Average and Interindividual Effects to a Comprehensive Cardiovascular Rehabilitation Program

Abstract

Background: To describe the average effects and the interindividual variability after a comprehensive outpatient cardiovascular rehabilitation (CCR) program using concurrent exercise training prescribed according to cardiovascular risk stratification on cardiorespiratory fitness (CRF), anthropometric/body composition, quality of life and emotional health in patients of four cardiovascular disease profiles. Methods: CRF, anthropometric/body composition, quality of life, and emotional health were measured before and after a CCR and analyzed in heart valve surgery (HVS), heart failure with reduced ejection fraction (HFrEF), post-acute myocardial infarction (post-AMI), and in coronary artery disease (CAD) patients. Twenty, twenty-four, and thirty-two exercise sessions were prescribed according to mild, moderate, and severe baseline cardiovascular risk, respectively. In addition to concurrent exercise training, nutritional counseling, psychological support, and lifestyle education programs were performed. Results: The main outcomes by delta changes comparisons (Δ) revealed no significant differences at anthropometric/body composition as ΔBody fat decreases (HVS Δ−1.1, HFrEF Δ−1.0, post-AMI Δ−1.4, CAD Δ−1.2 kg) and ΔSkeletal muscle mass increases (HVS Δ+1.4, HFrEF Δ+0.8, post-AMI Δ+0.9, CAD Δ+0.9 kg), and CRF performance as ΔVO2peak increases (HVS Δ+4.3, HFrEF Δ+4.8, post-AMI Δ+4.1, CAD Δ+5.1 mL/kg/min) outcomes among HVS, HFrEF, post-AMI, and CAD (p > 0.05). Secondary outcomes showed significant pre-post delta changes in METs (HVS Δ+1.8, HFrEF Δ+0.7, post-AMI Δ+1.4, CAD Δ+1.4), and maximal O2pulse (HVS Δ+3.1, post-AMI Δ+2.1, CAD Δ+1.9). In addition, quality of life had a significant improvement in physical functioning (HVS Δ+17.0, HFrEF Δ+12.1, post-AMI Δ+9.8, CAD Δ+11.2), physical role (HVS Δ+28.4, HFrEF Δ+26.8, post-AMI Δ+25.6, CAD Δ+25.3), vitality (HVS Δ+18.4, HFrEF Δ+14.3, post-AMI Δ+14.2, CAD Δ+10.6) and social functioning (HVS Δ+20.4, HFrEF Δ+25.3, post-AMI Δ+20.4, CAD Δ+14.8) in all cardiovascular disease. For anxiety (HVS Δ−3.6, HFrEF Δ−2.3, post-AMI Δ−3.0, CAD Δ−3.1) and depression (HVS Δ−2.8, HFrEF Δ−3.4, post-AMI Δ−3.2, CAD Δ−2.3) significant changes were also observed. Conclusions: A CCR program that prescribes the number of exercise sessions using a cardiovascular risk stratification improves CRF, QoL, and emotional health, and the average results show a wide interindividual variability (~25% of non-responders) in this sample of four CVD profile of patients.

Evaluation of Change in Body Composition, including Phase Angle, in Post-Myocardial Infarction Patients Rehabilitated under the KOS-Zawał (MC-AMI) Programme

“…Furthermore, Tuesta et al assessed the effect of cardiac rehabilitation in patients who participated in different lengths of exercise cycles (from 24 to 36 training sessions). They attempted to determine the optimal length of exercise sessions and concluded that the recommended minimum number of exercise sessions should be 24, and preferably 36 [32,33]. Considering the above, it would be reasonable to ask whether the changes in body composition (including the phase angle) assessed using BIA in patients from the MC-AMI programme would have been even more satisfying if the number of training sessions was increased by extending the rehabilitation to be followed with telerehabilitation and hybrid telerehabilitation.…”

Assessment of qualitative body composition, including phase angle, in the context of primary prevention and secondary prevention of cardiovascular diseases (cardiac rehabilitation)

“…In a study by Tuesta et al [50], the authors evaluated the effects of cardiac rehabilitation, during which the number of exercise sessions (22-36 sessions) was adjusted according to the cardiovascular risk of individual cardiac patient profiles (4 profiles were distinguished). It was found improvements in cardiorespiratory fitness, life quality, as well as in the emotional sphere, with mean scores showing high individual variability.…”

“…It was found improvements in cardiorespiratory fitness, life quality, as well as in the emotional sphere, with mean scores showing high individual variability. Furthermore, it was pointed out that expert positions on the optimal duration of a rehabilitation programme for patients are still unclear [50,51]. It is recommended that the minimum number of training sessions should be between 24, and preferably 36 sessions [50,52].…”

“…Furthermore, it was pointed out that expert positions on the optimal duration of a rehabilitation programme for patients are still unclear [50,51]. It is recommended that the minimum number of training sessions should be between 24, and preferably 36 sessions [50,52]. Matsuo et al [17] in their study looked at a group of patients hospitalised for acute heart failure.…”