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Long-term benefits of exercise training in patients with a systemic right ventricle |
van der Bom T, Winter MM, Knaake JL, Cervi E, de Vries LSC, Balducci A, Meregalli PG, Pieper PG, van Dijk APJ, Bonvicini M, Mulder BJM, Bouma BJ |
International Journal of Cardiology 2015 Jan 20;179:105-111 |
clinical trial |
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
OBJECTIVES: The aim of the present study is to determine the long-term effects of a ten-week exercise training program in adult patients with a systemic right ventricle. METHODS: All patients who participated in a 2009 randomized controlled trial were approached. At approximately three years of follow-up from initial baseline, patients underwent cardiopulmonary exercise testing, filled out two quality of life questionnaires, and NT proBNP levels were measured. All examinations were performed according to the protocols of the 2009 trial. In addition, patients were asked about their current sports habits. RESULTS: Of the 54 patients who were randomized in the 2009-trial 40 participated in the current re-evaluation (male 50%, ccTGA 35%, age 36 +/- 10years, intervention group n = 22, control group n = 18). After three years, no persistent effect of exercise training on VO2peak training remained (-2% of predicted, 95% CI -3% to 5%; p = 0.56). However, patients who already participated in regular sports or exercise at baseline (n = 23/40 (58%)) showed higher VO2peak of 13% of predicted (95% CI 4% to 23%; p > 0.01) and a decrease of 62% in plasma NT-proBNP (95% CI -115% to -10%; p > 0.03) during follow-up, when compared to patients who did not. Moreover, sports were associated with a lower incidence of clinical events (p = 0.032). CONCLUSION: Short-term beneficial effects of exercise training did not persist over a three-year follow-up period. However, sports participation at baseline was associated with better exercise capacity, lower neurohormone levels, and increased event-free survival.
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