Supervisors info:
Ελευθέριος Καρατζάνος, Επιστημονικός Συνεργάτης, Ιατρική Σχολή, ΕΚΠΑ
Σεραφείμ Νανάς, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ουρανία Παπαζάχου, Επιστημονική Συνεργάτης, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Background: Exercise programs appear to have a positive effect on both oncology patients and patients with chronic heart failure. However, there is a gap in scientific literature regarding whether exercise is appropriate and beneficial for patients with heart failure and cardiac amyloidosis. The aim of this study was to investigate the effect and safety of an exercise and rehabilitation program in patients with heart failure and cardiac amyloidosis.
Design and Methods: This is a case study of two female patients, A and B, with heart failure and cardiac amyloidosis, 61 and 66 years old, with ejection fraction 45% and 35%, on optimal medication and clinically stable. The protocol followed, was a combination of aerobic exercise (20'-30' on a cycle ergometer) with muscle strengthening (2-3 sets, 10-12 repetitions, for muscle groups of the chest and upper limbs, and quadriceps and posterior thighs, 3 times/week for 12 weeks. Before and after the program, a maximal cardiopulmonary exercise testing, strength measurements, and a quality of life questionnaire were completed. Microcirculation was assessed using the NIRS method before and after the first maximal cardiopulmonary exercise testing.
Results: For patient A the pre/post-program values were as follows: quality of life: 67/15, quadriceps strength: 35/42 kg, chest strength: 20/25 kg, maximal oxygen uptake: 19,6/20,1 mL/kg/min and 1,47/1,51 L/min, anaerobic threshold: 12,5/11,0 mL/kg/min, maximal workload: 80/100 W, occlusion slope: 15,17/12,26, recovery slope: 6,03/3,74. For patient B the pre/post-intervention values were: quality of life: 50/21, quadriceps strength: 15/18 kg, chest strength: 20/22 kg, maximal oxygen uptake: 13,5/14,6 mL/kg/min and 0,74/0,79 L/min, anaerobic threshold: 9,3/8,9 mL/kg/min, maximal workload: 35/45 W, occlusion slope: 16,78/12,77 , recovery slope: 3,79/1,89. During exercise, no events were observed.
Conclusions: Patients with cardiac amyloidosis and heart failure can safely follow exercise programs and improve their functional status and quality of life. These results require investigation with randomized trials.
