TY - JOUR
T1 - Cardiac Rehabilitation After Heart Valve Surgery
T2 - IMPROVEMENT IN EXERCISE CAPACITY AND MORBIDITY
AU - Pollmann, Agathe Gerwina Elena
AU - Frederiksen, Marianne
AU - Prescott, Eva
PY - 2017/5/1
Y1 - 2017/5/1
N2 - PURPOSE: Evidence of the effect of cardiac rehabilitation (CR) after heart valve surgery is scarce, but nevertheless CR is recommended for this group of patients. Therefore, this study assessed the effect of CR on exercise capacity, cardiovascular risk factors, and long-term mortality and morbidity, as well as predictors for enrolment in or failing to complete CR. METHODS: A review of medical records identified 250 patients who underwent heart valve surgery between January 2009 and August 2013. Of these, 211 patients eligible for CR were identified. Effect of CR was assessed by peak oxygen uptake (o2peak) or 6-minute walk test (6MWT). A composite endpoint of all-cause mortality and hospital admission due to myocardial infarction, stroke, heart failure, endocarditis, revascularization, or reoperation was used to assess the hazard ratio between CR attenders and nonattenders. Multivariable logistic regression was used to find predictors for CR attendance and CR completion. RESULTS: A total of 146 patients completed CR. o2peak improved by 16% from 21.6 to 24.8 mL/kg/min (P <.0001) and 6MWT distance by 13% from 349 to 393 m (P =.0016). Rate of clinical events was higher among nonattenders with an adjusted hazard ratio of 2.46 (95% CI, 1.26-4.80). Age >75 years was predictive for not attending (adjusted OR, 2.99; 95% CI,.37-6.53), whereas ethnic minorities were less likely to complete CR (adjusted OR, 4.88; 95% CI, 1.58-15.06). CONCLUSIONS: CR after heart valve surgery improved exercise capacity and was associated with reduced morbidity. Elderly and ethnic minorities were less likely to attend or complete CR and deserve special attention.
AB - PURPOSE: Evidence of the effect of cardiac rehabilitation (CR) after heart valve surgery is scarce, but nevertheless CR is recommended for this group of patients. Therefore, this study assessed the effect of CR on exercise capacity, cardiovascular risk factors, and long-term mortality and morbidity, as well as predictors for enrolment in or failing to complete CR. METHODS: A review of medical records identified 250 patients who underwent heart valve surgery between January 2009 and August 2013. Of these, 211 patients eligible for CR were identified. Effect of CR was assessed by peak oxygen uptake (o2peak) or 6-minute walk test (6MWT). A composite endpoint of all-cause mortality and hospital admission due to myocardial infarction, stroke, heart failure, endocarditis, revascularization, or reoperation was used to assess the hazard ratio between CR attenders and nonattenders. Multivariable logistic regression was used to find predictors for CR attendance and CR completion. RESULTS: A total of 146 patients completed CR. o2peak improved by 16% from 21.6 to 24.8 mL/kg/min (P <.0001) and 6MWT distance by 13% from 349 to 393 m (P =.0016). Rate of clinical events was higher among nonattenders with an adjusted hazard ratio of 2.46 (95% CI, 1.26-4.80). Age >75 years was predictive for not attending (adjusted OR, 2.99; 95% CI,.37-6.53), whereas ethnic minorities were less likely to complete CR (adjusted OR, 4.88; 95% CI, 1.58-15.06). CONCLUSIONS: CR after heart valve surgery improved exercise capacity and was associated with reduced morbidity. Elderly and ethnic minorities were less likely to attend or complete CR and deserve special attention.
KW - Journal Article
U2 - 10.1097/HCR.0000000000000208
DO - 10.1097/HCR.0000000000000208
M3 - Journal article
C2 - 27755256
SN - 1932-7501
VL - 37
SP - 191
EP - 198
JO - Journal of Cardiopulmonary Rehabilitation and Prevention
JF - Journal of Cardiopulmonary Rehabilitation and Prevention
IS - 3
ER -