Abstract 15524: Cardiac Rehabilitation Improves Health Status and Six Minute Walk Distance in Patients With Continuous Flow Left Ventricular Assist Devices
Objective: Continuous-flow left ventricular assist devices (LVAD) show improved patient reported health status (HS) and six-minute walk distance (6MW) within the first 1 to 6 months following implantation. However, what has not been reported is the extent to which exercise training interacts with these metrics.
Purpose: Examine the effects of a six week cardiac rehabilitation (CR) exercise program on HS and 6MW in patients with newly implanted LVADs.
Methods: Subjects (n = 23, 7 females; age 53 ± 13 yr; ejection fraction 21 ± 8%) completed the Kansas City Cardiomyopathy Questionnaire (KCCQ) and 6MW before being randomized in a 2:1 fashion to either CR or usual care (UC). Subjects in the CR group received 18 visits of CR which included supervised exercise, group educational classes, and individualized care plans. Within group changes from baseline to 6 weeks were analyzed with a paired t-test, while an independent t-test was used to compare differences in the change between groups.
Results: Initial tests were administered 84 ± 40 days following LVAD implant with no difference between groups. The CR group showed greater improvements in both outcomes (figure). Within group improvement (15%) was observed for the 6MW in the CR group (p= 0.001), but not UC (p = 0.43). The KCCQ clinical summary score increased 23% (p=0.001) in the CR group compared to no change in the UC group (p = 0.874), a difference that was statistically significant (p= 0.005). Additionally, within group improvements in 5 (of 7) subdomains of the KCCQ occured in the CR group.
Conclusion: CR improves KCCQ scores and 6MW distance in patients with recently implanted continuous flow LVADs. Although improved perfusion from the LVAD likely results in some spontaneous improvement to function and reported symptoms, it appears that exercise may accentuate some of these effects. Additional research regarding timing of exercise training, frequency, intensity, and duration are warranted.
- Cardiac rehabilitation
- Quality of life
- Ventricular assist devices
- Exercise tests
- Cardiorespiratory fitness
- © 2013 by American Heart Association, Inc.