TY - JOUR
T1 - Exercise-Based Cardiac Rehabilitation Improves Exercise Capacity Regardless of the Response to Cardiac Resynchronization Therapy in Patients with Heart Failure and Reduced Ejection Fraction
AU - Misumi, Kayo
AU - Nakanishi, Michio
AU - Miura, Hiroyuki
AU - Date, Ayumi
AU - Tokeshi, Tatsuo
AU - Kumasaka, Leon
AU - Arakawa, Tetsuo
AU - Nakao, Kazuhiro
AU - Hasegawa, Takuya
AU - Fukui, Shigefumi
AU - Yanase, Masanobu
AU - Noguchi, Teruo
AU - Kusano, Kengo
AU - Yasuda, Satoshi
AU - Goto, Yoichi
N1 - Publisher Copyright:
© 2022 Japanese Circulation Society. All rights reserved.
PY - 2022
Y1 - 2022
N2 - Background: In patients with chronic heart failure with reduced ejection fraction (HFrEF), cardiac resynchronization therapy (CRT) improves left ventricular ejection fraction (LVEF) and exercise-based cardiac rehabilitation (ECR) enhances exercise capacity. This study examined the relationship between the 2 responses. Methods and Results: Sixty-four consecutive HFrEF patients who participated in a 3-month ECR program after CRT were investigated. Patients were categorized according to a median improvement in peak oxygen uptake (PV O2) after ECR of 7% as either good (n=32; mean percentage change in PV O2 [%∆PV O2]=23.2%) or poor (n=32; mean %∆PV O2=2.5%) responders. There was no significant difference in baseline characteristics between the good and poor responders, except for PV O2 (51% vs. 59%, respectively; P=0.01). The proportion of good CRT responders was similar between the good and poor responders (%∆LVEF ≥10%; 53% vs. 47%, respectively; P=NS). Overall, there was no significant correlation between %∆LVEF after CRT and %∆PV O2 after ECR. Notably, among poor CRT responders (n=32), the prevalence of atrial fibrillation (0% vs. 29%; P<0.03) and baseline PV O2 (48% vs. 57%; P<0.05) were significantly lower among those with a good (n=15) than poor (n=17) response to ECR. Conclusions: In patients with HFrEF, good ECR and CRT responses are unrelated. A good PV O2 response to ECR can be achieved even in poor CRT responders, particularly in those with a sinus rhythm or low baseline PV O2.
AB - Background: In patients with chronic heart failure with reduced ejection fraction (HFrEF), cardiac resynchronization therapy (CRT) improves left ventricular ejection fraction (LVEF) and exercise-based cardiac rehabilitation (ECR) enhances exercise capacity. This study examined the relationship between the 2 responses. Methods and Results: Sixty-four consecutive HFrEF patients who participated in a 3-month ECR program after CRT were investigated. Patients were categorized according to a median improvement in peak oxygen uptake (PV O2) after ECR of 7% as either good (n=32; mean percentage change in PV O2 [%∆PV O2]=23.2%) or poor (n=32; mean %∆PV O2=2.5%) responders. There was no significant difference in baseline characteristics between the good and poor responders, except for PV O2 (51% vs. 59%, respectively; P=0.01). The proportion of good CRT responders was similar between the good and poor responders (%∆LVEF ≥10%; 53% vs. 47%, respectively; P=NS). Overall, there was no significant correlation between %∆LVEF after CRT and %∆PV O2 after ECR. Notably, among poor CRT responders (n=32), the prevalence of atrial fibrillation (0% vs. 29%; P<0.03) and baseline PV O2 (48% vs. 57%; P<0.05) were significantly lower among those with a good (n=15) than poor (n=17) response to ECR. Conclusions: In patients with HFrEF, good ECR and CRT responses are unrelated. A good PV O2 response to ECR can be achieved even in poor CRT responders, particularly in those with a sinus rhythm or low baseline PV O2.
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U2 - 10.1253/circj.CJ-20-1300
DO - 10.1253/circj.CJ-20-1300
M3 - Article
C2 - 34193751
AN - SCOPUS:85121986777
VL - 86
SP - 49
EP - 57
JO - Circulation Journal
JF - Circulation Journal
SN - 1346-9843
IS - 1
ER -