In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.


The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Response to cardiac rehabilitation: does left ventricle ejection fraction matter?

Session Poster session 4

Speaker Marta Braga

Congress : ESC Congress 2017

  • Topic : preventive cardiology
  • Sub-topic : Rehabilitation: Outcomes
  • Session type : Poster Session
  • FP Number : P3430

Authors : M Braga (Porto,PT), A Rocha (Porto,PT), H Nascimento (Porto,PT), G Pestana (Porto,PT), R Pinto (Porto,PT), M Tavares-Silva (Porto,PT), P Araujo (Porto,PT), A Nunes (Porto,PT), V Araujo (Porto,PT), F Parada-Pereira (Porto,PT), M J Maciel (Porto,PT)

15 views

Authors:
M. Braga1 , A. Rocha1 , H. Nascimento1 , G. Pestana1 , R. Pinto1 , M. Tavares-Silva1 , P. Araujo1 , A. Nunes1 , V. Araujo1 , F. Parada-Pereira1 , M.J. Maciel1 , 1Sao Joao Hospital - Porto - Portugal ,

Citation:
European Heart Journal ( 2017 ) 38 ( Supplement ), 716-717

Introduction: Development of left ventricular systolic dysfunction (LVSD) in acute coronary syndrome (ACS) patients significantly worsens their prognosis. In addition, LVSD is associated with diminished functional capacity (FC). Even though CRP is an essential tool for secondary prevention, some argue against an early cardiac rehabilitation program (CRP) referral of patients with LVSD.

Purpose: The aim of this study was to evaluate baseline clinical characteristics and compare the response to CRP of patients according to left ventricle ejection fraction (LVEF).

Methods: We performed a retrospective analysis of prospectively collected data on a cohort of patients referred to CRP after an ACS. Patients were divided into three groups: Preserved LVEF (pLVEF): LVEF≥50%, mid-range LVEF (mrLVEF): LVEF 40–49% and reduced LVEF (rLVEF): LVEF<40%. FC was assessed using metabolic equivalents (METs) achieved at a standard exercise test using Bruce protocol before and after CRP. We used ANOVA analysis and a mixed between-within analysis of variance.

Results: Of a total 586 patients, 370 (63.1%) had pLVEF, 115 (19.6%) had mrLVEF and 101 (17.3%) had rLVEF. Mean age was no different between groups (pLVEF: 53.9±10.0, mrLVEF: 53.8±9.6, rLVEF: 54.9±10.5, p=0.601) and most patients were males in all groups. Prevalence of diabetes, hypertension, active smoking, and dyslipidaemia were no different between groups. The main diagnosis in pLVEF patients was acute myocardial infarction (AMI) without ST elevation (51.4%) while in mrLVEF and rLVEF patients was AMI with ST elevation (73.0% and 76.2%, respectively). Coronarography showed obstructive disease of one coronary artery in majority of patients in all groups and percutaneous coronary intervention was the treatment of choice in pLVEF, mrLVEF and rLVEF groups. Baseline FC was better in pLVEF patients (9.2±2.3 METs), followed by mrLVEF (8.6±2.3 METs) and rLVEF patients (8.5±2.3 METs). After CRP, all groups significantly improved their FC (pLVEF: 10.8±2.1 METs, mrLVEF: 10.7±2.0 METs, rLVEF: 10.5±2.1 METs, within-groups partial Eta square 0.28, p<0.001). Comparing between-groups, improvement of FC was associated with LVEF, being mrLVEF patients the group that showed the best response to CRP (p=0.041).

Conclusion: FC ameliorated after CRP in all groups of patients despite different LVEF. Patients with mrLVEF were those who presented a better responder to CRP. Other studies are needed to further confirm this data in order to reinforce the referral of patients to CRP in spite of LVEF.



Based on your interests

Three reasons why you should become a member

Become a member now
  • 1Access your congress resources all year-round on the New ESC 365
  • 2Get a discount on your next congress registration
  • 3Continue your professional development with free access to educational tools
Become a member now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are