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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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Cardiac rehabilitation program - Real life results
Session:
Painel 12 - Prevenção / Reabilitação Cardíaca 4
Speaker:
Rafael Santos
Congress:
CPC 2020
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.2 Cardiovascular Rehabilitation
Session Type:
Posters
FP Number:
---
Authors:
Rafael Santos; Inês Aguiar Ricardo; Nelson P. Cunha; Tiago Graça Rodrigues; Joana Rigueira; Afonso Nunes Ferreira; Pedro Silvério António; Sara Couto Pereira; Pedro Morais; Beatriz Silva ; Pedro Alves Da Silva; Paula Sousa; Sandra Miguel; Fausto José Pinto; Ana Abreu
Abstract
<p><strong>Introduction:</strong> Cardiac Rehabilitation is a multidimensional structured intervention aimed at recovering a patient after an acute cardiovascular event or improvement of a patient with a significant cardiovascular risk. <br /> <br /> <strong>Purpose:</strong> Evaluation of the results of a cardiac rehabilitation program. <br /> <br /> <strong>Methods:</strong> Observational single center study including consecutive patients, undergoing structured cardiac rehabilitation program (CRP) since April 2018 until August 2019. The phase 2 CRP included 3 months of exercise training, aerobic and strength exercise, individually prescribed, 3 times a week, 60 minutes sessions. All patients were submitted to a clinical evaluation, echocardiogram and cardiopulmonary exercise test after and before the CRP.<br /> <br /> <strong>Results:</strong> 78 patients (60.3±11 years, 84.6% men, 85.9% ischemic disease) were included in a phase 2 CRP. Of the cardiovascular risk factors, hypertension was the most frequent (73.1%), followed by diabetes (69.2%), smoking 39.7% and dyslipidemia 35.9%. At initial evaluation, 61% of patients were at NYHA II and the mean LVEF was 48.6±13 (23.9% of patients with LVEF<40%). All patients completed the program except one patient who dropped out (compliance of 98,7%).<br /> <br /> After the CRP, there was a significant improvement of LVEF (48.6 vs 51.5%, p = 0.006) and the LV volumes tended to reduce (LV end-diastolic volume decreased from 168±87 to 135±54, p=NS; LV end-systolic volume reduced from 112±73 to 83±55, p=NS). PSAP also reduced from 38±16 to 32±9mmHg (p=0,05). From laboratory analysis, Nt-proBNP decreased (942 ± 1535 vs 806pg/ml ± 2026, p = 0.035), HDL increased (from 43.1 ± 11.6 to 47.2 ± 14mg/dL, p = 0.006), there was no other statistically significant differences. <br /> <br /> Regarding the cardiopulmonary exercise test, the duration of the test increased on average from 8.8±2.1 to 9.5±2.3min (p= 0.019), also the workload from 100±36w to 129±43w (p<0.001); VO2 peak 17.2± 4.3 to 18± 5.4ml/kg/min (p=NS), predicted VO2 65.9±16% to 68.3± 17% (p=NS) and QR 1.09± 0.7 to 1.12± 0.09 (p=0.019). <br /> <br /> <strong>Conclusions:</strong> In this group of patients undergoing a cardiac rehabilitation program, there was an improvement in echocardiographic and laboratory terms. The compliance rate was very good. These data reinforce the importance of referencing the patients to these programs.</p>
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