A comparative analysis of open heart surgery and minimally invasive cardiac surgery in exercise-based cardiac rehabilitation.

Autor: Hubisz MM; Hochgebirgsklinik, Medicine Campus Davos, Herman-Burchard-Strasse 1, 7270, Davos, Switzerland., van der Stouwe JG; Department of Cardiology, University Hospital Basel, Basel, Switzerland., Ziob M; Hochgebirgsklinik, Medicine Campus Davos, Herman-Burchard-Strasse 1, 7270, Davos, Switzerland., Steiner S; Hochgebirgsklinik, Medicine Campus Davos, Herman-Burchard-Strasse 1, 7270, Davos, Switzerland., Uzun N; Hochgebirgsklinik, Medicine Campus Davos, Herman-Burchard-Strasse 1, 7270, Davos, Switzerland., Weibel S; Hochgebirgsklinik, Medicine Campus Davos, Herman-Burchard-Strasse 1, 7270, Davos, Switzerland., Lesan V; Hochgebirgsklinik, Medicine Campus Davos, Herman-Burchard-Strasse 1, 7270, Davos, Switzerland., Erni D; Hochgebirgsklinik, Medicine Campus Davos, Herman-Burchard-Strasse 1, 7270, Davos, Switzerland., Meier-Ruge L; Hochgebirgsklinik, Medicine Campus Davos, Herman-Burchard-Strasse 1, 7270, Davos, Switzerland., Rodriguez Cetina Biefer H; Department of Cardiac Surgery, University Heart Center Zurich, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Department of Cardiac Surgery, City Hospital of Zurich Triemli, Zurich, Switzerland.; Department of Cardiology, Center of Translational and Experimental Cardiology (CTEC), University Heart Center Zurich, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Dzemali O; Department of Cardiac Surgery, University Heart Center Zurich, University Hospital Zurich, University of Zurich, Zurich, Switzerland.; Department of Cardiac Surgery, City Hospital of Zurich Triemli, Zurich, Switzerland.; Department of Cardiology, Center of Translational and Experimental Cardiology (CTEC), University Heart Center Zurich, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Vontobel J; Hochgebirgsklinik, Medicine Campus Davos, Herman-Burchard-Strasse 1, 7270, Davos, Switzerland.; Christine Kühne Center for Allergy Research and Education (CK-CARE), Medicine Campus Davos, Davos, Switzerland., Niederseer D; Hochgebirgsklinik, Medicine Campus Davos, Herman-Burchard-Strasse 1, 7270, Davos, Switzerland. david.niederseer@hgk.ch.; Department of Cardiology, Center of Translational and Experimental Cardiology (CTEC), University Heart Center Zurich, University Hospital Zurich, University of Zurich, Zurich, Switzerland. david.niederseer@hgk.ch.; Christine Kühne Center for Allergy Research and Education (CK-CARE), Medicine Campus Davos, Davos, Switzerland. david.niederseer@hgk.ch.
Jazyk: angličtina
Zdroj: Journal of cardiothoracic surgery [J Cardiothorac Surg] 2024 Jun 27; Vol. 19 (1), pp. 390. Date of Electronic Publication: 2024 Jun 27.
DOI: 10.1186/s13019-024-02871-z
Abstrakt: Background: Historically, the majority of patients admitted to inpatient exercise-based cardiac rehabilitation (EBCR) have undergone open heart surgery (OHS). However, with advances in minimally invasive cardiac surgery (MICS), these patient groups are also increasingly referred for inpatient EBCR. Herein, we aimed to compare the progress of these groups during rehabilitation.
Methods: In this prospective, nonrandomized study, 403 inpatient EBCR patients were recruited from December 2022 until September 2023 and stratified into two groups: OHS, and MICS. Participants completed a 3-4-week certified EBCR program. The primary endpoint was defined as a change in the 6-minute walk test (6MWT). Moreover, a comprehensive panel of quality-of-life (QoL) assessments were performed at admission and discharge.
Results: At baseline, patients with OHS were older (66 years [IQR 59 - 72]), more often male (83%), and underwent emergency/urgent procedures more often (20%) than patients with MICS. Furthermore, patients with MICS showed a better 6MWT at admission (426 meters [IQR 336 - 483]) compared to patients with OHS (381 meters [IQR 299 - 453]). While all patients were able to increase the distance in the 6MWT, regression analyses in fully adjusted models showed no difference in improvements between the two groups (β -5, 95% CI, -26 - 14, p = 0.58). Moreover, during EBCR, we observed significant improvements in all QoL measures in all groups.
Conclusions: In this study, improvements in fitness, as assessed by the 6WMT were observed in all groups. Furthermore, multiple QoL measures improved equally across all groups. These encouraging results emphasize the importance of EBCR.
(© 2024. The Author(s).)
Databáze: MEDLINE
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