Impact of an Exercise-Based Cardiac Rehabilitation Program on Cardiopulmonary Test Parameters.

IF 1.9 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiology Pub Date : 2024-08-27 DOI:10.1159/000541011

Fabiana Duarte, Inês Ricardo, Clarissa Faria, Pedro Alves da Silva, Nelson Cunha, Sandra Miguel, Rita Pinto, Fausto Pinto, Ana Abreu

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Abstract

Introduction: Exercise-based cardiac rehabilitation programs (CRPs) represent a multidisciplinary therapeutic approach tailored to improve cardiorespiratory fitness and overall health-related quality of life, while reducing cardiovascular hospitalizations and mortality. Our aim was to determine changes in exercise capacity and cardiac events according to the left ventricular ejection fraction (LVEF) following a CRP.

Methods: This single-center cohort study included 131 patients who completed a center-based CRP from 2015 to 2022. Cardiopulmonary exercise testing (CPET), transthoracic echocardiography, and laboratory analysis were performed before and after program completion.

Results: Of 232 enrolled patients, 131 were included in our cohort analysis, with 36.6% having a reduced LVEF. These patients exhibited higher rates of atrial fibrillation (p = 0.019) and NT-proBNP values (p < 0.001). Patients with reduced LVEF had lower peak VO2 (pVO2) (p = 0.046), percentage of predicted oxygen consumption (ppVO2) (p < 0.001), and VO2 at anaerobic threshold (p = 0.015) during baseline CPET. Completion of the CRP led to comparable improvements in exercise performance between groups, assessed through Δ pVO2 (p = 0.990), Δ ppVO2 (p = 0.610), and Δ VE/VCO2 slope (p = 0.200). In the study population, male gender and hypertension independently predicted variation in VE/VCO2 slope (p = 0.017) and oxygen uptake efficiency slope (p = 0.048), respectively, post-CRP. During follow-up, 9.2% of all patients had hospital admissions for cardiac events, and 3.8% died, with no significant differences between groups.

Conclusion: Patients with reduced LVEF admitted to our CRP showed lower functional status based on specific CPET parameters. After CRP, both reduced and preserved LVEF groups experienced similar functional improvements. Therefore, strategies to increase participation of patients with reduced LVEF in such programs are warranted.

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以运动为基础的心脏康复计划对心肺测试参数的影响。

介绍：以运动为基础的心脏康复计划（CRP）是一种多学科治疗方法，旨在改善心肺功能和与健康相关的整体生活质量，同时降低心血管疾病的住院率和死亡率。我们的目的是根据左心室射血分数（LVEF）来确定心肺康复治疗后运动能力和心脏事件的变化：这项单中心队列研究对 2015 年至 2022 年期间完成中心 CRP 的 131 名患者进行了研究。在项目完成前后进行了心肺运动测试（CPET）、经胸超声心动图和实验室分析：在 232 名注册患者中，131 人被纳入队列分析，其中 36.6% 的患者 LVEF 降低。这些患者的心房颤动率（p=0.019）和NT-proBNP值（p<0.001）均较高。在基线 CPET 中，LVEF 降低的患者的峰值 VO2（p=0.046）、ppVO2（p<0.001）和无氧阈值 VO2（p=0.015）均较低。通过Δ pVO2（p=0.990）、Δ ppVO2（p=0.610）和Δ VE/VCO2 斜率（p=0.200）评估，完成 CRP 后，各组之间的运动表现改善程度相当。在研究人群中，男性性别和高血压分别独立预测了CRP后VE/VCO2斜率（p=0.017）和摄氧效率斜率（p=0.048）的变化。在随访期间，9.2%的患者因心脏事件入院，3.8%的患者死亡，没有组间差异：结论：根据特定的 CPET 参数，接受 CRP 治疗的 LVEF 降低的患者功能状态较差。经过 CRP 治疗后，LVEF 降低组和 LVEF 保持组的功能改善情况相似。因此，有必要制定策略，让更多 LVEF 降低的患者参与此类项目。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiology 医学-心血管系统

CiteScore

3.40

自引率

5.30%

发文量

审稿时长

1.5 months

期刊介绍： ''Cardiology'' features first reports on original clinical, preclinical and fundamental research as well as ''Novel Insights from Clinical Experience'' and topical comprehensive reviews in selected areas of cardiovascular disease. ''Editorial Comments'' provide a critical but positive evaluation of a recent article. Papers not only describe but offer critical appraisals of new developments in non-invasive and invasive diagnostic methods and in pharmacologic, nutritional and mechanical/surgical therapies. Readers are thus kept informed of current strategies in the prevention, recognition and treatment of heart disease. Special sections in a variety of subspecialty areas reinforce the journal''s value as a complete record of recent progress for all cardiologists, internists, cardiac surgeons, clinical physiologists, pharmacologists and professionals in other areas of medicine interested in current activity in cardiovascular diseases.