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Left ventricular remodeling: Is there a real impact of Cardiac Rehabilitation?
Session:
Posters - J. Preventive Cardiology
Speaker:
Pedro Alves Da Silva
Congress:
CPC 2021
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.2 Cardiovascular Rehabilitation
Session Type:
Posters
FP Number:
---
Authors:
Pedro Alves Da Silva; Inês Aguiar-Ricardo; Nelson Cunha; Tiago Rodrigues; Sara Couto Pereira; Pedro Silvério António; Beatriz Valente Silva; Joana Brito; Ana Beatriz Garcia; Susana Pires; Marta Ramalhinho; Fausto j. Pinto; Ana Abreu
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Arial",sans-serif"><span style="color:black">Introduction:</span></span></strong><span style="font-family:"Arial",sans-serif"><span style="color:black"> Several randomized controlled trials have examined the effect of exercise training on left ventricle (LV) remodeling in individuals with cardiovascular disease. However, the results of these trials have been inconclusive. </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Arial",sans-serif"><span style="color:black">Purpose:</span></span></strong><span style="font-family:"Arial",sans-serif"><span style="color:black"> Evaluation of the impact of a cardiac rehabilitation program (CRP) on left ventricle remodelling evaluated by echocardiogram. </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="background-color:white"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Arial",sans-serif"><span style="color:black">Methods:</span></span></strong><span style="font-family:"Arial",sans-serif"><span style="color:black"> Observational single centre study including consecutive patients, undergoing structured CRP since June 2016 until February 2020. Phase II 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 before and after the CRP.</span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Arial",sans-serif"><span style="color:black">Results:</span></span></strong><span style="font-family:"Arial",sans-serif"><span style="color:black"> 205 patients (62.6±11 years, 83.4% men, 82.3% ischemic disease) were included in a phase II CRP. Most patients had ischemic disease (82.3%) and 23.5% of patients had left ventricular ejection fraction (LVEF) <40%. Of the cardiovascular risk factors, hypertension was the most prevalent (76%), followed by dyslipidaemia (67.4%), active smoking (45.9%) and diabetes (26.9%). </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><span style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif"><span style="color:black">After the CRP, there was a significant improvement of LVEF (from 48.3±13 to 52±11.6 %, p = 0.001) and a significant reduction of LV volumes (LV end-diastolic volume, LVEDV, decreased from 140±81 to 121±57, p=0.002; LV end-systolic volume , LVESV , reduced from 80±75 to 64±48, p=0.004). Considering only patients with LVEF<40% (n=38), the improvement was even greater: LVEF increased from 30±8 to 39±13 (p=0.002); LVEDV reduced from 206±107 to 159±81 (p=0.001) and LVESV reduced from 142±99 to 101±66 (p=0.002). 63.6%(n=14) of these patients improved at least 10% of LVEF and only 1 of them had a cardiac resynchronization therapy device. </span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Arial",sans-serif"><span style="color:black">Conclusions: </span></span></strong><span style="font-family:"Arial",sans-serif"><span style="color:black">A phase II CR program was associated with significant improvements in left ventricular reverse remodelling irrespective of baseline EF classification. Those with reduced baseline EF <span style="background-color:#fcfcfc">derived an even greater improvement, highlighting the great importance of CR in this subgroup of patients.</span></span></span></span></span></p>
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