BACKGROUND: Cardiac rehabilitation after heart transplantation has been documented to be beneficial for increased physical activity via a randomized trial using cardiopulmonary stress testing. It is not clear as to whether cardiac rehabilitation in the first year after transplant leads to better long-term outcome.
METHOD: We surveyed 164 heart transplant patients transplanted between 1991 and 2011, who underwent formal cardiac rehabilitation in the first year post-transplantation and compared them to 233 patients who did not undergo cardiac rehabilitation. End points include 5-year freedom from cardiac allograft vasculopathy (CAV). and non-fatal major adverse cardiac events (NF-MACE, defined as myocardial infarction, heart failure, need for percutaneous cardiac intervention, stroke).
RESULTS: Patients who underwent cardiac rehabilitation compared to those that did not had significantly greater 5-year freedom from CAV (85% vs 76%, p=0.024). There was no difference in baseline risk factors (except the rehab group being older) and 1-year freedom from treated rejection between groups.
|Outcomes||No Cardiac Rehab (N=233)||Cardiac Rehab (N=164)||p-value|
|5-Year Freedom from CAV||76%||85%||0.024|
|5-Year Freedom from NF-MACE||87%||89%||0.526|
|1-Year Freedom from Any-Treated Rejection||87%||85%||0.644|
|BMI at Baseline, Mean ± SD||25.0 ± 4.3||25.4 ± 4.7||0.381|
|Diabetes at Baseline, n (%)||57 (24%)||44 (27%)||0.595|
|Recipient Age, Mean Years ± SD||54 ± 12||58 ± 11||0.001|
|Donor Age, Mean Years ± SD||31 ± 12||33 ± 13||0.115|
CONCLUSION: Cardiac rehabilitation is associated with less development of CAV at 5-years. Further study into the mechanisms of this finding is to be pursued.
To cite this abstract in AMA style:Kittleson M, Patel J, Rafiei M, Osborne A, Chang D, Czer L, Kobashigawa J. Role of Cardiac Rehabilitation after Heart Transplantation in the Reduction of Cardiac Allograft Vasculopathy, The [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/role-of-cardiac-rehabilitation-after-heart-transplantation-in-the-reduction-of-cardiac-allograft-vasculopathy-the/. Accessed October 27, 2020.
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