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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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Impact of a cardiac rehabilitation on heart failure biomarker NT-proBNP
Session:
Posters 3 - Écran 4 - Reabilitação Cardíaca
Speaker:
Anai Durazzo
Congress:
CPC 2019
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.2 Cardiovascular Rehabilitation
Session Type:
Posters
FP Number:
---
Authors:
Anai Durazzo; Gustavo Sá Mendes; Luís Moreno; Sofia santos; Mónica Neto; Miguel Mendes
Abstract
<p><strong>Background and aim: </strong>Cardiac Rehabilitation Program (CRP) is a recognized intervention for heart failure patients with reduced ejection fraction (HFrEF), decreasing hospitalizations and improving both symptoms and exercise capacity. There are scarce data in the literature regarding the impact of CRP on NT-proBNP, a biomarker reflecting the status of HF compensation.</p> <p>The aim of our research is to evaluate the effectiveness of our CRP on the levels of NT-proBNP and clinical status of HFrEF patients.</p> <p><strong>Methods: </strong>Single-centre retrospective study of 56 consecutive HFrEF patients with ejection fraction <40%, admitted to our CRP from January to September 2018. After excluding patients with non-maximal CPET pre and post CRP, without pre and post NT-proBNP values and program dropouts, 38 patients, (76.3% males, n=29), mean age 59.1±9.7 years were included. Ischemic myocardiopathy was the leading etiology, present in 63% (n=24) of the study population. Pre and post CRP data regarding NT-proBNP, NYHA class, CPET (VO<sub>2</sub> at peak exercise and VT1 level) and Physical Dimension of Minnesota Living with Heart Failure Questionnaire (MLHFQ-PD) were compared.</p> <p><strong>Results: </strong>After the CRP a statistical significative decrease of NT-proBNP was found: 1616.5 pg/ml [715.3 – 2987.3, CI 95%] to 711.5 [210.8 – 1287.0, (p=0.008). This mean decrease of 44% on NT-proBNP, was associated with a better clinical profile in terms of NYHA functional class [(Pre: Class I=5, Class II=18, Class III-IV=15; Post: Class I=20, Class II=3, Class III-IV=3; (p=0.000)] and MLHFQ-PD (Pre: 18.8±11.0; Post: 12.8±9.2, p=0.029). Positive trends, although not statically significative, were observed on VO<sub>2</sub>, pre and post CRP, at peak exercise and VT1 level.</p> <p><strong>Conclusions: </strong>The CRP had a very positive impact on NT-proBNP and clinical parameters (NYHA and MLHF-PD), confirming benefits usually described in HFrEF patients, a recent indication for CRP. The positive trend found regarding VO2 (at peak and VT1 level), will probably be observed in a larger sample population.</p>
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