Guidelines and Expert Consensus Documents summarize and evaluate all currently available evidence on a particular issue with the aim to assist physicians in selecting the best management strategies for a typical patient, suffering from a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic or therapeutic means. Guidelines are not substitutes for textbooks. The legal implications of medical guidelines have been discussed previously.

A great number of Guidelines and Expert Consensus Documents have been issued in recent years by the European Society of Cardiology (ESC) as well as by other societies and organizations. Because of the impact on clinical practice, quality criteria for development of guidelines have been established in order to make all decisions transparent to the user. The recommendations for formulating and issuing ESC Guidelines and Expert Consensus Documents can be found on the ESC web site (http://www.escardio.org/knowledge/guidelines/rules).

In brief, experts in the field are selected and undertake a comprehensive review of the published evidence for management and/or prevention of a given condition. A critical evaluation of diagnostic and therapeutic procedures is performed, including assessment of the risk–benefit ratio. Estimates of expected health outcomes for larger societies are included, where data exist. The level of evidence and the strength of recommendation of particular treatment options are weighed and graded according to predefined scales, as outlined in the tables below.

The experts of the writing panels have provided disclosure statements of all relationships they may have which might be perceived as real or potential sources of conflicts of interest. These disclosure forms are kept on file at the European Heart House, headquarters of the ESC. Any changes in conflict of interest that arise during the writing period must be notified to the ESC. The Task Force report was entirely …

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European guidelines on cardiovascular disease prevention in clinical practice (version 2012) : the fifth joint task force of the European society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts).

Other experts who contributed to parts of the guidelines: Edmond Walma, Schoonhoven (The Netherlands), Tony Fitzgerald, Dublin (Ireland), Marie Therese Cooney, Dublin (Ireland), Alexandra Dudina, Dublin (Ireland) European Society of Cardiology (ESC) Committee for Practice Guidelines (CPG):, Alec Vahanian (Chairperson) (France), John Camm (UK), Raffaele De Caterina (Italy), Veronica Dean (France), Kenneth Dickstein (Norway), Christian Funck-Brentano (France), Gerasimos Filippatos (Greece), Irene Hellemans (The Netherlands), Steen Dalby Kristensen (Denmark), Keith McGregor (France), Udo Sechtem (Germany), Sigmund Silber (Germany), Michal Tendera (Poland), Petr Widimsky (Czech Republic), Jose Luis Zamorano (Spain)Document reviewers: Irene Hellemans (CPG Review Coordinator) (The Netherlands), Attila Altiner (Germany), Enzo Bonora (Italy), Paul N. Durrington (UK), Robert Fagard (Belgium), Simona Giampaoli(Italy), Harry Hemingway (UK), Jan Hakansson (Sweden), Sverre Erik Kjeldsen (Norway), Mogens Lytken Larsen ...

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European guidelines on cardiovascular disease prevention in clinical practice: full text. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts).

http://www.sisalombardia.it/pdfs/ehj_2007_28_2375.pdf

European guidelines on cardiovascular disease prevention in clinical practice: executive summary.

Characteristics of physical activity are indicative of one's mobility level, latent chronic diseases and aging process. Accelerometers have been widely accepted as useful and practical sensors for wearable devices to measure and assess physical activity. This paper reviews the development of wearable accelerometry-based motion detectors. The principle of accelerometry measurement, sensor properties and sensor placements are first introduced. Various research using accelerometry-based wearable motion detectors for physical activity monitoring and assessment, including posture and movement classification, estimation of energy expenditure, fall detection and balance control evaluation, are also reviewed. Finally this paper reviews and compares existing commercial products to provide a comprehensive outlook of current development status and possible emerging technologies.

A Review of Accelerometry-Based Wearable Motion Detectors for Physical Activity Monitoring

Context Depressive symptoms predict adverse cardiovascular outcomes in patients with coronary heart disease, but the mechanisms responsible for this association are unknown Objective To determine why depressive symptoms are associated with an increased risk of cardiovascular events Design and Participants The Heart and Soul Study is a prospective cohort study of 1017 outpatients with stable coronary heart disease followed up for a mean (SD) of 48 (14) years Setting Participants were recruited between September 11, 2000, and December 20, 2002, from 12 outpatient clinics in the San Francisco Bay Area and were followed up to January 12, 2008 Main Outcome Measures Baseline depressive symptoms were assessed using the Patient Health Questionnaire (PHQ) We used proportional hazards models to evaluate the extent to which the association of depressive symptoms with subsequent cardiovascular events (heart failure, myocardial infarction, stroke, transient ischemic attack, or death) was explained by baseline disease severity and potential biological or behavioral mediators Results A total of 341 cardiovascular events occurred during 4876 person-years of follow-up The age-adjusted annual rate of cardiovascular events was 100% among the 199 participants with depressive symptoms (PHQ score ≥10) and 67% among the 818 participants without depressive symptoms (hazard ratio [HR], 150; 95% confidence interval, [CI], 116-195; P = 002) After adjustment for comorbid conditions and disease severity, depressive symptoms were associated with a 31% higher rate of cardiovascular events (HR, 131; 95% CI, 100-171; P = 04) Additional adjustment for potential biological mediators attenuated this association (HR, 124; 95% CI, 094-163; P = 12) After further adjustment for potential behavioral mediators, including physical inactivity, there was no significant association (HR, 105; 95% CI, 079-140; P = 75) Conclusion In this sample of outpatients with coronary heart disease, the association between depressive symptoms and adverse cardiovascular events was largely explained by behavioral factors, particularly physical inactivity

https://jamanetwork.com/journals/jama/articlepdf/182968/joc80118_2379_2388.pdf

Depressive Symptoms, Health Behaviors, and Risk of Cardiovascular Events in Patients With Coronary Heart Disease

Regular aerobic physical activity (PA) increases exercise capacity and physical fitness (PF), which can lead to many health benefits. Accurate quantification of PA and PF becomes essential in terms of health outcome and effectiveness of intervention programmes. In this manuscript we present a review

http://www.luzimarteixeira.com.br/wp-content/uploads/2009/11/physical-activity-level-evaluation.pdf

How to assess physical activity? How to assess physical fitness?

Cardiac rehabilitation (CR) has been defined as the sum of interventions required to ensure the best possible physical, psychological, and social conditions so that patients with subacute or chronic disease may, by their own efforts, preserve or resume as normal a place as possible in the life of the community.1, 2, 3, 4, 5

Cardiac Rehabilitation: Europe

Ketone ester therapy reduces cardiac inflammation and cardiac dysfunction in sepsis

Implantable devices were introduced as life-saving equipment for millions of people suffering from coronary heart disease. Nowadays, not only traditional antiarrhythmic pharmacological therapy has been shown to decrease sudden cardiac death, but also pacemakers and cardioverter defibrillators have proved their value in the treatment of life-threatening rhythm disorders. In heart failure, cardiac resynchronisation therapy (CRT) and assist devices have recently demonstrated their importance,but no published data regarding physical exercise or training are available yet. This chapter will mainly deal with physical exercise and rehabilitation in patients who have received an implantable cardioverter defibrillator. Cardiac rehabilitation in patients with assist devices or pacemakers will be discussed only briefly.

Martine Martens

Papers

How to assess physical activity? How to assess physical fitness?

Cardiac Rehabilitation: Europe

Ketone ester therapy reduces cardiac inflammation and cardiac dysfunction in sepsis

Rehabilitation in Patients with Implantable Devices.