{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:11:57Z","timestamp":1787026317772,"version":"build-2736575974"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T00:00:00Z","timestamp":1623110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>\n                    <jats:bold>Aims:<\/jats:bold>\n                    The number of elderly patients affected with multiple chronic diseases is constantly increasing. Even though multiple studies demonstrated a beneficial effect of cardiac rehabilitation, we do not have data on the outcomes in elderly patients with obesity and heart disease.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    We studied 772 consecutive obese subjects (275 women; 35.6%) aged \u226570 years, affected with coronary artery disease and\/or heart failure. We conducted a symptom limited exercise test at the beginning and at the end of the program, which consisted of aerobic and strength physical activity, diet, and psychological counseling.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Mean body mass index (BMI) at baseline was 37.6 \u00b1 4.4 kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    and decreased to 36.4 \u00b1 4.3 kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    (\n                    <jats:italic>P<\/jats:italic>\n                    &amp;lt; 0.001). At baseline, attained metabolic equivalents (METs) were 4.7 \u00b1 1.7, and by the end of the program, they were 5.6 \u00b1 2.1 (\n                    <jats:italic>P<\/jats:italic>\n                    &amp;lt; 0.001). The mean improvement was 21.6 \u00b1 21.7% (median, 17.6%; 95% CI, 20.0\u201323.1%). Patients over 80 years old had similar results compared to the younger ones. Diabetics did worse than non-diabetic patients: the improvement they reached was 19.4 \u00b1 18.9% vs. 23.8 \u00b1 23.9% (\n                    <jats:italic>P<\/jats:italic>\n                    = 0.005). The presence of heart failure was significantly related to both the baseline and final performance, but the attained improvement was significantly greater in heart failure patients: 24.3 \u00b1 23.8% vs. 16.3 \u00b1 15.4% (\n                    <jats:italic>P<\/jats:italic>\n                    &amp;lt; 0.001). No patient had adverse events related to the program.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    This study documents a significant improvement in exercise capacity in elderly obese patients affected with heart disease who underwent a rehabilitation program.\n                  <\/jats:p>","DOI":"10.3389\/fcvm.2021.652921","type":"journal-article","created":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T00:28:45Z","timestamp":1623112125000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Beneficial Effect on Exercise Tolerance of a Comprehensive Rehabilitation Program in Elderly Obese Patients Affected With Heart Disease"],"prefix":"10.3389","volume":"8","author":[{"given":"Luca 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