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Cardiac Optimal Point: Identifying high risk patients for an optimal approach
Session:
Posters (Sessão 5 - Écran 5) - Exercício e Reabilitação Cardíaca 2
Speaker:
Pedro Alves Da Silva
Congress:
CPC 2022
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.2 Cardiovascular Rehabilitation
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Pedro Alves da Silva; Pedro Silvério António; Sara Couto Pereira; Joana Brito; Beatriz Valente Silva; Ana Margarida Martins; Ana Beatriz Garcia; Catarina Simões de Oliveira; João Santos Fonseca; Inês Aguiar-Ricardo; Nelson Cunha; Rita Pinto; Fausto j. Pinto; Ana Abreu
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction</strong>: In recent years it has been proposed the concept of cardiorrespiratory optimal point (COP) to best characterize populations who underwent cardiac rehabilitation programmes (CRP). The COP is defined as the minimum ratio between ventilation and oxygen consumption (VE/VO2) obtained during the cardiopulmonary exercise test (CPET) and it has been suggested that COP values > 30 conveyed worse prognosis.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Purpose</strong>: To validate OP as a predictor of events and its correlation with exercise activity and quality of life on the long term.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods</strong>: Single center observational study of patients enrolled on CRP - from February 2018 to May 2019 – who did CPET as part of routine evaluation. COP was defined as the lowest point of VE/VO2 ratio. Clinical and laboratorial characteristics were obtained at admission and discharge of CRP. Exercise practice was accessed using IPAQ questionnaire and quality of life was assessed based on a validated inquire - Kansas City Cardiomyopathy Questionnaire (KCCQ-23) – both by phone interview.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results</strong>: A total of 78 patients (mean age 63.2 ±11.6, 84.6% male) were evaluated and followed for a mean follow-up of 2,68±0,53 years. Main aetiology was ischemic heart disease (86%), followed by dilated cardiomyopathy (5,1%) and valvular heart disease (2,6%).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">A COP value below 30 correlated with a worse global score in KCC-23 <span style="color:#222222">(r =0.283, p = 0.47), and in particular domains such as frequency and severity of symptoms (r 0.335, p = 0.046; and r= 0.4, P=0.16, respectively), quality of life (r= 0.293, p=0.039) and social limitation (r=0.5, p = 0.001,). COP also correlated with VO2 peak in basal CPET ( r= 0.450, p<0.001,) and on follow-up CPET (r= 0.303, p= 0.39).</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"><span style="color:#222222">COP failed to predict events or levels of exercise activity on the long term, as evaluated by the IPAQ score. However, COP>30 did seem to correlate with a higher mortality rate on the follow-up although such trend was not statistically significant (possibly due to short follow-up time and sample size).</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion</strong>: COP values > 30 identifed patients with worse prognosis, predicting worse quality of life and higher mortality. Although it did not seem to be a good predictor of exercise adherence after CRP.</span></span></p>
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