Sarno LA, J Cardiopulm Rehabil Prev. 2020 Jan;40(1):E1-E4.
Cardiac rehabilitation (CR) has been well recognized as an important component of cardiac care, as it improves the physiologic and psychological effects of cardiac illness. CR effectively decreases morbidity and mortality in adults with congenital heart disease (CHD). Sarno LA, et al. conducted a retrospective study to evaluate the inclusion of adolescents and adults with CHD in a CR program by analyzing data from 4 years single center CR program. The study also evaluated the efficacy and safety of CR as well as referral barriers.
Over a 4 years period, a total of 36 patients were successfully referred to 23 regional centers in which 23 patients who completed CR after excluding, 12 patients were currently enrolled in CR or in the referral process and 1 patient died before CR initiation. The median age was 22 years (range: 15-55 years). The primary indication for CR was post-surgical (n=14, 61%), followed by chronic HF (n=7, 30%) and post-transplant (n=2, 9%). Post-CR, metabolic equivalent tasks increased by 1.6 (95% CI, 1.0-2.2; p < 0.05), maximal heart rate increased by 13 beats/min (95% CI, 2-25; p < 0.05), exercise time increased by a median of 1.35 min (95% CI, 0.1-11; p < 0.05), and treadmill speed increased by 0.7 mph (95% CI, 0.3-1.0; p < 0.05) (Figure 1).
Figure 1: Comparison of exercise variables (median and first/third quartiles) during CR sessions between initial and final evaluations: (A) metabolic equivalent, (B) maximum heart rate during CR, and (C) exercise time. CR indicates cardiac rehabilitation
There were no serious adverse events reported during CR session. All patients who completed CR remain alive at a median follow-up of 17 months (range: 5-45). Common barriers to CR included accessibility, social circumstances (work and school), post-operative pain, transportation, cost for phase III CR, and the required presence of a guardian for patients younger than 18 yr. Thus, CR was effective and safe for adolescents and adults with CHD.
