Background: Heart failure is a chronic and severe condition that often results from various heart diseases. Cardiac rehabilitation (CR) is currently a crucial component in managing this condition. The aim was to assess the effects of cardiac rehabilitation on physical capacity of heart failure patients. Methods: This was a cross-sectional study conducted from February 1, 2021, to June 30, 2023. We included all patients with heart failure who underwent cardiac rehabilitation. Data analysis was performed using SPSS software version 24.0, with a significance level set at p < 0.05. Results: The study included 87 heart failure patients, with a male-to-female ratio of 1.8. Mean age was 57.10 years (±11.75). Coronary artery disease was the primary cause of heart failure, accounting for 75.9% of cases. Atrial fibrillation was present in 4.7% of cases. Following cardiac rehabilitation, Left Ventricular Ejection Fraction increased from 40.15% to 49.48% (p = 0.001). Resting heart rate decreased significantly from 81.4 bpm to 68.3 bpm (p = 0.000), and the number of METS increased from 4.3 to 6.57 (+56.8%; p = 0.000). The mean distance covered in the 6-minute walk test significantly increased from 337.8 meters to 522.7 meters (p = 0.000), reflecting a gain of 183.5 meters. Moreover, the increase in the number of METS was more pronounced in females (p = 0.001), non-obese individuals (p = 0.000), non-diabetics (p = 0.001), non-sedentary individuals (p = 0.000), and non-smokers (p = 0.000). The study reported a low readmissions rate of 2.2% and a mortality rate of 1.1%. Conclusion: Our study demonstrates that cardiac rehabilitation is beneficial for black African heart failure patients, resulting in significant improvements in symptoms, physical and capacity.
References
[1]
Joseph, P., Roy, A., Lonn, E., Störk, S., Floras, J., Mielniczuk, L., et al. (2023) Global Variations in Heart Failure Etiology, Management, and Outcomes. JAMA, 329, 1650-1661. https://doi.org/10.1001/jama.2023.5942
[2]
Ngeno, G.T.K., Barasa, F., Kamano, J., Kwobah, E., Wambui, C., Binanay, C., et al. (2022) Feasibility of Cardiac Rehabilitation Models in Kenya. Annals of Global Health, 88, Article 7. https://doi.org/10.5334/aogh.3392
[3]
Bozkurt, B., Fonarow, G.C., Goldberg, L.R., Guglin, M., Josephson, R.A., Forman, D.E., et al. (2021) Cardiac Rehabilitation for Patients with Heart Failure. Journal of the American College of Cardiology, 77, 1454-1469. https://doi.org/10.1016/j.jacc.2021.01.030
[4]
Mandic, S., Tymchak, W., Kim, D., Daub, B., Quinney, H.A., Taylor, D., et al. (2009) Effects of Aerobic or Aerobic and Resistance Training on Cardiorespiratory and Skeletal Muscle Function in Heart Failure: A Randomized Controlled Pilot Trial. Clinical Rehabilitation, 23, 207-216.
[5]
Tyni-Lenné, R., Gordon, A., Europe, E., Jansson, E. and Sylven, C. (1998) Exercise-Based Rehabilitation Improves Skeletal Muscle Capacity, Exercise Tolerance, and Quality of Life in Both Women and Men with Chronic Heart Failure. Journal of Cardiac Failure, 4, 9-17. https://doi.org/10.1016/s1071-9164(98)90503-6
[6]
Doukky, R., Mangla, A., Ibrahim, Z., Poulin, M., Avery, E., Collado, F.M., et al. (2016) Impact of Physical Inactivity on Mortality in Patients with Heart Failure. The American Journal of Cardiology, 117, 1135-1143. https://doi.org/10.1016/j.amjcard.2015.12.060
[7]
Convertino, V., Hung, J., Goldwater, D. and DeBusk, R.F. (1982) Cardiovascular Responses to Exercise in Middle-Aged Men after 10 Days of Bedrest. Circulation, 65, 134-140. https://doi.org/10.1161/01.cir.65.1.134
[8]
Taylor, R.S., Dalal, H.M. and Zwisler, A. (2023) Cardiac Rehabilitation for Heart Failure: ‘Cinderella’ or Evidence-Based Pillar of Care? European Heart Journal, 44, 1511-1518. https://doi.org/10.1093/eurheartj/ehad118
[9]
Karvonen, M.J., Kentala, E. and Mustala, O. (1957) The Effects of Training on Heart Rate; a Longitudinal Study. Annales Medicinae Experimentalis et Biologiae Fenniae, 35, 307-315.
[10]
Girerd, X., Hanon, O., Anagnostopoulos, K., Ciupek, C., Mourad, J.J. and Consoli, S. (2001) Assessment of Antihypertensive Compliance Using a Self-Administered Questionnaire: Development and Use in a Hypertension Clinic. La Presse Médicale, 30, 1044-1048.
[11]
Pavy, B., Iliou, M.C., Vergès, B., Brion, R., Monpère, C., Carré, F., et al. (2001) Recommendations du Groupe Exercice Réadaptation Sport (GERS) De La Société Française De Cardiologie Conçernant La Pratique De La Réadaptation Cardio-Vasculaire Chez L’adulte. Version 3. https://www.sfcardio.fr/sites/default/files/2023-05/GERSP-Recommandations-Readaptation-cardiovasculaire-0811.pdf
[12]
Passantino, A., Dalla Vecchia, L.A., Corrà, U., Scalvini, S., Pistono, M., Bussotti, M., et al. (2021) The Future of Exercise-Based Cardiac Rehabilitation for Patients with Heart Failure. Frontiers in Cardiovascular Medicine, 8, Article 709898. https://doi.org/10.3389/fcvm.2021.709898
[13]
O’Connor, C.M., Whellan, D.J., Lee, K.L., Keteyian, S.J., Cooper, L.S., Ellis, S.J., et al. (2009) Efficacy and Safety of Exercise Training in Patients with Chronic Heart Failure. JAMA, 301, 1439-1450. https://doi.org/10.1001/jama.2009.454
[14]
Uddin, J., Zwisler, A., Lewinter, C., Moniruzzaman, M., Lund, K., Tang, L.H., et al. (2015) Predictors of Exercise Capacity Following Exercise-Based Rehabilitation in Patients with Coronary Heart Disease and Heart Failure: A Meta-Regression Analysis. European Journal of Preventive Cardiology, 23, 683-693. https://doi.org/10.1177/2047487315604311
[15]
Taylor, R.S., Walker, S., Ciani, O., Warren, F., Smart, N.A., Piepoli, M., et al. (2019) Exercise-Based Cardiac Rehabilitation for Chronic Heart Failure: The EXTRAMATCH II Individual Participant Data Meta-Analysis. Health Technology Assessment, 23, 1-98.
[16]
Awotidebe, T.O., Adedoyin, R.A., Balogun, M.O., Adebayo, R.A., Adeyeye, V.O., Oke, K.I., et al. (2016) Effects of Cardiac Rehabilitation Exercise Protocols on Physical Function in Patients with Chronic Heart Failure: An Experience from a Resource Constraint Nation. International Journal of Clinical Medicine, 7, 547-557. https://doi.org/10.4236/ijcm.2016.78060
[17]
de Souza e Silva, C.G., Nishijuka, F.A., de Castro, C.L.B., Franca, J.F., Myers, J., Laukkanen, J.A., et al. (2021) Women Have Lower Mortality than Men after Attending a Long-Term Medically Supervised Exercise Program. Journal of Cardiopulmonary Rehabilitation and Prevention, 42, 120-127. https://doi.org/10.1097/hcr.0000000000000623
[18]
Oosenbrug, E., Marinho, R.P., Zhang, J., Marzolini, S., Colella, T.J.F., Pakosh, M., et al. (2016) Sex Differences in Cardiac Rehabilitation Adherence: A Meta-Analysis. Canadian Journal of Cardiology, 32, 1316-1324. https://doi.org/10.1016/j.cjca.2016.01.036
[19]
Colella, T.J., Gravely, S., Marzolini, S., Grace, S.L., Francis, J.A., Oh, P., et al. (2014) Sex Bias in Referral of Women to Outpatient Cardiac Rehabilitation? A Meta-Analysis. European Journal of Preventive Cardiology, 22, 423-441. https://doi.org/10.1177/2047487314520783
[20]
Kentner, A.C. and Grace, S.L. (2017) Between Mind and Heart: Sex-Based Cognitive Bias in Cardiovascular Disease Treatment. Frontiers in Neuroendocrinology, 45, 18-24. https://doi.org/10.1016/j.yfrne.2017.02.002
[21]
Santiago de Araújo Pio, C., Beckie, T.M., Varnfield, M., Sarrafzadegan, N., Babu, A.S., Baidya, S., et al. (2020) Promoting Patient Utilization of Outpatient Cardiac Rehabilitation: A Joint International Council and Canadian Association of Cardiovascular Prevention and Rehabilitation Position Statement. International Journal of Cardiology, 298, 1-7. https://doi.org/10.1016/j.ijcard.2019.06.064
[22]
Ghisi, G.L.d.M., Marzolini, S., Price, J., Beckie, T.M., Mamataz, T., Naheed, A., et al. (2022) Women-Focused Cardiovascular Rehabilitation: An International Council of Cardiovascular Prevention and Rehabilitation Clinical Practice Guideline. Canadian Journal of Cardiology, 38, 1786-1798. https://doi.org/10.1016/j.cjca.2022.06.021
[23]
Colella, T.J.F., Hardy, M., Hart, D., Price, J.A.D., Sarfi, H., Mullen, K., et al. (2021) The Canadian Women’s Heart Health Alliance Atlas on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women—Chapter 3: Patient Perspectives. CJC Open, 3, 229-235. https://doi.org/10.1016/j.cjco.2020.11.020
[24]
Molloy, C.D., Long, L., Mordi, I.R., Bridges, C., Sagar, V.A., Davies, E.J., et al. (2023) Exercise‐Based Cardiac Rehabilitation for Adults with Heart Failure—2023 Cochrane Systematic Review and Meta‐Analysis. European Journal of Heart Failure, 25, 2263-2273. https://doi.org/10.1002/ejhf.3046