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Transforming Heart Failure Care: The Impact of Cardiac Rehabilitation
Session:
SESSÃO DE POSTERS 49 - RESSINCRONIZAÇÃO CARDÍACA E TERAPÊUTICA MÉDICA
Speaker:
Ana L. Silva
Congress:
CPC 2025
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.4 Chronic Heart Failure – Treatment
Session Type:
Cartazes
FP Number:
---
Authors:
Ana L. Silva; Bernardo Lisboa Resende; Rafaela Fernandes; Tomás Carlos; Ana Luísa Rocha; Gonçalo Terleira Batista; Mariana Rodrigues Simões; Tatiana Pereira Dos Santos; José Luís Martins; João Gameiro; Paulo Dinis; Lino Gonçalves
Abstract
<p style="text-align:justify">Background: Cardiac rehabilitation (CR) plays a pivotal role in managing heart failure (HF), providing significant benefits in functional capacity, symptom relief, and overall prognosis. The use of cardiopulmonary exercise testing (CPET) before and after CR allows for an objective evaluation of changes in key physiological parameters.<br /> Purpose: Evaluate the impact of a phase II structured CR program on CPET metrics, echocardiographic parameters, and analytical biomarkers in patients with HF.<br /> Methods: Single-center, retrospective observational study. Patients who successfully completed a supervised, structured CR program between January 2023 and September 2024 were included. Data were collected by a specialized multidisciplinary team. Statistical analysis was performed using SPSS 28.0.1.1 software.<br /> Results: A total of 44 patients were included, with a mean age of 55.5±12.4 years, 68.2% male. The most frequent referral criterion was coronary artery disease (26/59.1%), followed by HF (15/34.1%). The mean program duration was 22.3 weeks. 6/13.6% of patients had preserved, 15/34.1% had mid-range, and 21/47.7% had reduced left ventricular ejection fraction (LVEF). Advanced HF was identified in 9 patients (20.5%), and most were classified NYHA II (54.5%).<br /> Significant improvements in CPET parameters were observed. The percentage of predicted maximum heart rate (HR) increased (76.2±13.3 to 79.3±12.3, p=0.038), along with peak VO<sub>2</sub> (19.5±6.5 to 21.6±7.0mL/kg/min, p=0.020) and the percentage of predicted maximum VO<sub>2</sub> (71.5±21.4% to 78.8±20.2%, p=0.010). While peak circulatory power improved (3259.6±1444.9 to 3575.7±1552.1mmHg·min/mL/kg), this difference did not reach statistical significance (p=0.086). The VE/VCO<sub>2</sub> slope remained similar before and after CR (26.4, IQR 11.3 vs. 26.5, IQR 8.0, p=0.238). In terms of physical performance, there was a significant increase in peak power output (watts) after CR (102.6±58.4 to 124.2±51.3, p=0.004), accompanied by an increase in the number of patients with normal or high physical performance (17 to 24, p<0.001).<br /> LVEF significantly increased (41.2±9.0% to 47.3±12.6%, p=0.007). Also, LDL cholesterol (77.0, IQR 64.0 to 60.0, IQR 36.0, p=0.016), triglycerides (112.0, IQR 87.0 to 92.0, IQR 71.0, p=0.016), and NT-proBNP (296.5, IQR 902.0 to 263.5, IQR 575.0, p=0.006) significantly decreased.<br /> Conclusions: A structured phase II CR program significantly improved functional capacity, as evidenced by enhanced CPET metrics, including peak VO<sub>2</sub> and predicted maximum HR, along with notable gains in physical performance. Also, the favorable changes in LVEF, NT-proBNP levels, and lipid profile suggest an overall enhancement in cardiovascular health. These findings emphasize the crucial role of CR in optimizing physiological, analytical, and clinical parameters, reinforcing its importance in the comprehensive management of HF patients.</p>
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