SPC365

Impact of a cardiac rehabilitation program on anxiety and depressive symptoms on patients with heart failure and coronary artery disease

Session: Posters (Sessão 5 - Écran 8) - Reabilitação cardíaca
Speaker: Ana Santos

Congress: CPC 2023
Topic: J. Preventive Cardiology
Theme: 29. Rehabilitation and Sports Cardiology
Subtheme: 29.2 Cardiovascular Rehabilitation
Session Type: Pósters Electrónicos
FP Number: ---
Authors: Ana Raquel Carvalho Santos; Ricardo Carvalheiro; Inês Ferreira Neves; Pedro Rio; Joana Pinto; Carolina Marques; Marisa Macarrinha; Luciano Alves; Bruno Rodrigues; Inês Perez; Ana Sofia Silva; Jorge Dias

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:9.5pt"><span style="font-family:&quot;ProximaNovaCond-Light&quot;,sans-serif">Cardiac rehabilitation (CR) improves exercise capacity and quality of life (QoL). However, depression (D) and anxiety (A) are highly prevalent among cardiac patients and might impact rehabilitation outcomes. Nowadays, there are validated questionnaires for the screening of D and A, like Hospital Anxiety and Depression Scale (HADS) and EQ-5D with EQ visual analogue scale (VAS) element.</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-size:9.5pt"><span style="font-family:&quot;ProximaNovaCond-Light&quot;,sans-serif">Objective</span></span></strong><span style="font-size:9.5pt"><span style="font-family:&quot;ProximaNovaCond-Light&quot;,sans-serif">: Evaluate mental health symptoms and patients</span></span><span style="font-size:9.5pt">&rsquo;</span><span style="font-size:9.5pt"><span style="font-family:&quot;ProximaNovaCond-Light&quot;,sans-serif"> characteristics during enrolment on a CR program.</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-size:9.5pt"><span style="font-family:&quot;ProximaNovaCond-Light&quot;,sans-serif">Methods</span></span></strong><span style="font-size:9.5pt"><span style="font-family:&quot;ProximaNovaCond-Light&quot;,sans-serif">: This retrospective non-randomized study included patients (P) that underwent CR program between 2017 and 2022. The validated questionnaires HADS and EQ-5D were applied to P at the beginning and end of the CR program. When testing hypothesis, Chi-squared, Mann Whitney and Wilcoxon signed rank test were performed. A p value </span></span><span style="font-size:9.5pt">&le; </span><span style="font-size:9.5pt"><span style="font-family:&quot;ProximaNovaCond-Light&quot;,sans-serif">0.05 was considered significant.</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-size:9.5pt"><span style="font-family:&quot;ProximaNovaCond-Light&quot;,sans-serif">Results</span></span></strong><span style="font-size:9.5pt"><span style="font-family:&quot;ProximaNovaCond-Light&quot;,sans-serif">: The population of the study was composed by 228 P, 81.6% (n=186) were male, median age 57 years (50-64) and median body mass index 26.0 (21.2-29.6). Most P enrolled in the CR program had coronary artery disease (CAD) 63.6% (n=145) and the remaining P heart failure (HF). Analysing HADS, EQ-5D fifth question, related to A and D, and EQ-5D VAS at the beginning and end of CR programme there was a statistically significant improvement, with p&lt;0.001 for all parameters. At the beginning of the program, median HADS score was 10 (6-15) and EQ-5D VAS 60 (50-75), with 34.1% responding they were not anxious or depressed at EQ-5D fifth question. At the end of the program, HADS score was 7 (4-13) and EQ-5D VAS 70 (60-80), with 43.1% responding they were not anxious or depressed at EQ-5D fifth question. Evaluating only the P with a HADS score</span></span><span style="font-size:9.5pt">&ge;</span><span style="font-size:9.5pt"><span style="font-family:&quot;ProximaNovaCond-Light&quot;,sans-serif">12 (suggestive of A or D) there was a statistically significant difference for sex [47.6% female Vs 27% male (p= 0.009)], type of disease [HF 24.8% Vs CAD 43.5% (p=0.028)] and distance on the 6-minute walking test (6MWT), with lower distance for this group of P</span></span><span style="font-size:9.5pt">&rsquo;</span><span style="font-size:9.5pt"><span style="font-family:&quot;ProximaNovaCond-Light&quot;,sans-serif">s [498m (424-563) Vs 536m (469-601), p=0.007]. There were no differences in the number of sessions of CR and HADS score at the end of the program. </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-size:9.5pt"><span style="font-family:&quot;ProximaNovaCond-Light&quot;,sans-serif">Conclusion: </span></span></strong><span style="font-size:9.5pt"><span style="font-family:&quot;ProximaNovaCond-Light&quot;,sans-serif">Enrolment on a CR program improves not only exercise capacity and QoL but also A and D symptoms. HF P</span></span><span style="font-size:9.5pt">&rsquo;</span><span style="font-size:9.5pt"><span style="font-family:&quot;ProximaNovaCond-Light&quot;,sans-serif">s have those symptoms more frequently when compared with CAD P</span></span><span style="font-size:9.5pt">&rsquo;</span><span style="font-size:9.5pt"><span style="font-family:&quot;ProximaNovaCond-Light&quot;,sans-serif">s. Apparently, there is not an association with number of sessions. As expected, there is a higher percentage of P with these symptoms when physical activity is more compromised (lower distance in 6MWT). </span></span></span></span></p>