Abstract 12981: Effect of Cardiac Rehabilitation on Functional and Emotional Status in Patients after Transcatheter Aortic-Valve Replacement
Introduction Transcatheter aortic-valve replacement (TAVR) is an alternative option in patients with severe aortic stenosis and a high surgical risk. Despite a rapid growth in its use, there are no data available about the efficacy of cardiac rehabilitation (CR) in these patients.
Hypothesis We assessed the hypothesis that patients after TAVR benefit from CR, comparably to patients after surgical aortic-valve replacement (sAVR).
Methods From September 2009 to August 2011, 442 consecutive patients after TAVR (n = 79) or sAVR (n = 363) were referred to a three-week inpatient CR. Data regarding functional (6-minute walk distance, 6-MWD and maximal exercise capacity) and emotional status (Hospital Anxiety and Depression Scale, HADS) in the two groups were evaluated and compared with each other.
Results Patients after TAVR were significantly older (80.19 ± 6.15 years vs. 67.71 ± 10.66 years; p<0.001), more female (59.5% vs. 33.9%; p<0.001) and had more often coronary artery disease (63.3% vs. 50.7%; p = 0.042), renal failure (44.9% vs. 31.1%; p = 0.02) and a pacemaker (15.2% vs. 8.0%; p = 0.046). At admission, they showed a significantly shorter mean 6-MWD (301.87 ± 101.66 m vs. 258.07 ± 92.58 m; p = 0.003) and a lower maximal exercise capacity (69.4 ± 26.52 watt vs. 53.05 ± 22.86 watt; p = <0.001). During CR, 6-MWD was significantly increased in both groups (+31.9% after sAVR vs. +23.6% after TAVR, p = <0.001). Only patients after sAVR showed a significant improvement in maximal exercise capacity (+15.2% vs. +8.6% p = 0.013 and p = 0.258 respectively). While patients after sAVR demonstrated a significant reduction in anxiety (p = 0.008), depression was not significantly reduced in both groups. After adjustment for baseline differences only 6-MWD increases were significantly different between sAVR and TAVR patients (p = 0.026).
Conclusions In conclusion, patients improve after TAVR despite their older age and co-morbidities. CR is a helpful tool to maintain independency for daily life activities and participation in socio-cultural life.
- © 2012 by American Heart Association, Inc.