***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Hypertension is the most prevalent comorbidity after heart transplantation ( HT ) .  Exercise training ( ET ) is widely recommended as a key non-pharmacologic intervention for the prevention and management of hypertension , but its effects on ambulatory blood pressure ( ABP ) and some mechanisms involved in the pathophysiology of hypertension have not been studied in this population . The primary purpose of this study was to investigate the effects of ET on ABP and arterial stiffness of HT recipients . METHODS 40 HT patients , r and omized to ET ( n = 31 ) or a control group ( n = 9 ) underwent a maximal grade d exercise test , 24-hour ABP monitoring , and carotid-femoral pulse wave velocity ( PWV ) assessment before the intervention and at a 12-week follow-up assessment . The ET program was performed thrice-weekly and consisted primarily of endurance exercise ( 40 minutes ) at ~70 % of maximum oxygen uptake ( Vo2MAX ) . RESULTS The ET group had reduced 24-hour ( 4.0 ± 1.4 mm Hg , p < 0.01 ) and daytime ( 4.8 ± 1.6 mm Hg , p < 0.01 ) systolic ABP , and 24-hour ( 7.0 ± 1.4 mm Hg , p < 0.001 ) daytime ( 7.5 ± 1.6 mm Hg , p < 0.001 ) and nighttime ( 5.9 ± 1.5 mm Hg , p < 0.001 ) diastolic ABP after the intervention . The ET group also had improved Vo2MAX ( 9.7 % ± 2.6 % , p < 0.001 ) after the intervention . However , PWV did not change  after ET . No variable was changed in the control group after the intervention . CONCLUSIONS The 12-week ET program was effective for reducing ABP but not PWV in heart transplant recipients . This result suggests that endurance ET may be a tool to counteract hypertension in this high-risk population In heart transplant ( HTx ) recipients , there has been reluctance to recommend high‐intensity interval training ( HIIT ) due to denervation and chronotropic impairment of the heart . We compared the effects of 12 weeks ' HIIT versus continued moderate exercise ( CON ) on exercise capacity and chronotropic response in stable HTx recipients > 12 months after transplantation in a r and omized crossover trial . The study was completed by 16 HTx recipients ( mean age 52 years , 75 % males )  . Baseline peak oxygen uptake ( VO2peak ) was 22.9 mL/kg/min . HIIT increased VO2peak by 4.9 ± 2.7 mL/min/kg ( 17 % ) and CON by 2.6 ± 2.2 mL/kg/min ( 10 % ) ( significantly higher in HIIT ; p < 0.001 ) . During HIIT , systolic blood pressure decreased significantly ( p = 0.037 ) with no significant change in CON ( p = 0.241 ; between group difference p = 0.027 ) . Peak heart rate ( HRpeak ) increased significantly by 4.3 beats per minute ( p = 0.014 ) after HIIT with no significant change in CON ( p = 0.34 ; between group difference p = 0.027 ) . Heart rate recovery ( HRrecovery ) improved in both groups with a trend toward greater improvement after HIIT . The 5‐month washout showed a significant loss of improvement . HIIT was well tolerated , had a superior effect on oxygen uptake , and led to an unexpected increase in HRpeak accompanied by a faster HRrecovery . This indicates that the benefits of HIIT are partly a result of improved chronotropic response Background Aerobic exercise training improves vasodilatory capacity of peripheral resistance vasculature and modifies plasma proinflammatory markers in chronic heart failure patients . It is , however , currently unknown whether aerobic exercise has a similar effect in heart transplant recipients ( HTR ) . Design and Methods Eight weeks after transplantation , 14 HTR were r and omly assigned to 12 weeks of supervised aerobic exercise training ( TRAINED ; n = 8) or attention-time control ( CONTROL ; n = 6 ) in addition to posttransplantation medical care . Peak forearm blood flow and calf blood flow ( CBF ) during reactive hyperemia after 5 min of limb ischemia was used as a measure of endothelium-dependent vasodilation of limb resistance arteries . Plasma C-reactive protein , interleukin-6 ( IL-6 ) , tumor necrosis factor-alpha ( TNF-α ) , soluble intercellular adhesion molecule-1 ( sICAM-1 ) , and exercise capacity were measured at baseline and again after 12 weeks in both groups . Results Peak CBF increased 22 % in the TRAINED ( 25.9±5.8 - 31.6±7.9 ml/min/100 ml , P<0.05 ) , but there was no change in peak CBF after 12 weeks in CONTROL . Plasma C-reactive protein , IL-6 , TNF-α , sICAM-1 did not change in TRAINED , but there was a significant increase in TNF-α ( 1.66±1.02 vs. 3.07± 1.10 pg/ml , P < 0.05 ) , and sICAM-1 ( 205.9±59.1 vs. 245.0 ± 47.9 ng/ml , P<0.01 ) in CONTROL after 12 weeks . Furthermore , exercise test duration improved 51.7 % ( P<0.01 ) and there was a trend toward an increase in peak VO2 ( P = 0.05 ) in TRAINED after 12 weeks but neither changed in CONTROL . Conclusion A program of supervised aerobic exercise  improves endothelium-dependent vasodilation of the calf , but not forearm resistance arteries , and may attenuate a progressive increase in selected proinflammatory markers in HTR Aim To evaluate the effects of home- and hospital-exercise programs on exercise capacity and chronotropic variables in patients with heart transplantation . Methods Forty patients were r and omized into two groups either hospital- or home-based exercise program . The patients were compared , before and after the rehabilitation program , with respect to maximal oxygen uptake ( pVO2 ) , chronotropic variables [ heart rate reserve ( HRRe ) , heart rate recovery ( HRR1 ) , and chronotropic response index ( CRI ) ] and Duke Treadmill Score ( DTS ) . Results Hospital-based exercise group has shown a significant recovery in post-exercise pVO2 ( pre-exercise 16.73 ± 3.9 ml/kg/min , post-exercise 19.53 ± 3.89 ml/kg/min , P = 0.002 ) and DTS ( pre-exercise 4.74 ± 1.17 , post-exercise 5.61 ± 1.11 , P = 0.002 ) . A significant recovery in favor of the hospital-based exercise group was found in HRRe ( pre-exercise 26.9 ± 14.6 , post-exercise 34.6 ± 14.6 , P = 0.01 ) . No significant change was observed in HRR1 ( pre-exercise −1.38 ± 1.04 , post-exercise −1.21 ± 1.89 , P = 0.49 ) and CRI ( pre-exercise 0.44 ± 0.23 , post-exercise 0.48 ± 0.20 , P = 0.15 ) in hospital-based exercise group . No significant change was observed in any parameters of home-based group ( P > 0.05 ) . Conclusion A significant recovery was observed both in the functional capacity and the chronotropic response  in hospital-based exercise program . Exercise programs that are planned to be performed under supervision in rehabilitation units are useful for the patients with heart transplant in terms of the exercise capacity and chronotropic variables OBJECTIVE To compare the effects of two physical therapy exercise in-hospital programs in pulmonary function and functional capacity of patients in the postoperative period of heart transplantation . METHODS Twenty-two heart transplanted patients were r and omized to the control group ( CG , n=11 ) and training group ( TG , n=11 ) . The control group conducted the exercise program adopted as routine in the institution and the training group has had a protocol consisting of 10 stages , with incremental exercises : breathing exercises , resistance training , stretching and walking . The programs began on the first day after extubation and stretched until hospital discharge . Assessed pulmonary function , distance walked in six minutes walk test ( 6MWT ) and peripheral muscle strength by one repetition maximum test ( 1RM ) . RESULTS Similar behavior was observed between the two groups treated , with statistically significant increases between the first and second test of the following variables : FVC ( 59 % in CG and 35.2 % in TG ) ; MIP ( 8.6 % in CG and 53.5 % in TG ) , MEP ( 28.8 % in CG and 40.7 % in TG ) and 6MWT ( 44.5 % in CG and 31.4 % in TG ) . There was an increase of peripheral strength by 1RM test , over time , to the muscle groups of the elbow flexors , shoulder flexors , hip abductors and knee flexors . CONCLUSION Heart transplant patients benefit from exercise programs in hospital , regardless of the program type applied . A new training proposal did not result in superiority compared to routine programme applied . Exercise protocol s provided improves in ventilatory variables and functional capacity of this population The aim of the review was to assess the effect of patient education in ischaemic heart disease . Thirteen r and omised controlled trials of moderate to good quality including 68,556 patients were selected . The effect on mortality , cardiac morbidity , hospitalisation and health-related quality of life was assessed and only non-significant tendencies of effect were found . The authors of the review nevertheless conclude that the review supports current rehabilitation programmes that include patient education . Further research in patient education , especially concerning the most effective methods of education delivery , is needed BACKGROUND Heart transplantation normalizes central hemodynamics , but endothelial dysfunction persists after transplantation . METHODS To investigate the effects of aerobic exercise on arterial function , oxidative stress , lipid profile , and sympathetic nervous system activity , 20 heart transplant recipients ( age , 54.3 + /- 9.1 years ; 17 men , 3 women ) were r and omly assigned to 12 weeks of supervised treadmill exercise ( Trained ; n = 10 ) or st and ard medical care ( Control ; n = 10 ) . Supervised exercise was initiated at 8 weeks after transplant .  Brachial artery reactivity was assessed using flow-mediated dilation . RESULTS The VO2 peak increased 26 % in the Trained patients ( 15.4 + /- 4.3 vs 19.4 + /- 5.5 ml/kg/min ; p < or = 0.05 ) but did not change in the Controls ( 16.2 + /- 5.2 vs 16.8 + /- 2.8 ml/kg/min ; p > or = 0.05 ) . Brachial artery flow-mediated dilation ( 10.1 % + /- 6.1 % vs 9.6 % + /- 6.2 % ) and absolute brachial diameter ( 0.48 + /- 0.22 vs 0.42 + /- 0.24 mm ) did not change in Trained patients , but brachial flow-mediated dilation ( 10.5 % + /- 2.8 % vs 7.9 % + /- 5.1 % ) and the absolute change in brachial diameter ( 0.48 + /- 0.16 vs 0.36 + /- 0.24 mm ) decreased significantly ( p < or = 0.05 ) in the Control patients . Resting norepinephrine decreased significantly ( p < or = 0.05 ) after training ( 0.32 + /- 0.19 vs 0.22 + /- 0.22 ng/ml ) , but there was a nonsignificant trend toward increased norepinephrine in the Controls ( 0.26 + /- 0.17 vs 0.53 + /- 0.41 ng/ml ; p = 0.07 ) . The lipid profile and marker of oxidative stress did not differ between the groups before or after the intervention . CONCLUSIONS To our knowledge , this is the first prospect i ve , r and omized study to investigate the effects of heart transplantation and aerobic exercise on peripheral artery function in the same cohort of heart transplant recipients . Brachial artery flow-mediated dilation increased early in the post-operative period . Aerobic exercise preserved but did not improve brachial artery flow-mediated dilation .  Heart transplant recipients who did not participate in supervised exercise showed a progressive decline in brachial artery flow-mediated dilation Longterm treatment after heart transplantation ( HTX ) improves survival , although the quality of life and exercise tolerance decreased continuously between one and ten years after transplantation . The role of physical exercise and psychological support in longterm treatment after HTX has not been determined . We analyzed the effects of a one year outpatient rehabilitation program in combination with a home based , computer assisted training program on exercise 
    Output:
    
One adverse event was reported by one study .Exercise-based cardiac rehabilitation improves exercise capacity , but exercise was found to have no impact on health-related quality of life in the short-term ( median 12 weeks follow-up ) , in heart transplant recipients whose health is stable .
There was no evidence of statistical heterogeneity across trials for exercise capacity and no evidence of small study bias .
We found moderate quality evidence suggesting that exercise-based cardiac rehabilitation improves exercise capacity , and that exercise has no impact on health-related quality of life in the short-term ( median 12 weeks follow-up ) , in heart transplant recipients .