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Predictors of quality of life after cardiac rehabilitation
Session:
Painel 12 - Prevenção / Reabilitação Cardíaca 4
Speaker:
Pedro Morais
Congress:
CPC 2020
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.2 Cardiovascular Rehabilitation
Session Type:
Posters
FP Number:
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Authors:
Pedro Morais; Tiago Graça Rodrigues; Inês Aguiar Ricardo; Nelson P. Cunha; Joana Rigueira; Afonso Nunes Ferreira; Rafael Santos; Joana Brito; Susana Pires; Pedro Silva; Madalena Lemos Pires; Helena Santa Clara; Fausto José Pinto; Ana Abreu
Abstract
<p><strong>Introduction</strong>: Despite the recent advances in diagnosis and treatment, cardiovascular disease is still responsable for high morbidity and loss of quality of life (QoL). Cardiac rehabilitation (CR) is a multi-factorial intervention designed to limit the physiological and psychological effects of cardiovascular disease, manage symptoms, and reduce the risk of future events.</p> <p><strong>Aim</strong>: To determine predictors of quality of life 1 year after an hospital CR phase 2 program. </p> <p><strong>Methods</strong>: Prospective study of consecutive patients, after completion of phase 2 CR. All patients were submitted to clinical, laboratorial and echocardiographic evaluation. A cardiorespiratory exercise test (CPET) was performed after phase 2 completion. Patients were advised to continue the phase 3 CR at a specialized CR center. After 1 year of follow-up, the QoL was assessed by completing the Heart Quality of Life Questionnaire (HeartQoL). Through logistic regression analysis, predictors of better QoL were determined after 1 year of phase 2 CR program. </p> <p><strong>Results</strong>: 78 patients (60.3±11 years, 84.6% men, 85.9% ischemic disease, mean LVEF 48.6±13%) were included in a phase 2 CR program. Of the cardiovascular risk factors, hypertension was the most frequent (73.1%), followed by diabetes (69.2%), active smoking 39.7% and dyslipidemia 35.9%. All patients completed the phase 2 program except 1 patient (dropped out). At the end of phase 2 CR, 55.8% of the patients were in NYHA class II and the others were in NYHA class I. Mean LVEF was 51.5±12%, LV end-diastolic volume 121±53mL, LV end-systolic volume 71.5±52mL and TAPSE 19.9±4.3mm. In a CPET performed on a cycle ergometer the mean of maximum workload was 128.5±42W, duration was 9.4±2.5min, VO2 peak was 17.7±5.5 ml/kg/min, corresponding to 67.8±16.6% of the predicted maximum VO2, VE/VCO2 slope was 29.8±5.6 and MYERS score 8.3±5.2 points. After 1 year of phase 2 completion, the mean value of HeartQoL score was 2.2±0.84 (0 meaning worse QoL and 3 better QoL). In a univariate analysis non-smoking, MYERS score, maximum workload (MWL), VO2 peak, VE/VCO2 slope and duration of CPET were associated with a higher score (p<0.05). Patients who entered phase 3 CR in a specialized CR center had, on average, better QoL than the remaining patients (2.46±0.78 vs 2.09±0.86, p=NS) and higher levels of physical activity were also associated with better QoL (p=0.06). </p> <p><strong>Conclusion</strong>: The MWL, duration of CPET, peak VO2, VE/VCO2 slope and MYERS were associated to a higher level of physical activity 1 year after phase 2 CR. The MYERS score, in our study, that included also patients without heart failure, was associated with better QoL, suggesting that this score may have some value in other populations. Although not statistically significant, possibly related to the sample size, higher levels of activity level seems to associate to better QoL and so, patients should be motivated to maintain physical activity.</p> <p> </p> <p> </p>
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