Ann Rehabil Med.  2021 Apr;45(2):150-159. 10.5535/arm.20123.

Do Patients Maintain Proper Long-Term Cardiopulmonary Fitness Levels After Cardiac Rehabilitation? A Retrospective Study Using Medical Records

• Kim C
• Choi HE
• Jang JH
• Song JH
• Kim BO

• KMID: 2515396
• DOI: http://doi.org/10.5535/arm.20123

Abstract

Objective
To examine whether patients who participated in a cardiac rehabilitation (CR) program after hospitalization for acute coronary syndrome maintained cardiorespiratory fitness (CRF) in the community.
Methods
We conducted a retrospective study including 78 patients who underwent percutaneous coronary intervention or coronary artery bypass graft surgery at our hospital’s cardiovascular center and participated in a CR program and a 5-year follow-up evaluation. Patients were divided into a center-based CR (CBCR) group, participating in an electrocardiography-monitored exercise training in a hospital setting, and a home-based CR (HBCR) group, receiving aerobic exercise training and performed self-exercise at home.
Results
No significant differences were found between groups (p>0.05), except the proportion of non-smokers (CBCR 59.5% vs. HBCR 31.7%; p=0.01). In both groups, the maximal oxygen consumption (VO_2max) increased significantly during the first 12 weeks of follow-up and remained at a steady state for the first year, but it decreased after the 1-year follow-up. Particularly, VO_2max at 5 years decreased below the baseline value in the HBCR group. In the low CRF group, the CRF level significantly improved at 12 weeks, peaked at 1 year, and was still significantly different from the baseline value after 5 years. The high CRF group did not show any significant increase over time relative to the baseline value, but most patients in the high CRF group maintained relatively appropriate CRF levels after 5 years.
Conclusion
Continuous support should be provided to patients to maintain optimal CRF levels after completing a CR program.

Keyword

Acute coronary syndrome, Cardiorespiratory fitness, Cardiac Rehabilitation, Exercise test

Figure

• 

  Fig. 1. Flow diagram of the study participants. ACS, acute coronary syndrome; PCI, percutaneous coronary intervention; CABG, coronary artery bypass graft; CPX, cardiopulmonary exercise; CR, cardiac rehabilitation.

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  Fig. 2. Five-year trends of VO2max and VO2AT in the CBCR and HBCR groups. CBCR, center-based cardiac rehabilitation; HBCR, home-based cardiac rehabilitation; MAX, maximal oxygen consumption; AT, oxygen consumption at anaerobic threshold. §p<0.05, significant difference between the two groups at the same time. *p<0.05, significantly different from the baseline value.

• 

  Fig. 3. Five-year trends of maximal metabolic equivalents (METsmax) in three cardiorespiratory fitness groups: high (≥8 METs), average, (≥6 METs and <8 METs), and low (<6 METs). §p<0.05, significant difference between two periods in the same group. *p<0.05, significantly different from the baseline value.

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