Assessment of the Physical Capabilities of Heart Failure Patients before and after Cardiovascular Rehabilitation: A Study of 125 Patients from West Africa, Dakar, Senegal
Background: Cardiac rehabilitation represents a critical therapeutic strategy for patients suffering from chronic heart failure. The physical capacity of patients with heart failure, assessed using the exercise test and the 6-minute walk test, is the measure of the patient’s overall functional ability to perform physical activities and tolerate exercise loads. The objective of this study was to assess the impact of cardiac rehabilitation on patients’ physical capabilities and to conduct a thorough comparison of data obtained via exercise testing and the 6-minute walk test before and after the rehabilitation programme. Methods: This was a descriptive and analytical cross-sectional study, conducted from 1 February 2021 to 31 June 2022. Included were heart failure patients who had participated in an outpatient cardiovascular rehabilitation programme. The collected data included anamnestic, clinical, paraclinical data, and the 6-minute walk test. Informed consent was obtained. Data analysis, word processing, and charting were performed using Microsoft Word 2016, Excel 2013, and Sphinx version 5.1.0.2. Data analysis was performed using SPSS (Statistical Package for Social Sciences) version 24.0. Any difference less than 0.05 was considered statistically significant. Results: In a Senegalese study, heart failure patients undergoing rehabilitation in a cardiac unit represented 45.59% of all cases, with a prevalence rate of 3.21%. The average participant was 57.97 years old, with those aged 61 to 70 forming the largest group (35.5%). The study noted a male predominance (sex ratio of 2.1) and identified dyslipidaemia (80.6%) and sedentarism (71%), as prevalent cardiovascular risk factors. All participants initially suffered from NYHA stage 2 or 3 dyspnoea, yet 80.65% showed no symptoms following rehabilitation. Significant improvements were recorded in resting heart rate (from 79 to 67 bpm), and the 6-minute walk test distance (from 328 m to 470 m). Enhanced exercise tolerance and walking test outcomes were particularly notable in patients with LVEF ≥ 50%, women, non-obese individuals, those initially walking less than 300 m, achieving more than 3 METs, and non-smokers. Conclusion: The findings underscore the effectiveness of cardiovascular rehabilitation in improving symptoms, physical capability, and overall quality of life for heart failure patients in Senegal.
References
[1]
Delahaye, F. (2016) Recommandations de la Société Européenne de Cardiologie sur le diagnostic et le traitement de l’insuffisance cardiaque aiguë et chronique. Réalités Cardiologiques, 11, 1-39.
[2]
Delahaye, F. and de Gevigney, G. (2001) Épidémiologie de l'insuffisance cardiaque. Annales de Cardiologie et d’Angéiologie, 50, 6-11. https://doi.org/10.1016/s0003-3928(01)80003-2
[3]
World Health Organization (1993) Needs and Action Priorities in Cardiac Rehabilitation and Secondary Prevention in Patients with Coronary Heart Disease.
[4]
Davies, E.J., Moxham, T., Rees, K., et al. (2014) Exercise Based Rehabilitation for Heart Failure. Cochrane Database of Systematic Reviews, 4, CD003331.
[5]
Yameogo, A.R., Millogo, G.R.C., Palm, A.F., Bamouni, J., Mandi, G.D., Kologo, J.K., et al. (2017) Évaluation de la satisfaction des patients dans le service de cardiologie du CHU Yalgado Ouedraogo. Pan African Medical Journal, 28, Article No. 267. https://doi.org/10.11604/pamj.2017.28.267.13288
[6]
Bjarnason-Wehrens, B., McGee, H., Zwisler, A., Piepoli, M.F., Benzer, W., Schmid, J., et al. (2010) Cardiac Rehabilitation in Europe: Results from the European Cardiac Rehabilitation Inventory Survey. European Journal of Cardiovascular Prevention & Rehabilitation, 17, 410-418. https://doi.org/10.1097/hjr.0b013e328334f42d
[7]
Turk-Adawi, K., Supervia, M., Lopez-Jimenez, F., Pesah, E., Ding, R., Britto, R.R., et al. (2019) Cardiac Rehabilitation Availability and Density around the Globe. EClinicalMedicine, 13, 31-45. https://doi.org/10.1016/j.eclinm.2019.06.007
[8]
Koukoui, F., Desmoulin, F., Lairy, G., Bleinc, D., Boursiquot, L., Galinier, M., et al. (2015) Benefits of Cardiac Rehabilitation in Heart Failure Patients According to Etiology. Medicine, 94, e544. https://doi.org/10.1097/md.0000000000000544
[9]
Tabet, J., Meurin, P., Beauvais, F., Weber, H., Renaud, N., Thabut, G., et al. (2008) Absence of Exercise Capacity Improvement after Exercise Training Program. Circulation: Heart Failure, 1, 220-226. https://doi.org/10.1161/circheartfailure.108.775460
[10]
Klecha, A., Kawecka-Jaszcz, K., Bacior, B., Kubinyi, A., Pasowicz, M., Klimeczek, P., et al. (2007) Physical Training in Patients with Chronic Heart Failure of Ischemic Origin: Effect on Exercise Capacity and Left Ventricular Remodeling. European Journal of Cardiovascular Prevention & Rehabilitation, 14, 85-91. https://doi.org/10.1097/hjr.0b013e3280114f12
[11]
Rhissassi, A.K. (2019) Bilan d’activité à 8 mois de la première expérience sénégalaise: Bibliothèque numérique de l’université Cheikh Anta DIOP de Dakar. Réadaptation Cardiaque, 262, 89-102.
[12]
Giannuzzi, P., Temporelli, P.L., Corrà, U. and Tavazzi, L. (2003) Antiremodeling Effect of Long-Term Exercise Training in Patients with Stable Chronic Heart Failure. Circulation, 108, 554-559. https://doi.org/10.1161/01.cir.0000081780.38477.fa
[13]
Adams, B.J., Carr, J.G., Ozonoff, A., Lauer, M.S. and Balady, G.J. (2008) Effect of Exercise Training in Supervised Cardiac Rehabilitation Programs on Prognostic Variables from the Exercise Tolerance Test. The American Journal of Cardiology, 101, 1403-1407. https://doi.org/10.1016/j.amjcard.2008.01.016
[14]
Sutherland, N., Harrison, A. and Doherty, P. (2018) Factors Influencing Change in Walking Ability in Patients with Heart Failure Undergoing Exercise-Based Cardiac Rehabilitation. International Journal of Cardiology, 268, 162-165. https://doi.org/10.1016/j.ijcard.2018.05.021
[15]
Taylor, R.S., Walker, S., Smart, N.A., et al. (2019) Impact of Exercise Rehabilitation on Exercise Capacity and Quality-of-Life in Heart Failure: Individual Participant Meta-Analysis. Journal of the American College of Cardiology, 73, 1430-1443.