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Examining Risk Factors Related to Cardiac Rehabilitation Cessation Among Patients With Advanced Heart Failure

Sharnendra K Sidhu1, Bernard S Kadosh, Ying Tang

  • 1Author Affiliations: Department of Medicine, New York University Grossman School of Medicine (Dr Sidhu); Leon H. Charney Division of Cardiology, New York University Grossman School of Medicine (Drs Kadosh, Katz, Reyentovich, and Dodson); and Department of Physical Medicine and Rehabilitation, New York University Grossman School of Medicine, New York, New York State (Drs Tang, Sweeney, Pierre, and Whiteson).

Journal of Cardiopulmonary Rehabilitation and Prevention
|October 30, 2024
PubMed

Insights

Nearly half of heart transplant and left ventricular assist device (LVAD) recipients completed cardiac rehabilitation (CR). Complete adherence to CR improved exercise capacity and outcomes in these patients.

Area of Science:

  • Cardiology
  • Rehabilitation Medicine

Background:

  • Cardiac rehabilitation (CR) is recognized for its benefits in patients who have undergone heart transplantation or received a left ventricular assist device (LVAD).
  • However, understanding the patterns of CR attendance and adherence in these specific patient populations remains limited.

Purpose of the Study:

  • To investigate the adherence rates and reasons for cessation of CR among heart transplant and LVAD recipients.
  • To compare post-operative complications, hospitalization duration, and readmissions between patients with complete and incomplete CR adherence.
  • To evaluate the impact of complete CR adherence on exercise parameters.

Main Methods:

  • A retrospective review was conducted on 137 heart transplant and LVAD recipients who participated in CR between 2013 and 2022.
  • Complete adherence was defined as attending 36 CR sessions.
  • Statistical analyses, including logistic and linear regressions, were used to compare outcomes between adherence groups, and paired sample t tests assessed changes in exercise metrics.

Main Results:

  • 91% of participants either completed 36 CR sessions or attended fewer than 24 sessions.
  • Among those not completing CR (n=74), medical reasons (72%) and personal reasons (15%) were primary cessation factors.
  • Incomplete adherence was associated with higher rates of post-operative complications (44% vs. 24%) and major bleeding (23% vs. 7%) prior to CR.
  • Complete adherence led to significant improvements in exercise time, metabolic equivalent of task (MET), and peak oxygen uptake.

Conclusions:

  • Approximately half of heart transplant and LVAD recipients achieved complete adherence to the 36-session CR protocol.
  • Complete adherence to CR is linked to significant improvements in exercise capacity and functional outcomes.
  • These findings highlight the crucial benefits of CR for heart transplant and LVAD recipients.
Abstract

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