Cardiac rehabilitation in Takotsubo cardiomyopathy: Predictors of utilization and effects of exercise training

• Published in: Heart & lung 2021-03, Vol.50 (2), p.230-234
• Main Authors: Gobeil, Kyle, White, Kevin, Bhat, Anusha, Szalai, Heidi, Lagu, Tara C., Pack, Quinn R.
• Format: Article
• Language: English
• Subjects: Cardiac Rehabilitation; Exercise; Exercise Therapy; Exercise Tolerance; Exercise training; Humans; Takotsubo Cardiomyopathy
• ISSN: 0147-9563; 1527-3288
• DOI: 10.1016/j.hrtlng.2020.12.006

•Cardiac rehabilitation is inconsistently utilized for Takotsubo patients.•Enrollment and adherence to cardiac rehabilitation is low with Takotsubo patients.•Takotsubo patients achieve gains in exercise capacity with cardiac rehabilitation.•Further treatments options are needed for Takotsubo cardiomyopathy patients. Takotsubo cardiomyopathy (TCM) patients may benefit from cardiac rehabilitation (CR). The purpose to this study is to examine utilization of CR in TCM. We conducted a review of hospitalized TCM patients at Baystate Medical Center between 2010 and 2017. We evaluated rates of referral, enrollment, adherence, and changes in exercise capacity. Predictors of CR utilization were analyzed using t-test, chi-square/odds ratio and multivariable hierarchical modeling when appropriate. Over 8 years, 35% of 590 patients with TCM were evaluated by phase I (inpatient) and 13.6% enrolled in phase II (outpatient) CR. Inpatient CR evaluation (OR 21, 95% CI 7–64) and cardiac catheterization (OR 5.7, 95% CI 1.9–17) were strong predictors of outpatient CR participation. Patients enrolling in CR attended 15±14 sessions and increased their exercise capacity by 1.2 METs (95% CI 0.9–1.5). CR is inconsistently used in TCM, despite the potential physiologic benefits of exercise in TCM.