4th Asian Preventive Cardiology And Cardiac Rehabilitation Conference

December 2012 Abstracts Presentation (Oral): B1 J HK Coll Cardiol, Vol 20 (Suppl 2) 2. Multidisciplinary Rehabilitation Program in Patients with Advanced Heart Failure after Cardiac Resynchronization Therapy KY NG, K FAN, G YIP, JYY NG, B YUNK, KYP CHAN, KY CHENG, KW LAI, KW SIT, D CHAN Cardiac Rehabilitation Center, Cardiac Medical Unit; Physiotherapy Department, Grantham Hospital, Hong Kong Introduction: Cardiac resynchronization therapy (CRT) has been proven to improve functional class and systolic function in heart failure patients (NYHA class IIIambulatory IV) and additional cardiac rehabilitation program with exercise training in this high risk group remains to be determined. Objective: The objective of this program was to assess further improvement of exercise capacity of patients with advanced heart failure after CRT through multidisciplinary cardiac rehabilitation program. Methods: Twelve patients (5 women and 7 men; mean age 48, ranged 1870) who received CRT (mean duration of 2.2 months) further completed an 8-week multidisciplinary cardiac rehabilitation program with aerobic exercise training (including 3 sessions/week with a total of 24 sessions & 40 minutes/ session on treadmill walking & cycling) plus specific counseling services on heart failure disease with emphasis on patients' self-management, in the Cardiac Rehabilitation Center of Grantham Hospital. Cardiopulmonary exercise test (CPET) and six-minute hall walk (6-MWT) were assessed and compared at baseline (before implantation of CRT), after CRT and after rehabilitation respectively. Results: There were statistically significantly further improvement on the duration (seconds) of the CPET (614±166 to 743.46±147, p<0.001), peak VO2 (ml/kg/min.) (17.44±4.76 to 20.11+5.36, p<0.001), MET level (4.97± 1. 1.37 to 5.73±1.53, p<0.001), oxygen pulse (9.46±3.76 to 10.58±3.36, p<0.05), VE/VCO2 (39.42±8.40 to 36.58±7.82, p<0.05) as well as 6-MWT (meters) (433±58.95 to 494.33±74.77, p<0.001) after the 8-week rehabilitation program. After physicians' assessment, 4 subjects out of 6 (who were originally on heart transplantation work up) were deleted from the heart transplantation waiting list due to the improvement of functional class to NYHA class II. Conclusions: Well prescribed exercise training program specifically designed for heart failure patients who received evidence-based heart failure therapy is beneficial and safe. Additional multidisciplinary intervention further improved patients' well being. The Role of Personal Resources in Patients with Coronary Heart Disease in Response to Cardiac Rehabilitation Program KWN WONG, ST KWOK Faculty of Science and Technology, The Technological and Higher Education Institute of Hong Kong; School of Nursing, The Hong Kong Polytechnic University, Hong Kong Purpose of the Study: This study investigated the impact of personal resources (including optimism, self-esteem, perceived control, social support, and gratitude) on outcome measures in Chinese coronary heart disease (CHD) patients in response to a cardiac rehabilitation program. The posttraumatic growth among Chinese CHD patients and how far personal resources predicted posttraumatic growth among these patients were also examined. Methods: 67 Chinese patients with CHD went through an 8-week cardiac rehabilitation program that consisted of structured exercise sessions, nursing care, and health education and promotion. Physiological impairment parameters were assessed preand post-program. Blood profiles were obtained during the first consultation and subsequent follow-up at the cardiac centre. Personal resources data and general health status were collected in the first consultation while the posttraumatic growth data and the post program general health status were collected at the last session of the program. Results: Results indicated that CHD patients high in personal resources achieved better outcomes than those low in personal resources, as indicated by higher physical and mental summary measures in SF-36, lower cholesterol levels and better performance on the 6-minute walk test. Moreover, personal resources were demonstrated to be a significant predictor of the level of posttraumatic growth although the rehabilitation program exerted a weak mediating effect on the link between personal resources and posttraumatic growth. Conclusion: Human beings are able to experience growth after a lifethreatening disease, and this can be predicted by individual difference in personal resources. In addition to teaching the client to manage their physical health in rehabilitation program, it may be beneficial to incorporate trainings or interventions in the rehabilitation program to increase personal resources of individuals.