Predictors of pre-rehabilitation exercise capacity in elderly European cardiac patients - The EU-CaRE study.

Marcin, Thimo; Eser, Prisca; Prescott, Eva; Mikkelsen, Nicolai; Prins, Leonie F; Kolkman, Evelien K; Lado-Baleato, Óscar; Cardaso-Suaréz, Carmen; Bruins, Wendy; van der Velde, Astrid E; Peña Gil, Carlos; Iliou, Marie Christine; Ardissino, Diego; Zeymer, Uwe; Meindersma, Esther P; Van't Hof, Arnoud Wj; de Kluiver, Ed P; Wilhelm, Matthias (2020). Predictors of pre-rehabilitation exercise capacity in elderly European cardiac patients - The EU-CaRE study. European journal of preventive cardiology, 27(16), pp. 1702-1712. SAGE Publications 10.1177/2047487319894676

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AIMS

Functional capacity is an important endpoint for therapies oriented to older adults with cardiovascular diseases. The literature on predictors of exercise capacity is sparse in the elderly population. In a longitudinal European study on effectiveness of cardiac rehabilitation of seven European countries in elderly (>65 years) coronary artery disease or valvular heart disease patients, predictors for baseline exercise capacity were determined, and reference ranges for elderly cardiac patients provided.

METHODS

Mixed models were performed in 1282 patients (mean age 72.9 ± 5.4 years, 79% male) for peak oxygen consumption relative to weight (peak VO2; ml/kg per min) with centre as random factor and patient anthropometric, demographic, social, psychological and nutritional parameters, as well as disease aetiology, procedure, comorbidities and cardiovascular risk factors as fixed factors.

RESULTS

The most important predictors for low peak VO2 were coronary artery bypass grafting or valve surgery, low resting forced expiratory volume, reduced left ventricular ejection fraction, nephropathy and peripheral arterial disease. Each cumulative comorbidity or cardiovascular risk factors reduced exercise capacity by 1.7 ml/kg per min and 1.1 ml/kg per min, respectively. Males had a higher peak VO2 per body mass but not per lean mass. Haemoglobin was significantly linked to peak VO2 in both surgery and non-surgery patients.

CONCLUSIONS

Surgical procedures, cumulative comorbidities and cardiovascular risk factors were the factors with the strongest relation to reduced exercise capacity in the elderly. Expression of peak VO2 per lean mass rather than body mass allows a more appropriate comparison between sexes. Haemoglobin is strongly related to peak VO2 and should be considered in studies assessing exercise capacity, especially in studies on patients after cardiac surgery.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Marcin, Thimo; Eser, Prisca and Wilhelm, Matthias

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2047-4873

Publisher:

SAGE Publications

Language:

English

Submitter:

Thimo Marcin

Date Deposited:

22 Apr 2020 11:23

Last Modified:

15 Oct 2020 01:31

Publisher DOI:

10.1177/2047487319894676

PubMed ID:

31852300

Uncontrolled Keywords:

Cardiac rehabilitation cardiopulmonary exercise testing cardiorespiratory fitness peak VO2

BORIS DOI:

10.7892/boris.142718

URI:

https://boris.unibe.ch/id/eprint/142718

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