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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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A. Basics
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07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
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Impact of Cardiac Rehabilitation on Functional and Metabolic Outcomes in Patients With Preserved and Non-Preserved Left Ventricular Ejection Fraction
Session:
Sessão de Posters 35 - Medir o que importa na reabilitação cardíaca
Speaker:
Bárbara Antunes Rocha
Congress:
CPC 2026
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.2 Cardiovascular Rehabilitation
Session Type:
Posters Eletrónicos
FP Number:
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Authors:
Bárbara Antunes Rocha; Carla Ferreira; João Faria; Filipe Vilela; Mónica Dias; Sofia Fernandes; Inês Conde; Cátia Costa Oliveira; Carlos Galvão Braga; Jorge Marques
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Introduction and Objectives: </span></span></span></strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Cardiac rehabilitation (CR) is a cornerstone of secondary prevention in cardiovascular disease, combining exercise training, risk factor optimisation, and patient education to improve prognosis and quality of life. In heart failure, CR enhances exercise tolerance and promotes better control of modifiable risk factors. Differences in cardiac function and comorbidity profiles between patients with preserved and non-preserved left ventricular ejection fraction (LVEF) may influence their response to rehabilitation. This study aimed to assess the effects of a phase II CR programme in patients with non-preserved LVEF and to compare changes in cardiovascular risk factors, chronotropic response, and functional capacity with those observed in patients with preserved LVEF.</span></span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Methods: </span></span></span></strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">A retrospective study was conducted including patients with ischaemic or non-ischaemic heart disease referred for CR between June 2017 and March 2025. Participants were stratified according to baseline LVEF into preserved (≥50%) and non-preserved (<50%) groups. Clinical and laboratory assessments were performed at the first and final CR consultations, including body mass index (BMI), lipid profile, chronotropic index, and functional capacity derived from exercise testing.</span></span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Results: </span></span></span></strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">A total of 124 patients were included, 69 with preserved and 55 with non-preserved LVEF. Patients with non-preserved LVEF were more frequently hypertensive, exhibited higher NYHA class and BNP levels, and had lower baseline functional capacity. After completion of the phase II CR programme, both groups showed a statistically significant improvement in functional capacity and a reduction in LDL cholesterol. A significant increase in the chronotropic index was observed in patients with preserved LVEF, whereas no significant change occurred in those with non-preserved LVEF. However, no significant differences were found between groups in the magnitude of overall improvements.</span></span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Aptos,sans-serif"><span style="color:#000000"><strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Conclusion: </span></span></span></strong><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="color:black">Phase II cardiac rehabilitation produced significant improvements in exercise capacity and LDL cholesterol in both preserved and reduced LVEF groups. Despite a less favourable baseline profile, patients with reduced LVEF achieved functional gains comparable to those with preserved LVEF, underscoring the value of CR in this high-risk population. These results reinforce cardiac rehabilitation for all eligible patients, while highlighting the need to tailor programme delivery for the high-risk reduced-LVEF subgroup.</span></span></span></span></span></span></p>
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