Comprehensive geriatric assessment (CGA)-based cardiac rehabilitation (CR) program
is essential for patients before and after transcatheter aortic valve implantation
(TAVI). This study aimed to explore the values of CGA and exercise capacity in CR
for patients referred to TAVI. A retrospective analysis was conducted in 90 patients
referred to TAVI from January to October 2019. CR strategies started before TAVI.
The association between clinical characteristics, CGA, and change in six-minute walk
distance (Δ6MWD) was analyzed with multivariate regression models. Most of patients
had cognitive impairment (50%), malnutrition (61%), and frailty (83%). After the CR,
the proportion of cognitive impairment, malnutrition, and frail patients was significantly
decreased by 21%, 40%, and 57%, respectively (p = 0.002, p <0.001, p <0.001). The
6MWD at a month after discharge (291.9 ± 98.8 m) was significantly improved than that
at discharge after TAVI (218.8 ± 114.3m, p <0.001). The multivariate regression analysis
indicated body mass index (BMI; Δ6MWD:12.0, 95% confidence interval [CI] 0.3 to 23.8,
p = 0.045), frailty (Δ6MWD: −57.9, 95% CI −81.8 to −34.1, p <0.001) and malnutrition
(Δ6MWD: −25.1, 95% CI −47.0 to −3.2, p = 0.026) as the associated predictors of Δ6MWD.
In conclusion, functional status in patients referred to TAVI could be improved by
CGA-based CR. BMI, frailty, and malnutrition were associated with the efficacy of
CR on exercise capacity. CGA can play the important role in the evaluation and making
strategies for CR in patients.
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Article info
Publication history
Published online: August 29, 2021
Received in revised form:
July 22,
2021
Received:
May 7,
2021
Footnotes
Funding: The current study is funded by the National Key R&D Program of China (grant number: 2020YFC2008100).
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