Abstract 18093: Effect of Cardiac Rehabilitation with Supervised Exercise Training on Urinary Albumin Excretion in Patients with Cardiovascular Disease

Abstract

Background Urinary albumin excretion is a predictor of cardiovascular death. Cardiac rehabilitation (CR) with exercise training (ET) has been shown to improve exercise capacity and prognosis in patients with cardiovascular disease (CVD). However, it remains unclear whether CR reduces urinary albumin excretion in CVD patients. Methods and Results One hundred CVD patients without macroalbuminuria and estimated glomerular filtration rate (eGFR) < 30 ml/min/1.73 m² (mean age of 66 ± 10 years) participated in CR with ET during hospitalization. Nineteen patients continued supervised ET for six months (ET group) and 81 patients quit supervised ET (inactive group). The supervised ET program consisted of supervised sessions 1-3 times a week and 30-60 minutes of home exercise at least twice a week. Urinary albumin/creatinine ratio (ACR), eGFR, and B-type natriuretic peptide (BNP) were measured before and 6 months after enrollment in both groups. ACR was significantly decreased in the ET group at 6 months after enrollment (32 ± 54 mg/g to 15 ± 18 mg/g creatinine, p<0.05). eGFR was unchanged in the ET group; however, eGFR significantly decreased in the inactive group (71 ± 18 ml/min/1.73 m² to 66 ± 18 ml/min/1.73 m², p<0.001). In addition, BNP decreased in the ET group (121 ± 119 pg/ml to 61 ± 44 pg/ml, p<0.05). Conclusions CR with supervised ET decreased urinary albumin excretion and BNP without deterioration of renal function. These findings suggest that continuation of a supervised ET program has a cardiorenal protective effect in CVD patients.