The impact of mitral regurgitation grade on exercise capacity following cardiac rehabilitation program after transcatheter aortic valve implantation

Abstract Introduction Severe aortic stenosis (AS) and mitral regurgitation (MR) often coexist. Transcatheter valve implantation (TAVI) is becoming widely used for the treatment of patients (pts) with symptomatic severe AS. However, conflicting data reside concerning impact MR on outcomes after TAVI. Also, very few exist regarding benefits a cardiac rehabilitation program (CRP) following TAVI in pts MR. Purpose To evaluate effect CRP functional parameters TAVI, particularly grade ≥ II. Methods Retrospective study which included all submitted to between 2014 2020 that completed procedure. Cardiopulmonary exercise tests (CPET) were performed at baseline (pre-CRP) post-CRP. We evaluated pre- post-CRP peak oxygen consumption (pVO2), pVO2 anaerobic threshold (AT), respiratory exchange ratio (RER), VE/VCO2 CPET duration. The protocol low/medium intensity exercises consisted sessions 3 times per week carried over months. grading severity was assessed transthoracic echocardiography divided into 2 groups (grade < II vs II). Results Fifty-two included, 59,6% male, mean age 78,6±8,6 years-old. Mean Society Thoracic Surgery (STS) risk score 4,9. pre-TAVI area 0,68 cm2, gradient 45,5 mmHg ejection fraction (EF) 51%. majority implanted self-expandable prosthesis (55,8%). Twenty-seven (51,9%) had Baseline characteristics similar II, exception prevalence coronary artery disease higher (p=0,036). Patients maximum median gradients before (p<0,05 all). number 21±7, without differences both groups. In there an improvement duration (HF from 03:57 min 05:02 min; p=0,017 modified Bruce 06:03 06:41 p=0,049) but significant changes (14,7 mL/kg/min 14,9 mL/kg/min; p=0,990), RER or VEVCO2/VO2 ratio. significantly improved (13,8 14,7 p=0,015), HF 05:04 06:23 p=0,006 CRP. There also ratio, although not statically significant. Conclusions who underwent Although did CRP, may translate clinical benefit these pts. These results highlight importance further research personalization among this potentially subset FUNDunding Acknowledgement Type funding sources: None.