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

Effects of cardiac rehabilitation as independent predictor for favourable long term postoperative evolution in patients undergoing coronary artery bypass grafting

Session Poster Session 1

Speaker Associate Professor Luminita Iliuta

Event : ESC Congress 2019

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

Authors : L Iliuta (Bucharest,RO)

Authors:
L Iliuta1 , 1University of Medicine and Pharmacy Carol Davila - Bucharest - Romania ,

Citation:

Aim: 1. To evaluate whether a supervised cardiac rehabilitation (CR) program improves physical capacity and quality of life (QoL) of patients with LV systolic dysfunction undergoing coronary artery bypass grafting (CABG) compared to patients training by their own.
2. To investigate LV diastolic function dynamics according to the results of tissue Doppler imaging (TDI) in these patients.
3. To define the echographic predictors for long term prognosis in these patients and their adjusted value for calculation of a preoperative risk score.

Material and method:
Prospective randomized study on 665 CABG patients with LV systolic dysfunction (LVEF<35%), comparing 12 weeks of supervised exercise training (SET) 3 times per week to home-based training based upon public health recommendations of minimum level of physical activity. Patients were evaluated including TDI preoperatively and till 5 years postoperatively. The primary endpoints were the composites of death from any cause or hospitalization for cardiac causes and  the secondary endpoints were changes in peak oxygen uptake and in physical capacity (measured with cardiopulmonary exercise testing), changes in health-related QoL and changes in physical activity level (measured with International Physical Activity Questionnary). Stastistical analysis used SYSTAT and SPSS programs. 

Results:
1. . SET was more efficient in rehabilitating CABG patients being an independent predictor for a more favourable postoperative evolution, mostly in patients with normal LV diastolic filling pattern (LVDFP) (97,27%) compared with restrictive LV filling (89.83%). At 5 years postoperatively, cardiovascular event-free survival was significantly higher in nonrestrictive LVDFP group(74.94%) compared with restrictive LVDFP(55,75%). 
2. Conventional transmitral diastolic Doppler indices before and after CABG remained unchanged. TDI showed significant improvement in SET group at 3 and 12 months postoperatively of both LV systolic (S: 6.1±0.9, 7.5±1.1 and 7.3±1.2cm/s) and diastolic function (e': 7.2 ± 1.8, 8.3 ± 1.4 and 8.8 ± 1.5cm/s.; E/e' ratio: 17.8 ± 2.1, 13.1 ± 1.7 and 11.3 ± 1.8; Vp 3.2 ± 0.55, 2.4 ± 0.28 and 1.9 ± 0.26)
3. The main predictors for unfavorable evolution at 5 years postoperatively were: age>75years (RR=7.3), LV end-systolic volume (LVESV)>85cm3(RR=6.4), restrictive LVDFP (RR=8.9) and pulmonary hypertension (PHT) (RR=5.2).

Conclusions: 1. SET improves physical capacity and QoL in CABG patients, mainly in those with normal LVDFP,  the restrictive LVDFP being associated with an early and late postoperative unfavourable evolution and difficult CR.
2. Exercise capacity and symptoms are more closely correlated with indices assessed by TDI which demonstrate significant improvement of LV systolic and diastolic function in SET patients, regardless of transmitral flow pattern
3. On long term postoperatively  the unfavorable evolution was predicted by: age>75years, LVESV>85cm3, restrictive LVDFP and severe PHT.

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

Members get more

Join now
  • 1ESC Professional Members – access all resources from general ESC events 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. 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