title: Association Between Early Cardiac Rehabilitation and Long-term Survival in Cardiac Transplant Recipients.
abstract: OBJECTIVE
  To determine whether participation in early cardiac rehabilitation (CR) after heart transplant (HTx) affects long-term survival.
  
  
  METHODS
  A retrospective review was conducted in 201 patients who underwent HTx at Mayo Clinic between June 1, 2000, and July 31, 2013. Patients were excluded with multiorgan transplant, no CR data, and follow-up less than 90 days after HTx. Demographic and exercise data at baseline before HTx were collected. Post-HTx exercise capacity, biopsy, CR data, and medications were collected at 1 through 5 and 10 years.
  
  
  RESULTS
  Overall survival at 1, 5, and 10 years was 98%, 88%, and 82%, respectively; 29 patients died. Number of CR sessions attended in the first 90 days after HTx predicted survival in multivariate regression, controlling for baseline post-HTx 6-minute walk test (6MWT) results and rejection episodes (hazard ratio, 0.90; 95% CI, 0.82-0.97; P=.007). Additional univariate predictors of survival included pre-HTx 6MWT results, weight at HTx, and body mass index and systolic blood pressure at CR enrollment. Pre-HTx 6MWT results, body mass index, and post-HTx were associated with improvement in peak oxygen consumption.
  
  
  CONCLUSIONS
  This report demonstrates, for the first time, an association between CR and long-term survival in patients after HTx. Further work should clarify the most beneficial aspects of CR.
authors: Department of Medicine, Mayo Clinic, Rochester, MN.
authors: Andrew N
authors: AN
authors: Rosenbaum
authors: Department of Health Sciences Research, Mayo Clinic, Rochester, MN; William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN.
authors: Walter K
authors: WK
authors: Kremers
authors: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN; William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN.
authors: John A
authors: JA
authors: Schirger
authors: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors: Randal J
authors: RJ
authors: Thomas
authors: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors: Ray W
authors: RW
authors: Squires
authors: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors: Thomas G
authors: TG
authors: Allison
authors: Division of Cardiovascular Surgery, Mayo Clinic, Rochester, MN; William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN.
authors: Richard C
authors: RC
authors: Daly
authors: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN; William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN.
authors: Sudhir S
authors: SS
authors: Kushwaha
authors: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN; William J. von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic, Rochester, MN.
authors: Brooks S
authors: BS
authors: Edwards
mesh_terms: D000328:Adult; D061345:Early Medical Intervention / Q000379:methods*; D005080:Exercise Test / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D016027:Heart Transplantation / Q000009:adverse effects / Q000379:methods / Q000401:mortality / Q000534:rehabilitation; D006801:Humans; D000069451:Long Term Adverse Effects / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010101:Oxygen Consumption; D059035:Perioperative Period / Q000379:methods / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology