Kourek C, Dimopoulos S. Cardiac rehabilitation after cardiac surgery: An important underutilized treatment strategy. World J Cardiol 2024; 16(2): 67-72 [PMID: 38456068 DOI: 10.4330/wjc.v16.i2.67]
Corresponding Author of This Article
Stavros Dimopoulos, MD, PhD, Director, Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, L.A.Syggrou 356, Athens 17674, Greece. stdimop@gmail.com
Research Domain of This Article
Rehabilitation
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Feb 26, 2024; 16(2): 67-72 Published online Feb 26, 2024. doi: 10.4330/wjc.v16.i2.67
Cardiac rehabilitation after cardiac surgery: An important underutilized treatment strategy
Christos Kourek, Stavros Dimopoulos
Christos Kourek, Medical School of Athens, National and Kapodistrian University of Athens, Athens 15772, Greece
Stavros Dimopoulos, Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, Athens 17674, Greece
Stavros Dimopoulos, Clinical Ergospirometry, Exercise & Rehabilitation Laboratory, 1st Critical Care Medicine Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens 10676, Greece
Author contributions: Kourek C and Dimopoulos S contributed to this paper; Dimopoulos S designed the overall concept and outline of the manuscript; Kourek C contributed to the discussion and design of the manuscript; Kourek C and Dimopoulos S contributed to the writing, editing the manuscript, illustrations, and review of literature.
Conflict-of-interest statement: Authors have no conflict of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Stavros Dimopoulos, MD, PhD, Director, Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, L.A.Syggrou 356, Athens 17674, Greece. stdimop@gmail.com
Received: December 10, 2023 Peer-review started: December 10, 2023 First decision: December 19, 2023 Revised: December 21, 2023 Accepted: January 15, 2024 Article in press: January 15, 2024 Published online: February 26, 2024 Processing time: 72 Days and 11.9 Hours
Abstract
Physical inactivity remains in high levels after cardiac surgery, reaching up to 50%. Patients present a significant loss of functional capacity, with prominent muscle weakness after cardiac surgery due to anesthesia, surgical incision, duration of cardiopulmonary bypass, and mechanical ventilation that affects their quality of life. These complications, along with pulmonary complications after surgery, lead to extended intensive care unit (ICU) and hospital length of stay and significant mortality rates. Despite the well-known beneficial effects of cardiac rehabilitation, this treatment strategy still remains broadly underutilized in patients after cardiac surgery. Prehabilitation and ICU early mobilization have been both showed to be valid methods to improve exercise tolerance and muscle strength. Early mobilization should be adjusted to each patient’s functional capacity with progressive exercise training, from passive mobilization to more active range of motion and resistance exercises. Cardiopulmonary exercise testing remains the gold standard for exercise capacity assessment and optimal prescription of aerobic exercise intensity. During the last decade, recent advances in healthcare technology have changed cardiac rehabilitation perspectives, leading to the future of cardiac rehabilitation. By incorporating artificial intelligence, simulation, telemedicine and virtual cardiac rehabilitation, cardiac surgery patients may improve adherence and compliance, targeting to reduced hospital readmissions and decreased healthcare costs.
Core Tip: Cardiac rehabilitation is a medically supervised program designed to maintain or improve cardiovascular health, and should be considered as an important treatment strategy in patients after cardiac surgery. It has multiple beneficial effects on functional capacity, endothelial and skeletal muscle function, and quality of life. Recent advances have been made in cardiac rehabilitation during the last decades, including the use of artificial intelligence, simulation, telemedicine and virtual cardiac rehabilitation that improve compliance. As a result, reduced hospital readmissions and decreased healthcare costs are being observed in the modern healthcare systems.
