Key result
Type 2 diabetes linked to ~2.3-fold higher odds of reduced exercise capacity during cardiac rehabilitation.
Cohort (n=425)
No
In patients qualifying for cardiac rehabilitation, specific comorbidities like diabetes and chronic kidney disease strongly predict poor exercise capacity, while female sex predicts ventilatory inefficiency, highlighting the value of routine cardiopulmonary exercise testing to tailor rehabilitation programs.
T2DM signals higher risk of reduced exercise capacity in cardiac rehab; extends comorbidity data but leaves open tailored intervention trials.
Background/Objectives: Exercise capacity and patient prognosis are heavily influenced by comorbidities. However, the specific impact of individual comorbid conditions on objective measures of exercise performance remains insufficiently characterized. The study aimed to identify predictors of reduced physical capacity in patients qualified for cardiac rehabilitation. Methods: A single-center retrospective analysis was conducted on 518 patients qualified for cardiac rehabilitation. After excluding 51 post-cardiac surgery patients, cardiopulmonary exercise testing data from 425 patients (316 men, median age 63 years) were analyzed. Comorbidities data, peak oxygen uptake (peak VO2), and the ventilation-to-carbon dioxide output slope (VE/VCO2 slope) were evaluated. Results: A significantly reduced exercise capacity (peak VO2 < 70% of the predicted value) was observed in 29.4% of patients, while an increased VE/VCO2 slope (≥36) was noted in 20.8% of patients. Univariate logistic regression identified sex, heart failure, valvular disease, peripheral artery disease, diabetes mellitus (T2DM), chronic kidney disease (CKD), Charlson Comorbidity Index (CCI), left ventricular ejection fraction <50%, diastolic dysfunction, and anemia as predictors of both reduced peak VO2 and a steeper VE/VCO2 slope. Multivariate regression analysis further identified T2DM and CKD as independent predictors of reduced peak VO2, while sex, CKD, and CCI were independent predictors of a steeper VE/VCO2 slope. Conclusions: Among patients qualified for cardiac rehabilitation, patient’s sex, T2DM, CKD, and the CCI emerged as key predictors of reduced exercise capacity. Reduced peak VO2 was more commonly observed in men, while women more frequently exhibited a steeper VE/VCO2 slope, indicating potential sex-related physiological mechanisms influencing exercise performance.
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Kurpaska et al. (2025) conducted a cohort in Cardiovascular disease (patients qualified for cardiac rehabilitation) (n=425). Type 2 Diabetes Mellitus (T2DM) vs. Patients without T2DM was evaluated on Significantly reduced exercise capacity (peak VO2 < 70% of predicted value) (OR 2.29, 95% CI 1.15-4.56, p=0.018). Type 2 diabetes mellitus was identified as a significant independent predictor of reduced exercise capacity (peak VO2 < 70% of predicted) in patients undergoing cardiac rehabilitation.
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