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Biomedical subjects

Gary J Balady

Publications and source records attributed to Gary J Balady.

16 recordsLinked to original sources
PubMed2006

An intracardiac accessory thyroid gland.

This report describes a 62-year-old woman with a history of pulmonary embolism who presented with a right ventricular cardiac mass that proved histologically to be normal thyroid tissue. The patient was clinically and biochemically euthyroid. Six months after excision, an iodine-123 whole-body uptake and scan demonstrated no residual ectopic thyroid tissue.

Choristoma↗
PubMed2005

Cardiac rehabilitation and secondary prevention of coronary heart disease: an American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in collaboration with the American association of Cardiovascular and Pulmonary Rehabilitation.

This article updates the 1994 American Heart Association scientific statement on cardiac rehabilitation. It provides a review of recommended components for an effective cardiac rehabilitation/secondary prevention program, alternative ways to deliver these services, recommended future research directions, and the rationale for each component of the rehabilitation/secondary prevention program, with emphasis on the exercise training component.

Coronary Disease↗
PubMed2005

Prevalence of metabolic syndrome in cardiac rehabilitation/secondary prevention programs.

BACKGROUND: Metabolic syndrome (MS) consists of a cluster of obesity-related risk factors that have been linked to the development and progression of coronary heart disease (CHD). The purpose of this study was to examine the prevalence of MS, as defined by the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol, in patients with CHD attending cardiac rehabilitation (CR) after a coronary event. METHODS: We analyzed baseline data of 1912 individuals with established coronary artery disease entering CR in Burlington, Vt, and Boston, Mass. RESULTS: Overall, 50% of patients entering CR have MS. A significantly greater percentage of women than men have MS (54% vs 48, respectively, P < .001). This is due to higher prevalence of abdominal obesity, high triglycerides, and hypertension (all, P < .05) in women. In women, the prevalence of MS peaked in the eighth decade vs the fifth decade in men. CONCLUSIONS: The prevalence of MS in patients with CHD participating in CR is greater than twice that of the general population. The prevalence of MS is higher and occurs at an older age in women than men. This study highlights the need for CR programs to develop specific interventions to assist patients with risk factor modification primarily by targeting physical inactivity and weight control.

Adult↗
PubMed2004

Usefulness of exercise testing in the prediction of coronary disease risk among asymptomatic persons as a function of the Framingham risk score.

BACKGROUND: The purpose of this study is to determine the usefulness of exercise treadmill testing (ETT) among asymptomatic persons in predicting coronary heart disease (CHD) events over and above the Framingham CHD risk score. METHODS AND RESULTS: Subjects included 3043 members of the Framingham Heart Study offspring cohort without CHD (1431 men and 1612 women; age, 45+/-9 years) who underwent ETT and were followed up for 18.2 years. The risk of developing CHD was evaluated relative to 3 exercise test variables: (1) ST-segment depression > or =1 mm, (2) failure to achieve target heart rate (THR) of 85% predicted maximum, and (3) exercise capacity. In multivariable analyses that adjusted for age and Framingham CHD risk score, among men, ST-segment depression (hazard ratio [HR], 1.88; 95% CI, 1.21 to 2.91) and failure to achieve THR (HR, 1.70; 95% CI, 1.18 to 2.45) predicted higher CHD risk, whereas a greater exercise capacity predicted lower CHD risk (HR per MET, 0.94; 95% CI, 0.89 to 0.99). Although similar HRs were seen in women, those results were not statistically significant. Among men with 10-year predicted risk > or =20%, failure to reach THR and ST-segment depression both more than doubled the risk of an event (HR, 2.66 and HR, 2.11, respectively), and each MET increment in exercise capacity reduced risk by 13% (HR, 0.87). CONCLUSIONS: Among asymptomatic men, ST-segment depression, failure to reach THR, and exercise capacity during ETT provided additional prognostic information in age- and Framingham risk score-adjusted models, particularly among those in the highest risk group (10-year predicted CHD risk of > or =20%). The evaluation of exercise test variables in women is limited, given our sample size and the few CHD events in women.

Adult↗
PubMed2004

Results of cardiac rehabilitation in patients with diabetes mellitus.

To study the prevalence, risk profile, and outcomes of diabetics in cardiac rehabilitation, data on 952 consecutively enrolled patients were evaluated. Diabetics on entry had poor glycemic control, and compared with nondiabetics, had a greater adverse risk profile (body mass index, waist circumference, hypertension, triglycerides, peripheral vascular disease, and lower fitness levels), and a lower program adherence rate. Although exercise capacity significantly improved, it is clear from the outcomes reported in this study that more effective interventions in weight management, lipid lowering, and glycemic control are needed. This study emphasizes the need to identify diabetic patients in contemporary cardiac rehabilitation programs and target them for an aggressive program of risk factor management, including exercise training.

Anthropometry↗
PubMed2002

Effect of exercise on upper and lower extremity endothelial function in patients with coronary artery disease.

Aerobic exercise training improves endothelial vasomotor function in the coronary circulation of patients with coronary artery disease (CAD), an effect that has been attributed to local repetitive increases in shear stress on the endothelium. To study the effects of exercise on endothelial function in the peripheral circulation, we used vascular ultrasound to examine flow-mediated dilation and nitroglycerin-mediated dilation in the brachial and posterior tibial arteries of 58 subjects with CAD. Studies were performed at baseline and after 10 weeks in 40 subjects (aged 59 +/- 10 years) who participated in a supervised cardiac rehabilitation program that predominantly involved moderate intensity leg exercise (three 30-minute sessions/week), and 18 matched patients who did not exercise and maintained a sedentary lifestyle. Exercise was associated with a 29% increase in functional capacity (7.3 +/- 2.2 vs 9.4 +/- 2.7 METs, p <0.001), and significant improvement in endothelium-dependent, flow-mediated dilation in a conduit artery of the leg, but not the arm. Nitroglycerin-mediated dilation in the upper arm and lower extremity was unaffected. These findings suggest that exercise improves endothelial function in peripheral conduit arteries of patients with CAD and that the beneficial effect may be more marked in the vascular beds of the exercised limbs.

Arm↗