Exercise-Based Cardiac Rehabilitation Improves Exercise Capacity Regardless of the Response to Cardiac Resynchronization Therapy in Patients With Heart Failure and Reduced Ejection Fraction.
Circ J
; 86(1): 49-57, 2021 12 24.
Article
in En
| MEDLINE
| ID: mdl-34193751
ABSTRACT
BACKGROUND:
In patients with chronic heart failure with reduced ejection fraction (HFrEF), cardiac resynchronization therapy (CRT) improves left ventricular ejection fraction (LVEF) and exercise-based cardiac rehabilitation (ECR) enhances exercise capacity. This study examined the relationship between the 2 responses.MethodsâandâResults:
Sixty-four consecutive HFrEF patients who participated in a 3-month ECR program after CRT were investigated. Patients were categorized according to a median improvement in peak oxygen uptake (PVÌO2) after ECR of 7% as either good (n=32; mean percentage change in PVÌO2[%∆PVÌO2]=23.2%) or poor (n=32; mean %∆PVÌO2=2.5%) responders. There was no significant difference in baseline characteristics between the good and poor responders, except for PVÌO2(51% vs. 59%, respectively; P=0.01). The proportion of good CRT responders was similar between the good and poor responders (%∆LVEF ≥10%; 53% vs. 47%, respectively; P=NS). Overall, there was no significant correlation between %∆LVEF after CRT and %∆PVÌO2after ECR. Notably, among poor CRT responders (n=32), the prevalence of atrial fibrillation (0% vs. 29%; P<0.03) and baseline PVÌO2(48% vs. 57%; P<0.05) were significantly lower among those with a good (n=15) than poor (n=17) response to ECR.CONCLUSIONS:
In patients with HFrEF, good ECR and CRT responses are unrelated. A good PVÌO2response to ECR can be achieved even in poor CRT responders, particularly in those with a sinus rhythm or low baseline PVÌO2.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Atrial Fibrillation
/
Cardiac Resynchronization Therapy
/
Cardiac Rehabilitation
/
Heart Failure
Type of study:
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Circ J
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
Year:
2021
Document type:
Article