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Cardiac rehabilitation increases physical capacity but not mental health after heart valve surgery: a randomised clinical trial
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Cardiac rehabilitation increases physical capacity but not mental health after heart valve surgery: a randomised clinical trial
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Journal Article
Cardiac rehabilitation increases physical capacity but not mental health after heart valve surgery: a randomised clinical trial
2016
Overview
ObjectiveThe 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.MethodsThe 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.Results76% 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).ConclusionsCardiac 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.Trial registration numberNCT01558765, Results.
Publisher
BMJ Publishing Group LTD
Subject
/ Aged
/ Cardiac Rehabilitation - methods
/ Cardiac Surgical Procedures - adverse effects
/ Cardiac Surgical Procedures - rehabilitation
/ Denmark
/ Exercise
/ Female
/ Health Knowledge, Attitudes, Practice
/ Heart Valve Diseases - diagnosis
/ Heart Valve Diseases - physiopathology
/ Heart Valve Diseases - psychology
/ Heart Valve Diseases - surgery
/ Heart Valves - physiopathology
/ Humans
/ Male
/ Patients
