Are we aware of the importance of the cardiac rehabilitation?

Cardiovascular diseases are worldwide number one cause of mortality and morbidity (1). The main reason ofthe decrease in mortality due to coronary artery disease is not just the advances in treatment of the acute coronary syndromes, but also the advances in the secondary prevention methods. Cardiac rehabilitation programs are secondary prevention methods for the treatment of cardiovascular diseases (2). Cardiac rehabilitation is a comprehensive and long term program that aims to keep the physical, physiologic, psychologic, social and working capacities of cardiologic patients at high levels and consists of personal exercises under supervision, medical evaluation, and evaluation of risk profiles, education, medical counseling and modification of coronary artery disease by pharmacologic and non-pharmacologic approaches (3-5).

The cardiac rehabilitation first came into question in 1970s and itwas only applied after myocardial infarction (MI). After the benefits and reliabilities have been proved the indications have been extended, and today widely used in most cardiovascular diseases (cardiomyopathy, hearth valve replacement, pacemaker, cardiac transplant, heart failure, metabolic syndrome, diabetes mellitus) (6).

Even though the previous studies showed that cardiac rehabilitation lowers the risk of mortality, only 20% patients in USA (the most widely used country) are taking the cardiac rehabilitation programs (7).

This article aims to review the scientific researches about cardiac rehabilitation in Turkey and all in the world to demonstrate their number and distribution in journals by years and through that to evaluate the researches in our country.

We evaluated the publications of the journals in science citation index (SCI) and science citation index expanded (SCI-E) about cardiac rehabilitation. For this purpose, we used Thomson Reuters Web of Knowledge-Web of Science software. 'Cardiac rehabilitation' and '2003-2013' were the key words which were entered for the topic and years published section (31/10/2013).

We also evaluated the abstracts of the scientific publications that researchers from our country take part. There are 3889 scientific publications about cardiac rehabilitation all in the world between the years 2003-2013. The distribution of the publications by country is listed in Table 1.

Among all the publications about cardiac rehabilitation the USA is number one with 28% and our country ranked 28th with a percentage of 0.74.2632 (67.7%) of those publications are article, 620 (15.9%) of those are meeting summary, 316 (8.1%) of those are review.

Among all the scientific publications that researchers from our country take part 72% of them are article and 6.8% of them are review.

Since 2003 there is a rise in the number of the researches all in the world. In our country maximum number (seven scientific publications) of publications are added to world literature in 2007. The distribution of the publications by years in all over the world and in Turkey is demonstrated in Figure 1 and 2.

The list of the first 10 journals of SCI and SCI-E that has published articles about cardiac rehabilitation is outlined in Table 2. The Anadolu Kardiyoloji Dergisi (Anatolian Cardiology Journal) is in the first place among the journals that accepts the manuscripts of Turkish researchers with 5 articles (17.2%) and Clinical Research in Cardiology is in the second place with 2 articles (6.8%). The Anatolian Cardiology Journal is mostly preferred as a SCI-E journal.

Among all the publications in Turkey the cardiology and cardiovascular diseases departments take the first place.

Overall the number of the articles about cardiac rehabilitation in our country has a lower percentage in the world due to the higher costs and the unawareness of the physicians about cardiac rehabilitation programs. These results demonstrate the limited number of publications from our country. Therefore assemblies of societies in many countries should focus on training and assessment of competence of physicians about cardiac rehabilitation. Courses aiming to develop skills and knowledge and hands-on training in the field of cardiac rehabilitation are needed to implement cardiac rehabilitation in physicians' daily practice. We believe that this analysis and contribution of physicians to the literature are essential in developing and improving future plans of our society regarding cardiac rehabilitation.

Conflict of interest: None declared.

Peer-review: Externally peer-reviewed.

Authorship contributions: Concept - G.Ö., S.E.; Design - G.Ö.; Supervision - A.A., E.O., Ö.S.; Resource - G.Ö., S.E.; Data collection&/or processing - S.B., G.Ö., S.E.; Analysis &/or interpretation - G.Ö., S.E.; Literature search - G.Ö., S.E.; Writing - G.Ö., S.E., S.B.; Critical review - E.O., A.A., Ö.S.

References

References

1. Fox S. Relationship of activity habits to coronary heart disease. Exercise Testing and Exercise Training in Coronary Heart Disease. In: Naughton J, Hellerstein HK, editors. Academic Press. New York: 1973.p. 3-21.

2. Aggarwal A, Ades PA. Exercise rehabilitation of older patients with cardiovascular disease. Cardiol Clin 2001; 19: 525-36. [CrossRef]

3. Frontera WR, Dawson MD, Slovik DM, editors. Exercise in Rehabilitation Medicine. Human Kinetics; 1999.

4. Topol JE. Textbook of Cardiovascular Medicine (çeviri: Ülker, T, Yüksel, A, Talay, M.), Dursun, NA, Ed. Lippincott Williams & Wilkins: Diizey Matbaacilik; 2005.

5. Oral A. Kardiyak Rehabilitasyon. In; Diniz F, Ketenci A, editors, Fiziksel Tip ve Rehabilitasyon. Istanbul: Nobel Tip Kitapevleri; 2000.p.509-29.

6. Demirsoy N, Taskiran ÖÖ. Yaslilarda Kardiyak Rehabilitasyon: Türkiye'ye ve Dünya'ya Genel Bir Bakis. Turkish Journal of Geriatrics 2010; özel sayi 2: 125-33.

7. Williams MA, Fleg JL, Ades PA, Chaitman BR, Miller NH, Mohiuddin SM, et al. Secondary prevention of coronary heart disease in the elderly (with emphasis on patients > or =75 years of age). Circulation 2002; 105: 1735-43. [CrossRef]