Characteristics of good response to aerobic axercise training in decompensated heart failure patients

• Main Author: Delgado, Bruno
• Publication Date: 2020
• Other Authors: Lopes, Ivo, Gomes, Bárbara, Novo, André
• Language: eng
• Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
• Download full: http://hdl.handle.net/10198/22873
• topic: Chronic heart failure; Rehabilitation

Exercise training is an excellent tool to promote functional capacity in chronic heart failure (HF) patients. Although its benefits in this population, it needs to be demonstrated in decompensated HF patients. A way to optimize an intervention is to evaluate who are the good responder and understand the causes of no response. Knowing the factors of good response is also important to emphasize the feasibility of an intervention and to deliver it to the ones who get the most benefit of it. Purpose To identify the characteristics that lead a patient to have a better response to an aerobic exercise training program for decompensated HF inpatients – ERICHF (early rehabilitation in cardiology – heart failure) Methods 50 patients who performed ERICHF program during the phase of stabilization were evaluated in terms of their sociodemographic, functional and physiological characteristics and performance during the program. The main variable used to understand the performance of the patients was the variation of the distance walked in the 6minute walking test (6MWT), performed as soon as the patient were able to do it (6MWTinicial) and at discharge (6MWTdischarge). A multiple linear regression was made in order to determine which variables are related to a better variation on the 6MWT, namely: age, LCADL and Barthel index (BI) scores at admission and discharge, number of days of hospitalization, number of cardiovascular risk factors, NYHA class, etiology of HF and ventricular function. DurbinWatson test was used to analyze the existence of independence of residual random variables. It was assumed a significance level at p<0.05. Results: Patient’s average age was 71 (±11) years old, 34 are male, 80% are in NYHA class III and 73% have severe left ventricular depression. Patients present a median of 76 points in BI at admission (minimum of 45 and maximum of 97) and a median of 32 at LCADL (minimum of 24 and maximum of 45 points). The mean distance walked in the 6MWTinicial performed by the patients was 199,9 (±115,9) meters and 287,6 (±128,9) meters at 6MWTdischarge, representing a 87,7 (±170,6) meters variation. According to the linear regression, an equation was obtained: Difference of the 6MWT = 454,6941* 6MWTinitial+2,981*Barthelinitial5,554* age. This equation explains 65% of the variation of the model in this sample of patients. Using this variables it’s possible to know how much distance a patient can walk, and understand if he is going to have a good performance in the program. Conclusions Patients with the worst results in the initial 6MWT, higher initial Barthel and younger ages, will get the most gains in terms of difference walked between the initial and final 6MWT and have the most benefit from the intervention program.