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Published on: October 1, 2019
Improved Peak Oxygen Uptake Reduces Cardiac Events After 3 Weeks of Inpatient Cardiac Rehabilitation for Chronic
Makoto Murata1, Saya Yanai2, Shogo Nitta2
1Department of Cardiology, Gunma Prefectural Cardiovascular Center Maebashi Japan.
Insights
Three weeks of inpatient cardiac rehabilitation (CR) improved peak oxygen uptake and reduced cardiovascular events in heart failure (HF) patients. This program is vital for enhancing recovery and lowering rehospitalization rates in aging populations.
Area of Science:
- Cardiology
- Exercise Physiology
Background:
- Heart failure (HF) incidence and mortality are rising, particularly in aging populations.
- Cardiac rehabilitation (CR) improves outcomes but faces low outpatient participation.
- Inpatient CR programs offer a structured approach to address these challenges.
Purpose of the Study:
- To evaluate the effectiveness of a 3-week inpatient cardiac rehabilitation program (3w In-CRP) for HF patients.
- To assess changes in cardiorespiratory fitness and cardiovascular event rates post-discharge.
Main Methods:
- Ninety-three HF patients participated in 30 sessions of 3w In-CRP, including twice-daily aerobic exercise.
- Cardiopulmonary exercise tests were conducted before and after the program.
- Post-discharge cardiovascular events were monitored.
Main Results:
- Peak oxygen uptake (V̇O2) significantly increased from 11.8±3.2 to 13.7±4.1 mL/min/kg.
- A 6.1% improvement in peak V̇O2 correlated with reduced cardiovascular events.
- During follow-up, 20 patients were rehospitalized for HF, 1 had a stroke, and 8 died.
Conclusions:
- A 3-week inpatient cardiac rehabilitation program effectively improves cardiorespiratory fitness in HF patients.
- Improved peak V̇O2 following 3w In-CRP is associated with a reduction in cardiovascular events.
- Inpatient CR represents a viable strategy to enhance recovery and reduce adverse outcomes in heart failure management.
Abstract:
The incidence of heart failure (HF) is increasing, and the mortality from HF remains high in an aging society. Cardiac rehabilitation (CR) programs (CRP) increase oxygen uptake (V̇O2) and reduce HF rehospitalization and mortality. Therefore, CR is recommended for every HF patient. However, the number of outpatients undergoing CR remains low, with insufficient attendance at CRP sessions. In this study we evaluated the outcomes of 3 weeks of inpatient CRP (3w In-CRP) for HF patients. This study enrolled 93 HF patients after acute-phase hospitalization between 2019 and 2022. Patients participated in 30 sessions of 3w In-CRP (30 min aerobic exercise twice daily, 5 days/week). Before and after 3w In-CRP, patients underwent a cardiopulmonary exercise test, and cardiovascular (CV) events (mortality, HF rehospitalization, myocardial infarction, and cerebrovascular disease) after discharge were evaluated. After 3w In-CPR, mean (±SD) peak V̇O2 increased from 11.8±3.2 to 13.7±4.1 mL/min/kg (116.5±22.1%). During the follow-up period (357±292 days after discharge), 20 patients were rehospitalized for HF, 1 had a stroke, and 8 died for any reasons. Proportional hazard and Kaplan-Meier analyses demonstrated that CV events were reduced among patients with a 6.1% improvement in peak V̇O2 than in patients without any improvement in peak V̇O2. 3w In-CRP for HF patients improved peak V̇O2 and reduced CV events in HF patients with a 6.1% improvement in peak V̇O2.
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