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Predictors of physical inactivity 1 year after a cardiac rehabilitation program

Session EAPC Essentials 4 You - ePosters

Speaker Ines Aguiar Ricardo

Event : EAPC Essentials 4 You 2020

  • Topic : preventive cardiology
  • Sub-topic : Rehabilitation: Education
  • Session type : ePosters

Authors : I Aguiar Ricardo (Lisbon,PT), T Rodrigues (Lisbon,PT), N Cunha (Lisbon,PT), J Rigueira (Lisbon,PT), R Santos (Lisbon,PT), A Nunes-Ferreira (Lisbon,PT), SC Pereira (Lisbon,PT), PS Antonio (Lisbon,PT), P Morais (Lisbon,PT), B Silva (Lisbon,PT), R Pinto (Lisbon,PT), S Miguel (Lisbon,PT), H Santa-Clara (Lisbon,PT), FJ Pinto (Lisbon,PT), A Abreu (Lisbon,PT)

Authors:
I Aguiar Ricardo1 , T Rodrigues1 , N Cunha1 , J Rigueira1 , R Santos1 , A Nunes-Ferreira1 , SC Pereira1 , PS Antonio1 , P Morais1 , B Silva1 , R Pinto2 , S Miguel3 , H Santa-Clara2 , FJ Pinto1 , A Abreu1 , 1Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology - Lisbon - Portugal , 2Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa - Lisbon - Portugal , 3Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Physical Medicine and Rehabilitation - Lisbon - Portugal ,

Citation:

Introduction: Physical activity practice presents an inverse relation with risk factors of cardiovascular disease, with positive effects in quality of life. Cardiac Rehabilitation (CR) programs are effective in guiding patients with cardiovascular disease to safely and sustainably incorporate lifestyle physical activity (PA) changes, however its impact in long-term follow-up is unknown.

Purpose: To determine predictors of PA 1 year after an hospital cardiac rehabilitation phase 2 program

Methods: Observational study including consecutive patients, after completion of phase 2 CR. All the patients were submitted to a clinical and echocardiographic evaluation and performed a cardiorespiratory stress test after phase 2 cardiac rehabilitation program completion.  The patients were advised to continue the phase 3 CR at a specialized cardiac rehabilitation center (CRECUL). After one year of follow-up, the level of PA activity was assessed by completing the International Physical Activity Questionnaire (IPAQ) by telephone. Through logistic regression analysis, predictors of physical activity were determined after 1 year of phase 2 CR program. 

Results: 78 patients (60.3±11 years, 84.6% men, 85.9% ischemic disease, mean LVEF was 48.6±13) were included in a phase 2 cardiac rehabilitation program. Of the cardiovascular risk factors, hypertension was the most frequent (73.1%), followed by diabetes (69.2%), smoking 39.7% and dyslipidemia 35.9%. 

All patients completed the phase 2 program except one patient who dropped out. At the end of phase 2 CR, 55.8% of the patients were at class II. The mean LV ejection fraction was 51.5±12%, LV end-diastolic volume 121+53mL, LV end-systolic volume 71.5+52mL and TAPSE 19.9+4.3mm. In a cardiorespiratory stress test the mean of maximum workload was 128.5±42W, the duration of the test was 9.4±2.5min, the VO2 peak was 17.7±5.5 ml/kg/min, corresponding to 67.8±16.6% of the predicted maximum VO2, the slope was 29.8±5.6 and MYERS score 8.3±5.2 points. 

After 1 year of phase 2 completion, the IPAQ showed that 10.9% of patients had a low level of PA, 34.8% a moderate level and 54.3% had an high PA level. 

In multivariable analysis the participation in phase 3 CR program in CRECUL was an independent predictor of higher level of physical activity (p=0.017) as was the MYERS score (P=0.002). No cardiovascular risk factor, echocardiographic or isolated cardiorespiratory stress test variable were associated with a higher level of physical activity one year after the completion of phase 2 of CR.

Conclusion: The MYERS score and the participation in phase 3 CR in CRECUL were independent predictors of higher level of physical activity 1 year after phase 2 CR completion. So, after investing in phase 2 cardiac rehabilitation, it is critical to encourage patients to participate in phase 3 specialized programs to maintain lifestyles with higher level of physical activity.

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