Abstract
BackgroundCardiac rehabilitation (CR) improves outcomes in patients with heart disease. We investigated the differences in outcomes of comprehensive phase II CR in obese and non-obese patients.MethodsWe performed a retrospective analysis of functional outcomes including metabolic equivalents (METS), heart rate (chronotropic competence - CC), and blood pressure response (BPR) in 178 patients undergoing CR based on underlying body mass index (BMI). Demographic and clinical variables were assessed for age, gender, race, smoking, hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease, stroke, heart failure, medication use, and several sessions attended.ResultsInitial CC and METS were impaired in majority of patients attending CR, whereas BPR to exercise was mostly preserved. Significant improvement occurred in CC (non-obese: 0.71 ± 0.11 vs 0.76 ± 0.11, p < 0.001; obese: 0.72 ± 0.10 vs 0.75 ± 0.12, p = 0.0010) and METS (non-obese: 4.96 ± 1.98 vs 7.33 ± 2.94, p < 0.001; obese: 4.39 ± 1.81 vs 6.79 ± 3.34, p < 0.001). Post-CR obese patients were able to reach similar level of physical activity as non-obese patients (6.79 ± 3.34 vs 7.33 ± 2.94; p = 0.2). Improvement in BPR was only seen in non-obese patients (24.02 ± 20.07 vs 30.18 ± 21.93; p = 0.019). Improvement in functional variables occurred despite increase in BMI in non-obese (25.91 ± 2.85 vs 26.21 ± 2.96; p = 0.031), and there was no significant change in BMI in obese (35.30 ± 5.60 vs 34.93 ± 5.42; p > 0.05).ConclusionCR concurrently improves functional outcomes in both obese and non-obese patients despite no associated weight loss. The difference in BPR, however, is seen in only non-obese individuals. Future studies are needed to validate the role of weight-optimized CR protocols as a potential target for improving cardiac outcomes.
Highlights
Cardiovascular disease (CVD) is a leading cause of morbidity and mortality and is responsible for approximately 20% of the worldwide disease burden [1]
We performed a retrospective analysis of functional outcomes including metabolic equivalents (METS), heart rate, and blood pressure response (BPR) in 178 patients undergoing Cardiac rehabilitation (CR) based on underlying body mass index (BMI)
Initial CC and METS were impaired in majority of patients attending CR, whereas BPR to exercise was mostly preserved
Summary
Cardiovascular disease (CVD) is a leading cause of morbidity and mortality and is responsible for approximately 20% of the worldwide disease burden [1]. The mortality from coronary heart disease has decreased over recent decades, nearly 470,000 recurrent myocardial infarctions are reported annually in the United States [2]. Cardiac rehabilitation (CR), a structured outpatient program, has become an essential component in the continuum of care post-hospital discharge to improve patient’s quality of life and social functioning and as a means for secondary prevention of CVDs [3]. There are three phases of CR: initial phase, outpatient cardiac rehab, post-cardiac rehab. In this context, we studied the impact of CR on functional outcomes such as chronotropic competence (CC), heart rate (HR), and systolic blood pressure (SBP) in the. Cardiac rehabilitation (CR) improves outcomes in patients with heart disease. We investigated the differences in outcomes of comprehensive phase II CR in obese and non-obese patients
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