Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Exercise Rehabilitation Improves Cardiac Volumes and Functional Capacity in Patients With Endomyocardial Fibrosis


Sayegh, Ana Luiza Carrari PhD; dos Santos, Marcelo R. PhD; Rondon, Eduardo MSc; de Oliveira, Patricia MD; de Souza, Francis R.; Salemi, Vera M. C. MD, PhD; Alves, Maria-Janieire de N. N. MD, PhD; Mady, Charles MD, PhD

Journal of Cardiopulmonary Rehabilitation and Prevention: November 2019 - Volume 39 - Issue 6 - p 373–380
doi: 10.1097/HCR.0000000000000445
Cardiac Rehabilitation

Purpose: Endomyocardial fibrosis (EMF) is a restrictive cardiomyopathy associated with low functional capacity and high mortality rates. Exercise training has been proved to be a nonpharmacological treatment of cardiovascular diseases. Therefore, the purpose of this study was to determine the effects of exercise rehabilitation in EMF patients.

Methods: Twenty-two EMF patients, functional classes II and III (New York Heart Association [NYHA]), were randomized to the control (C-EMF) or exercise rehabilitation (Rehab-EMF) group. Patients in the Rehab-EMF group underwent 4 mo of exercise rehabilitation, whereas patients in the C-EMF group were instructed to maintain their usual daily routine. Peak oxygen uptake (

O2), cardiac function, and quality of life were evaluated. All assessments were performed at baseline and after 4 mo.

Results: After 4 mo of rehabilitation, peak

O2 increased in the Rehab-EMF group (17.4 ± 3.0 to 19.7 ± 4.4 mL/kg/min, P < .001), whereas the C-EMF group showed no difference (15.3 ± 3.0 to 15.0 ± 2.0 mL/kg/min, P = .87). Also, post-intervention, peak

O2 in the Rehab-EMF group was greater than that in the C-EMF group (P < .001). Furthermore, the Rehab-EMF group, when compared to the C-EMF group, showed an increase in left ventricular end-diastolic volume (102.1 ± 64.6 to 136.2 ± 75.8 mL vs 114.4 ± 55.0 to 100.4 ± 49.9 mL, P < .001, respectively) and decrease in left atrial diastolic volume (69.0 ± 33.0 to 34.9 ± 15.0 mL vs 44.6 ± 21.0 to 45.6 ± 23.0 mL, P < .001, respectively). Quality-of-life scores also improved in the Rehab-EMF group, whereas the C-EMF group showed no change (45 ± 23 to 27 ± 15 vs 47 ± 15 to 45 ± 17, P < .001, respectively).

Conclusion: Exercise rehabilitation is a nonpharmacological intervention that improves functional capacity, cardiac volumes, and quality of life in EMF patients after endocardial resection surgery. In addition, exercise rehabilitation should be prescribed to EMF patients to improve their clinical condition.

Four months of exercise rehabilitation improved functional capacity, left atrial and left ventricular diastolic volumes, and quality of life in patients with endomyocardial fibrosis (EMF). In addition, exercise rehabilitation should be prescribed for EMF patients to improve their clinical condition.

Clinical Unit of Cardiomyopathy, Heart Institute (InCor) (Drs Sayegh and Mady), Cardiovascular Rehabilitation and Exercise Physiology Unit, Heart Institute (InCor-HC-FMUSP) (Drs dos Santos, de Oliveira, and Alves and Messrs Rondon and de Souza), and Clinical Unit of Heart Failure, Heart Institute (InCor) (Dr Salemi), University of São Paulo Medical School, Sao Paulo, Brazil.

Correspondence: Ana Luiza Carrari Sayegh, PhD, Clinical Unit of Cardiomyopathy, Heart Institute, University of São Paulo Medical School, Av. Dr. Eneas de Carvalho Aguiar, 44 Cerqueira Cesar, Sao Paulo, SP 05403-000, Brazil (

The authors declare no conflicts of interest.

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.