Article

Increased exercise capacity favourably influences clinical outcomes
after transcatheter aortic valve implantation. In our
SPORT:TAVI randomised pilot
trial, eight weeks of endurance and resistance training (training group, TG)
shortly after transcatheter aortic valve implantation resulted in significantly
improved exercise capacity, muscular strength and quality of life compared to
usual care (UC). However, the long-term clinical benefits of such an intervention
are unknown. Design A randomised controlled trial. Methods SPORT:TAVI
participants underwent reassessment of trial endpoints 24 +/- 6 months after
baseline: maximal oxygen uptake (VO2peak) and anaerobic threshold (VO2AT) were
assessed with cardiopulmonary exercise testing, muscular strength with
one-repetition maximum testing, quality of life with the Kansas City
cardiomyopathy and medical outcomes study 12-item short-form health survey
questionnaires, and prosthetic aortic valve function with echocardiography.
Results Of 27 original participants (TG 13; UC 14; age 81 +/- 6 years), more
patients had died during follow-up in UC ( n = 5) than in TG ( n = 2; P = 0.165);
three further patients (TG 1; UC 2) were unavailable for other reasons. In the
remaining patients (TG 10; UC 7), a significant between-group difference in
favour of TG was observed for change in VO2AT from baseline (2.7 ml/min/kg (95%
confidence interval 0.8-4.6); P = 0.008), but not for change in VO2peak (2.1
ml/min/kg (-1.1-5.4); P = 0.178). Changes in muscular strength and quality of
life did not differ between groups over time. Overall, prosthetic valve function
remained intact in both groups. Conclusions Eight weeks of exercise training
shortly after transcatheter aortic valve implantation resulted in preserved
long-term improvements in VO2AT, but not VO2peak, muscular strength or quality of
life compared to usual care. The findings emphasise the importance of ongoing
exercise interventions following transcatheter aortic valve implantation to
maintain initial improvements long term. Clinical Trial Registration (original
trial): Clinicaltrials.gov NCT01935297.

Langue : ANGLAIS