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Special features of cardiac rehabilitation programs in patients with systolic dysfunction

Session Poster session 4 Tuesday 08:30 - 12:30

Speaker Oscar Gonzalez Fernandez

Event : Heart Failure 2015

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure
  • Session type : Poster Session

Authors : R Dalmau (Madrid,ES), O Gonzalez Fernandez (Madrid,ES), A Castro (Madrid,ES), I Ponz (Madrid,ES), R Mori (Madrid,ES), Z Blazquez (Madrid,ES), C Alvarez (Madrid,ES), N Montoro (Madrid,ES), J Caro (Madrid,ES), JL Lopez Sendon (Madrid,ES)

Authors:
R Dalmau1 , O Gonzalez Fernandez1 , A Castro1 , I Ponz1 , R Mori1 , Z Blazquez1 , C Alvarez1 , N Montoro1 , J Caro1 , JL Lopez Sendon1 , 1University Hospital La Paz - Madrid - Spain ,

Citation:
European Journal of Heart Failure Abstracts Supplement ( 2015 ) 17 ( Supplement 1 ), 415

Background and Objectives: despite the benefit of cardiac rehabilitation in patients with systolic heart failure, their referral rate is often insufficient. The particular characteristics of these patients require some degree of individualization in order to achieve the goals. We compared the base-line characteristics of a cohort of patients referred to a cardiac rehabilitation program (CRP), according to their ventricular ejection fraction (EF >35% or ≤35%).

Methods: 921 patients referred to a CRP were studied, EF was determined by an echocardiogram (Simpson method) 1-2 weeks before starting the CRP. 91% of the patients were referred after a recent acute coronary syndrome. Functional capacity was determined in METS with a treadmill exercise test. The patients were classified according to their EF in two groups: patients with EF >35% (n = 749, 81,4%) and patients with EF ≤35% (n = 172, 18,6%). We compared their base-line characteristics in order to determine whether a different kind of intervention was required. Student t-test and Chi-square test were used for continuous and categorical variables respectively.

Results: mean age was 56,9, women were less prevalent in the low EF group (10,5% vs 16,7%, p = 0,04). CV risk factors were common in both groups, with a similar distribution. Patients in the low EF group were more likely to have co-morbidities such as chronic obstructive pulmonary disease (7,6% vs 4,2%, p = 0,02), renal impairment (6,4% vs 2,7%, p = 0,01), atrial fibrillation (6,4% vs 2,8%, p = 0,05), or moderate to severe valvulopathies (16% vs 5,3%, p < 0,001). As expected, exercise capacity was lower in the low EF group (6,37 ± 3.0 vs 8,04 ± 2,4 METS, p < 0,001). Patients with low EF were more likely to abandon the program (15,1% vs 10,1%, NS). Conclusion: patients referred to CRP are mostly coronary disease patients, with a high prevalence of CV risk factors, despite their systolic function. Patients with low EF have more comorbidities and a worse functional status, and therefore require a more individualized intervention.

EF >35%

EF 35%

p

Hypertension

50,1%

51,7%

NS

Diabetes

22,6%

27,6%

NS

Dislipideamia

61,3%

55,2%

NS

Tobacco

53,3%

56,4%

NS

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