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Improved Maximal Workload and Systolic Blood Pressure After Cardiac Rehabilitation Following Thoracic Aortic Repair:
Niek Koenders1, Henrita van Zetten, Michelle Smulders
1Departments of Rehabilitation (Dr Koenders) and Physiology (Dr Eijsvogels), Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands; Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, the Netherlands (Mss van Zetten and Smulders and Dr Smith); Department of Physiotherapy, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (Dr Verra); Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands (Dr van Kimmenade); and Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, the Netherlands (Dr van Brakel).
Purpose:
It is of clinical importance to gain more knowledge about the risks and benefits of exercise in patients recovering from thoracic aortic repair. Therefore, the aim of this review was to perform a meta-analysis on changes in cardiorespiratory fitness, blood pressure, and the incidence of adverse events during cardiac rehabilitation (CR) in patients recovering from thoracic aortic repair.
Review Methods:
We performed a systematic review and random-effects meta-analysis of outcomes before versus after outpatient CR in patients recovering from thoracic aortic repair. The study protocol was registered (PROSPERO CRD42022301204) and published. MEDLINE, EMBASE, and CINAHL were systematically searched for eligible studies. Overall certainty of evidence was scored with Grading of Recommendations Assessment, Development, and Evaluation (GRADE).
Summary:
We included five studies with data from in total 241 patients. Data from one study could not be used in our meta-analysis because they were provided in a different unit of measure. Four studies with data of 146 patients were included in the meta-analysis. The mean maximal workload increased with 28.7 W (95% CI: 21.8-35.6 W, n = 146, low certainty of evidence). The mean systolic blood pressure during exercise testing increased with 25.4 mm Hg (95% CI: 16.6-34.3, n = 133, low certainty of evidence). No exercise-induced adverse events were reported. These outcomes indicate that CR seems beneficial and safe to improve exercise tolerance in patients recovering from thoracic aortic repair, although outcomes were based on data from a small, heterogeneous group of patients.
