Kirstine L Sibilitz1,2, Selina K Berg1,3, Trine B Rasmussen1,3, Signe Stelling Risom1,4, Lau C Thygesen2, Lars Tang1,5,6, Tina B Hansen1,7, Pernille Palm Johansen1,8, Christian Gluud9, Jane Lindschou9, Jean Paul Schmid10, Christian Hassager1, Lars Køber1, Rod S Taylor2,11, Ann-Dorthe Zwisler1,2,12,13. 1. Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 2. National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark. 3. Department of Cardiology, Gentofte Hospital, Gentofte, Denmark. 4. Bachelor's Degree Programme in Nursing, Metropolitan University College, Copenhagen, Denmark. 5. Faculty of Health and Technology, Bachelor's Degree Programme in Physiotherapy, Department of Rehabilitation and Nutrition, Metropolitan University College, Copenhagen, Denmark. 6. CopenRehab, Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark. 7. Zealand University Hospital, Department of Cardiology, Køgevej 7-13, 4000 Roskilde, Denmark. 8. Department of Cardiology, Bispebjerg Hospital, Copenhagen, Denmark. 9. Copenhagen Trial Unit, Department 7812, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 10. Cardiology Clinic, Tiefenau Hospital and University of Bern, Bern, Switzerland. 11. Institute of Health Research, University of Exeter Medical School, Exeter, England. 12. Department of Cardiology, Holbaek Sygehus, Holbaek, Denmark. 13. National Centre of Rehabilitation and Palliation, University of Southern Denmark, and University Hospital of Odense, Odense, Denmark.
Abstract
OBJECTIVE: The evidence for cardiac rehabilitation after valve surgery remains sparse. Current recommendations are therefore based on patients with ischaemic heart disease. The aim of this randomised clinical trial was to assess the effects of cardiac rehabilitation versus usual care after heart valve surgery. METHODS: The trial was an investigator-initiated, randomised superiority trial (The CopenHeartVR trial, VR; valve replacement or repair). We randomised 147 patients after heart valve surgery 1:1 to 12 weeks ofcardiac rehabilitation consisting of physical exercise and monthly psycho-educational consultations (intervention) versus usual care without structured physical exercise or psycho-educational consultations (control). Primary outcome was physical capacity measured by VO2 peak and secondary outcome was self-reported mental health measured by Short Form-36. RESULTS:76% were men, mean age 62 years, with aortic (62%), mitral (36%) or tricuspid/pulmonary valve surgery (2%). Cardiac rehabilitation compared with control had a beneficial effect on VO2 peak at 4 months (24.8 mL/kg/min vs 22.5 mL/kg/min, p=0.045) but did not affect Short Form-36 Mental Component Scale at 6 months (53.7 vs 55.2 points, p=0.40) or the exploratory physical and mental outcomes. Cardiac rehabilitation increased the occurrence of self-reported non-serious adverse events (11/72 vs 3/75, p=0.02). CONCLUSIONS:Cardiac rehabilitation after heart valve surgery significantly improves VO2 peak at 4 months but has no effect on mental health and other measures of exercise capacity and self-reported outcomes. Further research is needed to justify cardiac rehabilitation in this patient group. TRIAL REGISTRATION NUMBER: NCT01558765, Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
RCT Entities:
OBJECTIVE: The evidence for cardiac rehabilitation after valve surgery remains sparse. Current recommendations are therefore based on patients with ischaemic heart disease. The aim of this randomised clinical trial was to assess the effects of cardiac rehabilitation versus usual care after heart valve surgery. METHODS: The trial was an investigator-initiated, randomised superiority trial (The CopenHeartVR trial, VR; valve replacement or repair). We randomised 147 patients after heart valve surgery 1:1 to 12 weeks of cardiac rehabilitation consisting of physical exercise and monthly psycho-educational consultations (intervention) versus usual care without structured physical exercise or psycho-educational consultations (control). Primary outcome was physical capacity measured by VO2 peak and secondary outcome was self-reported mental health measured by Short Form-36. RESULTS: 76% were men, mean age 62 years, with aortic (62%), mitral (36%) or tricuspid/pulmonary valve surgery (2%). Cardiac rehabilitation compared with control had a beneficial effect on VO2 peak at 4 months (24.8 mL/kg/min vs 22.5 mL/kg/min, p=0.045) but did not affect Short Form-36 Mental Component Scale at 6 months (53.7 vs 55.2 points, p=0.40) or the exploratory physical and mental outcomes. Cardiac rehabilitation increased the occurrence of self-reported non-serious adverse events (11/72 vs 3/75, p=0.02). CONCLUSIONS: Cardiac rehabilitation after heart valve surgery significantly improves VO2 peak at 4 months but has no effect on mental health and other measures of exercise capacity and self-reported outcomes. Further research is needed to justify cardiac rehabilitation in this patient group. TRIAL REGISTRATION NUMBER: NCT01558765, Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Authors: Devin K Patel; Meredith S Duncan; Ashish S Shah; Brian R Lindman; Robert A Greevy; Patrick D Savage; Mary A Whooley; Michael E Matheny; Matthew S Freiberg; Justin M Bachmann Journal: JAMA Cardiol Date: 2019-12-01 Impact factor: 14.676
Authors: Karin Vonbank; Daniel Haubenberger; Raphael Rosenhek; Matthias Schneider; Stefan Aschauer; Marco Idzko; Harald Gabriel Journal: Front Cardiovasc Med Date: 2021-02-12
Authors: Lizette N Abraham; Kirstine L Sibilitz; Selina K Berg; Lars H Tang; Signe S Risom; Jane Lindschou; Rod S Taylor; Britt Borregaard; Ann-Dorthe Zwisler Journal: Cochrane Database Syst Rev Date: 2021-05-07