Association Between Early Cardiac Rehabilitation and Long-term Survival in Cardiac Transplant Recipients

Andrew N. Rosenbaum, Walter K Kremers, John A. Schirger, Randal J. Thomas, Ray W. Squires, Thomas G. Allison, Richard C. Daly, Sudhir S. Kushwaha, Brooks Sayre Edwards

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Abstract

Objective To determine whether participation in early cardiac rehabilitation (CR) after heart transplant (HTx) affects long-term survival. Patients and Methods A retrospective review was conducted in 201 patients who underwent HTx at Mayo Clinic between June 1, 2000, and July 31, 2013. Patients were excluded with multiorgan transplant, no CR data, and follow-up less than 90 days after HTx. Demographic and exercise data at baseline before HTx were collected. Post-HTx exercise capacity, biopsy, CR data, and medications were collected at 1 through 5 and 10 years. Results Overall survival at 1, 5, and 10 years was 98%, 88%, and 82%, respectively; 29 patients died. Number of CR sessions attended in the first 90 days after HTx predicted survival in multivariate regression, controlling for baseline post-HTx 6-minute walk test (6MWT) results and rejection episodes (hazard ratio, 0.90; 95% CI, 0.82-0.97; P=.007). Additional univariate predictors of survival included pre-HTx 6MWT results, weight at HTx, and body mass index and systolic blood pressure at CR enrollment. Pre-HTx 6MWT results, body mass index, and post-HTx were associated with improvement in peak oxygen consumption. Conclusion This report demonstrates, for the first time, an association between CR and long-term survival in patients after HTx. Further work should clarify the most beneficial aspects of CR.

Original languageEnglish (US)
Pages (from-to)149-156
Number of pages8
JournalMayo Clinic Proceedings
Volume91
Issue number2
DOIs
StatePublished - Feb 1 2016

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Survival
Body Mass Index
Exercise
Blood Pressure
Transplants
Transplant Recipients
Cardiac Rehabilitation
Oxygen Consumption
Demography
Biopsy
Weights and Measures
Walk Test

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Association Between Early Cardiac Rehabilitation and Long-term Survival in Cardiac Transplant Recipients. / Rosenbaum, Andrew N.; Kremers, Walter K; Schirger, John A.; Thomas, Randal J.; Squires, Ray W.; Allison, Thomas G.; Daly, Richard C.; Kushwaha, Sudhir S.; Edwards, Brooks Sayre.

In: Mayo Clinic Proceedings, Vol. 91, No. 2, 01.02.2016, p. 149-156.

Research output: Contribution to journalArticle

Rosenbaum, Andrew N. ; Kremers, Walter K ; Schirger, John A. ; Thomas, Randal J. ; Squires, Ray W. ; Allison, Thomas G. ; Daly, Richard C. ; Kushwaha, Sudhir S. ; Edwards, Brooks Sayre. / Association Between Early Cardiac Rehabilitation and Long-term Survival in Cardiac Transplant Recipients. In: Mayo Clinic Proceedings. 2016 ; Vol. 91, No. 2. pp. 149-156.
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