Key result
Exercise-based cardiac rehab significantly improves walking distance and functional independence after TAVI.
Why the study?
Patients undergoing TAVI for severe aortic stenosis are often elderly, frail, and have low exercise capacity, and cardiac rehabilitation is expected to improve quality of life and cardiac functional performance.
Does exercise-based cardiac rehabilitation improve exercise tolerance and functional independence in patients after TAVI?
Systematic Review (n=2,365)
Does exercise-based cardiac rehabilitation improve exercise tolerance and functional independence in patients after TAVI?
Standardized Mean Difference: 0.65 (95% CI 0.51–0.79)
Exercise-based cardiac rehabilitation significantly improves exercise tolerance and functional independence in patients recovering from TAVI.
Supports integrating exercise-based CR into post-TAVI care pathways; extends limited prior evidence for functional recovery in this population.
BACKGROUND: Currently, transcatheter aortic valve implantation (TAVI) is presently a recognized treatment modality for patients with severe aortic stenosis who are often old, disabled, frail, and have low exercise capacity (ExCap). It is further expected from this therapy to improve quality of life by improving of the cardio function performance. The aim of this study is to evaluate the effect of exercise-based cardiac rehabilitation (CR) on patients after TAVI. METHODS: PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to December 10, 2022 for relevant studies that evaluated the effect of CR on patients after TAVI. The primary outcome was the improvement of 6-minute walked distance and Barthel index score after CR. The secondary outcomes included other parameters such as SF-12 scale, HADS score, Morse Fall Scale, Frailty-Index, ExCap, and FIM score. All statistical analyses were performed using the standard statistical procedures provided in Review Manager 5.2. RESULTS: A total of 12 observational studies were identified, with 2365 participants. Pooled data indicated that CR programmers significantly improved the 6-minute walked distance (SMD 0.65; 95% confidence intervals [CI] 0.51-0.79) and Barthel index score (SMD 0.83; 95% CI 0.61-1.06). In addition, compared with admission, patients experienced significant improvement in SF-12 scale at CR discharge, with a pooled mean differences (MD) of 2.74 (95% CI 0.86-4.61) in physical component score and 2.76 (95% CI 0.59-4.93) in mental component score. Similar results were also observed in ExCap (MD 8.10 W; 95% CI 1.57 W-14.63 W) and FIM score (MD 11.0; 95% CI 6.22-15.78). CONCLUSIONS: Our analysis indicated that exercise-based CR programmers had significant effect on patients after TAVI in improving exercise tolerance and functional independence.
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Li et al. (2023) conducted a systematic review in Severe symptomatic aortic stenosis post-transcatheter aortic valve implantation (TAVI) (n=2,365). Exercise-based cardiac rehabilitation vs. Pre-rehabilitation baseline (admission) was evaluated on Improvement in 6-minute walked distance (6-MWD) (SMD 0.65, 95% CI 0.51-0.79). Exercise-based cardiac rehabilitation programs significantly improved 6-minute walked distance (SMD 0.65) and functional independence measured by the Barthel index (SMD 0.83) in patients following transcatheter aortic valve implantation.
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