The effect of Beta-Hydroxy beta-Methyl Butyrate calcium combined with exercise therapy in patients with heart disiase(The effect of HMB-Ca combined with exercise therapy in patients with heart disiase)

INTERVENTION: Use 1.5 g of HMB‐Ca tablets. The study period is 60 days from the start of cardiac rehabilitation. 52 patients were randomly divided into 2 groups, HMB‐Ca group consuming 1.5 g of 6 tablets of HMB‐C a once daily for 60 days, and Placebo group consuming1.2 g of reduced maltose once daily for 60 days. Exercise therapy was performed in both groups, with supervised exercise therapy (1‐5 times a week) combined with unsupervised exercise therapy (1‐2 times a week), and exercise therapy for 30 minutes each, for a total of 3 times (at least) a week. CONDITION: Heart disease (myocardial infarction or angina, post‐open heart surgery, chronic heart failure) ; Heart disease (myocardial infarction or angina, post‐open heart surgery, chronic heart failure) PRIMARY OUTCOME: Quadriceps muscle strength SECONDARY OUTCOME: grip strength; lower limb extension strength; Skeletal muscle mass; quadriceps muscle thickness; Energy consumption (physical activity); Short Physical Performance Battery(SPPB); 10‐m timed gait test; SF‐12v2 Japanese edition; cardiopulmonart exercise testing(peakVO2,Peak‐Load,AT); albumin; total protein; brain natriuretic peptide; creatinine; blood urea nitrogen; estimated glomerular filtration rate; cystatin C; calcium; creatine kinase; CK‐MB; microRNA(miR‐181a, miR‐181b, miR‐181c, miR‐484); BDNF(Brain Derived Neurotrophic Factor); nutritional components in urine and dietary survey INCLUSION CRITERIA: 1) Patients who newly started outpatient cardiac rehabilitation at Showa University Fujigaoka Rehabilitation Hospital 2) Patients with heart disease (myocardialinfarction or angina, post‐open heart surgery, chronic heart failure) as the name of rehabilitation disease 3) Patients who voluntarily consented to the document after receiving an explanation using the patient's document when participating in this study. 4) Patients are 40 years of age or more.