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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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  1. Valve regurgitation in patients surviving endocarditis and the subsequent risk of heart failure

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  3. Interaction of ischaemic postconditioning and thrombectomy in patients with ST-elevation myocardial infarction

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  4. Outcome after heart-lung or lung transplantation in patients with Eisenmenger syndrome

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  5. Significantly increased risk of all-cause mortality among cardiac patients feeling lonely

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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.

TRIAL REGISTRATION NUMBER: NCT01558765, Results.

Original languageEnglish
JournalHeart (British Cardiac Society)
Volume102
Pages (from-to)1995-2003
ISSN1355-6037
DOIs
Publication statusPublished - 4 Aug 2016

ID: 48311277