Early hybrid cardiac rehabilitation in congenital heart disease: the QUALIREHAB trial.

Congenital heart defect Exercise therapies Patient education Physical activity Physical fitness Quality of life

Journal

European heart journal

ISSN: 1522-9645

Titre abrégé: Eur Heart J

Pays: England

ID NLM: 8006263

Informations de publication

Date de publication:
02 Mar 2024

Historique:

received: 06 08 2023

revised: 17 01 2024

accepted: 30 01 2024

medline: 2 3 2024

pubmed: 2 3 2024

entrez: 2 3 2024

Statut: aheadofprint

Résumé

Cardiopulmonary fitness in congenital heart disease (CHD) decreases faster than in the general population resulting in impaired health-related quality of life (HRQoL). As the standard of care seems insufficient to encourage and maintain fitness, an early hybrid cardiac rehabilitation programme could improve HRQoL in CHD. The QUALIREHAB multicentre, randomized, controlled trial evaluated and implemented a 12-week centre- and home-based hybrid cardiac rehabilitation programme, including multidisciplinary care and physical activity sessions. Adolescent and young adult CHD patients with impaired cardiopulmonary fitness were randomly assigned to either the intervention (i.e. cardiac rehabilitation) or the standard of care. The primary outcome was the change in HRQoL from baseline to 12-month follow-up in an intention-to-treat analysis. The secondary outcomes were the change in cardiovascular parameters, cardiopulmonary fitness, and mental health. The expected number of 142 patients was enroled in the study (mean age 17.4 ± 3.4 years, 52% female). Patients assigned to the intervention had a significant positive change in HRQoL total score [mean difference 3.8; 95% confidence interval (CI) 0.2; 7.3; P = .038; effect size 0.34], body mass index [mean difference -0.7 kg/m2 (95% CI -1.3; -0.1); P = .022; effect size 0.41], level of physical activity [mean difference 2.5 (95% CI 0.1; 5); P = .044; effect size 0.39], and disease knowledge [mean difference 2.7 (95% CI 0.8; 4.6); P = .007; effect size 0.51]. The per-protocol analysis confirmed these results with a higher magnitude of differences. Acceptability, safety, and short-time effect of the intervention were good to excellent. This early hybrid cardiac rehabilitation programme improved HRQoL, body mass index, physical activity, and disease knowledge, in youth with CHD, opening up the possibility for the QUALIREHAB programme to be rolled out to the adult population of CHD and non-congenital cardiac disease.

Sections du résumé

BACKGROUND AND AIMS OBJECTIVE

METHODS METHODS

The QUALIREHAB multicentre, randomized, controlled trial evaluated and implemented a 12-week centre- and home-based hybrid cardiac rehabilitation programme, including multidisciplinary care and physical activity sessions. Adolescent and young adult CHD patients with impaired cardiopulmonary fitness were randomly assigned to either the intervention (i.e. cardiac rehabilitation) or the standard of care. The primary outcome was the change in HRQoL from baseline to 12-month follow-up in an intention-to-treat analysis. The secondary outcomes were the change in cardiovascular parameters, cardiopulmonary fitness, and mental health.

RESULTS RESULTS

The expected number of 142 patients was enroled in the study (mean age 17.4 ± 3.4 years, 52% female). Patients assigned to the intervention had a significant positive change in HRQoL total score [mean difference 3.8; 95% confidence interval (CI) 0.2; 7.3; P = .038; effect size 0.34], body mass index [mean difference -0.7 kg/m2 (95% CI -1.3; -0.1); P = .022; effect size 0.41], level of physical activity [mean difference 2.5 (95% CI 0.1; 5); P = .044; effect size 0.39], and disease knowledge [mean difference 2.7 (95% CI 0.8; 4.6); P = .007; effect size 0.51]. The per-protocol analysis confirmed these results with a higher magnitude of differences. Acceptability, safety, and short-time effect of the intervention were good to excellent.

CONCLUSIONS CONCLUSIONS

This early hybrid cardiac rehabilitation programme improved HRQoL, body mass index, physical activity, and disease knowledge, in youth with CHD, opening up the possibility for the QUALIREHAB programme to be rolled out to the adult population of CHD and non-congenital cardiac disease.

Identifiants

DOI: 10.1093/eurheartj/ehae085 PMID: 38430485

pubmed: 38430485

pii: 7617843

doi: 10.1093/eurheartj/ehae085

pii:

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Subventions

Organisme : French Ministry of Health

Organisme : French Society of Cardiology

Organisme : French Federation of Cardiology

Organisme : Saint-Pierre Foundation

Organisme : APARD healthcare provider

Investigateurs

Pascal Amedro (P)

Arthur Gavotto (A)

Helena Huguet (H)

Luc Souilla (L)

Anne-Cecile Huby (AC)

Johanna Calderon (J)

Stefan Matecki (S)

Anne Cadene (A)

Gregoire De La Villeon (G)

Marie Vincenti (M)

Oscar Werner (O)

D'Arcy Vandenberghe (D)

Charlene Bredy (C)

Kathleen Lavastre (K)

Hamouda Abassi (H)

Sarah Cohen (S)

Sebastien Hascoet (S)

Claire Dauphin (C)

Aurelie Chalard (A)

Yves Dulac (Y)

Nathalie Souletie (N)

Philippe Acar (P)

Helene Bouvaist (H)

Stephanie Douchin (S)

Matthias Lachaud (M)

Caroline Ovaert (C)

Camille Soulatges (C)

Nicolas Combes (N)

Jean-Benoit Thambo (JB)

Xavier Iriart (X)

Emilie Testet (E)

Fanny Bajolle (F)

Antoine Legendre (A)

Damien Bonnet (D)

Helene Ansquer (H)

Jean-Guillaume Delpey (JG)

Laurence Cohen (L)

Victor Pommier (V)

Remi Vincent (R)

Frederique Sidney-Hetmaniak (F)

Laurent Poirette (L)

Sonia Corone (S)

Cecile Rocca (C)

Marianne Noirclerc (M)

Oxana-Anca Neagu (OA)

Hervé Ngayap-Nemkam (H)

Isaam Kammache (I)

Clara Bourgarde (C)

Jean-Marie Chevalier (JM)

Christelle Pons (C)

Marie-Christine Picot (MC)

Sophie Guillaumont (S)