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Impact of Cardiac Rehabilitation on Heart Failure Across Ejection Fraction Spectrum
Session:
Posters (Sessão 6 - Écran 4) - Provas de Esforço e Reabilitação
Speaker:
Andreia Campinas
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:
Andreia Campinas; Cristine Schmidt; Maria Isilda Oliveira; Sandra Magalhães; Catarina Gomes; José Preza-Fernandes; Severo Torres; Mário Santos
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">Introduction: Cardiac rehabilitation (CR) is a class I recommendation to all Heart Failure (HF) patients, however most of its supporting data come from HF with reduced ejection fraction (HFrEF). </span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">Objective: We aimed to study the adherence and effectiveness of a CR program on HF across the ejection fraction spectrum. </span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">Methods: We conducted a prospective single-center study of consecutive 93 patients with HF referred to the CR program at our hospital between September 2019 and July 2021. Our groups of interest were patients with HFrEF [Left ventricular ejection fraction (LVEF) <50%] and HF with preserved EF (HEpEF) (LVEF>50%). We defined adherence as the percentage of sessions patients attended. The effectiveness outcomes were differences in peak oxygen uptake (VO2peak) and quality of life (QoL) measurement differences before (baseline) and after the CR program (3-month). VO2peak was assessed by a maximal effort cardiopulmonary exercise testing on a treadmill. QoL was assessed using Minnesota Living with Heart Failure Questionnaire® (MLHFQ). </span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">Results: Among a cohort of 93 patients, 86% had HFrEF. HFpEF patients were significantly older (mean age 78±2.9vs61±1.3;p=0.002) and predominantly women (75%vs28%;p=0.012). Their baseline characteristics differed regarding atrial fibrillation, which was significantly more prevalent in the HFpEF group (63%vs20%;p=0.017). Regarding adherence, no significant difference was found between the groups (HFrEFvsHFpEF:85%vs75%;p=0.608). The significant increase in VO2peak observed in the overall cohort (+1.3±2.3L/min/Kg;p<0.001) did not statistically differ between HF phenotype, however HFpEF patients had a numerically reduced improvement (HFrEFvsHFpEF: 1.3±2.3vs0.35±1.2L/min/Kg, p=0.348). We also observed a significant reduction in total, physical and emotional MLHFQ scores in HFrEF patients (all p<0.001). However, in the HFpEF group, it was only observed a significant reduction in the total and emotional dimension of MLHFQ scores (p=0.011 and p=0.012, respectively), not the physical one. </span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">Conclusions: We observed similar adherence to our CR program and an overall improvement in maximal functional capacity and QoL in HF patients regardless of LVEF. However, the magnitude of improvement in the VO2peak and physical dimension of QoL was higher in HFrEF. Together, these data emphasize the importance to increase the referral of patients with HF across LVEF to CR programs.</span></span></span></p>
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