Cardiac rehabilitation for patients with aortic stenosis undergoing transcatheter aortic valve replacement_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Ran , YAN Tingting , CHEN Qi , YAO Jing , LIU Xinmin , LUO Taiyang , YUAN Fei , WU Wenhui , YIN Chengqian , LU Zhinan ,  SONG Guangyuan

Department of Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, P. R. China;

Corresponding author：

SONG Guangyuan, Email: songgy_fuwai@163.com

Keywords：

Aortic stenosis; transcatheter aortic valve replacement; cardiac rehabilitation

DOI：

10.7507/1007-4848.202209018

Video：

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Aortic stenosis (AS) is the most common primary valve lesion requiring surgery or transcatheter intervention in modern era. Its prevalence is rising rapidly as a consequence of the aging population. Transcatheter aortic valve replacement (TAVR) as a therapy option for older high-risk symptomatic severe AS patients has emerged and is currently extending its indications towards surgery intermediate- and low-risk subjects. Considering the common characteristics of frailty and high comorbidity among AS patients, cardiac rehabilitation (CR) has been proven to improve not only survival but also quality of life in previous reports. CR as a classⅠ recommendation in guidelines for the prevention and treatment of cardiovascular disease has been widely used in clinical practice. The purpose of this article is to sort out the current CR programs for TAVR patients in global medical management, and explore the CR optimization program fit for China medical model in post COVID-19 pandemic era.

Citation： LIU Ran, YAN Tingting, CHEN Qi, YAO Jing, LIU Xinmin, LUO Taiyang, YUAN Fei, WU Wenhui, YIN Chengqian, LU Zhinan, SONG Guangyuan. Cardiac rehabilitation for patients with aortic stenosis undergoing transcatheter aortic valve replacement. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(12): 1567-1573. doi: 10.7507/1007-4848.202209018 Copy

1.	Ozkan A, Kapadia S, Tuzcu M, et al. Assessment of left ventricular function in aortic stenosis. Nat Rev Cardiol, 2011, 8(9): 494-501.
2.	Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC), European Association for Cardio-Thoracic Surgery (EACTS). Guidelines on the management of valvular heart disease (version 2012). Eur Heart J, 2012, 33(19): 2451-2496.
3.	齐喜玲, 许海燕, 刘庆荣, 等. 中国老年退行性心脏瓣膜病住院患者诊疗现状分析. 中国循环杂志, 2019, 34(8): 771-776.
4.	Xu HY, Liu QR, Cao K, et al. Distribution, characteristics, and management of older patients with valvular heart disease in China: China-DVD Study. JACC: Asia, 2022, 2(3): 354-365.
5.	Kapadia SR, Leon MB, Makkar RR, et al. 5-year outcomes of transcatheter aortic valve replacement compared with standard treatment for patients with inoperable aortic stenosis (PARTNER 1): A randomised controlled trial. Lancet, 2015, 385(9986): 2485-2491.
6.	Leon MB, Smith CR, Mack MJ, et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med, 2016, 374(17): 1609-1620.
7.	Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J, 2022, 43(7): 561-632.
8.	Tarro Genta F. Cardiac rehabilitation for transcatheter aortic valve replacement. Clin Geriatr Med, 2019, 35(4): 539-548.
9.	Sathananthan J, Lauck S, Piazza N, et al. Habitual physical activity in older adults undergoing TAVR: Insights from the FRAILTY-AVR study. JACC Cardiovasc Interv, 2019, 12(8): 781-789.
10.	Goel K, Holmes D. Transcatheter aortic valve replacement: Optimizing outcomes for healthy recovery. J Cardiopulm Rehabil Prev, 2018, 38(38): 1-7.
11.	Guduguntla V, Yaser J, Keteyian S, et al. Variation in cardiac rehabilitation participation during aortic valve replacement episodes of care. Circ Cardiovasc Qual Outcomes, 2022, 15(e009175): 2125.
12.	Pelliccia A, Sharma S, Gati S, et al. 2020 ESC guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur Heart J, 2021, 42(1): 17-96.
13.	Ambrosetti M, Abreu A, Corrà U, et al. Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology. Eur J Prev Cardiol, 2020, 2047487320913379.
14.	American Association of Cardiovascular and Pulmonary Rehabilitation. AACVPR Guidelins for Cardiac Rehabilitation Programs, sixth edition. Champaign, IL: Human Kinetics. 202. 301-302.
15.	中国医师协会心血管内科医师分会结构性心脏病专业委员会. 经导管主动脉瓣置换术后运动康复专家共识. 中国介入心脏病学杂志, 2020, 28(7): 361-368.
16.	Fauchère I, Weber D, Maier W, et al. Rehabilitation after TAVI compared to surgical aortic valve replacement. Int J Cardiol, 2014, 173: 564-566.
17.	Kleczynski P, Trebacz J, Stapor M, et al. Inpatient cardiac rehabilitation after transcatheter aortic valve replacement is associated with improved clinical performance and quality of life. J Clin Med, 2021, 10(10): 2125.
18.	Butter C, Groß J, Haase-Fielitz A, et al. Impact of rehabilitation on outcomes after TAVI: A preliminary study. J Clin Med, 2018, 7(10): 326.
19.	Yu ZK, Zhao QH, Ye YQ, et al. Comprehensive geriatric assessment and exercise capacity in cardiac rehabilitation for patients referred to transcatheter aortic valve implantation. Am J Cardiol, 2021, 158: 98-103.
20.	Tarro Genta F, Tidu M, Bouslenko Z, et al. Cardiac rehabilitation after transcatheter aortic valve implantation compared to patients after valve replacement. J Cardiovasc Med (Hagerstown), 2017, 18(2): 114-120.
21.	Russo N, Compostella L, T arantini G, et al. Cardiac rehabilitation after transcatheter versus surgical prosthetic valve implantation for aortic stenosis in the elderly. Eur J Prev Cardiol, 2014, 21(11): 1341-1348.
22.	Imran HM, Baig M, Mujib M, et al. Comparison of phase 2 cardiac rehabilitation outcomes between patients after transcatheter versus surgical aortic valve replacement. Eur J Prev Cardiol, 2018, 25(15): 1577-1584.
23.	Pressler A, Christle JW, Lechner B, et al. Exercise training improves exercise capacity and quality of life after transcatheter aortic valve implantation: A randomized pilot trial. Am Heart J, 2016, 182: 44-53.
24.	Rogers P, Al-Aidrous S, Banya W, et al. Cardiac rehabilitation to improve health-related quality of life following trans-catheter aortic valve implantation: A randomised controlled feasibility study: RECOVER-TAVI pilot, ORCA 4, for the optimal restoration of Cardiac Activity Group. Pilot Feasibility Stud, 2018, 4: 185.
25.	Penati C, Incorvaia C, Mollo V, et al. Cardiac rehabilitation outcome after transcatheter aortic valve implantation. Monaldi Arch Chest Dis, 2021, 91(2). doi: 10.4081/monaldi.2021.1621.
26.	Pressler A, Förschner L, Hummel J, et al. Long-term effect of exercise training in patients after transcatheter aortic valve implantation: Follow-up of the SPORT: TAVI randomised pilot study. Eur J Prev Cardiol, 2018, 25(8): 794-801.
27.	Dun Y, Thomas R, Smith J, et al. High-intensity interval training improves metabolic syndrome and body composition in outpatient cardiac rehabilitation patients with myocardial infarction. Cardiovasc Diabetol, 2019, 18(1): 104-115.
28.	Millen J, Bray S. Promoting self-efficacy and outcome expectations to enable adherence to resistance training after cardiac rehabilitation. J Cardiovasc Nurs, 2009, 24(4): 316-327.
29.	Bhattal GK, Park KE, Winchester DE. Home-based cardiac rehabilitation (HBCR) in post-TAVR patients: A prospective, single-center, cohort, pilot study. Cardiol Ther, 2020, 9(2): 541-548.
30.	Lindman BR, Gillam LD, Coylewright M, et al. Effect of a pragmatic home-based mobile health exercise intervention after transcatheter aortic valve replacement: A randomized pilot trial. Eur Heart J Digit Health, 2021, 2(1): 90-103.
31.	Hansen TB, Berg SK, Sibilitz KL, et al. Availability of, referral to and participation in exercise-based cardiac rehabilitation after heart valve surgery: Results from the national CopenHeart survey. Eur J Prev Cardiol, 2015, 22(6): 710-718.
32.	Thomas RJ, Beatty AL, Beckie TM,et al. Home-based cardiac rehabilitation: A scientific statement from the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. Circulation, 2019, 140(1): e69-e89.
33.	Tarro Genta F, Marcassa C, Ceresa M, et al. Predictors of survival in patients undergoing cardiac rehabilitation after transcatheter aortic valve replacement (TAVR): A multicenter retrospective study. Panminerva Medica, 2022. [Epub ahead of print].

1. Ozkan A, Kapadia S, Tuzcu M, et al. Assessment of left ventricular function in aortic stenosis. Nat Rev Cardiol, 2011, 8(9): 494-501.
2. Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC), European Association for Cardio-Thoracic Surgery (EACTS). Guidelines on the management of valvular heart disease (version 2012). Eur Heart J, 2012, 33(19): 2451-2496.
3. 齐喜玲, 许海燕, 刘庆荣, 等. 中国老年退行性心脏瓣膜病住院患者诊疗现状分析. 中国循环杂志, 2019, 34(8): 771-776.
4. Xu HY, Liu QR, Cao K, et al. Distribution, characteristics, and management of older patients with valvular heart disease in China: China-DVD Study. JACC: Asia, 2022, 2(3): 354-365.
5. Kapadia SR, Leon MB, Makkar RR, et al. 5-year outcomes of transcatheter aortic valve replacement compared with standard treatment for patients with inoperable aortic stenosis (PARTNER 1): A randomised controlled trial. Lancet, 2015, 385(9986): 2485-2491.
6. Leon MB, Smith CR, Mack MJ, et al. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med, 2016, 374(17): 1609-1620.
7. Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J, 2022, 43(7): 561-632.
8. Tarro Genta F. Cardiac rehabilitation for transcatheter aortic valve replacement. Clin Geriatr Med, 2019, 35(4): 539-548.
9. Sathananthan J, Lauck S, Piazza N, et al. Habitual physical activity in older adults undergoing TAVR: Insights from the FRAILTY-AVR study. JACC Cardiovasc Interv, 2019, 12(8): 781-789.
10. Goel K, Holmes D. Transcatheter aortic valve replacement: Optimizing outcomes for healthy recovery. J Cardiopulm Rehabil Prev, 2018, 38(38): 1-7.
11. Guduguntla V, Yaser J, Keteyian S, et al. Variation in cardiac rehabilitation participation during aortic valve replacement episodes of care. Circ Cardiovasc Qual Outcomes, 2022, 15(e009175): 2125.
12. Pelliccia A, Sharma S, Gati S, et al. 2020 ESC guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur Heart J, 2021, 42(1): 17-96.
13. Ambrosetti M, Abreu A, Corrà U, et al. Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology. Eur J Prev Cardiol, 2020, 2047487320913379.
14. American Association of Cardiovascular and Pulmonary Rehabilitation. AACVPR Guidelins for Cardiac Rehabilitation Programs, sixth edition. Champaign, IL: Human Kinetics. 202. 301-302.
15. 中国医师协会心血管内科医师分会结构性心脏病专业委员会. 经导管主动脉瓣置换术后运动康复专家共识. 中国介入心脏病学杂志, 2020, 28(7): 361-368.
16. Fauchère I, Weber D, Maier W, et al. Rehabilitation after TAVI compared to surgical aortic valve replacement. Int J Cardiol, 2014, 173: 564-566.
17. Kleczynski P, Trebacz J, Stapor M, et al. Inpatient cardiac rehabilitation after transcatheter aortic valve replacement is associated with improved clinical performance and quality of life. J Clin Med, 2021, 10(10): 2125.
18. Butter C, Groß J, Haase-Fielitz A, et al. Impact of rehabilitation on outcomes after TAVI: A preliminary study. J Clin Med, 2018, 7(10): 326.
19. Yu ZK, Zhao QH, Ye YQ, et al. Comprehensive geriatric assessment and exercise capacity in cardiac rehabilitation for patients referred to transcatheter aortic valve implantation. Am J Cardiol, 2021, 158: 98-103.
20. Tarro Genta F, Tidu M, Bouslenko Z, et al. Cardiac rehabilitation after transcatheter aortic valve implantation compared to patients after valve replacement. J Cardiovasc Med (Hagerstown), 2017, 18(2): 114-120.
21. Russo N, Compostella L, T arantini G, et al. Cardiac rehabilitation after transcatheter versus surgical prosthetic valve implantation for aortic stenosis in the elderly. Eur J Prev Cardiol, 2014, 21(11): 1341-1348.
22. Imran HM, Baig M, Mujib M, et al. Comparison of phase 2 cardiac rehabilitation outcomes between patients after transcatheter versus surgical aortic valve replacement. Eur J Prev Cardiol, 2018, 25(15): 1577-1584.
23. Pressler A, Christle JW, Lechner B, et al. Exercise training improves exercise capacity and quality of life after transcatheter aortic valve implantation: A randomized pilot trial. Am Heart J, 2016, 182: 44-53.
24. Rogers P, Al-Aidrous S, Banya W, et al. Cardiac rehabilitation to improve health-related quality of life following trans-catheter aortic valve implantation: A randomised controlled feasibility study: RECOVER-TAVI pilot, ORCA 4, for the optimal restoration of Cardiac Activity Group. Pilot Feasibility Stud, 2018, 4: 185.
25. Penati C, Incorvaia C, Mollo V, et al. Cardiac rehabilitation outcome after transcatheter aortic valve implantation. Monaldi Arch Chest Dis, 2021, 91(2). doi: 10.4081/monaldi.2021.1621.
26. Pressler A, Förschner L, Hummel J, et al. Long-term effect of exercise training in patients after transcatheter aortic valve implantation: Follow-up of the SPORT: TAVI randomised pilot study. Eur J Prev Cardiol, 2018, 25(8): 794-801.
27. Dun Y, Thomas R, Smith J, et al. High-intensity interval training improves metabolic syndrome and body composition in outpatient cardiac rehabilitation patients with myocardial infarction. Cardiovasc Diabetol, 2019, 18(1): 104-115.
28. Millen J, Bray S. Promoting self-efficacy and outcome expectations to enable adherence to resistance training after cardiac rehabilitation. J Cardiovasc Nurs, 2009, 24(4): 316-327.
29. Bhattal GK, Park KE, Winchester DE. Home-based cardiac rehabilitation (HBCR) in post-TAVR patients: A prospective, single-center, cohort, pilot study. Cardiol Ther, 2020, 9(2): 541-548.
30. Lindman BR, Gillam LD, Coylewright M, et al. Effect of a pragmatic home-based mobile health exercise intervention after transcatheter aortic valve replacement: A randomized pilot trial. Eur Heart J Digit Health, 2021, 2(1): 90-103.
31. Hansen TB, Berg SK, Sibilitz KL, et al. Availability of, referral to and participation in exercise-based cardiac rehabilitation after heart valve surgery: Results from the national CopenHeart survey. Eur J Prev Cardiol, 2015, 22(6): 710-718.
32. Thomas RJ, Beatty AL, Beckie TM,et al. Home-based cardiac rehabilitation: A scientific statement from the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. Circulation, 2019, 140(1): e69-e89.
33. Tarro Genta F, Marcassa C, Ceresa M, et al. Predictors of survival in patients undergoing cardiac rehabilitation after transcatheter aortic valve replacement (TAVR): A multicenter retrospective study. Panminerva Medica, 2022. [Epub ahead of print].

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Cardiac rehabilitation for patients with aortic stenosis undergoing transcatheter aortic valve replacement

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