Short- and long-term effects of a cardiac rehabilitation program in patients implanted with a left ventricular assist device

• Published in: PloS one Vol. 16; no. 12; p. e0259927
• Main Authors: Scaglione, Anna, Panzarino, Claudia, Modica, Maddalena, Tavanelli, Monica, Pezzano, Antonio, Grati, Paola, Racca, Vittorio, Toccafondi, Anastasia, Bordoni, Bruno, Verde, Alessandro, Cartella, Iside, Castiglioni, Paolo
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.12.2021; Public Library of Science (PLoS)
• Subjects: Aged; Biology and Life Sciences; Cardiac Surgical Procedures - adverse effects; Cardiac Surgical Procedures - instrumentation; Cardiac Surgical Procedures - methods; Cardiology; Cardiovascular disease; Congestive heart failure; Ejection fraction; Engineering and Technology; Exercise; Exercise Therapy - methods; Female; Heart failure; Heart Failure - rehabilitation; Heart Failure - surgery; Heart rate; Heart transplantation; Heart transplants; Heart-Assist Devices; Hemoglobin; Hospitals; Humans; Long-term effects; Male; Medicine and Health Sciences; Middle Aged; Pain; Physical fitness; Postoperative Complications - rehabilitation; Psychological assessment; Psychological tests; Psychotherapy - methods; Quality of life; Questionnaires; Recovery of function; Rehabilitation; Transplantation; Ventricle; Italy
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0259927

The efficacy of cardiac rehabilitation in heart-failure patients who received a left-ventricular assist device (LVAD) instead of heart transplantation (HTx) is still unclear. This study aims to evaluate whether cardiac rehabilitation is beneficial in LVAD as HTx patients in the short term and whether its effects in LVAD patients persist over time. Twenty-five LVAD patients were evaluated by functional and psychological tests at admission (T0) and discharge (T1) of a 4-week inpatient structured rehabilitation program, and follow-ups 3 (T2), 6 (T3), and 12 months (T4) after discharge. Twenty-five matched HTx patients were also studied from T0 to T1 to compare the improvements in the six-minute walk test (6MWT). The quality-of-life scores substantially improved in LVAD patients and the 6MWT showed the same functional recovery as in HTx patients from T0 to T1. After T1, numerous LVAD patients withdrew from the study. However, the 6MWT outcome increased further from T1 to T3, with a positive trend during the follow-ups. Hemoglobin and the ventilatory performance increased, and the psychological perception of heart-failure symptoms and pain further improved at T2. In conclusion, exercise-based rehabilitation programs provide similar beneficial effects in LVAD and HTx patients, without deterioration in LVAD patients up to 12 months after discharge.