Abstract 16264: Chronic Renal Insufficiency Predicts Decreased Improvement in Steady State Exercise Level During Cardiac Rehabilitation
Introduction: The correlation between renal insufficiency and increased cardiovascular disease-related mortality is well established. Cardiac rehabilitation (CR) is known to improve exercise capacity, quality of life (QOL), and risk factors in patients with coronary artery disease (CAD). However, the data on the benefits of CR in patients with renal insufficiency are sparse.
Hypothesis: We assessed the hypothesis that patients with baseline glomerular filtration rate (GFR) <60 ml/min per 1.73 m2 see a similar improvement in exercise capacity, QOL, and risk factors during cardiac rehabilitation compared to patients with a GFR ≥ 60 ml/min per 1.73 m2.
Methods: A total of 792 participants of a CR program were retrospectively studied and baseline demographics and risk factors were recorded at the start of CR. GFR, lipid profile, body mass index (BMI), and QOL were calculated pre and post CR. Steady state exercise levels (metabolic equivalents - METs) were calculated at each session.
Results: Patients with GFR <60 ml/min per 1.73 m2 significantly improved their MET levels, albeit to a lesser degree than patients with GFR ≥ 60 ml/min per 1.73 m2, as well as QOL, weight, BMI, and lipid profile. Baseline GFR <60 ml/min per 1.73 m2 was a significant predictor of decreased improvement in MET levels, controlling for age, gender, BMI as well as, abnormal systolic and diastolic function. The increase in peak MET level in patients with a baseline GFR <60 (Δ1.8, p<0.05) was lower than the increase in peak MET in patients with a baseline GFR 60-89 (Δ2.7, p<0.05) and patients with a baseline GFR ≥ 90 (Δ2.8, p<0.05, see Table).
Conclusion: Patients with renal insufficiency and baseline GFR <60 derive a significant benefit in their exercise capacity, QOL and lipid profile although not to the same extent as those with normal renal function.
- © 2013 by American Heart Association, Inc.