Article

Evidence of the effect of cardiac rehabilitation (CR) after heart valve
surgery is scarce, but nevertheless CR is recommended for this group of patients.
Therefore, this study assessed the effect of CR on exercise capacity,
cardiovascular risk factors, and long-term mortality and morbidity, as well as
predictors for enrolment in or failing to complete CR. METHODS: A review of
medical records identified 250 patients who underwent heart valve surgery between
January 2009 and August 2013. Of these, 211 patients eligible for CR were
identified. Effect of CR was assessed by peak oxygen uptake ((Equation is
included in full-text article.)O2peak) or 6-minute walk test (6MWT). A composite
endpoint of all-cause mortality and hospital admission due to myocardial
infarction, stroke, heart failure, endocarditis, revascularization, or
reoperation was used to assess the hazard ratio between CR attenders and
nonattenders. Multivariable logistic regression was used to find predictors for
CR attendance and CR completion. RESULTS: A total of 146 patients completed CR.
(Equation is included in full-text article.)O2peak improved by 16% from 21.6 to
24.8 mL/kg/min (P < .0001) and 6MWT distance by 13% from 349 to 393 m (P =
.0016). Rate of clinical events was higher among nonattenders with an adjusted
hazard ratio of 2.46 (95% CI, 1.26-4.80). Age >75 years was predictive for not
attending (adjusted OR, 2.99; 95% CI, .37-6.53), whereas ethnic minorities were
less likely to complete CR (adjusted OR, 4.88; 95% CI, 1.58-15.06). CONCLUSIONS:
CR after heart valve surgery improved exercise capacity and was associated with
reduced morbidity. Elderly and ethnic minorities were less likely to attend or
complete CR and deserve special attention.

Langue : ANGLAIS