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Impact of cardiac rehabilitation on inflammation in patients with ischaemic cardiomyopathy
Session:
Comunicações Orais (Sessão 25) - Risco CV, Prevenção e Reabilitação Cardíaca 2 - Vários
Speaker:
André Dias de Frias
Congress:
CPC 2022
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.2 Cardiovascular Rehabilitation
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Dias de Frias; Ricardo Costa; Cristine Schmidt; Andreia Campinas; André Alexandre; Anaisa Pereira; David Sá-Couto; Preza Fernandes; Sandra Magalhães; Mário Santos; Severo Torres
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Introduction</u>: The benefits of cardiac rehabilitation (CR) in patients with ischaemic cardiomyopathy are well-known. However, inflammatory states have been associated to an increased risk of cardiovascular events.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Aim</u>: Evaluate the impact of CR in the serum levels of inflammatory biomarkers and identify potential predictors of that effect.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Methods</u>: We retrospectively studied consecutive patients with ischaemic cardiomyopathy who completed a CR programme between 2011 and 2017. Patients underwent a supervised exercise training protocol, twice a week during a period of 8 to 12 weeks. Functional capacity was evaluated by metabolic equivalents assessed prior the beginning and 3 months after the programme with a symptom limited exercise treadmill test. Patients without levels of serum C-reactive protein at beginning and at the end of CR programme were excluded. Median variation of serum C-reactive protein was assessed and two groups were defined: one with levels above that and one with levels below.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Results</u>: Of 250 patients (60.3±11.1 years, 84% male), 67% were admitted after an acute myocardial infarction. Left ventricular ejection fraction ≤40% before CR was present in 32% of individuals. Median levels of serum C-reactive protein before CR were 8.8 (3.1-21.7) mg/L and median variation after CRP was a decrease of 5.1 (0.9-17.7) mg/L (<em>p</em><0.001). Before CR, higher levels of serum C-reactive protein were seen in obese (15.7 [8-52.7] versus 8.8 [3.2-27.8], <em>p</em>=0.04) and those with higher NT-proBNP (<em>p</em><0.001). Patients with decrease of >5.1mg/L of serum C-reactive protein had lower prevalence of hypertension (18% versus 30%, <em>p</em>=0.02), higher prevalence of obesity (16% versus 7%, <em>p</em>=0.03), lower levels of HDL cholesterol (38.3 [11.1] versus 43.2 [12.6], <em>p</em><0.001) and higher levels of NT-proBNP (1079 [610.3-1988] versus 488 [215-777], <em>p</em><0.001) at baseline. An increase of at least of 10% of functional capacity after CR was reached in 65% of patients, similar between groups. Patients with decrease of serum C-reactive protein >5.1mg/L had also higher reduction of NT-proBNP after CR comparing to baseline (491.1 [142.7-948.5] versus 162.0 [30.9-295.2], <em>p</em><0.001).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Conclusions</u>: Serum levels of inflammatory biomarkers decreased after CR in patients with ischaemic cardiomyopathy. Normotension, obesity, lower HDL and higher levels of natriuretic peptides are associated to a better response.</span></span></p>
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