Correlation between changes in diastolic dysfunction and health-related quality of life after cardiac rehabilitation program in dilated cardiomyopathy

Abstract

Chronic heart failure (CHF) is a complex syndrome characterized by progressive decline in left ventricular function, low exercise tolerance and raised mortality and morbidity. Left ventricular diastolic dysfunction plays a major role in CHF and progression of most cardiac diseases. The current recommended goals can theoretically be accomplished via exercise and pharmacological therapy so the aim of the present study was to evaluate the impact of cardiac rehabilitation program on diastolic dysfunction and health related quality of life and to determine the correlation between changes in left ventricular diastolic dysfunction and domains of health-related quality of life (HRQoL). Forty patients with chronic heart failure were diagnosed as having dilated cardiomyopathy (DCM) with systolic and diastolic dysfunction. The patients were equally and randomly divided into training and control groups. Only 30 of them completed the study duration. The training group participated in rehabilitation program in the form of circuit-interval aerobic training adjusted according to 55–80% of heart rate reserve for a period of 7 months. Circuit training improved both diastolic and systolic dysfunction in the training group. On the other hand, only a significant correlation was found between improvement in diastolic dysfunction and health related quality of life measured by Kansas City Cardiomyopathy Questionnaire. It was concluded that improvement in diastolic dysfunction as a result of rehabilitation program is one of the important underlying mechanisms responsible for improvement in health-related quality of life in DCM patients.

Impact of Inspiratory Muscle Training Versus Resistance Training on Ventricular Dysfunction in Patients With Dilated Cardiomyopathy: A Randomized Controlled Trial

“…There was a correlation between improved endotheliumdependent vasodilatation of the skeletal muscle vasculature and reduction of total peripheral resistance during exercise. Therefore, training is associated with a reduction in afterload that can improve ejection fraction [36]. The findings of this study are also supported by those of Laoutaris et al, who studied the benefits of a combined exercise program including aerobic, resistance, and inspiratory muscle training.…”

Effects of Cardiac Rehabilitation in Low- and Middle-Income Countries: A systematic Review and Meta-Analysis of Randomised Controlled Trials

“… Apolipoprotein A1b (mg/L) (12 months) pre-CR 1.01 ± 0.13; post-CR 1.65 ± 0.29; pre-UC 0.95 ± 0.14; post-UC 0.85 ± 0.27; Significant difference within CR groups (p = 0.0001) only and significant difference between groups (p = 0.0001) following the intervention. Mehani 2013, 39 Egypt, EMR N = 40; mean age 55.5 years; 0.0% female; 0.0% HF and/or non-ACS patients included PROBE with 2 parallel arms; 1 site. UC- Y (Patients received simple disease information and biweekly physician/cardiologist consultation); AC comparison- No ITT: y Adverse events (%) (7 months) CR 3 (20.00%); UC 0 (0.00%); No significant difference between groups.…”

Dilated cardiomyopathy

“…A recent study 184 identified three factors that predicted positive self-care with compliance to treatment: clear information about the medication, a belief in the illness having serious consequences and the effect of medication use on lifestyle. Moreover, previous studies showed a significant improvement in all aspects of QoL after comprehensive cardiac rehabilitation with daily light exercise, a weight management programme and nurse-led patient education 185,186 . Thus, the most important way to improve QoL in patients with DCM is providing an early, pathophysiologicalbased diagnosis, better risk stratification and, ultimately, personalized therapy based on aetiological assessment of disease.…”