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Cardiac rehabilitation after heart transplantation and HeartMate 3 support: a 10-year national experience and functional outcomes in advanced heart failure
Session:
Sessão de Comunicações Orais 08 – Reabilitação Cardíaca como terapia: recuperação funcional na doença cardiovascular avançada
Speaker:
Francisco Rocha Cardoso
Congress:
CPC 2026
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.2 Cardiovascular Rehabilitation
Session Type:
Comunicações Orais
FP Number:
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Authors:
Francisco Rocha Cardoso; Felipe Leão; Ana Raquel Santos; Ricardo Carvalheiro; Rita Ilhão Moreira; António Gonçalves; Joana Pinto; Carlos Franco; Rui Costa; Rui Cruz Ferreira; Pedro Rio
Abstract
<p><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:11pt">Cardiac rehabilitation (CR) is recommended after heart transplantation (HTx) and durable left ventricular assist device (LVAD) implantation, yet real-world evidence remains scarce. International data are limited by small heterogeneous cohorts, inconsistent functional endpoints, and under-representation of mixed HTx–LVAD populations. No structured national experience had been previously reported in Portugal. This study provides the first consecutive 10-year national series evaluating CR outcomes in advanced heart failure supported by HTx or HeartMate 3 (HM3).</span></span><br /> </p> <p><span style="font-family:Arial,Helvetica,sans-serif"><strong><span style="font-size:12.0pt">Methods:</span></strong><br /> <span style="font-size:11pt">We retrospectively analysed 29 adults who completed CR Phase II between 2015–2025 (HTx=24; HM3=5). Variables included planned and completed sessions, adherence, six-minute walk test (6MWT), and oxygen consumption (VO2/METs). Group assignment was validated through clinical documentation. NYHA class, quality of life and safety outcomes were not analysed due to non-systematic recording. Analysis was descriptive (median, interquartile range [IQR]).</span></span><br /> </p> <p><span style="font-family:Arial,Helvetica,sans-serif"><strong><span style="font-size:12.0pt">Results:</span></strong><br /> <span style="font-size:11pt">Overall adherence was high at 100% (IQR 91–106), with 26 planned sessions (20–35). HTx patients completed 28 sessions (23–31), while several HM3 patients had ongoing programmes (23 sessions, 19–28). Baseline 6MWT was 483 m (450–538), similar to international reports. Post-CR distance improved to 554 m (500–610), yielding a global gain of +59 m (+20 to +122). HTx patients showed consistent improvement (+59 m), closely matching published cohorts. HM3 patients with completed CR demonstrated comparable gains (+53 m). Pre-CR VO2/METs was higher in HM3 patients, reflecting device-specific physiology; only HTx patients had post-CR testing, improving by +15.9 units (+1.5 to +35.5).</span></span><br /> </p> <p><span style="font-family:Arial,Helvetica,sans-serif"><strong><span style="font-size:12.0pt">Conclusion:</span></strong><br /> <span style="font-size:11pt">This national experience confirms that CR is feasible, structured and clinically effective across advanced heart failure therapies, with functional improvements aligned with the best international evidence. These findings support broader implementation of dedicated CR programmes for HTx and HM3 patients and highlight the need for prospective, standardised registries to strengthen the evidence base in this complex population.</span></span></p>
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