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Exercise training improves cardiorespiratory fitness in heart failure patients: a look beyond peak oxygen consumption
Session:
Posters (Sessão 5 - Écran 5) - Exercício e Reabilitação Cardíaca 2
Speaker:
Cristine Schmidt
Congress:
CPC 2022
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.1 Exercise Testing
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Cristine Schmidt; Priscilla Gois Basílio; Maria Isilda Oliveira; Inês Lopes; Sandra Magalhães; Preza Fernandes; Rita Pinto; Fernando Ribeiro; Mário Santos
Abstract
<p style="text-align:justify"><span style="font-size:14px"><span style="color:#000000"><strong>Introduction: </strong>Exercise-based cardiac rehabilitation (ExCR) is an essential component in the treatment of heart failure (HF), as it improves functional capacity and quality of life, and reduces hospitalization rates. <span style="color:black">Cardiorespiratory fitness (CRF), as assessed by peak oxygen consumption (VO<sub>2</sub>peak) at a cardiopulmonary exercise test (CPET), is commonly used to assess the efficacy of ExCR because it is independently associated with all-cause mortality and HF hospitalization. To date, it remains poorly understood whether HF patients who do not show improvements on VO<sub>2</sub>peak after an ExCR program exhibit a concordant response in relation to other submaximal CRF parameters.</span></span></span></p> <p style="text-align:justify"><span style="font-size:14px"><span style="color:#000000"><strong><span style="color:black">Aim: </span></strong>To study the impact of an ExCR program on VO<sub>2</sub>peak, <span style="color:black">duration of the </span>effort<span style="color:black">, and the distance walked in the six-minute walking test (6MWT) in HF patients.</span></span></span></p> <p style="text-align:justify"><span style="font-size:14px"><span style="color:#000000"><strong><span style="color:black">Methods:</span></strong> This is a retrospective study that evaluated consecutive HF patients who attended and completed a phase-2 ExCR program between September 2019 to November 2021. The ExCR program consisted of a 12-week combined exercise program (60%-80% of VO<sub>2</sub>peak), 2 training sessions/week, for a total of 24 sessions. All patients performed a CPET and the 6MWT before and after the ExCR program.</span></span></p> <p style="text-align:justify"><span style="font-size:14px"><span style="color:#000000"><strong><span style="color:black">Results: </span></strong><span style="color:black">Sixty patients (81%) who had an attended rate for at least 80% of exercise sessions </span>were included in the study (65% males; age:63±12y; LVEF:36±11%)<em>.</em> Overall, VO<sub>2 </sub>peak improved by 1.31 ml/kg/min (95%IC: 0.7 to 1.8; p<0.001), the duration of the CPET improved in 2.11 minutes (95%IC:1.40 to 2.42; p<0.001) and the distance at the 6MWT increased 48 meters (95%IC: 38 to 57; p<0.001).<span style="color:black"> VO<sub>2</sub>peak did not improve (a variation less than +10% of baseline) in 57% of patients. From those, 88% improved the duration of the test (>10s). The 8% of patients that did not improve these 2 parameters, all had improved the walked distance in the 6MWT (+30m). </span></span></span></p> <p style="text-align:justify"><span style="font-size:14px"><span style="color:#000000"><strong><span style="color:black">Conclusion:</span></strong><span style="color:black"> Our results suggest that the assessment of submaximal physiological variables beyond VO<sub>2</sub>peak can provide a more comprehensive understanding of the impact of ExCR programs in HF patients. Further studies are needed to assess the prognostic significance of these submaximal variables.</span></span></span></p>
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