Impact of cardiac rehabilitation on the chronotropic response to exercise and exercise capacity

• Type: Summary of Presentation in an International Conference
• Date: 2012

Authors

Correia AS (Author) Other; Gonçalves A (Author) Other; Rocha A (Author) Other; Costa S (Author) Other; Ferreira G (Author) Other; Sousa C (Author) Other; Rangel I (Author) Other; Paiva M (Author) Other; Sousa A (Author) Other; Araújo V (Author) Other; Macedo F (Author) Other; Parada F (Author) Other; Maciel MJ (Author) FMUP

Conference proceedings International

Title: European Journal of Heart Failure Supplements

Initial page: P1392

Heart Failure Congress 2012

Belgrade, 2012

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Abstract (EN): Introduction: Many of the silent effects of exercise are thought to work by its effect on the careful orchestrated interplay between the sympathetic and parasympathetic nervous system. The purpose of this study was to evaluate the effects of a cardiac rehabilitation program (CRP), on chronotropic response to exercise and its relation to the improvement in exercise capacity. Methods: Prospective study enrolling consecutive patients admitted to an outpatient CRP after suffering an acute coronary event between September 2008 and September 2011. Exercise stress testing was performed at the beginning and at the end of CRP. The chronotropic response (CR) to exercise was assessed on the basis of the percentage of heart rate reserve used at peak exercise. Results: Two hundred and two patients were evaluated, mean age of [mean (SD): 54.9(107)] years, 177 (87.6%) male. Among these, 34 (17%) had previous history of coronary artery disease (CHD), 99 (49%) were dyslipidemic, 30 (15%) diabetic, 73 (36%) hypertensive, 31 (15%) were obese, and 111 (55%) were current smokers. Exercise training significantly improved CR to exercise: 72.5±17.7 to 75.4±16.5, p=0,022. CRP also improved exercise capacity (peak MET level: 9.9 to 10.8, p<0.001) and maximal double product (22216 to 22961, P=0.02). Double product (DP) reserve also tended to improve with exercise (12529 to 15080, p=0.06). The improvement in CR was significantly correlated with the improvement in exercise capacity, maximal double product and double product reserve (r=0.179, p=0.01; r=0.679, p<0.001; r=0.616, p<0.001 respectively). Improvement of CR was observed in both genders (60% of female vs 52% of men, p=0.627), in elderly patients (50 vs 54%, p= 0.885), diabetic and non-diabetic (47% vs 54%, p= 0.541), smokers and non-smokers (55% vs 52%, p=0.744) and obese patients (53% vs 60%, p=0.627). A positive effect of exercise training in CR was also similar in patients with history of dyslipidemia (51% vs 56%, p=0.493) or previous history of coronary artery disease (41% vs 56%, p=0.166) as well as in those with left ventricle dysfunction after the coronary event (50% vs 55%, p=0.661) and in patients under beta blockers therapy (75% vs 51%, p=0.187). Conclusions: CR improved with phase 2 CRP in the overall cohort after the acute coronary event. This improvement was significantly correlated to the improvement of exercise capacity and other well-established predictors of outcomes, as DP and DP reserve. The benefit of CRP in this recognized prognostic variable was observed independently to age, gender and the presence of a worse baseline cardiovascular risk profile.

Language: English

Type (Professor's evaluation): Scientific

Notes: Correia AS, Gonçalves A, Rocha A, Costa S, Ferreira G, Sousa C, Rangel I, Paiva M, Sousa A, Araújo V, Macedo F, Parada F, Maciel MJ. Impact of cardiac rehabilitation on the chronotropic response to exercise and exercise capacity. Eur J Heart Fail Suppl 2012; 11(Suppl 1): P1392. ISSN 1567-4215. Heart Failure Congress 2012, Belgrade, 2012