TY - JOUR
T1 - Association Between Early Cardiac Rehabilitation and Long-term Survival in Cardiac Transplant Recipients
AU - Rosenbaum, Andrew N.
AU - Kremers, Walter K.
AU - Schirger, John A.
AU - Thomas, Randal J.
AU - Squires, Ray W.
AU - Allison, Thomas G.
AU - Daly, Richard C.
AU - Kushwaha, Sudhir S.
AU - Edwards, Brooks S.
N1 - Publisher Copyright:
© 2016 Mayo Foundation for Medical Education and Research
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Objective To determine whether participation in early cardiac rehabilitation (CR) after heart transplant (HTx) affects long-term survival. Patients and Methods A retrospective review was conducted in 201 patients who underwent HTx at Mayo Clinic between June 1, 2000, and July 31, 2013. Patients were excluded with multiorgan transplant, no CR data, and follow-up less than 90 days after HTx. Demographic and exercise data at baseline before HTx were collected. Post-HTx exercise capacity, biopsy, CR data, and medications were collected at 1 through 5 and 10 years. Results Overall survival at 1, 5, and 10 years was 98%, 88%, and 82%, respectively; 29 patients died. Number of CR sessions attended in the first 90 days after HTx predicted survival in multivariate regression, controlling for baseline post-HTx 6-minute walk test (6MWT) results and rejection episodes (hazard ratio, 0.90; 95% CI, 0.82-0.97; P=.007). Additional univariate predictors of survival included pre-HTx 6MWT results, weight at HTx, and body mass index and systolic blood pressure at CR enrollment. Pre-HTx 6MWT results, body mass index, and post-HTx were associated with improvement in peak oxygen consumption. Conclusion This report demonstrates, for the first time, an association between CR and long-term survival in patients after HTx. Further work should clarify the most beneficial aspects of CR.
AB - Objective To determine whether participation in early cardiac rehabilitation (CR) after heart transplant (HTx) affects long-term survival. Patients and Methods A retrospective review was conducted in 201 patients who underwent HTx at Mayo Clinic between June 1, 2000, and July 31, 2013. Patients were excluded with multiorgan transplant, no CR data, and follow-up less than 90 days after HTx. Demographic and exercise data at baseline before HTx were collected. Post-HTx exercise capacity, biopsy, CR data, and medications were collected at 1 through 5 and 10 years. Results Overall survival at 1, 5, and 10 years was 98%, 88%, and 82%, respectively; 29 patients died. Number of CR sessions attended in the first 90 days after HTx predicted survival in multivariate regression, controlling for baseline post-HTx 6-minute walk test (6MWT) results and rejection episodes (hazard ratio, 0.90; 95% CI, 0.82-0.97; P=.007). Additional univariate predictors of survival included pre-HTx 6MWT results, weight at HTx, and body mass index and systolic blood pressure at CR enrollment. Pre-HTx 6MWT results, body mass index, and post-HTx were associated with improvement in peak oxygen consumption. Conclusion This report demonstrates, for the first time, an association between CR and long-term survival in patients after HTx. Further work should clarify the most beneficial aspects of CR.
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U2 - 10.1016/j.mayocp.2015.12.002
DO - 10.1016/j.mayocp.2015.12.002
M3 - Article
C2 - 26848001
AN - SCOPUS:84974687474
SN - 0025-6196
VL - 91
SP - 149
EP - 156
JO - Mayo Clinic proceedings
JF - Mayo Clinic proceedings
IS - 2
ER -