title: Anemia does not preclude increments in cardiac performance during a short period of intensive, exercise-based cardiac rehabilitation.
abstract: OBJECTIVE
  Anemia seems to be rather common in cardiac rehabilitation patients but it is not known whether it could influence cardiovascular performance indexes and prognosis immediately after an acute cardiac event. The purposes of this study were to define its prevalence and to investigate the safety and efficacy of an intensive exercise-based cardiac rehabilitation in patients with and without anemia.
  
  
  METHODS
  436 participants (77% males; mean age 64 ± 13 years) were submitted to a two-week cardiac rehabilitation program consisting of low to medium intensity, individualized training with respiratory, aerobic and calisthenic exercises (three sessions daily, six times per week). A six-minute walking test was performed at enrolment and repeated at discharge together with a cardiopulmonary test.
  
  
  RESULTS
  Anemia, as defined according to World Health Organization criteria, was detected in 328 patients (75.2% of the entire population). The distance walked increased from 381 ± 117 m at baseline to 457 ± 110 m (p < 0.001) after a mean period of 12.4 ± 4 days. A direct correlation was found between hemoglobin concentrations and both the absolute distance walked (r = 0.48; p < 0.001) and peak VO(2) (r = 0.39; p < 0.001). Anemic patients walked a significantly shorter distance at baseline and at discharge (p < 0.001); however, both groups showed the same increment in the distance walked: 76.0 ± 61 m vs 76.0 ± 60 m (p = 0.99).
  
  
  CONCLUSIONS
  Our data indicate: 1) a high prevalence of anemia in the study population and 2) that, in spite of a clear reduction in exercise capacity, a moderate anemia does not preclude increments in cardiac performance during a short period of intensive, exercise-based cardiac rehabilitation.
authors: Cardiac Prevention and Rehabilitation Unit, Istituto Codivilla Putti, Cortina d'Ampezzo (BL), Italy. abio.bellotto@unipd.it
authors: Fabio
authors: F
authors: Bellotto
authors: Pietro
authors: P
authors: Palmisano
authors: Leonida
authors: L
authors: Compostella
authors: Nicola
authors: N
authors: Russo
authors: Maria
authors: M
authors: Zaccaria
authors: Piero
authors: P
authors: Guida
authors: Tiziana
authors: T
authors: Setzu
authors: Arianna
authors: A
authors: Cati
authors: Anna
authors: A
authors: Maddalozzo
authors: Stefano
authors: S
authors: Favale
authors: Sabino
authors: S
authors: Iliceto
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D000740:Anemia / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D006331:Heart Diseases / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology / Q000534:rehabilitation*; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking
chemical_list: D015415:Biomarkers; D006454:Hemoglobins