Effects of cardiac rehabilitation on functional capacity, psychological symptoms and quality of life in patients with left ventricular assist device

Aim: In this prospective randomized trial, we aimed to study the effects of cardiac rehabilitation on functional capacity, depression, and quality of life, in patients undergoing left ventricular assist device (LVAD) implantation for the treatment of heart failure. We also aimed to compare the effectiveness of home and hospital-based exercise programs. Materials and Methods: 42 patients who had received LVAD implants in our university hospital were included in the study. After the subjects were randomized into a hospital exercise group (n=20) and a home exercise group (n=22). They were enrolled in a cardiac rehabilitation program for 8 weeks, which lasted for one hour, three times per week in the hospital and at home respectively. All subjects were assessed at baseline and at the end of 8th week. They were assessed using a cardiopulmonary exercise test (CPET) for peak oxygen consumption (VO2), pulmonary function tests, 6-minute walk test (6MWT) in addition to Short form 36 (SF-36), Minnesota Living with Heart Failure Questionnaire (MLHFQ), State Trait Anxiety Inventory (STAI) and Beck Depression Index for depression (BDI) before and after intervention Results: In our study, we detected a significant improvement in peak VO2, 6MWT values, MLHFQ, STAI state anxiety sub-score in the hospital exercise group (p<0.05). The home exercise group did not improve significantly in any of the parameters except in the pain sub-score of SF-36 (p<0.05). Comparison of the changes seen in the parameters over time, the hospital group showed significantly more improvement than the home exercise group in peak VO2, 6MWT, MLHFQ and trait anxiety sub score of STAI (p<0.05). Age correlated with better gains in FEV1 (r=-0.35, p<0.05) and 6MWT (r=-0.39, p<0.01). Gains in 6MWT correlated with the gains in peak VO2 (r=0.54**, p<0.01). Duration of HF correlated with a poorer response in the FEV1 (r=0.19, p<0.05) and 6MWT (r=-0.25, p<0.01) gains. Conclusion: In this study, we detected a positive effect of supervised hospital exercise program on functional capacity, quality of life and anxiety in patients with implanted LVADs.