INTRODUCTION: Prevalence of cardiovascular diseases (CVD) is 19.4% in Iran and diabetes mellitus is an important CVD risk factor in this country. Non-insulin-dependent diabetes mellitus (type II DM) is associated with increased morbidity and mortality due to atherosclerosis. With CARDIAC REHABILITATION (CR) we can modify CVD risk factors such as type II DM and play an important role in decreasing its mortality and morbidity. We investigated the effects of CR on CARDIAC patients with and without type II DM. METHODS: In this retrospective before-and-after study we analyzed data from 496 CARDIAC patients (419 with type II DM and 77 without type II DM). All of the subjects completed demographic data questionnaires and underwent weight and height measurement, exercise test to assess exercise capacity (EC), echocardiography, and blood test to assess lipid profile and fasting blood glucose. The subjects then participated in a 24-session CR program. Each session consisted of 10 minutes warm-up, 40 minutes aerobic exercise, 10 minutes cool-down and 20 minutes relaxation. They also took part in 8 educational sessions on life style modification, diet therapy and stress management supervised by CR team (a cardiologist, a physician, a physiotherapist, a nurse, a nutritionist and a psychiatrist). At the end of the program, all measurements, exams and tests were repeated. Data were analyzed with SPSS11.5 using independent t-test at level of P<0.05. RESULTS: We studied 419 non-diabetics (mean age: 55.61±9.41 years) and 77 diabetics (mean age: 58.59±7.76 years). Mean EC increased significantly after CR in both groups. In the diabetic group, EC increased significantly compared to the non-diabetic group (62.21±133.40 vs. 33.68±31/42, P=0.02). Mean levels of triglyceride, cholesterol, LDL cholesterol, as well as body mass index and heart rate decreased significantly after CR in both groups. However, no significant difference was seen between the two groups in respect of these variables. DISCUSSION: CR is an effective intervention in diabetics as well as non-diabetics especially given its remarkable effects in improving EC as a critical indicator of mortality and morbidity of diabetic patients. Hence we suggest these patients undergo CR programs.      

Hyperlipidemia plays a strong role in coronary artery disease and is the second major risk factors in our population in Isfahan. This study ' investigated the effect of CARDIAC REHABILITATION on serum lipids. Methods: Our group in the CARDIAC REHABILITATION center chose a group of 120 patients who were referred after CARDIAC surgery or post- MI and followed them for 2 months. 60 patients participated in CARDIAC REHABILITATION program containing 24 exercise sessions (45-60 minute/ session), dietary consultation and mental health and 60 patients (control group) being the same as the intervention group in age, socio-economic status, serum lipids profile, history of coronary heart disease and other risk factors who didn’t participate in CARDIAC REHABILITATION program because of begin far from this center or other reasons. At first the 14hour fasting blood samples of two groups were sent for serum total cholesterol (T.Cho), triglycerides (TG), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C) and in the same manner12 weeks later, the same samples were taken and measured the following data was obtained using students test.Results: T Cho, TG and LDL-C of intervention group has decreased in 70%,62% and 76% of patients and in 86% patients, HDL-C showed an increase. T.coh, TG, LDL-C and HDL-C was normalized in 35%, 30%, 68% and 66%, respectively after finishing their 2 month course which overall showed a 20, 56, and 30 mg/dl reduction in serum lipids respectively and 0.8 reduction in LDL-C / HDL_C (P<0.05) and 5 mg / dl increase serum HDL-C (P<0.05) in intervention group vs. control group. Discussion: The decrease in T.cho, TG and LDL-C and increase in HDL-C in all patients and normalization of lipid profile in most of them shows the importance of REHABILITATION in CARDIAC patients and the need for its continuity.  

It has been established that a reduction in the serum lipids decreases the clinical effects and morbidity and mortality in patients suffering from coronary heart disease. Thus it was decided to conduct a study evaluating the effect of CARDIAC REHABILITATION on lipid profile in CARDIAC patients. In this clinical trial which was carried out on 120 patients who had reported to the CARDIAC REHABILITATION unit and were suffering from myocardial infarction, or else had undergone a coronary artery bypass surgery or an angioplasty.At first the 14 hour fasting blood samples of two groups were sent for serum total cholesterol (T.Cho), triglycerides (TG), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C) and in the same manner 12 weeks later, the same samples were taken and measured. The following data was obtained using students test.Sixty patients participated in CARDIAC REHABILITATION program including 24 exercise sessions (45-60 minute/session), dietary consultation and mental health and 60 patients (control group) being the same as the intervention group in age, socioeconomic status, serum lipids profile, history of coronary heart disease and other risk factors who didnt participate in CARDIAC REHABILITATION program because of being far from this center or other reasons.T.Cho, TG and LDL-C of intervention group had decreased in 70%,62% and 76% of patients and in 86% patients, HDL-C showed an increase. T.Cho, TG, LDL-C and HDL-C was normalized in 35%, 30%, 68% and 66%, respectively after finishing their 2 month course which overall showed a 20, 56, and 30 mg/dl reduction in serum lipids respectively and 0.8 reduction in LDL-C/HDL-C (P<0.05) and 5 mg/dl increase serum HDL-C( P<0.05 ) in intervention group vs. control group.The decrease in T.Cho, TG and LDL-C and increase in HDL-C in all patients and normalization of lipid profile in most of them shows the importance of REHABILITATION in CARDIAC patients and the need for its continuity.

Background: Despite the positive impact of CARDIAC REHABILITATION (CR) on quality of life and mortality, the majority of people who could benefit from this program fail to participate in it. The lack of referral from the physician is a common reason that patients give for not seeking CR. The objective of this study was to compare factors affecting CR referral by cardiologists.Methods: A cross-sectional survey of 122 cardiologists, including 89 general CARDIAC specialists and 33 fellows in cardiology from 11 major cardiology training centers in Iran, was done in 2010. They responded to the 14-item investigator generated survey, examining the physician's attitudinal and knowledge factors affecting CR referral.Results: 47.9% of the subjects reported having available CR centers but only 6.6% reported continuous medical education on the topic. 90.7% of the physicians reported that less than 15% of patients are referred to CR centers. The main factor affecting the low referral rate was limited general knowledge about CR programs (79.5%) such as program attributes and benefits, methods of reimbursement. Lack of insurance coverage, unavailability of CR centers in the community and low physicians' fee were other factors reported by the physicians.Conclusion: Cardiologists’ inadequate general knowledge of and attitude toward CR programs seem to be a potential threat for CARDIAC prevention and REHABILITATION in some societies.

Basic life support (BLS) following by Advanced CARDIAC life support (ACLS) is intended to rescue the patients with acute circulatory or respiratory failure or both. The most important determinant of short and long-term neurologically intact survival is the interval from the onset of the CARDIAC or respiratory onset to restoration of effective spontaneous functions of these vital activities.It is commonly accepted that every physician, regardless of specialty, should be able to  perform CPR. It must be also emphasized that CPR, almost invariably, necessitates a rapid interventional follow-care with ACLS procedure.Without well-performed basic life support, advanced CARDIAC life support is of no remark-: able benefit, BLS and ACLS are processes that must be performed step by step and with respect to the patient's condition.