TY  - EJOU
AU  - Eser, Prisca 
AU  - Gruber, Thomas 
AU  - Marcin, Thimo 
AU  - Boeni, Claudia 
AU  - Wustmann, Kerstin 
AU  - DeLuigi, Christina 
AU  - Greutmann, Matthias 
AU  - Tobler, Daniel 
AU  - Schwerzmann, Markus 
AU  - Wilhelm, Matthias 

TI  - Effect of Exercise-Based Cardiac Rehabilitation on Cardiorespiratory Fitness in Adults with Congenital Heart Disease
T2  - Structural and Congenital Heart Disease

PY  - 2021
VL  - 16
IS  - 1
SN  - 3071-1738

AB  - <b>Background:</b> The purpose of this study was to investigate whether patients with adult congenital heart disease (ACHD) benefit from exercise-based cardiac rehabilitation (CR) short- and long-term with regard to improvement of cardiorespiratory fitness. <b>Methods:</b> Cardiopulmonary exercise tests (CPET) completed by ACHD patients between January 2000 and October 2019 were analysed retrospectively. Linear mixed models were performed for peak oxygen consumption (VO<sub>2</sub>) with patients as random effect and age, sex, disease classification, preceding surgery (≤3 months) and preceding CR (≤4 weeks for short term and >4 weeks for long term) as fixed effects. <b>Results:</b> 1056 CPETs of 311 ACHD patients with simple (7), moderate (188) or great (116) complexity heart defects were analysed. The 59 patients who completed a CR (median age 27 yrs, 38% females) increased peak VO<sub>2</sub> from before to after CR by a median of 2.7 (IQR –0.6 to 5.5) ml/kg/min. However, in the multivariate mixed model, peak VO<sub>2</sub> was non-significantly increased short-term after CR (β 0.8, 95%CI –0.7 to 2.4), not maintained long-term after CR (β 0.0, 95%CI –1.7 to 1.6) but significantly reduced after surgery (β –5.1, 95%CI –7.1 to –3.1). The 20 CR patients after surgery increased their peak VO<sub>2</sub> by 6.2 (IQR 3.6–9.5) ml/kg/min, while the 39 CR patients without preceding surgery increased it by 0.9 (IQR –1.5 to 3.1) ml/kg/min. <b>Conclusions:</b> The increase in peak VO<sub>2</sub> with CR was mainly due to recovery from surgical intervention. The small independent benefit from CR was not maintained long-term, highlighting the potential to improve current CR concepts in ACHD populations.
KW  - Grown-ups with congenital heart disease; exercise training; cardiac rehabilitation; surgical intervention; peak oxygen consumption; cardiorespiratory fitness

DO  - 10.32604/CHD.2021.013051