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Long-term effects of cardiac rehabilitation in obese patients

Session Poster session 3

Speaker Marta Braga

Event : Heart Failure 2017

  • Topic : preventive cardiology
  • Sub-topic : Exercise Testing
  • Session type : Poster Session

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

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

Citation:
European Journal of Heart Failure ( 2017 ) 19 ( Suppl. S1 ), 490

Introduction: Cardiac rehabilitation programs (CRP) improves exercise capacity (EC) and decreases cardiovascular morbidity and mortality after an acute coronary syndrome (ACS). However, some subpopulations are under-represented in CRP, namely obese patients.

Purpose: To compare the EC of obese patients with non-obese patients over 12 months of follow-up after CRP.

Methods: We retrospectively analysed data prospectively collected from patients who underwent CRP after an ACS. Patients were divided in two groups according to their body mass index (BMI): BMI=30Kg/m2 (obese) and BMI<30kg/m2 (non-obese). EC was assessed with a standard exercise test, including chronotropic index, rate-pressure product, exercise duration, and intensity in metabolic equivalents (METs). EC was evaluated at baseline (T1), end of CRP (T2) and after 12 months of follow-up (T3). The mixed between-within analysis of variance was used to compare groups.

Results: Of a total 469 patients, 108 patients were obese. Except for diabetes and hypertension, there were no additional significant differences at baseline between obese and non-obese patients. Regarding EC, obese showed lower chronotropic index at all three moments (p<0.001), but improved at T2 and T3, like the non-obese group (T1- obese: 63.3±17.0% vs non-obese: 70.6±18.9%; T2- obese: 70.5±13.7% vs. non-obese: 76.6±17.2%; T3- obese: 74.9±16.7% vs non-obese: 77.6±17.7%, within-groups partial Eta square 0.176, p<0.001). The same results were seen regarding rate-pressure product (T1- obese: 20090±3660 mmHg*bpm vs non-obese: 20600±3910 mmHg*bpm; T2- obese: 22360±4050 mmHg*bpm vs. non-obese: 22410±3930 mmHg*bpm; T3- obese: 23100±4210 mmHg*bpm vs non-obese: 22780±4320 mmHg*bpm, within-groups partial Eta square 0.213, p<0.001). Both groups improved exercise duration and intensity between T1 and T2, showing a nonsignificant decline in T3 (duration: T1- obese: 7.5±2.1 min vs 8.7±2.2 min; T2- obese: 9.4±1.8 min vs non-obese: 10.6±2.0 min; T3- obese: 9.3±2.0 min vs non-obese: 10.4±2.3 min; intensity: T1- obese 7.8±1.9 METs vs non-obese: 9.2±2.2 METs; T2- obese: 9.4±1.8 METs vs. non-obese: 11.1±2.0 METs; T3- obese: 9.3±1.8 vs non-obese: 11.0±2.2 METs, within-groups partial Eta square 0.47 and 0.38 respectively, p<0.001). Between-groups comparison showed that non-obese patients achieved a greater duration and intensity than obese patients at all 3 moments (p<0.001).

Conclusions: Although EC of obese patients was inferior to non-obese patients, our study revealed that CRP significantly improved EC in this population and this benefit persisted after 12 months of follow-up. This data highlights the importance of a greater referral of obese patient to CRP.

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