{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T23:14:41Z","timestamp":1787786081578,"version":"build-2784847793"},"reference-count":28,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2017,6,20]]},"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>To investigate the relationship between exercise participation, exercise \u2018dose\u2019 expressed as metabolic equivalent (MET) hours (h) per week, and prognosis in individuals attending an extended, community-based exercise rehabilitation programme.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Cohort study of 435 participants undertaking exercise-based cardiac rehabilitation (CR) in Leeds, West Yorkshire, UK between 1994 and 2006, followed up to 1 November 2013. MET intensity of supervised exercise was estimated utilising serial submaximal exercise test results and corresponding exercise prescriptions. Programme participation was routinely monitored. Cox regression analysis including time-varying and propensity score adjustment was applied to identify predictors of long-term, all-cause mortality across exercise dose and programme duration groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 133 events (31%) during a median follow-up of 14 years (range, 1.2 to 18.9 years). The significant univariate association between exercise dose and all-cause mortality was attenuated following multivariable adjustment for other predictors, including duration in the programme. Longer-term adherence to supervised exercise training (&gt;36 months) was associated with a 33% lower mortality risk (multivariate-adjusted HR: 0.67; 95% CI: 0.47 to 0.97; p=0.033) compared with all lesser durations of CR (3, 12, 36 months), even after adjustment for baseline fitness, comorbidities and survivor bias.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Exercise dose (MET-h per week) appears less important than long-term adherence to supervised exercise for the reduction of long-term mortality risk. Extended, supervised CR programmes within the community may play a key role in promoting long-term exercise maintenance and other secondary prevention therapies for survival benefit.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2017-000623","type":"journal-article","created":{"date-parts":[[2017,7,28]],"date-time":"2017-07-28T20:10:26Z","timestamp":1501272626000},"page":"e000623","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Exercise dose and all-cause mortality within extended cardiac rehabilitation: a cohort study"],"prefix":"10.1136","volume":"4","author":[{"given":"Claire","family":"Taylor","sequence":"first","affiliation":[{"name":"Carnegie School of Sport,Leeds Beckett University, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costas","family":"Tsakirides","sequence":"additional","affiliation":[{"name":"Carnegie School of Sport,Leeds Beckett University, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Moxon","sequence":"additional","affiliation":[{"name":"Burton Croft Surgery, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James W","family":"Moxon","sequence":"additional","affiliation":[{"name":"Retired General Practitioner, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Dudfield","sequence":"additional","affiliation":[{"name":"Leeds Leisure Services,Leeds City Council, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Witte","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular and Diabetes Research, University of Leeds, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Ingle","sequence":"additional","affiliation":[{"name":"Department of Sport, Health and Exercise Science, University of Hull, Hull, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Carroll","sequence":"additional","affiliation":[{"name":"Department of Sport, Health and Exercise Science, University of Hull, Hull, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,7,28]]},"reference":[{"key":"2025081709522825000_4.2.e000623.1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.876383"},{"key":"2025081709522825000_4.2.e000623.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.01.078"},{"key":"2025081709522825000_4.2.e000623.3","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.001365"},{"key":"2025081709522825000_4.2.e000623.4","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.066738"},{"key":"2025081709522825000_4.2.e000623.5","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2012-303022"},{"key":"2025081709522825000_4.2.e000623.6","doi-asserted-by":"crossref","unstructured":"Heran BS , Chen JM , Ebrahim S , et al . 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