Long-term effects of cardiac rehabilitation after heart valve surgery - results from the randomised CopenHeartVR trial

Sibilitz, K. L. et al. (2022) Long-term effects of cardiac rehabilitation after heart valve surgery - results from the randomised CopenHeartVR trial. Scandinavian Cardiovascular Journal, 56(1), pp. 247-255. (doi: 10.1080/14017431.2022.2095432)

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Aims. The CopenHeartVR trial found positive effects of cardiac rehabilitation (CR) on physical capacity at 4 months. The long-term effects of CR following valve surgery remains unclear, especially regarding readmission and mortality. Using data from he CopenHeartVR Trial we investigated long-term effects on physical capacity, mental and physical health and effect on mortality and readmission rates as prespecified in the original protocol. Methods. A total of 147 participants were included after heart valve surgery and randomly allocated 1:1 to 12-weeks exercise-based CR including a psycho-educational programme (intervention group) or control. Physical capacity was assessed as peak oxygen uptake (VO2 peak) measured by cardiopulmonary exercise testing, mental and physical health by Short Form-36 questionnaire, Hospital Anxiety and Depression Scale, and HeartQol. Mortality and readmission were obtained from hospital records and registers. Groups were compared using mixed regression model analysis and log rank test. Results. No differences in VO2 peak at 12 months or in self-assessed mental and physical health at 24 months (68% vs 75%, p = .120) was found. However, our data demonstrated reduction in readmissions in the intervention group at intermediate time points; after 3, 6 (43% vs 59%, p = .03), and 12 (53% vs 67%, p = .04) months, respectively, but no significant effect at 24 months. Conclusions. Exercise-based CR after heart valve surgery reduces combined readmissions and mortality up to 12 months despite lack of improvement in exercise capacity, physical and mental health long-term. Exercise-based CR can ensure short-term benefits in terms of physical capacity, and lower readmission within a year, but more research is needed to sustain these effects over a longer time period. These considerations should be included in the management of patients after heart valve surgery.

Item Type:Articles
Additional Information:The Danish Strategic Research Foundation [10-092790]; The Heart Centre Research Council, Rigshospitalet; Familien Hede Nielsen Foundation [2013-1226]; The National Institute of Public Health, University of Southern Denmark; and Region Zealand Health Research Foundation, Denmark [12-000095/jun2014].
Glasgow Author(s) Enlighten ID:Taylor, Professor Rod
Authors: Sibilitz, K. L., Tang, L. H., Berg, S. K., Thygesen, L. C., Risom, S. S., Rasmussen, T. B., Schmid, J.-P., Borregaard, B., Hassager, C., Køber, L., Taylor, R. L., and Zwisler, A.-D.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:Scandinavian Cardiovascular Journal
Publisher:Taylor & Francis
ISSN (Online):1651-2006
Published Online:09 July 2022
Copyright Holders:Copyright © 2022 The Author(s)
First Published:First published in Scandinavian Cardiovascular Journal 56(1):247-255
Publisher Policy:Reproduced under a Creative Commons Licence

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