Pre-operative oxygen uptake kinetics during 6-min walk test predicts short-term clinical outcomes after off-pump coronary artery bypass surgery. From a clinically applicable perspective, a threshold of 66% of pre-operative predicted 6-min walk test distance indicated slower kinetics, which leads to longer intensive care unit and post-surgery hospital length of stay. Implications for rehabilitation Coronary artery bypass grafting is a treatment aimed to improve expectancy of life and prevent disability due to the disease progression; The use of pre-operative submaximal functional capacity test enabled the identification of patients with high risk of complications, where patients with delayed oxygen uptake kinetics exhibited worse short-term outcomes; Our findings suggest the importance of the rehabilitation in the pre-operative in order to "pre-habilitate" the patients to the surgical procedure; Faster oxygen uptake on-kinetics could be achieved by improving the oxidative capacity of muscles and cardiovascular conditioning through rehabilitation, adding better results following cardiac surgery.
Background The 6-minute walk test distance is frequently used to assess functional capacity of cardiac disease population. Nevertheless, anthropometric differences can confound or misestimate performance, which highlights the need for new parameters. This study aims to investigate the potential of the body weight-walking distance product (D.W), compared to 6-minute walk test distance, to predict exercise capacity measured by VO 2 on-kinetics in coronary artery disease (CAD) patients.Methods Cross-section study in a tertiary-care reference institution. Forty-six participants with multiarterial CAD with and without left ventricular dysfunction underwent a 6-minute walk test with simultaneous use of mobile telemetric cardiopulmonary monitoring to evaluate oxygen uptake (VO 2 ) on-kinetics and other cardiorespiratory responses.Results Perceived effort Borg for lower limb fatigue was only correlated with the D.W (p=0.007). The percent-predicted and actual distance were only modestly to moderately correlated with VO 2 on-kinetics (p<0.05). All the associations of VO 2 on-kinetics parameters were improved by showing a stronger correlation to the D.W (p<0.0001), which also had a larger effect size to identify differences between coronary disease patients compared to distance ( d =1.32 vs d =0.84).Conclusion The D.W demonstrates potential as a measure superior to the distance in determining VO 2 on-kinetics in participants with CAD with and without left ventricular dysfunction.
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