Abstract

Background: To describe the average effects and the interindividual variability after a comprehensive outpatient cardiovascular rehabilitation (CCR) program using concurrent exercise training prescribed according to cardiovascular risk stratification on cardiorespiratory fitness (CRF), anthropometric/body composition, quality of life and emotional health in patients of four cardiovascular disease profiles. Methods: CRF, anthropometric/body composition, quality of life, and emotional health were measured before and after a CCR and analyzed in heart valve surgery (HVS), heart failure with reduced ejection fraction (HFrEF), post-acute myocardial infarction (post-AMI), and in coronary artery disease (CAD) patients. Twenty, twenty-four, and thirty-two exercise sessions were prescribed according to mild, moderate, and severe baseline cardiovascular risk, respectively. In addition to concurrent exercise training, nutritional counseling, psychological support, and lifestyle education programs were performed. Results: The main outcomes by delta changes comparisons (Delta) revealed no significant differences at anthropometric/body composition as Delta Body fat decreases (HVS Delta-1.1, HFrEF Delta-1.0, post-AMI Delta-1.4, CAD Delta-1.2 kg) and Delta Skeletal muscle mass increases (HVS Delta+1.4, HFrEF Delta+0.8, post-AMI Delta+0.9, CAD Delta+0.9 kg), and CRF performance as Delta VO2peak increases (HVS Delta+4.3, HFrEF Delta+4.8, post-AMI Delta+4.1, CAD Delta+5.1 mL/kg/min) outcomes among HVS, HFrEF, post-AMI, and CAD (p > 0.05). Secondary outcomes showed significant pre-post delta changes in METs (HVS Delta+1.8, HFrEF Delta+0.7, post-AMI Delta+1.4, CAD Delta+1.4), and maximal O(2)pulse (HVS Delta+3.1, post-AMI Delta+2.1, CAD Delta+1.9). In addition, quality of life had a significant improvement in physical functioning (HVS Delta+17.0, HFrEF Delta+12.1, post-AMI Delta+9.8, CAD Delta+11.2), physical role (HVS Delta+28.4, HFrEF Delta+26.8, post-AMI Delta+25.6, CAD Delta+25.3), vitality (HVS Delta+18.4, HFrEF Delta+14.3, post-AMI Delta+14.2, CAD Delta+10.6) and social functioning (HVS Delta+20.4, HFrEF Delta+25.3, post-AMI Delta+20.4, CAD Delta+14.8) in all cardiovascular disease. For anxiety (HVS Delta-3.6, HFrEF Delta-2.3, post-AMI Delta-3.0, CAD Delta-3.1) and depression (HVS Delta-2.8, HFrEF Delta-3.4, post-AMI Delta-3.2, CAD Delta-2.3) significant changes were also observed. Conclusions: A CCR program that prescribes the number of exercise sessions using a cardiovascular risk stratification improves CRF, QoL, and emotional health, and the average results show a wide interindividual variability (similar to 25% of non-responders) in this sample of four CVD profile of patients.