Abstract
AbstractBackgroundCardiac rehabilitation (CR) has shown benefits in heart transplant and left ventricular assist device (LVAD) recipients, but variable patterns of attendance remain poorly understood. We therefore aimed to describe CR adherence and factors associated with cessation in this population.MethodsWe performed a retrospective review of heart transplant and LVAD recipients who attended at least one CR session at a tertiary medical center (2013-2022). Complete adherence was defined as attending all 36 CR sessions. Primary reasons for cessation prior to 36 sessions were recorded. We compared post-operative complications and length of stay (following heart transplant or LVAD) between participants with and without complete adherence using logistic regression. In a subgroup analysis of participants with complete adherence, we compared changes in METs, exercise time, and peak VO2using paired-sample t tests.ResultsThere were 137 heart transplant and LVAD recipients (median age 56.9 years, 73.7% male) who attended CR. Ninety-one percent either completed all 36 CR sessions or fewer than 24 sessions. Among those without complete adherence (n=74), 71.6% reported medical reasons and 15.0% reported personal reasons for cessation. Participants without complete adherence experienced more post-operative complications (43.9% vs 34.4%, p = 0.02) and major bleeding (22.7% vs 15.2%, p = 0.02) prior to enrolling in CR, but there were no other significant differences between groups. Participants with complete adherence experienced significant improvements in exercise time (160.9 seconds), METs (0.8), and peak VO2(1.5 mL/kg per min).ConclusionsAmong heart transplant and LVAD recipients, there was a bimodal distribution of CR attendance; nearly half completed all 36 sessions. Among those with complete adherence, there were significant improvements in exercise measures, underscoring the important benefits of CR in this population.
Publisher
Cold Spring Harbor Laboratory