studies suggest an association exists between coronary artery disease (CAD) and the development of neurodegenerative diseases, with CAD acting as a precursor. Our study aimed to investigate the relationship between baseline measures of cognitive functioning and long-term health-related quality of life (HRQoL) in individuals with CAD with specification to Type D personality traits and sex. Methods and results This prospective observational cohort study consisted of 864 participants (mean age 58 SD = 9 years, 74.0% men) with CAD after acute coronary syndrome. Baseline characteristics included comprehensive cognitive testing, measures of sociodemographic and clinical factors, and psychological assessment scales, such as Type D personality scale and the Hospital Anxiety and Depression scale. The Minnesota Living with Heart Failure Questionnaire assessed participants' HRQoL, conducted through phone interviews at baseline, every 6 months for up to 2 years, and after 5 years. Cognitive functioning correlated with HRQoL at all time intervals over the 5-year follow-up. Regarding sex and Type D personality, significant differences emerged in associations between impaired cognitive functioning at baseline and HRQoL measured over the period of 5 years. Men participants with characteristics of Type D personality were especially vulnerable to impaired cognitive functioning affecting the 5-year quality of life. Conclusion Men with CAD who obtained scores indicating characteristics of Type D personality were significantly more likely to have lower baseline cognitive functions and long-term HRQoL outcomes. This information could inform healthcare practitioners to screen for personality characteristics and closely follow-up those at a greater risk. [ABSTRACT FROM AUTHOR]

Background Focusing on detection of sleep apnoea early in the cardiac rehabilitation process may improve the recovery process and reduce recurrence of cardiovascular events. Patients who continue to be undiagnosed may experience a significantly worse outcome during their cardiac rehabilitation and recovery. Diastolic dysfunction has both diagnostic and prognostic importance in the management of coronary artery disease. We hypothesise that undiagnosed/untreated sleep apnoea in middle-aged coronary artery disease patients with preserved left ventricular ejection fraction changes the pattern of diastolic filling close to that in elderly patients without sleep apnoea. Methods and results This cross-sectional study included the 450 coronary artery disease patients with undiagnosed sleep apnoea who had left ventricular ejection fraction >50% and were referred consecutively to the Clinic of Cardiovascular Rehabilitation within two weeks after treatment for acute coronary syndrome. Polysomnographic and echocardiographic measurements were analysed. Mild to severe sleep apnoea was defined as the apnoea-hypopnea index >5. Age was dichotomised into under the age of 60 years and age 60 years or over. Up to 35% of coronary artery disease patients were likely to have undiagnosed sleep apnoea. There was a statistically significant interaction between the effect of sleep apnoea and age group on diastolic function defined as the ratio peak flow velocity in early diastole/peak flow velocity in atrial contraction ratio (p = 0.036). This ratio was significantly (p = 0.029) lower in the mild-severe sleep apnoea group (0.97, 95% confidence interval 0.88-1.06) than in the non-sleep apnoea group (1.09, 95% confidence interval 1.03-1.15) among middle aged (<60 years) coronary artery disease patients. Therefore, filling patterns in the middle aged (<60 years) patients with sleep apnoea resemble those observed in the elderly (>60 years) patients without sleep apnoea. The effect of sleep apnoea on left ventricular filling pattern in elderly was not observed. Conclusions Age modifies the effect of sleep apnoea on cardiovascular outcomes. The findings that undiagnosed sleep apnoea impairs diastolic function in a middle-aged coronary artery disease patient underscore the importance of early diagnosis and treatment of sleep apnoea. It is recommended to train and educate cardiac rehabilitation staff on the importance of sleep disorders in this population. [ABSTRACT FROM AUTHOR]

Purpose: There is still insufficient data on mental distress factors contributing to exercise capacity (EC) improvement before and after cardiac rehabilitation (CR) in patients with coronary artery disease (CAD). The aim of our study was to evaluate the associations between various mental distress factors and EC before and after exercise-based CR (EBCR).Methods: Over 12 months, 223 CAD patients (70% men, mean age 58 ± 9 years) were evaluated for socio-demographic, clinical, and mental distress symptoms as measured by the Hospital Anxiety and Depression scale (HADS), Beck Depression Inventory-II (BDI-II), and Spielberger State-Trait Anxiety Inventory (STAI). Patients were tested for EC at baseline and after EBCR.Results: In a multivariate linear regression model, EC before EBCR was associated with HADS anxiety subscale (β = −.186, p = .002) and BDI-II somatic/affective subscale (β = −.249, p < .001). EC after EBCR was associated with HADS anxiety and depression subscales (β = −.198, p < .001; β = −.170, p = .002, respectively) and BDI-II (β = −.258, p < .001). The BDI-II somatic/affective subscale was the best predictor of reduced EC before and after EBCR.Conclusions: Mental distress and somatic/affective symptoms of depression are strongly associated with EC both at the beginning and after EBCR. Analysis of possible mediating or moderating factors was beyond the scope of our study. Future studies should focus on comprehensive evaluation of EC risk factors including other mental distress characteristics, subjectively experienced fatigue, and post-operative CAD symptoms. [ABSTRACT FROM AUTHOR]

Objective: The study objective was to evaluate the relationship of health-related quality of life (HRQoL) with fatigue and exercise capacity in coronary artery disease (CAD) patients. Methods: A total of 1072 consecutive CAD patients on admission to a cardiac rehabilitation program were evaluated for HRQoL (36-item Short Form Medical Outcome Questionnaire; SF-36), body mass index, clinical characteristics (New York Heart Association (NYHA) class, angina pectoris class, coronary interventions, treatment with beta blockers, hypertension and diabetes), symptoms of depression and anxiety (Hospital Anxiety and Depression Scale), fatigue (Multidimensional Fatigue Inventory-20; MFI-20), and exercise capacity (bicycle ergometer test). Results: In univariate regression analyses lower scores on all SF-36 domains were associated with greater scores on all MFI-20 subscales. Exercise capacity was associated with all SF-36 domains, except for social functioning and mental health domains. In multivariate regression analyses, after adjusting for age, gender, body mass index, NYHA class, angina pectoris class, hypertension, diabetes, coronary interventions, treatment with betablockers, and symptoms of depression and anxiety, greater limitation due to physical and due to emotional problems, poor social functioning, decreased energy/vitality, worse general health perception, reduced mental component summary and lower global SF-36 score were independently associated with higher MFI-20 general fatigue score. Reduced physical functioning, greater pain, and reduced physical component summary SF-36 scores were associated with greater MFI-20 physical fatigue score. Lower SF-36 mental health score was associated, with greater MFI-20 mental fatigue score. Conclusion: In CAD patients undergoing rehabilitation, poor HRQoL is associated with greater fatigue and decreased exercise capacity independently from mental distress and CAD severity score [ABSTRACT FROM AUTHOR]