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Effect of cardiac rehabilitation on functional and emotional status in patients after transcatheter aortic-valve implantation

  • Background Transcatheter aortic-valve implantation (TAVI) is an established alternative therapy in patients with severe aortic stenosis and a high surgical risk. Despite a rapid growth in its use, very few data exist about the efficacy of cardiac rehabilitation (CR) in these patients. We assessed the hypothesis that patients after TAVI benefit from CR, compared to patients after surgical aortic-valve replacement (sAVR). Methods From September 2009 to August 2011, 442 consecutive patients after TAVI (n=76) or sAVR (n=366) were referred to a 3-week CR. Data regarding patient characteristics as well as changes of functional (6-min walk test. 6-MWT), bicycle exercise test), and emotional status (Hospital Anxiety and Depression Scale) were retrospectively evaluated and compared between groups after propensity score adjustment. Results Patients after TAVI were significantly older (p<0.001), more female (p<0.001), and had more often coronary artery disease (p=0.027), renal failure (p=0.012) and a pacemaker (p=0.032). During CR,Background Transcatheter aortic-valve implantation (TAVI) is an established alternative therapy in patients with severe aortic stenosis and a high surgical risk. Despite a rapid growth in its use, very few data exist about the efficacy of cardiac rehabilitation (CR) in these patients. We assessed the hypothesis that patients after TAVI benefit from CR, compared to patients after surgical aortic-valve replacement (sAVR). Methods From September 2009 to August 2011, 442 consecutive patients after TAVI (n=76) or sAVR (n=366) were referred to a 3-week CR. Data regarding patient characteristics as well as changes of functional (6-min walk test. 6-MWT), bicycle exercise test), and emotional status (Hospital Anxiety and Depression Scale) were retrospectively evaluated and compared between groups after propensity score adjustment. Results Patients after TAVI were significantly older (p<0.001), more female (p<0.001), and had more often coronary artery disease (p=0.027), renal failure (p=0.012) and a pacemaker (p=0.032). During CR, distance in 6-MWT (both groups p0.001) and exercise capacity (sAVR p0.001, TAVI p0.05) significantly increased in both groups. Only patients after sAVR demonstrated a significant reduction in anxiety and depression (p0.001). After propensity scores adjustment, changes were not significantly different between sAVR and TAVI, with the exception of 6-MWT (p=0.004). Conclusions Patients after TAVI benefit from cardiac rehabilitation despite their older age and comorbidities. CR is a helpful tool to maintain independency for daily life activities and participation in socio-cultural life.show moreshow less

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Metadaten
Author:Heinz VöllerORCiDGND, Annett SalzwedelORCiDGND, Aischa Nitardy, Hermann Buhlert, Andra ́s Treszl, Karl WegscheiderORCiDGND
URN:urn:nbn:de:kobv:517-opus4-404100
Parent Title (English):Postprints der Universität Potsdam : Humanwissenschaftliche Reihe
Series (Serial Number):Postprints der Universität Potsdam : Humanwissenschaftliche Reihe (385)
Document Type:Postprint
Language:English
Date of first Publication:2018/04/05
Year of Completion:2014
Publishing Institution:Universität Potsdam
Release Date:2018/04/05
Tag:Cardiac rehabilitation; emotional status; functional capacity; surgical aortic valve replacement (sAVR); transcatheter aortic valve implantation (TAVI)
Issue:385
Pagenumber:7
Source:European journal of preventive cardiology 22 (2015) Nr. 5, S. 568–574 DOI: 10.1177/2047487314526072
Organizational units:Humanwissenschaftliche Fakultät
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Peer Review:Referiert
Publication Way:Open Access
Grantor:Sage
Licence (German):License LogoKeine Nutzungslizenz vergeben - es gilt das deutsche Urheberrecht
Notes extern:Bibliographieeintrag der Originalveröffentlichung/Quelle