1. Multicomponent cardiac rehabilitation in patients after transcatheter aortic valve implantation: Predictors of functional and psychocognitive recovery
- Author
-
Sarah Eichler, Axel Harnath, Heinz Völler, Annett Salzwedel, Rona Reibis, Martin Schikora, Christian Butter, Karl Wegscheider, and Jörg Nothroff
- Subjects
Male ,Time Factors ,Epidemiology ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Cognition ,0302 clinical medicine ,Quality of life ,Risk Factors ,Germany ,Prospective Studies ,030212 general & internal medicine ,Aged, 80 and over ,Cardiac Rehabilitation ,Exercise Tolerance ,Rehabilitation ,Frailty ,Age Factors ,Treatment Outcome ,Aortic Valve ,cardiovascular system ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,Transcatheter aortic ,Frail Elderly ,Nutritional Status ,Walk Test ,Transcatheter Aortic Valve Replacement ,03 medical and health sciences ,Predictive Value of Tests ,Internal medicine ,parasitic diseases ,medicine ,Humans ,In patient ,6-minute walk test ,Mobility Limitation ,Geriatric Assessment ,Aged ,Chi-Square Distribution ,business.industry ,Aortic Valve Stenosis ,Recovery of Function ,medicine.disease ,Surgical risk ,Surgery ,Stenosis ,Nutrition Assessment ,Treatment modality ,Multivariate Analysis ,Personal Autonomy ,Quality of Life ,business - Abstract
Background In the last decade, transcatheter aortic valve implantation has become a promising treatment modality for patients with aortic stenosis and a high surgical risk. Little is known about influencing factors of function and quality of life during multicomponent cardiac rehabilitation. Methods From October 2013 to July 2015, patients with elective transcatheter aortic valve implantation and a subsequent inpatient cardiac rehabilitation were enrolled in the prospective cohort multicentre study. Frailty-Index (including cognition, nutrition, autonomy and mobility), Short Form-12 (SF-12), six-minute walk distance (6MWD) and maximum work load in bicycle ergometry were performed at admission and discharge of cardiac rehabilitation. The relation between patient characteristics and improvements in 6MWD, maximum work load or SF-12 scales were studied univariately and multivariately using regression models. Results One hundred and thirty-six patients (80.6 ± 5.0 years, 47.8% male) were enrolled. 6MWD and maximum work load increased by 56.3 ± 65.3 m ( p 0.001) and 8.0 ± 14.9 watts ( p 0.001), respectively. An improvement in SF-12 (physical 2.5 ± 8.7, p = 0.001, mental 3.4 ± 10.2, p = 0.003) could be observed. In multivariate analysis, age and higher education were significantly associated with a reduced 6MWD, whereas cognition and obesity showed a positive predictive value. Higher cognition, nutrition and autonomy positively influenced the physical scale of SF-12. Additionally, the baseline values of SF-12 had an inverse impact on the change during cardiac rehabilitation. Conclusions Cardiac rehabilitation can improve functional capacity as well as quality of life and reduce frailty in patients after transcatheter aortic valve implantation. An individually tailored therapy with special consideration of cognition and nutrition is needed to maintain autonomy and empower octogenarians in coping with challenges of everyday life.
- Published
- 2016