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Cardiac rehabilitation after surgical correction of congenital heart disease in adult patients. Difficult questions

Authors: Dzhitava T.G., Filaretova O.V., Filatova A.G., Danilov T.Yu., Kovalev D.V.

Company: Bakоulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russia Federation

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Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2024-18S-S17-S33

For citation: Dzhitava T.G., Filaretova O.V., Filatova A.G., Danilov T.Yu., Kovalev D.V. Cardiac rehabilitation after surgical correction of congenital heart disease in adult patients. Difficult questions. Creative Cardiology. 2024; 18 (Special Issue): S17–S33 (in Russ.). DOI: 10.24022/1997-3187-2024-18S-S17-S33

Received / Accepted:  07.11.2024 / 02.12.2024

Keywords: congenital heart disease cardiopulmonary exercise testing peak oxygen consumption cardiorespiratory training physical exercise submaximal cardiopulmonary test values

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Abstract

In recent decades, the number of adults with congenital heart disease (CHD) has been increasing, with their population trend surpassing that of pediatric patients. The frequency of repeat and palliative surgeries in this patient category is also on the rise. Throughout their lifetime, adult patients with CHD may develop comorbidities, which heighten the risk of adverse outcomes post-surgery. One of the most crucial tools for risk stratification, surgical prognosis, disease course, and cardiorespiratory fitness is cardiopulmonary exercise testing (CPET). Given the diversity in heart defect anatomy, physiological status, baseline reduced physical capacity, and associated comorbidities, data analysis and interpretation are complex. Additional submaximal variables can serve as significant indicators. The temporal dynamics of key CPET indicators in individual patients have greater prognostic significance.

Controlled exercise is a fundamental component of cardiac rehabilitation programs for patients with CHD. Post most restorative surgeries, exercise improves physical performance and enables patients to achieve normal or near-normal activity levels. Due to the significant heterogeneity among CHD patients, rehabilitation methodology and cardiac rehabilitation in general necessitate diversity, flexible exercise protocols, and a combination of various components.

The expansion of cardiac rehabilitation capabilities today is determined by the development of an interconnected system across all stages: inpatient and outpatient; the expansion of patient educational programs, and tele cardiac rehabilitation. Cardiac rehabilitation stages should be viewed as a continuous process employing interconnected approaches to the organization of each patient’s rehabilitation process.

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About Authors

  • Tamara G. Dzhitava, Cand. Med. Sci., Head of Department; ORCID
  • Olga V. Filaretova, Dr. Med. Sci., Professor of Chair; ORCID
  • Angelina G. Filatova, Doctor of Physical and Rehabilitaion Medicine, Cardiologist; ORCID
  • Timur Yu. Danilov, Dr. Med. Sci., Chief Researcher, Head of Department; ORCID
  • Dmitry V. Kovalev, Dr. Med. Sci., Leading Researcher; ORCID

Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery


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