PURPOSE: This single center cohort study was conducted to document responses of cardiac patients performing combined resistance-endurance training after a cardiovascular event and whether readmission to cardiovascular rehabilitation (CR) is able to achieve equal or increased benefits gained at the end of first discharge of CR.
METHODS: Eighty-three consecutive patients were referred for CR for 26±5 days of residential stay. Readmission to second CR was 439±231 days later. Patients underwent cycle ergometry tests and blood sampling at both admissions and discharges. Cycle ergometry exercise consisted of cycling, 6 times/week, walking for 45 min 5 times/week at 60-70% of the individual maximal heart rate and resistance training 2 times/week.
RESULTS: Increased markers of cardiovascular fitness and decreased risk factors were negatively and significantly impacted after discharge from the first residential CR stay until readmission although medication was unchanged. Body weight, hip and waist circumference, and waist-to-hip ratio increased 2% to 4%, while VO2max and maximal cycling power were reduced 5% to 9% after the first CR discharge. The blood lipids and lipoproteins related to CVD risk measured in our study, cholesterol, LDL-C, and triglyceride concentrations increased 14% to 16% between D1 and A2. Paradoxically, HDL-C was 9% higher at A2. All strength values on the 10 resistance exercises included in this study were reduced 13% to 35% at A2 compared with D1, but of these, only changes in latissimus pull (-22%), leg press (-13%), rowing (-25%), leg curl (-18%), pull-down (-17%), and total weight lifted (-33%) were statistically significant. This demonstrates a substantial loss of muscular strength at the second CR admission from that gained during the first CR stay. All strength values on resistance exercises were reduced at readmission. However, both CR stays resulted in significant improvements in physical fitness and reduced CVD risk status.
CONCLUSION: Absence of supervision after CR resulted in an increase in CVD risk factors and decrease in physical fitness. However, at the end of readmission these risk factors could be significantly reduced again, and lost muscle strength and exercise capacity were regained.