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Effectiveness of a Cardiac Rehabilitation Program in Women with Heart Failure
Session:
Comunicações Orais - Sessão 05 - Doença cardiovascular na mulher
Speaker:
Andreia Campinas
Congress:
CPC 2023
Topic:
K. Cardiovascular Disease In Special Populations
Theme:
30. Cardiovascular Disease in Special Populations
Subtheme:
30.2 Cardiovascular Disease in Women
Session Type:
Comunicações Orais
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:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">Introduction: Cardiac rehabilitation (CR) improves exercise capacity and quality of life (QoL) and reduces hospital readmission rates in heart failure (HF) patients. However, like other cardiovascular treatments, CR remains underutilized in women for several reasons, namely a misperception of its reduced effectiveness.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">Objective: We aimed to compare the adherence and effectiveness of a CR program of women and men with HF.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">Methods: We conducted a prospective single-centre study of consecutive 93 patients with HF referred to the CR program at our hospital between September 2019 and July 2021. We defined adherence as the percentage of sessions patients attended. The effectiveness outcomes were differences in peak oxygen uptake (VO2peak) and 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:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">Results: Of the 93 studied patients, 30 (32.3%) were female. Their baseline features differed regarding smoking and chronic kidney disease (CKD) which were more prevalent in men (71.4% vs 27.6%, p<0.001 and 20.6% vs 3.3%, p=0.032, respectively). The HF with reduced ejection fraction (EF) phenotype [Left ventricular ejection fraction (LVEF) <40%] was more prevalent in men (92.1% vs 73.3%, p=0.024). Regarding adherence, 84% of the 93 studied patients completed the CR program and no differences were found between groups (female vs male: 76.7% vs 87.3%; p=0.232). The significant increase in VO2peak observed in the overall cohort (+1.3±2.3 L/min/Kg; p<0.001) did not differed between gender (female: vs men: 1.5±2.1 vs 1.2±2.4 L/min/Kg; p=0.938). We also observed a significant reduction in the total, physical and emotional dimension MLHFQ scores in both genders (all p<0.05). However, the overall improvement in QoL was significantly higher in women as indicated by a larger reduction of MLHFQ total score (p=0.042) and physical dimension score (p=0.009).</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">Conclusion: Women with HF had similar adherence to the CR program and had the same increase in VO2peak - a robust and validated HF prognostic marker in this setting. Women benefited more than men regarding QoL improvements, particularly in the physical dimension score. Together, these data emphasize the need to increase the referral of women with HF to CR programs.</span></span></span></p>
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