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| Exercise rehabilitation improves cardiac volumes and functional capacity in patients with endomyocardial fibrosis: a randomized controlled trial |
| Sayegh ALC, dos Santos MR, Rondon E, de Oliveira P, de Souza FR, Salemi VMC, Alves M-JNN, Mady C |
| Journal of Cardiopulmonary Rehabilitation and Prevention 2019 Nov;39(6):373-380 |
| clinical trial |
| 4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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PURPOSE: Endomyocardial fibrosis (EMF) is a restrictive cardiomyopathy associated with low functional capacity and high mortality rates. Exercise training has been proved to be a nonpharmacological treatment of cardiovascular diseases. Therefore, the purpose of this study was to determine the effects of exercise rehabilitation in EMF patients. METHODS: Twenty-two EMF patients, functional classes II and III (New York Heart Association (NYHA)), were randomized to the control (c-EMF) or exercise rehabilitation (rehab-EMF) group. Patients in the rehab-EMF group underwent 4 mo of exercise rehabilitation, whereas patients in the c-EMF group were instructed to maintain their usual daily routine. Peak oxygen uptake (VO2), cardiac function, and quality of life were evaluated. All assessments were performed at baseline and after 4 mo. RESULTS: After 4 mo of rehabilitation, peak VO2 increased in the rehab-EMF group (17.4 +/- 3.0 to 19.7 +/- 4.4 mL/kg/min, p < 0.001), whereas the c-EMF group showed no difference (15.3 +/- 3.0 to 15.0 +/- 2.0 mL/kg/min, p = 0.87). Also, post-intervention, peak VO2 in the rehab-EMF group was greater than that in the c-EMF group (p < 0.001). Furthermore, the rehab-EMF group, when compared to the c-EMF group, showed an increase in left ventricular end-diastolic volume (102.1 +/- 64.6 to 136.2 +/- 75.8 mL versus 114.4 +/- 55.0 to 100.4 +/- 49.9 mL, p < 0.001, respectively) and decrease in left atrial diastolic volume (69.0 +/- 33.0 to 34.9 +/- 15.0 mL versus 44.6 +/- 21.0 to 45.6 +/- 23.0 mL, p < 0.001, respectively). Quality-of-life scores also improved in the rehab-EMF group, whereas the c-EMF group showed no change (45 +/- 23 to 27 +/- 15 versus 47 +/- 15 to 45 +/- 17, p < 0.001, respectively). CONCLUSION: Exercise rehabilitation is a nonpharmacological intervention that improves functional capacity, cardiac volumes, and quality of life in EMF patients after endocardial resection surgery. In addition, exercise rehabilitation should be prescribed to EMF patients to improve their clinical condition.
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