Abstract
Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): This work was financially supported by the project POCI-01-0145-FEDER-030011, funded by FEDER, through COMPETE2020-POCI, and by national funds, through FCT/MCTES (PTDC/MEC-CAR/30011/2017). CIAFEL, UnIC and UMIB are supported by national funds through Fundação para a Ciência e Tecnologia, I.P. [(UIDB/00617/2020), (UIDB/00051/2020 and UIDP/00051/2020), and (UIDB/00215/2020 and UIDP/00215/2020), respectively]. CS received an individual grant from CAPES [BEX 0554/14-6].
Introduction
Cardiac rehabilitation (CR) is an evidence-based recommended treatment of heart failure (HF) patients. During the COVID-19 pandemic, the shutdown of CR centers was necessary to limit the infection risk among high-risk patients. The integration of a home-based CR (HBCR) program in CR units can help to improve the delivery of care and improve cardiovascular outcomes of HF patients.
Purpose
To assess the effectiveness of an HBCR program in HF patients.
Methods
This is a substudy of the EXercise InTervention in Heart Failure trial (EXIT-HF), which include forty-nine HF patients (preserved and reduced ejection fraction). The HBCR program consisted in 12-week combined exercise program (60%-80% of peak oxygen consumption (VO2 peak)), 2 training sessions per week, for a total of 24 sessions. Patients performed 4 supervised training sessions and the remaining sessions at home. All patients performed a cardiopulmonary exercise test (VO2 peak), the 6-minute-walking test (6MWT), collected blood analysis (plasma NT-proBNP), and answered the Minnesota Living with Heart Failure Questionnaire.
Results
Forty-two patients (86%) complete at least 80% of prescribed training sessions (age: 61.1±12; FEVE: 37.1±10.8). The HBCR program improve VO2 peak from 18.3 to 20.1ml/kg/min (+1.8 ml/kg/min; 95%IC:1.4 to 2.4; p<0.001) and the walked distance at the 6MWT from 462 to 512 meters (+49 meters; 95%IC: 38 to 60; p<0.001). In addition, overall quality of life was improved (-13 points; 95%IC:-7.8 to -18.5; p<0.001), as well physical (-6.3 points; 95%IC:-3.5 to -9; p<0.001) and emotional dimension of quality of life (-2.8points ; 95%IC: -0.9 to -4.7; p=0.06). No significant change was found in NT-proBNP levels (820±1220 vs 674±903; p=0.285).
Conclusions
Our results showed that HBCR is feasible and can improve functional capacity and quality of life in HF patients.
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