Cardiac Rehabilitation in Covid Era: was it equally effective?

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiac rehabilitation is currently described as a mainstay when it comes to treatment of cardiac patients (pts), mainly ischemic heart disease. Despite this, referral and implementation suffered a decrease amidst covid outbreak. Purpose To describe, in a cardiac rehabilitation center, the real life data regarding programme effects during covid pandemic and after the release of most sanitary measures. Methods Prospective cohort study which included consecutive pts who were participating in a center-based CR program lasting 8-12 weeks from 2019 to 2021. The CR program included initial evaluation by cardiologist and rehabilitation specialist with collection of clinical characteristics, three times weekly supervised exercise sessions, appointment with rehabilitation nurse, nutritionist and psychologist and educational sessions. Lab tests, echocardiogram and CPET were done before and after completion of the program. Results We analyzed 349 patients, mean age 60 ± 11,14 years, 83% male, most of them referred because of ischemic heart disease (83,6%), followed by valvular heart disease (7,0%). Mean ejection fraction was 48,4 ± 12,8 and most patients were in NYHA class II (65,1%). After program completion we noticed a clear benefit regarding functional class (NYHA before and after CRP: NYHA I 25,7% vs 63,7%; NYHA II 65,1% vs 34,5%; NYHA III 9,2% vs 1,9%; p<0.05), although differences in weight and body mass index were non significant. Laboratorial data also showed a favourable and significant improvement: NTproBNP 1068±752 pg/mL vs 498±764 (p<0.001); LDL-c 84±35,4 vs 70,6±30,2 (p=0.001); HDL-c 44,7±12,1mg/dL vs 46,8±10,4mg/dL (p=0.001); Triglycerides 126,9±66,6mg/dL vs 116,9±51,8mg/dL (p=0.34); HbA1c 6,07 vs 6,06 % (p=0.89). The significant differences in cholesterol were seen even after adjusting for statin dosage. Conclusions Despite constraints in CR programs during the pandemic, the long term data shows that maintaining such programs has an important effect when it comes to risk factor control and clinical improvement.