{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T22:57:40Z","timestamp":1784329060600,"version":"3.55.0"},"reference-count":48,"publisher":"Japanese Circulation Society","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Circ J"],"published-print":{"date-parts":[[2025,9,25]]},"DOI":"10.1253\/circj.cj-25-0227","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T22:07:45Z","timestamp":1756246065000},"page":"1616-1626","source":"Crossref","is-referenced-by-count":3,"title":["Sex and Age Differences in Exercise Frequency and Exercise Capacity After Home-Based Cardiac Rehabilitation During the Coronavirus Disease 2019 (COVID-19) Pandemic"],"prefix":"10.1253","volume":"89","author":[{"given":"Tomoaki","family":"Hama","sequence":"first","affiliation":[{"name":"Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic"},{"name":"Department of Cardiology, Tokyo Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audry S.","family":"Chacin-Suarez","sequence":"additional","affiliation":[{"name":"Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas G.","family":"Bissen","sequence":"additional","affiliation":[{"name":"Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam M.","family":"Shultz","sequence":"additional","affiliation":[{"name":"Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalyn M.","family":"Salstrand","sequence":"additional","affiliation":[{"name":"Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua R.","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda R.","family":"Bonikowske","sequence":"additional","affiliation":[{"name":"Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas P.","family":"Olson","sequence":"additional","affiliation":[{"name":"Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"330","reference":[{"key":"1","doi-asserted-by":"crossref","unstructured":"1. Nichols M, Townsend N, Scarborough P, Rayner M. Cardiovascular disease in Europe: Epidemiological update. <i>Eur Heart J<\/i> 2013; 34: 3028\u20133034.","DOI":"10.1093\/eurheartj\/eht356"},{"key":"2","doi-asserted-by":"crossref","unstructured":"2. Balady GJ, Williams MA, Ades PA, Bittner V, Comoss P, Foody JAM, et al. Core components of cardiac rehabilitation\/secondary prevention programs: 2007 update: A scientific statement from the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; the Councils on Cardiovascular Nursing, Epidemiology and Prevention, and Nutrition, Physical Activity, and Metabolism; and the American Association of Cardiovascular and Pulmonary Rehabilitation. <i>Circulation<\/i> 2007; 115: 2675\u20132682.","DOI":"10.1161\/CIRCULATIONAHA.106.180945"},{"key":"3","doi-asserted-by":"crossref","unstructured":"3. Yamamoto S, Okamura M, Akashi YJ, Tanaka S, Shimizu M, Tsuchikawa Y, et al. Impact of long-term exercise-based cardiac rehabilitation in patients with chronic heart failure: A systematic review and meta-analysis. <i>Circ J<\/i> 2024; 88: 1360\u20131371.","DOI":"10.1253\/circj.CJ-23-0820"},{"key":"4","doi-asserted-by":"crossref","unstructured":"4. Hiruma T, Nakayama A, Sakamoto J, Hori K, Nanasato M, Hosoda T, et al. Comprehensive cardiac rehabilitation following acute myocardial infarction improves clinical outcomes regardless of exercise capacity. <i>Circ J<\/i> 2024; 88: 982\u2013992.","DOI":"10.1253\/circj.CJ-23-0668"},{"key":"5","doi-asserted-by":"crossref","unstructured":"5. Alberto RR, Carlos PG, Emad AA, Raposeiras S, Hof A, Meindersma E, et al. Participation and adherence to cardiac rehabilitation programs. A systematic review. <i>Int J Cardiol<\/i> 2016; 223: 436\u2013443.","DOI":"10.1016\/j.ijcard.2016.08.120"},{"key":"6","doi-asserted-by":"crossref","unstructured":"6. Goto Y, Saito M, Iwasaka T, Daida H, Kohzuki M, Ueshima K, et al. Poor implementation of cardiac rehabilitation despite broad dissemination of coronary interventions for acute myocardial infarction in Japan: A nationwide survey. <i>Circ J<\/i> 2007; 71: 173\u2013179.","DOI":"10.1253\/circj.71.173"},{"key":"7","doi-asserted-by":"crossref","unstructured":"7. Thomas RJ, Beatty AL, Beckie TM, Brewer LPC, Brown TM, Forman DE, et al. Home-based cardiac rehabilitation: A scientific statement from the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. <i>Circulation<\/i> 2019; 140: e69\u2013e89.","DOI":"10.1161\/CIR.0000000000000663"},{"key":"8","doi-asserted-by":"publisher","unstructured":"8. Smith JR, Thomas RJ, Bonikowske AR, Hammer SM, Olson TP. Sex differences in cardiac rehabilitation outcomes. <i>Circ Res<\/i> 2022; 130: 552\u2013565, doi:10.1161\/CIRCRESAHA.121.319894.","DOI":"10.1161\/CIRCRESAHA.121.319894"},{"key":"9","doi-asserted-by":"crossref","unstructured":"9. Grace SL, Gravely-Witte S, Kayaniyil S, Brual J, Suskin N, Stewart DE. A multisite examination of sex differences in cardiac rehabilitation barriers by participation status <i>J Womens Health (Larchmt)<\/i> 2009; 18: 209\u2013216.","DOI":"10.1089\/jwh.2007.0753"},{"key":"10","unstructured":"10. Bitter V, Sanderson BK. Women in cardiac rehabilitation. <i>J Am Med Womens Assoc (1972)<\/i> 2003; 58: 227\u2013235."},{"key":"11","doi-asserted-by":"publisher","unstructured":"11. Benz Scott LA, Ben-Or K, Allen JK. Why are women missing from outpatient cardiac rehabilitation programs?: A review of multilevel factors affecting referral, enrollment, and completion. <i>J Womens Health (Larchmt)<\/i> 2002; 11: 773\u2013791, doi:10.1089\/15409990260430927.","DOI":"10.1089\/15409990260430927"},{"key":"12","doi-asserted-by":"publisher","unstructured":"12. Heid HG, Schmelzer M. Influences on women\u2019s participation in cardiac rehabilitation. <i>Rehabil Nurs<\/i> 2004; 29: 116\u2013121, doi:10.1002\/j.2048-7940.2004.tb00327.x.","DOI":"10.1002\/j.2048-7940.2004.tb00327.x"},{"key":"13","doi-asserted-by":"crossref","unstructured":"13. Koike A, Sobue Y, Kawai M, Yamamoto M, Yukina Banno Y, Harada M, et al. Safety and feasibility of a telemonitoring-guided exercise program in patients receiving cardiac resynchronization therapy. <i>Ann Noninvasive Electrocardiol<\/i> 2022; 27: e12926, doi:10.1111\/anec.12926.","DOI":"10.1111\/anec.12926"},{"key":"14","doi-asserted-by":"crossref","unstructured":"14. Kikuchi A, Taniguchi T, Nakamoto K, Sera F, Ohtani T, Yamada T, et al. Feasibility of home-based cardiac rehabilitation using an integrated telerehabilitation platform in elderly patients with heart failure. <i>J Cardiol<\/i> 2021; 78: 66\u201371.","DOI":"10.1016\/j.jjcc.2021.01.010"},{"key":"15","doi-asserted-by":"publisher","unstructured":"15. Beatty AL, Beckie TM, Dodson J, Goldstein CM, Hughes JW, Kraus WE, et al. A new era in cardiac rehabilitation delivery: Research gaps, questions, strategies, and priorities. <i>Circulation<\/i> 2023; 147: 254\u2013266, doi:10.1161\/CIRCULATIONAHA.122.061046.","DOI":"10.1161\/CIRCULATIONAHA.122.061046"},{"key":"16","doi-asserted-by":"crossref","unstructured":"16. Kemps HMC, Brouwers RWM, Cramer MJ, Jorstad HT, Kluiver EP, Kraaijenhagen RA, et al. Recommendations on how to provide cardiac rehabilitation services during the COVID-19 pandemic. <i>Neth Heart J<\/i> 2020; 28: 387\u2013390.","DOI":"10.1007\/s12471-020-01474-2"},{"key":"17","doi-asserted-by":"crossref","unstructured":"17. Gruska M, Aigner G, Altenberger J, Burkart-K\u00fcttner D, Fiedler L, Gwechenberger M, et al. Recommendations on the utilization of telemedicine in cardiology. <i>Wien Klin Wochenschr<\/i> 2020; 132: 782\u2013800.","DOI":"10.1007\/s00508-020-01762-2"},{"key":"18","doi-asserted-by":"publisher","unstructured":"18. Subedi N, Rawstorn JC, Gao L, Koorts H, Maddison R. Implementation of telerehabilitation interventions for the self-management of cardiovascular disease: Systematic review. <i>JMIR Mhealth Uhealth<\/i> 2020; 8: e17957, doi:10.2196\/17957.","DOI":"10.2196\/17957"},{"key":"19","doi-asserted-by":"publisher","unstructured":"19. Nakayama A, Takayama N, Kobayashi M, Hyodo K, Maeshima N, Takayuki F, et al. Remote cardiac rehabilitation is a good alternative of outpatient cardiac rehabilitation in the COVID-19 era. <i>Environ Health Prev Med<\/i> 2020; 25: 48, doi:10.1186\/s12199-020-00885-2.","DOI":"10.1186\/s12199-020-00885-2"},{"key":"20","doi-asserted-by":"crossref","unstructured":"20. Yeo TJ, Wang YTL, Low TT. Have a heart during the COVID-19 crisis: Making the case for cardiac rehabilitation in the face of an ongoing pandemic. <i>Eur J Prev Cardiol<\/i> 2020; 27: 903\u2013905.","DOI":"10.1177\/2047487320915665"},{"key":"21","doi-asserted-by":"crossref","unstructured":"21. Scherrenberg M, Falter M, Dendale P. Patient experiences and willingness-to-pay for cardiac telerehabilitation during the first surge of the COVID-19 pandemic: Single-centre experience. <i>Acta Cardiol<\/i> 2021; 76: 151\u2013157.","DOI":"10.1080\/00015385.2020.1846920"},{"key":"22","doi-asserted-by":"crossref","unstructured":"22. Hama T, Suarez ASC, Bissen TG, Bonikowske AR, Smith JR, Taylor BJ, et al. Home-based cardiac rehabilitation among attendees from a large health care system during the COVID-19 pandemic. <i>JACC Adv<\/i> 2024; 3: 101403.","DOI":"10.1016\/j.jacadv.2024.101403"},{"key":"23","doi-asserted-by":"crossref","unstructured":"23. Drwal KR, Forman DE, Wakefield BJ, Accaoui RNE. Cardiac rehabilitation during COVID-19 pandemic: Highlighting the value of home-based programs. <i>Telemed J E Health<\/i> 2020; 26: 1322\u20131324.","DOI":"10.1089\/tmj.2020.0213"},{"key":"24","doi-asserted-by":"crossref","unstructured":"24. Borg G. Perceived exertion as an indicator of somatic stress. <i>Scand J Rehabil Med<\/i> 1970; 2: 92\u201398.","DOI":"10.2340\/1650197719702239298"},{"key":"25","doi-asserted-by":"crossref","unstructured":"25. Scherr J, Wolfarth B, Christle JW, Pressler A, Wagenpfeil S, Halle M. Associations between Borg\u2019s rating of perceived exertion and physiological measures of exercise intensity. <i>Eur J Appl Physiol<\/i> 2013; 113: 147\u2013155.","DOI":"10.1007\/s00421-012-2421-x"},{"key":"26","doi-asserted-by":"crossref","unstructured":"26. Hlatky MA, Boineau RE, Higginbothamet MB, Lee KL, Mark DB, Califf RM, et al. A brief self-administered questionnaire to determine functional capacity (the Duke Activity Status Index). <i>Am J Cardiol<\/i> 1989; 64: 651\u2013654.","DOI":"10.1016\/0002-9149(89)90496-7"},{"key":"27","doi-asserted-by":"crossref","unstructured":"27. Coutinho-Myrrha MA, Dias RC, Fernandes AA, Ara\u00fajo CG, Hlatky MA, Pereira DG, et al. Duke Activity Status Index for cardiovascular diseases: Validation of the Portuguese translation. <i>Arq Bras Cardiol<\/i> 2014; 102: 383\u2013390.","DOI":"10.5935\/abc.20140031"},{"key":"28","doi-asserted-by":"crossref","unstructured":"28. Struthers R, Erasmus P, Holmes K, Warman P, Collingwood A, Sneyd JR. Assessing fitness for surgery: A comparison of questionnaire, incremental shuttle walk, and cardiopulmonary exercise testing in general surgical patients. <i>Br J Anaesth<\/i> 2008; 101: 774\u2013780.","DOI":"10.1093\/bja\/aen310"},{"key":"29","doi-asserted-by":"publisher","unstructured":"29. Cahalin LP, Mathier MA, Semigran MJ, Dec GW, DiSalvo TG. The six-minute walk test predicts peak oxygen uptake and survival in patients with advanced heart failure. <i>Chest<\/i> 1996; 110: 325\u2013332, doi:10.1378\/chest.110.2.325.","DOI":"10.1378\/chest.110.2.325"},{"key":"30","doi-asserted-by":"publisher","unstructured":"30. Frost AE, Langleben D, Oudiz R, Hill N, Horn E, McLaughlin V, et al. The 6-min walk test (6MW) as an efficacy endpoint in pulmonary arterial hypertension clinical trials: Demonstration of a ceiling effect. <i>Vascul Pharmacol<\/i> 2005; 43: 36\u201339, doi:10.1016\/j.vph.2005.03.003.","DOI":"10.1016\/j.vph.2005.03.003"},{"key":"31","doi-asserted-by":"publisher","unstructured":"31. Kaminsky LA, Arena R, Myers J. Reference standards for cardiorespiratory fitness measured with cardiopulmonary exercise testing: Data from the Fitness Registry and the Importance of Exercise National Database. <i>Mayo Clin Proc<\/i> 2015; 90: 1515\u20131523, doi:10.1016\/j.mayocp.2015.07.026.","DOI":"10.1016\/j.mayocp.2015.07.026"},{"key":"32","doi-asserted-by":"crossref","unstructured":"32. Pinto R, Pires ML, Borges M, Pinto ML, Guerreiro CS, Miguel S, et al. Digital home-based multidisciplinary cardiac rehabilitation: How to counteract physical inactivity during the COVID-19 pandemic. <i>Rev Port Cardiol<\/i> 2022; 41: 209\u2013218.","DOI":"10.1016\/j.repc.2021.05.013"},{"key":"33","doi-asserted-by":"publisher","unstructured":"33. Ramachandran HJ, Jiang Y, Tam WWS, Yeo TJ, Wang W. Effectiveness of home-based cardiac telerehabilitation as an alternative to Phase 2 cardiac rehabilitation of coronary heart disease: A systematic review and meta-analysis. <i>Eur J Prev Cardiol<\/i> 2022; 29: 1017\u20131043, doi:10.1093\/eurjpc\/zwab106.","DOI":"10.1093\/eurjpc\/zwab106"},{"key":"34","doi-asserted-by":"crossref","unstructured":"34. Batalik L, Konecny V, Dosbaba F, Vlazna D, Brat K. Cardiac rehabilitation based on the walking test and telerehabilitation improved cardiorespiratory fitness in people diagnosed with coronary heart disease during the COVID-19 pandemic. <i>Int J Environ Res Public Health<\/i> 2021; 18: 2241.","DOI":"10.3390\/ijerph18052241"},{"key":"35","doi-asserted-by":"crossref","unstructured":"35. Brouwers RWM, Kraal JJ, Regis M, Spee RF, Kemps HMC. Effectiveness of cardiac telerehabilitation with relapse prevention: SmartCare-CAD randomized controlled trial. <i>J Am Coll Cardiol<\/i> 2021; 77: 2754\u20132756.","DOI":"10.1016\/j.jacc.2021.03.328"},{"key":"36","doi-asserted-by":"crossref","unstructured":"36. Shikuma A, Nishi M, Matoba S. Sex differences in process-of-care and in-hospital prognosis among elderly patients hospitalized with acute myocardial infarction. <i>Circ J<\/i> 2024; 88: 1201\u20131207.","DOI":"10.1253\/circj.CJ-23-0543"},{"key":"37","doi-asserted-by":"crossref","unstructured":"37. Garcia M, Mulvagh SL, Merz CNB, Buring JE, Manson JAE. Cardiovascular disease in women: Clinical perspectives. <i>Circ Res<\/i> 2016; 118: 1273\u20131293.","DOI":"10.1161\/CIRCRESAHA.116.307547"},{"key":"38","doi-asserted-by":"crossref","unstructured":"38. Hoshi T, Sawano M, Kohsaka S, Ishii H, Amano T, Takeuchi T, et al. Impact of sex differences on clinical outcomes in patients following primary revascularization for acute myocardial infarction: Insights from the Japanese nationwide registry. <i>Circ J<\/i> 2024; 88: 1211\u20131222.","DOI":"10.1253\/circj.CJ-23-0966"},{"key":"39","doi-asserted-by":"publisher","unstructured":"39. Champney KP, Frederick PD, Bueno H, Parashar S, Foody J, Merz CNB, et al. The joint contribution of sex, age and type of myocardial infarction on hospital mortality following acute myocardial infarction. <i>Heart<\/i> 2009; 95: 895\u2013899, doi:10.1136\/hrt.2008.155804.","DOI":"10.1136\/hrt.2008.155804"},{"key":"40","doi-asserted-by":"publisher","unstructured":"40. Vaccarino V, Parsons L, Peterson ED, Rogers WJ, Kiefe CI, Canto J. Sex differences in mortality after acute myocardial infarction: Changes from 1994 to 2006. <i>Arch Intern Med<\/i> 2009; 169: 1767\u20131774, doi:10.1001\/archinternmed.2009.332.","DOI":"10.1001\/archinternmed.2009.332"},{"key":"41","doi-asserted-by":"crossref","unstructured":"41. Kimberley LW, Reed JL. Meeting the needs of women in cardiac rehabilitation. <i>Circulation<\/i> 2019; 139: 1247\u20131248.","DOI":"10.1161\/CIRCULATIONAHA.118.037754"},{"key":"42","doi-asserted-by":"crossref","unstructured":"42. Samayoa L, Grace SL, Gravely S, Scott LB, Marzolini S, Colella TJF. Sex differences in cardiac rehabilitation enrollment: A meta-analysis. <i>Can J Cardiol<\/i> 2014; 30: 793\u2013800.","DOI":"10.1016\/j.cjca.2013.11.007"},{"key":"43","doi-asserted-by":"crossref","unstructured":"43. Ghram A, Briki W, Mansoor H, Al-Mohannadi AS, Lavie CJ, Chamari K. Home-based exercise can be beneficial for counteracting sedentary behavior and physical inactivity during the COVID-19 pandemic in older adults. <i>Postgrad Med<\/i> 2021; 133: 469\u2013480.","DOI":"10.1080\/00325481.2020.1860394"},{"key":"44","doi-asserted-by":"crossref","unstructured":"44. Thomas RJ, Petersen CE, Olson TP, Beatty AL, Ding R, Supervia M. Asynchronous and synchronous delivery models for home-based cardiac rehabilitation: A scientific review. <i>J Cardiopulm Rehabil Prev<\/i> 2021; 41: 407\u2013412.","DOI":"10.1097\/HCR.0000000000000656"},{"key":"45","doi-asserted-by":"publisher","unstructured":"45. Irfan A, Lever JM, Fouad MN, Sleckman BP, Smith H, Chu DI, et al. Does health literacy impact technological comfort in cancer patients? <i>Am J Surg<\/i> 2022; 223: 722\u2013728, doi:10.1016\/j.amjsurg.2021.08.006.","DOI":"10.1016\/j.amjsurg.2021.08.006"},{"key":"46","doi-asserted-by":"crossref","unstructured":"46. Brower RG. Consequences of bed rest. <i>Crit Care Med<\/i> 2009; 37(Suppl): S422\u2013S428.","DOI":"10.1097\/CCM.0b013e3181b6e30a"},{"key":"47","doi-asserted-by":"publisher","unstructured":"47. Taylor JL, Medina-Inojosa JR, Chacin-Suarez A, Smith JR, Squires RW, Thomas RJ, et al. Age-related differences for cardiorespiratory fitness improvement in patients undergoing cardiac rehabilitation. <i>Front Cardiovasc Med<\/i> 2022; 9: 872757, doi:10.3389\/fcvm.2022.872757.","DOI":"10.3389\/fcvm.2022.872757"},{"key":"48","doi-asserted-by":"publisher","unstructured":"48. Kwast S, Hoffmann J, P\u00f6kel C, Falz R, Schulze A, Schr\u00f6ter T, et al. Cardiopulmonary exercise capacity markers and their link to symptom burden in patients at risk for heart failure with non-reduced ejection fraction. <i>Sci Rep<\/i> 2025; 15: 8940, doi:10.1038\/s41598-025-94172-1.","DOI":"10.1038\/s41598-025-94172-1"}],"container-title":["Circulation Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/circj\/89\/10\/89_CJ-25-0227\/_pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T03:38:25Z","timestamp":1758944305000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/circj\/89\/10\/89_CJ-25-0227\/_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,25]]},"references-count":48,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.1253\/circj.cj-25-0227","relation":{},"ISSN":["1346-9843","1347-4820"],"issn-type":[{"value":"1346-9843","type":"print"},{"value":"1347-4820","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,25]]},"article-number":"CJ-25-0227"}}