Effects of Home-based Remote Cardiac Rehabilitation on Left Ventricular Function and Fear of Exercise in Patients after Percutaneous Coronary Intervention (PCI): A Retrospective Cohort Study
DOI:
https://doi.org/10.59958/hsf.6827Keywords:
home remote, cardiac rehabilitation, percutaneous coronary intervention, left ventricular function, kinesophobiaAbstract
Aim: This study aims to explore the effects of home-based remote cardiac rehabilitation on left ventricular function and exercise fear in patients after percutaneous coronary intervention (PCI). Methods: A total of 232 patients with coronary heart disease after PCI treated in Tianshan Traditional Chinese Medicine Hospital from January 2020 to December 2022 were retrospectively analyzed. The patients were divided into the remote rehabilitation group (169 cases) and the routine group (63 cases) according to the exposure factor (home-based remote cardiac rehabilitation). Changes in left ventricular function and sports phobia Tampa Scale in patients with coronary heart disease after PCI were compared using propensity score matching to reduce selection bias and confounding factors. Results: After the intervention, the scores of patients in the tele-rehabilitation group were significantly higher than those in the conventional group in terms of fear of movement, perception of danger, fear of movement, avoidance of movement, and dysfunction (p-value < 0.05). Left heart function was compared between the tele-rehabilitation group and the conventional group. Patients in the tele-rehabilitation group had significantly higher peak mitral valve blood flow in the early diastolic period (E), peak mitral valve blood flow in the late diastolic period (A), six-minute walk test (6MWT), and ratio of the peak mitral valve blood flow in the early diastolic period to the peak mitral valve blood flow in the late diastolic period (E/A) than those in the conventional group (p-value < 0.05). However, the peak deceleration time and isovolumic diastolic time in the early mitral valve diastolic period were significantly higher in the tele-rehabilitation group than in the conventional group (p-value < 0.05). Conclusions: Home-based remote cardiac rehabilitation instruction can improve the heart function and exercise fear state of patients after PCI.
References
Azzalini L, Karmpaliotis D, Santiago R, Mashayekhi K, Di Mario C, Rinfret S, et al. Contemporary Issues in Chronic Total Occlusion Percutaneous Coronary Intervention. JACC. Cardiovascular Interventions. 2022; 15: 1–21.
Ajmal M, Chatterjee A, Acharya D. Persistent or Recurrent Angina Following Percutaneous Coronary Revascularization. Current Cardiology Reports. 2022; 24: 1837–1848.
Kovacevic M, Burzotta F, Srdanovic I, Petrovic M, Trani C. Percutaneous coronary intervention to treat unprotected left main: Common (un-answered) challenges. Kardiologia Polska. 2022; 80: 417–428.
Vanneman MW. Anesthetic Considerations for Percutaneous Coronary Intervention for Chronic Total Occlusions-A Narrative Review. Journal of Cardiothoracic and Vascular Anesthesia. 2022; 36: 2132–2142.
Kikuchi A, Taniguchi T, Nakamoto K, Sera F, Ohtani T, Yamada T, et al. Feasibility of home-based cardiac rehabilitation using an integrated telerehabilitation platform in elderly patients with heart failure: A pilot study. Journal of Cardiology. 2021; 78: 66–71.
Ades PA, Keteyian SJ, Wright JS, Hamm LF, Lui K, Newlin K, et al. Increasing Cardiac Rehabilitation Participation From 20% to 70%: A Road Map From the Million Hearts Cardiac Rehabilitation Collaborative. Mayo Clinic Proceedings. 2017; 92: 234-242.
Hamilton S, Mills B, McRae S, Thompson S. Evidence to service gap: cardiac rehabilitation and secondary prevention in rural and remote Western Australia. BMC Health Services Research. 2018; 18: 64.
Committee of Cardiac Rehabilitation and Prevention of Chinese Association of Rehabilitation Medicine, Committee of Cardiovascular Disease of China Association of Gerontology and Geriatrics. China expert consensus on center guided home-based cardiac rehabilitation. Zhonghua Nei Ke Za Zhi. 2021; 60: 207–215. (In Chinese)
Kulnik ST, Sareban M, Höppchen I, Droese S, Egger A, Gutenberg J, et al. Outpatient Cardiac Rehabilitation Closure and Home-Based Exercise Training During the First COVID-19 Lockdown in Austria: A Mixed-Methods Study. Frontiers in Psychology. 2022; 13: 817912.
Scherrenberg M, Bonneux C, Yousif Mahmood D, Hansen D, Dendale P, Coninx K. A Mobile Application to Perform the Six-Minute Walk Test (6MWT) at Home: A Random Walk in the Park Is as Accurate as a Standardized 6MWT. Sensors (Basel, Switzerland). 2022; 22: 4277.
Cai L, Liu Y, Woby SR, Genoosha N, Cui M, Guo L. Cross-Cultural Adaptation, Reliability, and Validity of the Chinese Version of the Tampa Scale for Kinesiophobia-11 Among Patients Who Have Undergone Total Knee Arthroplasty. The Journal of Arthroplasty. 2019; 34: 1116–1121.
Correction: Effects of home-based cardiac exercise rehabilitation with remote electrocardiogram monitoring in patients with chronic heart failure: a study protocol for a randomised controlled trial. BMJ Open. 2020; 10: e023923corr1.
Nakayama A, Takayama N, Kobayashi M, Hyodo K, Maeshima N, Takayuki F, et al. Remote cardiac rehabilitation is a good alternative of outpatient cardiac rehabilitation in the COVID-19 era. Environmental Health and Preventive Medicine. 2020; 25: 48.
Field PE, Franklin RC, Barker RN, Ring I, Leggat PA. Cardiac rehabilitation services for people in rural and remote areas: an integrative literature review. Rural and Remote Health. 2018; 18: 4738.
Rathore S, Kumar B, Tehrani S, Khanra D, Duggal B, Chandra Pant D. Cardiac rehabilitation: Appraisal of current evidence and utility of technology aided home-based cardiac rehabilitation. Indian Heart Journal. 2020; 72: 491–499.
Li J, Yang P, Fu D, Ye X, Zhang L, Chen G, et al. Effects of home-based cardiac exercise rehabilitation with remote electrocardiogram monitoring in patients with chronic heart failure: a study protocol for a randomised controlled trial. BMJ Open. 2019; 9: e023923.
Thomas RJ, Beatty AL, Beckie TM, Brewer LC, Brown TM, Forman DE, et al. Home-Based Cardiac Rehabilitation: A Scientific Statement From the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. Journal of the American College of Cardiology. 2019; 74: 133–153.
Bravo-Escobar R, González-Represas A, Gómez-González AM, Montiel-Trujillo A, Aguilar-Jimenez R, Carrasco-Ruíz R, et al. Effectiveness and safety of a home-based cardiac rehabilitation programme of mixed surveillance in patients with ischemic heart disease at moderate cardiovascular risk: A randomised, controlled clinical trial. BMC Cardiovascular Disorders. 2017; 17: 66.
Thomas RJ, Beatty AL, Beckie TM, Brewer LC, Brown TM, Forman DE, et al. Home-Based Cardiac Rehabilitation: A Scientific Statement From the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. Circulation. 2019; 140: e69–e89.
Santiago de Araújo Pio C, Chaves GS, Davies P, Taylor RS, Grace SL. Interventions to promote patient utilisation of cardiac rehabilitation. The Cochrane Database of Systematic Reviews. 2019; 2: CD007131.
Li Z, Hui Z, Zheng Y, Yu J, Zhang J. Efficacy of Phase II Remote Home Rehabilitation in Patients with Acute Myocardial Infarction after Percutaneous Coronary Intervention. Contrast Media & Molecular Imaging. 2022; 2022: 4634769.
Dorje T, Zhao G, Scheer A, Tsokey L, Wang J, Chen Y, et al. SMARTphone and social media-based Cardiac Rehabilitation and Secondary Prevention (SMART-CR/SP) for patients with coronary heart disease in China: a randomised controlled trial protocol. BMJ Open. 2018; 8: e021908.
Fang J, Huang B, Xu D, Li J, Au WW. Innovative Application of a Home-Based and Remote Sensing Cardiac Rehabilitation Protocol in Chinese Patients After Percutaneous Coronary Intervention. Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association. 2019; 25: 288–293.
Bernier J, Poitras MÈ, Lavoie M. Trajectoire et vécu des personnes traitées pour un infarctus du myocarde en région éloignée: étude exploratoire descriptive. Recherche en Soins Infirmiers. 2020; 111–122.
Olgoye AM, Samadi A, Jamalian SA. Effects of a home based exercise intervention on cardiac biomarkers, liver enzymes, and cardiometabolic outcomes in CABG and PCI patients. Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences. 2021; 26: 5.
Nabutovsky I, Nachshon A, Klempfner R, Shapiro Y, Tesler R. Digital Cardiac Rehabilitation Programs: The Future of Patient-Centered Medicine. Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association. 2020; 26: 34–41.
