{"id":"45965","type":"article","url":"https://hartvaat.nl/2026/05/21/swedeheart-na-een-eerste-hartinfarct-is-fysieke-fitheid-bij-start-cardiale-reval/","title":"SWEDEHEART: na een eerste hartinfarct is fysieke fitheid bij start cardiale revalidatie ver onder de norm","title_en":"","category":"algemeen","category_label":"Algemeen","professions":["cardioloog","huisarts"],"tags":[],"journal":"Open Heart","doi":"http://openheart.bmj.com/cgi/content/short/13/1/e004046?rss=1","source_url":"https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e004046?rss=1","authors":["Hedin","K.","Carlen","A.","Hadziosmaniovic","N.","Hagstro&#x0308;m","E.","Jernberg","T.","Leosdottir","M.","Ravn-Fischer","A.","Sandberg","C.","Ahlund","K.","Urell","C.","Ba&#x0308;ck","M."],"significance":6,"published":"2026-07-05","source_date":"2026-05-21","image":"","kennis":["https://hartvaat.nl/kennis/farmacologie/betablokkers-cardiale-indicaties/","https://hartvaat.nl/kennis/coronairlijden/stemi/"],"congress":"","summary_en":"Registry study from the Swedish SWEDEHEART post-MI register (2016-2019) in 15,105 patients with first-time myocardial infarction (mean age 62.5 years; 78.4% male) who underwent physiotherapist-led assessments of exercise capacity (symptom-limited cycle ergometry) and muscular endurance (unilateral heel-rise test) at the start of cardiac rehabilitation. Results were compared with Swedish age- and sex-stratified reference values (Kalmar dataset). Mean exercise capacity was only 64.7% of predicted in men and 68.4% in women; muscular endurance 78.4% in men and 61.7% in women. Women showed a steeper age-related decline in heel-rise performance. The results underscore the importance of systematic baseline assessment and tailored rehabilitation targeting both exercise capacity and muscle strength.","created":"2026-07-03T20:26:59Z","updated":"2026-07-04T14:56:28Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Registratiestudie uit het Zweedse SWEDEHEART post-MI-register (2016-2019) bij 15.105 patiënten met een eerste myocardinfarct (gemiddelde leeftijd 62,5 jaar; 78,4% mannen) die bij start van fysiotherapeut-gestuurde cardiale revalidatie inspanningscapaciteit (symptoomgelimiteerde fietsergometrie) en spieruithoudingsvermogen (unilaterale hielheffing-test) ondergingen. Resultaten werden vergeleken met Zweedse leeftijds- en geslachtsspecifieke referentiewaarden (Kalmar-dataset). De gemiddelde inspanningscapaciteit bedroeg slechts 64,7% van de voorspelde waarde bij mannen en 68,4% bij vrouwen; spieruithoudingsvermogen 78,4% bij mannen en 61,7% bij vrouwen. Vrouwen vertoonden een steilere leeftijdsgerelateerde achteruitgang in hielheffing. De resultaten onderstrepen het belang van systematische uitgangsmetingen en op maat gemaakte rehabilitatie-interventies, gericht op zowel inspanningscapaciteit als spierkracht.","abstract_original":"<sec><st>Purpose</st>\n<p>The primary aim of this study was to describe physical fitness in a large real-world cohort of patients entering exercise-based cardiac rehabilitation (EBCR) after first-time myocardial infarction (MI). The secondary aim was to compare the results with clinical reference values.</p>\n</sec>\n<sec><st>Methods</st>\n<p>This registry-based cohort study used data from the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART) post-MI registry between 2016 and 2019. Patients with first-time MI who underwent physiotherapist-led assessments of physical fitness at EBCR entry were included. Exercise capacity was evaluated by a symptom-limited cycle ergometer test and muscular endurance by a unilateral heel-rise test. Results were compared with age-stratified and sex-stratified clinical reference values. Reference values for exercise capacity were based on the Swedish Kalmar dataset, the national standard reference in Sweden since 2014, and reference values for heel-rise performance were based on a Swedish normative dataset of healthy adults.</p>\n</sec>\n<sec><st>Results</st>\n<p>A total of 15 105 patients (mean age 62.5&plusmn;9.1 years, 78.4% men) were included. Exercise capacity (Watt max from the exercise test) was higher in men than women across age groups, and muscular endurance declined with age, with a steeper age-related decline in women&rsquo;s heel rise performance. The mean exercise capacity of the study population corresponded to 64.7&plusmn;27.4% of predicted values in men and 68.4&plusmn;18.9% in women. Muscular endurance averaged 78.4%&plusmn;51.0% of reference values in men and 61.7%&plusmn;43.2% in women.</p>\n</sec>\n<sec><st>Conclusion</st>\n<p>At EBCR entry after a first-time MI, both exercise capacity and muscular endurance were substantially below age-specific and sex-specific reference values. These results underscore the importance of systematic baseline assessments and tailored rehabilitation interventions targeting both exercise capacity and muscular endurance.</p>\n</sec>"}