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Cardiac rehabilitation after elective heart surgery: a valvular surgery focused comparison to coronary artery bypass grafting
Session:
Posters (Sessão 4 - Écran 3) - Exercício e Reabilitação Cardíaca 1 - Foco nos Programas de Reabilitação
Speaker:
Geraldo Faia Carvalho Dias
Congress:
CPC 2022
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.2 Cardiovascular Rehabilitation
Session Type:
Pósters Electrónicos
FP Number:
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Authors:
Geraldo Dias; Raquel Araújo; Sandra Magalhães; Mario Santos; Ana Barreira; Preza Fernades; Severo Torres
Abstract
<p>Background: Cardiac rehabilitation (CR) after heart surgery is widely recommended and its benefits are well described for patients after coronary artery bypass graft (CABG) surgery. However, these benefits are not so well established for patients following heart valve (HV) surgery.</p> <p>Objectives: We aimed (1) to assess if patients submitted to elective HV surgery improved their functional capacity after completing a supervised CR phase II program, and (2) to compare this response between those who underwent CABG surgery and combined HV and CABG surgery.</p> <p>Methods: Retrospective study including consecutive patients that completed an exercise-based CR program from january 2012 to december 2019 in one center, admitted in the program after elective HV surgery, elective CABG surgery or elective combined HV and CABG surgery. Demographic, anthropometric and clinical variables were collected. Baseline and post-CR exercise test (ET) duration and maximum metabolic equivalents (MET) were compared between groups. Statistical analysis was performed using SPSS v20.0.</p> <p>Results: A total of 106 patients were included, divided into three groups: HV (N=19), HV+CABG (N=14) and CABG (N=73). Among valvular patients (HV and HV+CABG groups), the aortic valve was the most frequently implicated (78.8%), followed by combined aortic and mitral (12.1%) and mitral valve (9.1%). Among patients that had elective CABG surgery (CABG and HV+CABG), the majority had three vessel disease (61.3%), followed by two (26.7%) and one (12.0%) vessel disease.<br /> HV group presented a greater proportion of females (42.1%) than HV+CABG (21.4%) and CABG (11.0%) groups. Left ventricle systolic function, obesity and diabetes mellitus prevalence was similar among groups. Hypertension, dyslipidemia and smoking history were significantly more common in CABG and HV+CABG groups than in HV only group, and atrial fibrillation was more prevalent in the latter.<br /> When comparing pre and post-CR ET, patients increased 83.0 (IQR=99.0) seconds in ET duration and 1.3 (IQR=1.5) MET. Baseline, post-CR, and the variation of ET parameters were similar between groups. Self-reported physical activity, type or position of prosthetic valve didn’t relate to improvements in ET parameters.</p> <p>Conclusion: This study demonstrates that patients submitted to elective HV and/or CABG surgery have comparable improvements in functional capacity after a CR phase II program. This improvement seems to be independent of the existence of coronary artery disease, the type or position of the prosthetic valve, and self-reported physical activity.</p>
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