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Rehab-VAD: Cardiac rehabilitation benefited patients with LVADs
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Patients with continuous-flow left ventricular assist devices showed improved functional capacity and health status after cardiac rehabilitation, according to results from the Rehab-VAD randomized controlled trial.
Previous research has demonstrated that cardiac rehabilitation improves functional capacity and health status, but little was known about the effects in patients with LVADs, according to the study background.
Dennis J. Kerrigan, PhD, from the division of cardiovascular medicine at Henry Ford Hospital, Detroit, and colleagues enrolled 26 patients with HF and a newly implanted continuous-flow LVAD (seven women; mean age, 55 years) in the Rehab-VAD study. Patients were randomly assigned on a 2:1 basis to 6 weeks of cardiac rehabilitation or usual care. Those in the cardiac rehabilitation program underwent 18 visits of aerobic exercise at 60% to 80% of heart rate reserve.
At baseline and at the end of the program, participants completed a symptom-limited cardiopulmonary exercise test, Kansas City Cardiomyopathy Questionnaire, 6-minute walk test and single-leg isokinetic strength test. The primary outcome was change in peak VO2.
From baseline to follow-up, the cardiac rehabilitation group showed improvement in peak VO2 (10%), treadmill time (3.1 minutes), Kansas City Cardiomyopathy Questionnaire score (14.4 points), 6-minute walk distance (52.3 m) and leg strength (17%). Compared with controls, the cardiac rehabilitation group had better improvement in treadmill time (P=.001), Kansas City Cardiomyopathy Questionnaire score (P=.005) and leg strength (P=.016), but not in peak VO2 (P=.27) or 6-minute walk distance (P=.241).
“This study adds to the literature that shows improvements in functional capacity and [health status] for individuals with continuous-flow LVADs who participate in [cardiac rehabilitation] (vs. usual care),” the researchers wrote. “In addition, this is the first study to report that participation in [cardiac rehabilitation] can also lead to improvements in strength in this population. As mechanical assist devices become more commonplace, the utilization of [cardiac rehabilitation] should be considered to help these individuals regain physical function and improve their [health status].”
The next step is to conduct trials examining the mechanisms of improvement and determining whether they translate to improved clinical outcomes, according to the researchers.
Disclosure: The researchers report no relevant financial disclosures.
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