CARDIOVASCULAR EXERCISE & REHABILITATION
Cardiac rehabilitation is a multidisciplinary intervention with exercise as a core component, offering well-established benefits for cardiovascular patients. Research in this field is expanding through cross-disciplinary collaboration in physiology, molecular biology, bioengineering, and neurosciences. While traditionally focused on heart failure and coronary artery disease, current programs also address heart transplantation, CRT, ICDs, and LVADs.
The Exercise and Cardiac Rehabilitation Research Unit operates across three main areas: Teaching, Research, and Clinical Care, including cardiovascular disease management and community prevention.
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Teaching
The Lisbon School of Medicine pioneered the country’s first Master’s in Cardiovascular Rehabilitation, advancing professional training and scientific research. The program aims to prepare health professionals for multidisciplinary teams and promote high-level research in cardiovascular prevention and rehabilitation. -
Research
The Cardiovascular Exercise and Rehabilitation Laboratory is equipped to assess physical activity, sedentary behavior, strength, cardiac function, and exercise capacity using advanced techniques such as exercise testing and echocardiography. This includes standard and cardiorespiratory exercise testing, performed on a treadmill or cycle ergometer, as well as echocardiographic evaluation. Research focuses include the acute and chronic effects of exercise, training modalities (e.g., HIIT vs. MCT), autonomic function, cardiac remodeling, and predictors of exercise response. Our goal is to foster collaboration between cardiologists, internists, exercise physiologists, physiotherapists, technicians, nutritionists, biologists, engineers, and other professionals.
Our current research priorities include:
Effects of different exercise modalities (e.g., HIIT vs. MCT)
Mechanisms of exercise action across various protocols and patient profiles
Exercise and autonomic nervous system function
Predictors of exercise response and mechanisms underlying nonresponse
Cardiac rehabilitation programs tailored to frail, TAVI, and elderly patients
Cardiac rehabilitation in women
Cardiac rehabilitation in patients with comorbidities
Cardiac rehabilitation and depression
Tools to enhance long-term adherence to exercise programs -
Clinical Care
The ULS Santa Maria/FMUL-UL Cardiovascular Rehabilitation Programme covers all phases of care — from hospital (phase I) to community-based maintenance (phase III). The Cardiovascular Exercise and Rehabilitation Laboratory plays a central role in phase III, primarily serving patients in the long-term maintenance stage. It regularly evaluates their functional capacity, strength, physical activity levels and cardiac performance to guide and optimize ongoing rehabilitation. The Cardiovascular Rehabilitation Centre of the University of Lisbon (CRECUL), phase III, a partnership with FMUL, FMH, and the University Stadium, serves as a hub for community health promotion, student training, and secondary prevention.
In addition to the CRECUL, the Cardiovascular Exercise and Rehabilitation Laboratory carries out other actions to support the community, namely through strategic actions with the Portuguese population in primary and secondary prevention with a view to promoting healthy lifestyles.
RESEARCH TEAM
Pinto, Rita, PhD
Group Leader
Rita Pinto holds a PhD in Physical Activity and Health (2019) at the Faculty of Human Kinetics, University of Lisbon (FMH-UL), Portugal. She completed her Graduation degree in Sports Science (2010) and a Master degree in Exercise and Health (2012) at the FMH-UL. She also has a postgraduate qualification in Cardiac Rehabilitation since 2012 from FMH-UL and the EAPC Practical Course on Preventive Cardiology – Cardiovascular Prevention Rehabilitation, Sports Cardiology and Exercise since 2022.
She is currently an Invited Professor and Researcher at the Faculty of Medicine of the University of Lisbon (FMUL) and an Exercise Physiologist at the Cardiovascular Rehabilitation Center of the ULSSM/FMUL/CRECUL, an accredited centre from the European Association of Preventive Cardiology of the European Society of Cardiology.
Since 2021, she belongs to the Scientific Committee Member at the International Master degree in Cardiovascular Rehabilitation, FMUL. She also participates, as a member, of the Scientific Committee at the Health Research Network (RISE), since 2022. She is the Coordinator at the Physical Activity Unit of the Preventive Medicine Institute & Public Health, FMUL. She belongs to the EAPC Young Community Core Group for 2024-2026 at the Prevention Implementation Committee.
Since 2025 she is the Assistant Director at the Programa Nacional para a Promoção da Atividade Física (PNPAF), Direção Geral de Saúde (DGS).
Her main research targets are: Cardiovascular Disease, Cardiac Rehabilitation, Exercise Physiology, Exercise Testing, Exercise Prescription, Physical Activity, Sedentary Behavior, Long-term Adherence.
ORCID: 0000-0003-0925-4245
E-mail: mrpinto@medicina.ulisboa.pt
Abreu, Ana , MD, PhD
Senior Researcher
Ana Abreu obtained her Medical Degree from the Lisbon School of Medicine, Universidade de Lisboa, in 1984, and became a Cardiology Consultant in 2002. She coordinated Cardiac Rehabilitation at the Department of Cardiology of Hospital Santa Marta, Centro Hospitalar Lisboa Centro (2004–2017), and since 2018 has been Coordinator of Cardiac Rehabilitation at the Cardiology Department of Santa Maria University Hospital/Pulido Valente Hospital, CHULN, Lisbon. She earned her PhD in Cardiology from the Nova Medical School in 2016, with a thesis on the beneficial effects of exercise training in patients with cardiac resynchronization therapy.
She is Assistant Professor of Cardiology at the Lisbon School of Medicine, Universidade de Lisboa. She served as Chair of the Cardiac Rehabilitation Section of the European Association of Preventive Cardiology (2015–2017) and as Past-Chair (2018), as well as Chair of the Portuguese Working Group of Nuclear Cardiology (1999–2000), and Chair of the Portuguese Working Group of Exercise Pathophysiology and Cardiac Rehabilitation (2007–2011; 2013–2017). She was also National Coordinator for Prevention of the Portuguese Society of Cardiology (2017).
ORCID: 881A-1343-A491
Email: amabreu@medicina.ulisboa.pt
Ruivo, Jorge, MD, PhD
Researcher
Jorge Ruivo graduated from the Lisbon School of Medicine, University of Lisbon, Portugal, in 2004. He completed his Internal Medicine training at Santa Maria Hospital – CHULN, E.P.E., in Lisbon, where he worked as an Internal Medicine Consultant until 2019. He then joined an international pharmaceutical company, where he currently serves as Head of Cardiovascular Medical Affairs.
He holds a postgraduate degree in Sports Medicine (2007) from the Portuguese Society of Sports Medicine and the Lisbon School of Medicine, University of Lisbon. He also obtained a Master’s degree (MSc) in Cardiac Rehabilitation in 2015 from Trinity College Dublin, Ireland. In 2018, he completed a PhD in Cardiovascular Regenerative Medicine at University College London, supported by PhD fellowships from the Calouste Gulbenkian Foundation and the Portuguese Foundation for Science and Technology (FCT).
Since 2016, he has been an Assistant Professor of Internal Medicine at the Lisbon School of Medicine, University of Lisbon. He has also served as an invited lecturer in the MSc programme in Exercise and Wellbeing at Universidade Lusófona, Lisbon, since 2009.
Jorge Ruivo has been a researcher at the Cardiovascular Centre of the University of Lisbon (CCUL) since 2014. He is a member of the Scientific Committee of the National Programme for Physical Activity Promotion from the Portuguese Directorate-General of Health (Direção-Geral da Saúde) and is part of the Fighting Physical Inactivity Committee of ECOSEP (European College of Sports and Exercise Physicians).
He is a member of the Editorial Board and reviewer for Revista Medicina Desportiva inForma, and has reviewed manuscripts for Games for Health Journal, Revista Factores de Risco, BMC Geriatrics, and the Journal of Cardiopulmonary Rehabilitation and Prevention.
Areas of interest: Cardiovascular Prevention and Rehabilitation, Sports and Exercise Medicine, Hypertension, Cardiovascular Regenerative Medicine.
ORCID: 0000-0002-3219-4028
E-mail: jorgearsenioruivo@gmail.com
Borges, Mariana, MSc
PhD Student
Mariana Borges is an exercise physiologist at the Cardiovascular Rehabilitation Center of the University of Lisbon (CRECUL) since 2020. Finished her bachelor’s degree in Sports Science in 2015 and her master’s degree in Exercise and Health in 2017 both at the Faculty of Human Kinetics – University of Lisbon (FMH-UL). Between 2017 and 2020 worked as a research fellow at Institute of Molecular Medicine (IMM) and has been working as exercise physiologist at CRECUL since 2020 . She is also a member of the research team of the Laboratory of Cardiovascular Exercise and Rehabilitation from the Cardiovascular Center of the University of Lisbon (CCUL) since 2021.
She is currently a PhD student at the Faculty of Medicine of the University of Lisbon. Since 2022 she has been teaching a class on Functional Fitness Assessment in Cardiovascular Disease Patients at the Cardiovascular Rehabilitation master’s course at Faculty of Medicine of the University of Lisbon(FMUL).
Her areas of interest are Cardiovascular Disease, Cardiac Rehabilitation, Long-term Adherence, Exercise Physiology, Motivational Interviewing, Physical Activity and Sedentary Behaviour.
ORCID: 0000-0003-2829-1703
E-mail:mariana.borges@medicina.ulisboa.pt
Pires, Madalena, MSc
PhD Student
Madalena Lemos Pires completed the Master Degree in Exercise and Health in 2018 by Universidade de Lisboa, Faculdade de Motricidade Humana and the Bacheleror Degree in Sports Sciences in 2015 by the same university.
She is currently a PhD student at the Faculty of Medicine of the University of Lisbon attending the Doctoral Program of the Academic Centre of Medicine of Lisbon since 2023. She is a researcher at the Cardiovascular Exercise and Rehabilitation Laboratory from the Cardiovascular Centre of the University of Lisbon and a Clinical Exercise Physiologist, specialized in assessment and prescription of exercise and physical activity counselling for cardiovascular disease patients, at the Cardiovascular Rehabilitation Centre of the University of Lisbon (CRECUL).
She actively organizes and intervenes in primary and secondary prevention community events, promoting physical activity and healthy lifestyles. Every year she attends national and international congresses, looking for a continued acquisition of knowledge and to establish new relations with other researchers and colleagues.
Her main areas of study are: Exercise and Cardiovascular Disease, Women with Cardiovascular Disease, Physical Activity promotion, Sedentary Behaviour Reduction, Behaviour Modification, Exercise Prescription and Assessment, Healthy aging.
ORCID: 0000-0002-4449-4597
E-mail:madalenap@medicina.ulisboa.pt
Alves da Silva, Pedro, MD
Researcher
Graduated from Lisbon Medical School, Universidade de Lisboa, Portugal (2017). Cardiology resident in Santa Maria Hospital, Lisbon, from 2019-2024. Approved in first year of Cardiac Rehabilitation masters from Lisbon Medical School. Fellowship in Preventive Cardiology and Cardiac Rehabilitation in Inselspital, Bern (2023). Cardiologist working in Cardiac Rehabilitation Department and Echocardiography lab since 2024. Portuguese ambassador for EAPC Young Community from 2024.
ORCID: 0000-0002-3524-908X
E-mail: pmsilva@edu.ulisboa.pt
Nunes, Ana Portela, BSc
Cardiopneumologist Technician
Ana Portela obtained her degree in Cardiopneumology (1996–2000) from the School of Health Technologies of Lisbon (ESTESL). From 1999 to 2021, she worked at the Cardiovascular Institute of Lisbon, where she performed diagnostic procedures in the fields of non-invasive Cardiology and Pneumology. She is currently part of the CCUL – Exercise and Cardiac Rehabilitation Research Unit, where she is directly involved in cardiopulmonary exercise testing (CPET) and collaborates on various research projects.
Her main areas of interest include Cardiovascular Disease, CPET, and Cardiac Rehabilitation.
E-mail: a.portelanunes@gmail.com
Aguiar-Ricardo, Inês, MD
Researcher
Medical Degree in 2013 (NOVA Medical School, Lisbon). Cardiologist at Santa Maria Hospital – CHULN, E.P.E, Lisbon since 2019. Post-graduation in Sports Medicine (Faculty of Medicine of Porto University, July 2018). Cardiology Invited Assistant, NOVA Medical School, Lisbon (2014-2016). Areas of interest: heart failure and cardiomyopathies, cardiac rehabilitation, sports medicine.
ORCID: 0000-0002-9951-1104
E-mail: ines.a.ricardo@gmail.com
Co-Researcher in Heart Failure and Cardiomyopathies
Sá, Gonçalo, MSc
Research Assistant
Gonçalo de Sá completed his Master’s Degree in Exercise and Health in 2021 at the Faculty of Human Kinetics, University of Lisbon (FMH-UL), and holds a Degree in Physical Education and Sports (Exercise and Well-Being), completed in 2019 at the Lusophone University of Humanities and Technologies.
Since 2021, he has been working as an Exercise Physiologist at the Cardiovascular Rehabilitation Center of the University of Lisbon (CRECUL) and at Joaquim Chaves Saúde. He also contributed to the preparation of two abstracts accepted at both national (Portuguese Cardiology Congress) and international (ESC Preventive Cardiology) conferences, and has attended several seminars and congresses related to Cardiovascular Rehabilitation.
E-mail: goncalo.sa1904@gmail.com
Monteiro, Ana Luísa, MSc
Research Assistant
Ana Luísa Monteiro is completing her Master’s Degree in Cardiovascular Rehabilitation in 2022 at the Faculty of Medicine, University of Lisbon (FMUL). She also holds a degree in Physical Therapy (1997) from the Lisbon School of Health Technology, a degree in Social and Organizational Psychology (2004) from ISCTE – University Institute of Lisbon, and a postgraduate diploma in Health Education (2008) from the Faculty of Human Kinetics, University of Lisbon (FMH-UL).
She also holds a postgraduate certification in Yoga of the Heart – Cardiac and Cancer Certification for Health Professionals, and has attended several seminars and training programs in the fields of Yoga and Meditation.
She is a HeartMath Practitioner, with a Clinical Certification for Stress, Anxiety, and Self-Regulation, as well as a certification in The Resilient Heart™ – Trauma-Sensitive HeartMath.
Ana Luísa currently works as a Meditation Teacher at the University of Lisbon Cardiovascular Rehabilitation Centre (CRECUL), in the Azeitão Schools Emotional Intelligence Project, and at YogaDome Azeitão. She has participated in international congresses such as ESC Preventive Cardiology and SIPREreCA, and has taken part in various seminars and conferences related to rehabilitation.
Her main areas of interest include Yoga, Meditation, Health Promotion and Prevention, Cardiovascular Rehabilitation, Oncology Rehabilitation, Biopsychosocial Interventions, and Psychoneuroimmunology.
ORCID: 0000-0002-2943-5871
E-mail: almonteiro@campus.ul.pt
RECENT PROJECTS
2020-2026: CoroPrevention – Personalized Prevention for Coronary Heart Disease. EU Horizon 2020, Grant Agreement 848056.
2025-2028: COMPASS – CrOss-cultural Model for Postdischarge Assistance and Sustainable digital Solutions in cardiac rehabilitation, through multidimensional validation approach,” Projecto THCS/0010/2024
RECENT PUBLICATIONS
Duarte, F., Ricardo, I., Faria, C., Alves da Silva, P., Cunha, N., Miguel, S., Pinto, R., Pinto, F., & Abreu, A. (2025). Impact of an Exercise-Based Cardiac Rehabilitation Program on Cardiopulmonary Test Parameters. Cardiology, 150(2), 203–209. https://doi.org/10.1159/000541011
Ribeiro, M., Fernandes, E., Borges, M., Pires, M., Melo, X., Pinto, F. J., Abreu, A., & Pinto, R. (2024). Reliability and Validity of the Global Physical Activity Questionnaire for Portuguese Adults. Perceptual and motor skills, 131(5), 1548–1570. https://doi.org/10.1177/00315125241266341
Vilela, E. M., Bento, L., Oliveira, L., Abreu, A., Dores, H., Teixeira, M., Mendes, M., Fontes, P., Fontes-Carvalho, R., Pereira, H., & Gonçalves, L. (2024). Training and attitudes concerning cardiac rehabilitation in Portugal: A national survey of physician members of the Portuguese Society of Cardiology. Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 43(9), 487–496. https://doi.org/10.1016/j.repc.2023.12.009
Gavina, C., Araújo, F., Teixeira, C., Ruivo, J. A., Corte-Real, A. L., Luz-Duarte, L., Canelas-Pais, M., & Taveira-Gomes, T. (2023). Sex differences in LDL-C control in a primary care population: The PORTRAIT-DYS study. Atherosclerosis, 384, 117148. https://doi.org/10.1016/j.atherosclerosis.2023.05.017
Pedretti, R. F. E., Hansen, D., Ambrosetti, M., Back, M., Berger, T., Ferreira, M. C., Cornelissen, V., Davos, C. H., Doehner, W., de Pablo Y Zarzosa, C., Frederix, I., Greco, A., Kurpas, D., Michal, M., Osto, E., Pedersen, S. S., Salvador, R. E., Simonenko, M., Steca, P., Thompson, D. R., … Abreu, A. (2023). How to optimize the adherence to a guideline-directed medical therapy in the secondary prevention of cardiovascular diseases: a clinical consensus statement from the European Association of Preventive Cardiology. European journal of preventive cardiology, 30(2), 149–166. https://doi.org/10.1093/eurjpc/zwac204
Ruivo, J., Moholdt, T., & Abreu, A. (2023). Overview of Cardiac Rehabilitation following post-acute myocardial infarction in European Society of Cardiology member countries. European journal of preventive cardiology, 30(9), 758–768. https://doi.org/10.1093/eurjpc/zwad024
Hansen, D., Abreu, A., Ambrosetti, M., Cornelissen, V., Gevaert, A., Kemps, H., Laukkanen, J. A., Pedretti, R., Simonenko, M., Wilhelm, M., Davos, C. H., Doehner, W., Iliou, M. C., Kränkel, N., Völler, H., & Piepoli, M. (2022). Exercise intensity assessment and prescription in cardiovascular rehabilitation and beyond: why and how: a position statement from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology. European journal of preventive cardiology, 29(1), 230–245. https://doi.org/10.1093/eurjpc/zwab007
Hanssen, H., Boardman, H., Deiseroth, A., Moholdt, T., Simonenko, M., Kränkel, N., Niebauer, J., Tiberi, M., Abreu, A., Solberg, E. E., Pescatello, L., Brguljan, J., Coca, A., & Leeson, P. (2022). Personalized exercise prescription in the prevention and treatment of arterial hypertension: a Consensus Document from the European Association of Preventive Cardiology (EAPC) and the ESC Council on Hypertension. European journal of preventive cardiology, 29(1), 205–215. https://doi.org/10.1093/eurjpc/zwaa141
Abreu A. (2021). How healthy is cardiac rehabilitation in Portugal?. Revista portuguesa de cardiologia, 40(11), 889–890. https://doi.org/10.1016/j.repce.2021.11.004
Pinto, R., Pires, M. L., Borges, M., Pinto, M. L., Sousa Guerreiro, C., Miguel, S., Santos, O., Ricardo, I., Cunha, N., Alves da Silva, P., Correia, A. L., Fiúza, S., Caldeira, E., Salazar, F., Rodrigues, C., Cordeiro Ferreira, M., Afonso, G., Araújo, G., Martins, J., Ramalhinho, M., … Abreu, A. (2022). Digital home-based multidisciplinary cardiac rehabilitation: How to counteract physical inactivity during the COVID-19 pandemic. Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 41(3), 209–218. https://doi.org/10.1016/j.repc.2021.05.013
Aktaa, S., Gencer, B., Arbelo, E., Davos, C. H., Désormais, I., Hollander, M., Abreu, A., Ambrosetti, M., Bäck, M., Carballo, D., Crawford, C., Deaton, C., Dendale, P., Eijsvogels, T. M. H., Galbraith, M., Piepoli, M. F., Salzwedel, A., Smulders, Y., Wilhelm, M., Biondi-Zoccai, G., … Gale, C. P. (2022). European Society of Cardiology Quality Indicators for Cardiovascular Disease Prevention: developed by the Working Group for Cardiovascular Disease Prevention Quality Indicators in collaboration with the European Association for Preventive Cardiology of the European Society of Cardiology. European journal of preventive cardiology, 29(7), 1060–1071. https://doi.org/10.1093/eurjpc/zwab160
Wilhelm, M., Abreu, A., Adami, P. E., Ambrosetti, M., Antonopoulou, M., Biffi, A., Cavarretta, E., D’Ascenzi, F., Gibson, I., Grobbee, D. E., Iliou, M. C., Koskinas, K., Marques-Vidal, P., Nixdorff, U., Papadakis, M., Piepoli, M. F., Vassiliou, V., Wood, D., Dendale, P., & Halle, M. (2022). EAPC Core Curriculum for Preventive Cardiology. European journal of preventive cardiology, 29(1), 251–274. https://doi.org/10.1093/eurjpc/zwab017
Gonçalves, C., Raimundo, A., Abreu, A., & Bravo, J. (2021). Exercise Intensity in Patients with Cardiovascular Diseases: Systematic Review with Meta-Analysis. International journal of environmental research and public health, 18(7), 3574. https://doi.org/10.3390/ijerph18073574
Hansen, D., Abreu, A., Ambrosetti, M., Cornelissen, V., Gevaert, A., Kemps, H., Laukkanen, J. A., Pedretti, R., Simonenko, M., Wilhelm, M., Davos, C. H., Doehner, W., Iliou, M. C., Kränkel, N., Völler, H., & Piepoli, M. (2022). Exercise intensity assessment and prescription in cardiovascular rehabilitation and beyond: why and how: a position statement from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology. European journal of preventive cardiology, 29(1), 230–245. https://doi.org/10.1093/eurjpc/zwab007
Pinto, R., Melo, X., Angarten, V., Pires, M. L., Borges, M., Santos, V., Abreu, A., & Santa-Clara, H. (2021). The effects of 12-months supervised periodized training on health-related physical fitness in coronary artery disease: a randomized controlled trial. Journal of sports sciences, 39(16), 1893–1902. https://doi.org/10.1080/02640414.2021.1907062
Pedretti, R. F. E., Iliou, M. C., Israel, C. W., Abreu, A., Miljoen, H., Corrà, U., Stellbrink, C., Gevaert, A. B., Theuns, D. A., Piepoli, M. F., Reibis, R., Schmid, J. P., Wilhelm, M., Heidbuchel, H., Völler, H., Document reviewers:, Ambrosetti, M., Deneke, T., Cornelissen, V., R Heinzel, F., … Hansen, D. (2021). Comprehensive multicomponent cardiac rehabilitation in cardiac implantable electronic devices recipients: a consensus document from the European Association of Preventive Cardiology (EAPC; Secondary prevention and rehabilitation section) and European Heart Rhythm Association (EHRA). European journal of preventive cardiology, 28(15), 1736–1752. https://doi.org/10.1093/eurjpc/zwaa121