Changes in functional capacity and hemodynamic responses in Costa Rican cardiac rehabilitation patients

Abstract

Purpose: To examine changes in walking distance and hemodynamic responses (HED) following a 12-week exercise-based CR program in Costa Rican cardiac patients. Methods: Six-min walking distance (6MWD) and HED variables - systolic blood pressure (SBP), diastolic blood pressure (DBP), post-6MWD heart rate (FHR), post- 6MWD recovery heart rate (REC), post-6MWD SBP (PSBP), and post-6MWD DBP (PDBP) were measured before and after CR in three-hundred and eleven (237 males and 74 females) patients (age = 57.7 ± 13 yr.). Using age as a covariate, two by two (gender x measurement) ANCOVAs determined differences in 6MWD and HED variables. Pre-to-post CR intervention changes (Δ) in 6MWD and HED variables were correlated to the number of CR exercise sessions attended by age-quartile (Qn) within genders. Results: Patients underwent 33.0 ± 5.1 CR sessions. Males walked a longer distance than females (males = 493.5 ± 5.6 vs. females = 429.0 ± 9.9 m; p ≤ 0.001) from pre-to-post CR program (males pre = 429.3 ± 6.2 vs. post = 557.6 ± 5.8 m, p ≤ 0.001; females pre = 374.9 ± 11.2 vs. post = 483.2 ± 10.3 m, p ≤ 0.001). Both genders reduced DBP following the CR program (males pre = 67.01 ± 0.7 vs. post = 65.6 ± 0.5 mmHg, p = 0.034; females pre = 69.2 ± 1.2 vs. post = 65.0 ± 1.0 mmHg, p = 0.001), and increased FHR following a 6MWD test after the CR program (males pre = 97.7 ± 1.2 vs. post = 112.7 ± 1.4 bpm, p ≤ 0.001; females pre = 100.7 ± 2.1 vs. post = 110.2 ± 2.5 bpm, p ≤ 0.001). Males increased SBP immediately after 6MWD test (pre = 122.8 ± 1.3 vs. post = 133.6 ± 1.3 mmHg; p ≤ 0.001). Significant correlations between CR sessions completed were found in males in Q1 (age ≤ 49.9 yr.) for ΔDBP (r = -0.328; p = 0.013), Q2 (age 50 to 59.9 yr.) for ΔFHR (r = 0.407; p = 0.001), ΔREC (r = 0.286; p = 0.030), and Q4 (age ≥ 67 yr.) for ΔREC (r = -0.310; p = 0.016), but none for males in Q3 (age 59 to 66.9 yr.). For females in Q4 (age ≥ 67 yr.), significant correlations were found between CR sessions and ΔDBP (r = 0.474; p = 0.040) and Δpost-6MWD SBP (r = 0.510; p = 0.022). No significant correlations were found between CR sessions on Q1 (age ≤ 51.9 yr.), Q2 (age ≤ 52 to 59.4 yr.), Q3 (age ≤ 59.5 to 66.9 yr.) for 6MWD or any HED variable. Conclusion: Both men and women improved functional capacity as observed in the 6MWD and HED variable adaptations to exercise following a 12-week CR program.