Abstract 10474: Cardiac Rehabilitation Improves Physical Functioning in Refractory Angina
Introduction: Refractory angina patients suffer debilitating chest pain despite optimal medical therapy and previous cardiovascular intervention. Supervised exercise training such as cardiac rehabilitation (CR) is advocated for patients with CHD to improve functional capacity, long-term prognosis and quality of life. However refractory angina patients are currently excluded from CR due to a lack of evidence regarding potential efficacy and patient suitability. A randomized, controlled study was undertaken to explore CR as a treatment for refractory angina.
Hypothesis: We explored the hypothesis that cardiac rehabilitation would improve cardiovascular risk factors, physical ability, quality of life and psychological morbidity among refractory angina sufferers.
Methods: Forty two patients with refractory angina (65.1 ± 7.3 yrs) were randomly assigned to an eight-week Phase III CR program (n=22) or symptom diary control (n=20). Participants completed the Progressive Shuttle Walk (PSW) test, physical assessment, Hospital Anxiety and Depression Scale (HADS), Health Anxiety Questionnaire (HAQ), The York Angina Beliefs scale, ENRICHD Social Support Instrument (ESSI)and SF-36 pre- and post-intervention and at eight-week follow-up. All patients completed angina diaries during the intervention.
Results: Following CR, patients demonstrated improved physical ability compared with controls in PSW level attainment (p=0.005) and total distance covered (p=0.015). No change was noted in angina frequency or severity among either group, with the control demonstrating worsening SF-36 pain scale (63.43 ± 22.28 vs. 55.46 ± 23.98, p=0.025). The CR group showed improvements in HAQ reassurance (1.71 ± 1.72 vs. 1.14 ± 1.23, p=0.026) and HB anginal threat perception (12.42 ± 4.58 vs. 14.35 ± 4.73, p=0.05) at visit two. Physical measures were broadly unaffected.
Conclusions: In conclusion, cardiac rehabilitation can be prescribed to improve physical ability without compromising angina frequency or severity among patients with refractory angina.
- © 2011 by American Heart Association, Inc.