Cardiac rehabilitation increases physical capacity but not mental health after heart valve surgery: a randomised clinical trial

Kristine Lærum Sibilitz, Selina Kikkenborg Berg, Trine B. Rasmussen, Signe Stelling Risom, Lars Hermann Tang, Lau Caspar Thygesen, Tina B. Hansen, Pernille Palm Johansen, Christian Gluud, Jane Lindschou, Jean Paul Schmid, Christian Hassager, Lars Køber, Rod S Taylor, Ann-Dorthe Zwisler

    Publikation: Bidrag til tidsskriftTidsskriftsartikelForskningpeer review

    Abstract


    Objective The evidence for cardiac rehabilitation after valve surgery remains sparse. Current recommendations are therefore based on patients with ischaemic heart disease. The aim of this randomised clinical trial was to assess the effects of cardiac rehabilitation versus usual care after heart valve surgery.


    Methods The trial was an investigator-initiated, randomised superiority trial (The CopenHeartVR trial, VR; valve replacement or repair). We randomised 147 patients after heart valve surgery 1:1 to 12 weeks of cardiac rehabilitation consisting of physical exercise and monthly psycho-educational consultations (intervention) versus usual care without structured physical exercise or psycho-educational consultations (control). Primary outcome was physical capacity measured by VO2 peak and secondary outcome was self-reported mental health measured by Short Form-36.


    Results 76% were men, mean age 62 years, with aortic (62%), mitral (36%) or tricuspid/pulmonary valve surgery (2%). Cardiac rehabilitation compared with control had a beneficial effect on VO2 peak at 4 months (24.8 mL/kg/min vs 22.5 mL/kg/min, p=0.045) but did not affect Short Form-36 Mental Component Scale at 6 months (53.7 vs 55.2 points, p=0.40) or the exploratory physical and mental outcomes. Cardiac rehabilitation increased the occurrence of self-reported non-serious adverse events (11/72 vs 3/75, p=0.02).


    Conclusions Cardiac rehabilitation after heart valve surgery significantly improves VO2 peak at 4 months but has no effect on mental health and other measures of exercise capacity and self-reported outcomes. Further research is needed to justify cardiac rehabilitation in this patient group.
    OriginalsprogEngelsk
    TidsskriftHeart
    Vol/bind102
    Udgave nummer24
    Sider (fra-til)1995-2003
    Antal sider9
    ISSN1355-6037
    DOI
    StatusUdgivet - 15 dec. 2016

    Emneord

    • rehabilitering

    Citationsformater