Research Hotspots and Trends in Home-Based Cardiac Rehabilitation: A Bibliometric Visualization Analysis

Objective: This research was aimed at determining research hotspots and major topics in the field of international home-based cardiac rehabilitation (HBCR) over the past 20 years, and exploring future trends in HBCR. Methods: A total of 757 research articles from 2002 to 2022, with themes of home-based cardiac rehabilitation, were included in the core collection database of Web of Science. CiteSpace software was used for literature metrology and visualization analysis. Results: (1) The total number of research articles on HBCR is increasing. (2) Research hotspots in HBCR include the effectiveness of rehabilitation after coronary heart disease or heart failure; quality of life; mental health; and home rehabilitation after COVID-19. (3) Research trends in HBCR include wearable intelligent technology; telerehabilitation; lifestyle interventions; and home-based rehabilitation prescriptions for exercise, nutrition, psychology and continuous management. Conclusion: The effects of HBCR have been continuously verified. Research has focused primarily on secondary prevention and rehabilitation after coronary heart disease and heart failure. More attention must be paid to improving patients’ quality of life by HBCR. Telerehabilitation based on wearable intelligent technology, home-based lifestyle interventions and continuous management are future trends of HBCR development

Availability and trend of dissemination of cardiac rehabilitation in China: report from the multicenter national registration platform between 2012 and 2021

The study aimed to evaluate the current status of cardiac rehabilitation programs in China by registering and tracking patients undergoing CR programs in the database. Data were extracted from the online registry platform of the China Society of Cardiopulmonary Prevention and Rehabilitation from February 2012 to December 2021. Overall, data on 19,896 patients with cardiovascular diseases (CVDs) from 159 hospitals in 34 provinces of China were extracted. From a time point of view, the number of patients who had undergone CR and institutions that perform CR showed the first decline in 2009 and then increased until 2021. From a geographic point of view, the degree of participation varied greatly among regions, most of which were concentrated in eastern parts of China. A higher population of patients who underwent CR were male, aged less than 60 years, with low-a risk for coronary heart disease (CHD), and tended to choose the hospital-based CR program among all cases registered in the database. The top three diseases in the patients who participated in CR were CHD, hypertension, and metabolic syndrome (MS). Centers with CR were more likely to be tertiary-level hospitals. After adjusting for baseline values, there were significant differences in post-CR exercise capacity among the three groups (home-based CR group, hospital-based CR group, and hybrid CR group), which were in favor of the hybrid CR group compared with other groups. The underutilization of CR is a global issue, not just in China. Despite the number of CR programs showing an increasing trend in the past years, CR in China is still in the preliminary stage of development. Furthermore, the participation of CR in China shows wide diversity across geography, disease, age, sex, risk stratification, and hospital-level factors. These findings reinforce the importance of the implementation of effective measures to improve the participation, enrollment in, and uptake of cardiac rehabilitation

Immunogenomic Landscape in Breast Cancer Reveals Immunotherapeutically Relevant Gene Signatures

Breast cancer is characterized by some types of heterogeneity, high aggressive behaviour, and low immunotherapeutic efficiency. Detailed immune stratification is a prerequisite for interpreting resistance to treatment and escape from immune control. Hence, the immune landscape of breast cancer needs further understanding. We systematically clustered breast cancer into six immune subtypes based on the mRNA expression patterns of immune signatures and comprehensively depicted their characteristics. The immunotherapeutic benefit score (ITBscore) was validated to be a superior predictor of the response to immunotherapy in cohorts from various datasets. Six distinct immune subtypes related to divergences in biological functions, signatures of immune or stromal cells, extent of the adaptive immune response, genomic events, and clinical prognostication were identified. These six subtypes were characterized as immunologically quiet, chemokine dominant, lymphocyte depleted, wounding dominant, innate immune dominant, and IFN-γ dominant and exhibited features of the tumor microenvironment (TME). The high ITBscore subgroup, characterized by a high proportion of M1 macrophages:M2 macrophages, an activated inflammatory response, and increased mutational burden (such as mutations in TP53, CDH1 and CENPE), indicated better immunotherapeutic benefits. A low proportion of tumor-infiltrating lymphocytes (TILs) and an inadequate response to immune treatment were associated with the low ITBscore subgroup, which was also associated with poor survival. Analyses of four cohorts treated with immune checkpoint inhibitors (ICIs) suggested that patients with a high ITBscore received significant therapeutic advantages and clinical benefits. Our work may facilitate the understanding of immune phenotypes in shaping different TME landscapes and guide precision immuno-oncology and immunotherapy strategies

Nature of Cardiac Rehabilitation Around the Globe

BackgroundCardiac rehabilitation (CR) is a clinically-effective but complex model of care. The purpose of this study was to characterize the nature of CR programs around the world, in relation to guideline recommendations, and compare this by World Health Organization (WHO) region.MethodsIn this cross-sectional study, a piloted survey was administered online to CR programs globally. Cardiac associations and local champions facilitated program identification. Quality (benchmark of ≥ 75% of programs in a given country meeting each of 20 indicators) was ranked. Results were compared by WHO region using generalized linear mixed models.Findings111/203 (54.7%) countries in the world offer CR; data were collected in 93 (83.8%; N = 1082 surveys, 32.1% program response rate). The most commonly-accepted indications were: myocardial infarction (n = 832, 97.4%), percutaneous coronary intervention (n = 820, 96.1%; 0.10), and coronary artery bypass surgery (n = 817, 95.8%). Most programs were led by physicians (n = 680; 69.1%). The most common CR providers (mean = 5.9 ± 2.8/program) were: nurses (n = 816, 88.1%; low in Africa, p

Cardiac Rehabilitation Availability and Density around the Globe

BackgroundDespite the epidemic of cardiovascular disease and the benefits of cardiac rehabilitation (CR), availability is known to be insufficient, although this is not quantified. This study ascertained CR availability, volumes and its drivers, and density.MethodsA survey was administered to CR programs globally. Cardiac associations and local champions facilitated program identification. Factors associated with volumes were assessed using generalized linear mixed models, and compared by World Health Organization region. Density (i.e. annual ischemic heart disease [IHD] incidence estimate from Global Burden of Disease study divided by national CR capacity) was computed.FindingsCR was available in 111/203 (54.7%) countries; data were collected in 93 (83.8% country response; N?=?1082 surveys, 32.1% program response rate). Availability by region ranged from 80.7% of countries in Europe, to 17.0% in Africa (p

Who should have the strongest quit smoking willingness and much easier to persuade?

Background and challenges to implementation Base on the Report on cardiovascular diseases (CVD) in China in 2016. In China, the prevalence of CVD is continuously increasing. Currently, an estimated 290 million individuals suffer from CVD. Rates of cardiovascular morbidity and mortality are higher among smokers and passive smokers than among non-smokers. Intervention or response Put the “smoking history questionnaire” and “assessment of patient willingness to quit smoking survey” into process of 4154 cardiovascular disease patients diagnosis, treatment and rehabilitation. Increasing the frequency of intervention from none or 1 time to 3 times (intake, Discharge and follow-up) within one year in 27 difference hospitals from random province in China. Keep tracking the quit smoking willingness of the patients during the period from acute phase to recovery phase, and to maintenance phase. Results and lessons learnt Continuing to increase the awareness that cigarette smoking causes HEART DISEASE and other serious diseases in this group of people. 90.15% patients were becoming increasingly clear to the harm of cigarette smoking to their whole body, not only the lung. Base on the quit line success rate, more than 2%, in 2015. Strengthen patients' quit smoking willingness is easier than non-disease smokers. The number of patients who has the willing for quit smoking increase from 21(0.5%, acute stage) to 282(6.7%, follow up) within one years. The patients who have strong will to quit smoking is 75 individuals (1.8%). Conclusions and key recommendations Quitting smoking was found to substantially reduce the risks of death. Our retrospective study shows tremendous persuade successful rate in patient's population who have been educated by our cardiovascular doctors and their medical teams. We should start the quit smoking process from the “weakness” (willpower and physical) patients who are fearful of the disease may destroy his life or even take away his life and more dangerous groups. It will give us much more clinical outcomes than the normal person