Cardiac Rehabilitation in a Patient With Severe Heart Failure and Ventricular Septal Defect Secondary to Acute Myocardial Infarction.

The treatment of choice for patients with advanced heart failure (HF) and with limiting symptoms with evidence of a poor prognosis despite optimal conventional treatment is a heart transplant. However, there is little literature dealing with the effects of cardiovascular prehabilitation with an important change in physical capacity, which can influence the admission on the waiting list for a heart transplant. We presented one young male, smoker, with no prior history of cardiovascular disease, severe ventricular dysfunction, interventricular defect, and HF. It was decided to implant a cardioverter-defibrillator as primary prevention of sudden death and start the pre-cardiac transplant evaluation and subsequent inclusion in the waiting list on an elective basis. While waiting for the transplant, cardiopulmonary rehabilitation (CPR) was indicated. After 15 months of CPR, the patient improved his left ventricular ejection fraction (LVEF; 20% to 40%), systolic pulmonary artery pressure (55 to 40 mmHg), and peak oxygen uptake (23.9 to 29.1 ml/kg/min). In this patient, a program of CPR improved cardiac function and physical capacity, allowing him to be removed from the national waiting list for a heart transplant.

Does COVID-19 Affect the Exercise Capacity of Non-hospitalized Patients?

Objective To determine whether non-hospitalized adults post COVID-19 have impaired exercise capacity. Design Retrospective analysis. Setting Cardiovascular outpatients unit in Instituto Cardiovascular de Rosario, Argentina. Patients Eighty non-hospitalized patients post-infection by COVID-19. Interventions Participants completed an ergometry pre and post COVID-19 infection. Main outcome measures The study's main variables were the metabolic equivalents of task (METs) and the indirect peak oxygen consumption (VO2 peak). Results The median of METs was 11.7 (9.4-14.8) and 11.7 (11-11.7) in pre and post ergometry, respectively, (p = 0.022). The median VO2 (mL/Kg/min) was 21857 (16938-32761) and 21699 (17004-26467) in pre and post ergometry, respectively, without significant differences. Conclusions We found slight differences in maximal physical capacity evaluated through exercise testing in non-hospitalized patients by COVID-19.