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Efficacy of exercise training-based cardiac rehabilitation programmes after transcatheter aortic valve implantation:
Alireza Hosseinpour1,2, Pouria Azami1,2, Hamidreza Hosseinpour2
1Department of Cardiovascular Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Insights
Cardiac rehabilitation (CR) significantly improves exercise capacity and quality of life for patients after transcatheter aortic valve implantation (TAVI). These benefits in physical function and well-being are observed regardless of the CR program
Area of Science:
- Cardiology
- Rehabilitation Medicine
- Interventional Cardiology
Background:
- Cardiac rehabilitation (CR) is established for various heart conditions.
- The impact of CR on patients undergoing transcatheter aortic valve implantation (TAVI) requires focused investigation.
Purpose of the Study:
- To conduct a meta-analysis evaluating the effects of exercise-based CR on patients post-TAVI.
- To assess CR's impact on exercise capacity and health-related quality of life in TAVI patients.
Main Methods:
- Systematic search of multiple databases for eligible studies.
- Quantitative synthesis of data from 11 studies involving 685 patients.
- Primary endpoint: 6-minute walk test (6MWT); secondary endpoints included quality of life and depression scores.
Main Results:
- CR significantly improved 6MWT results (SMD 0.59, p < 0.01).
- Significant improvements were noted in Barthel Index (SMD 0.73, p < 0.01) and SF-12 scores (physical: SMD 0.30, p < 0.01; mental: SMD 0.27, p = 0.02).
- CR also led to a significant reduction in depression scores (HADS-D: SMD -0.26, p < 0.01).
Conclusions:
- Exercise-based CR offers substantial benefits for TAVI patients.
- CR positively impacts physical capacity and health-related quality of life post-TAVI.
- These benefits are achieved irrespective of the duration of the CR program.
Background:
The beneficial effects of exercise training-based cardiac rehabilitation (CR) in different cardiac conditions have been previously studied. In this meta-analysis, we focused on the potential impact of CR on patients undergoing transcatheter aortic valve implantation (TAVI).
Methods:
Multiple databases were searched in a systematic approach to find the eligible studies. All the studies investigating the potential impact of exercise training-based CR programmes on exercise capacity and health-related quality of life in patients undergoing TAVI were retrieved. The primary endpoint of interest was 6-min walk test (6MWT). The pooled standardized mean difference (SMD) and 95 % confidence interval (CI) were measured to compare the improvement or worsening the endpoints using a random- or fixed-effects model, as appropriate.
Results:
A total of eleven studies (685 patients) were considered eligible for quantitative synthesis. The results showed that performing exercise training-based CR after TAVI is associated with significant improvement in 6MWT (SMD 0.59, 95 % CI (0.48; 0.71), p < 0.01), Barthel index (SMD 0.73, 95 % CI (0.57; 0.89), p < 0.01), 12-item Short Form (SF-12) physical (SMD 0.30, 95 % CI (0.08; 0.52), p < 0.01) and mental (SMD 0.27, 95 % CI (0.05; 0.49), p = 0.02) survey scores, and hospital anxiety and depression scale - depression (HADS-D) score (SMD -0.26, 95 % CI (-0.42; -0.10), p < 0.01).
Conclusion:
Performing exercise training-based CR following TAVI has significant benefits regarding physical capacity and health-related quality of life irrespective of the programme duration.
