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Effectiveness of a cardiac rehabilitation program in patients with heart failure and skeletal muscle weakness
Session:
Comunicações Orais - Sessão 04 - Reabilitação cardíaca
Speaker:
Mariana Pereira Santos
Congress:
CPC 2024
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.2 Cardiovascular Rehabilitation
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Mariana Pereira Santos; Cristine Schmidt; Priscilla Gois Basilio; Cláudio Santos; Maria Isilda Oliveira; Sandra Magalhães; Fernando Ribeiro; Mário Santos
Abstract
<p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:11pt"><strong>Background</strong>: Cardiac rehabilitation (CR) programs improve functional capacity, symptoms, and quality of life (QoL) in patients with heart failure (HF), however, it is often underutilized in individuals perceived as most fragile. Skeletal muscle weakness is a predictor of adverse outcomes and worse functional status. The effectiveness of CR programs in this subgroup of patients is still unclear.</span></span></p> <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:11pt"><strong>Aim</strong>: We aimed to evaluate the effects of a CR program on cardiorespiratory fitness, functional capacity, and QoL in patients with HF and muscle weakness. </span></span></p> <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:11pt"><strong>Methods</strong>: We analyzed prospectively collected data on 99 patients with HF referred to our CR program between September 2019 and September 2022. Peak oxygen consumption (VO2 peak, assessed by cardiopulmonary exercise testing), 6-minute walk test (6MWT), and QoL (assessed by the Minnesota Living with Heart Failure Questionnaire, MLHFQ) before and 12-weeks after the CR program were analyzed. Muscle weakness was defined as handgrip strength <35.5 kg for men and <20kg for women. Paired Student t-tests were used to compare values from baseline to the end of the CR program, and a one-way ANCOVA was conducted to determine the effectiveness in different groups controlling for age.</span></span></p> <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:11pt"><strong>Results</strong>: The overall prevalence of muscle weakness was 53.5% (n=53) and was similar for both sexes (W 50.0% vs M 55.2%, p=0.625). Patients with muscle weakness were older [65.6(±10.0) vs 59.1(±11.0) years, p=0.003] and had a higher prevalence of HF with preserved ejection fraction (13.2% vs. 0.0%, p = 0.014).</span></span></p> <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:11pt">As indicated in Table 1, the CR program resulted in increased cardiorespiratory fitness (VO2 peak), functional capacity (6MWT), and quality of life (MLHFQ) in both groups, even though there was no improvement in muscle strength. Also, the magnitude of improvement in all assessed measures was similar for patients with and without muscle weakness when controlling for the effect of age. </span></span></p> <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:11pt"><strong>Conclusion: </strong></span><span style="font-size:11.0pt">Muscle weakness is common in patients with HF. The benefits of CR programs on functional capacity and QoL were consistent across patients with muscle weakness, underscoring the importance of extending the referral to these seemingly fragile patients.</span></span></p>
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