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Reviews in Cardiovascular Medicine  2019, Vol. 20 Issue (1): 47-52     DOI: 10.31083/j.rcm.2019.01.3183
Original Research Previous articles |
Cardiac rehabilitation improved oxygen uptake measured by cardiopulmonary exercise test in patients after aortic valve surgery
Feier Song1, #, Huimin Zhan2, #, Yuanfeng Liang3, #, Xuyu He4, *(), Lan Guo2, *()
1 Department of Emergency and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
2 Cardiac Rehabilitation Department, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 102 Zhongshan Road, Guangzhou, 510080, China
3 General Division, Guangdong Geriatric Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
4 Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
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Abstract:

Evidence for cardiac rehabilitation after valve surgery remains scarce. We retrospectively enrolled consecutive patients undergoing aortic valve surgery. The intervention group consisted of physical exercise for 3 months after surgery, while the control group underwent usual care without physical exercise. It was observed that cardiac rehabilitation has a beneficial effect on the peak oxygen uptake compared to the control group (24.2 ml/kg/min vs. 20.6 ml/kg/min) as measured by cardiopulmonary exercise testing 3 months after surgery. There was no significant difference observed in New York Heart Association class I or II between groups. Conversely, the intervention group underperformed the SF-36 Mental Component Scale at 3 months (50.3 vs. 53.8 points).

Key words:  Heart valve surgery      rehabilitation      physical exercise      cardiopulmonary exercise test      Short-Form 36     
Published:  30 March 2019     
*Corresponding Author(s):  Xuyu He E-mail: hexuyu97@126.com; Lan Guo E-mail:13826056262@139.com   
About author:  # These authors contributed equally.

Cite this article: 

Feier Song, Huimin Zhan, Yuanfeng Liang, Xuyu He, Lan Guo. Cardiac rehabilitation improved oxygen uptake measured by cardiopulmonary exercise test in patients after aortic valve surgery. Reviews in Cardiovascular Medicine, 2019, 20(1): 47-52.

URL: 

https://rcm.imrpress.com/EN/10.31083/j.rcm.2019.01.3183     OR     https://rcm.imrpress.com/EN/Y2019/V20/I1/47

Figure 1.  Flow diagram of the study.

Table 1  Baseline characteristics
Control group (n = 199) Rehabilitation group (n = 156) p value
Male, n (%) 124 (62.3) 90 (57.9) 0.678
Age, years 60.2 ± 11.5 61.8 ± 10.8 0.376
Aortic stenosis, n (%) 121 (60.8) 97 (62.3) 0.273
Aortic insufficiency, n (%) 126 (63.3) 90 (57.9) 0.064
Diabetes mellitus, n (%) 34 (17.3) 22 (14.4) 0.056
Atrial fibrillation, n (%) 31 (15.5) 16 (11.0) 0.043
eGFR, ml/min/1.73m2 53.34 ± 4.7 54.97 ± 5.1 0.485
Hypertension, n (%) 78 (39.1) 77 (49.4) 0.018
Dyslipidemia, n (%) 60 (30.4) 55 (35.3) 0.026
NYHA class I, n (%) 77 (38.7) 67 (42.9) 0.052
NYHA class II, n (%) 62 (31.2) 47 (30.1) 0.867
Mean LVEF, % 49.7 ± 5.6 50 ± 4.8 0.572
Preoperative LVEF 45%, n (%) 162 (81.2) 124 (79.4) 0.196
EuroSCORE II 1.08 ± 0.14 1.11 ± 0.12 0.073
Length of 6MWT, m 541.4 ± 7.5 553.9 ± 8.1 0.274
Table 2  Comparison of Cardiopulmonary exercise test at 3 months
Control group (n = 199) Rehabilitation group (n = 156) p value
Peak VO2, ml/kg/min 20.6 ± 4.26 24.2 ± 3.89 0.049
VE/VCO2 slope 26.3 ± 3.82 25.5 ± 4.11 0.242
Anaerobic threshold, ml/min/kg 9.3 ± 1.02 9.8 ± 0.89 0.034
SBP at rest, mmHg 124.5 ± 10.34 130.6 ± 9.37 0.042
Maximal SBP, mmHg 183.2 ± 9.38 188.9 ± 8.77 0.353
Heart rate at rest, bpm 87.5 ± 4.92 88.4 ± 4.18 0.634
Maximal heart rate, bpm 142.8 ± 9.38 144.6 ± 10.42 0.110
Total exercise time, min 6.57 ± 0.83 6.61 ± 0.77 0.058
Rate pressure product 16723 ± 834 17192 ± 738 0.062
Table 3  Comparison of self-reported and physical exploratory outcomes at 3 months
Control group (n = 199) Rehabilitation group (n = 156) p value
Length of 6MWT, m 503.6 ± 12.43 512.3 ± 11.97 0.324
NYHA function class I, n (%) 75 (37.7) 64 (41.0) 0.051
NYHA function class II, n (%) 61 (30.7) 45 (28.8) 0.763
Short Form-36
Mental component scale, pts 53.8 ± 5.83 50.3 ± 6.12 0.042
Physical component scale, pts 40.6 ± 4.94 41.2 ± 4.38 0.463
General health perception, pts 71.7 ± 7.30 72.3 ± 8.02 0.353
Mental health index, pts 77.2 ± 6.93 78.1 ± 7.32 0.632
Physical functioning index, pts 71.5 ± 7.15 72.6 ± 7.83 0.521
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[1] Feier Song, Huimin Zhan, Yuanfeng Liang, Xuyu He, Lan Guo. Corrigendum to “Cardiac rehabilitation improved oxygen uptake measured by cardiopulmonary exercise test in patients after aortic valve surgery” (Rev. Cardiovasc. Med. 2019, 20(1):47-52) [J]. Reviews in Cardiovascular Medicine, 2019, 20(2): 109-109.
[2] Yun Tian, Pingji Deng, Bing Li, Jieqiong Wang, Ju Li, Yulan Huang, Yan Zheng. Treatment models of cardiac rehabilitation in patients with coronary heart disease and related factors affecting patient compliance[J]. Reviews in Cardiovascular Medicine, 2019, 20(1): 27-33.
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