title: Physical activity increases survival after heart valve surgery.
abstract: Increased physical activity predicts survival and reduces risk of readmission in patients with coronary heart disease. However, few data show how physical activity is associated with survival and readmission after heart valve surgery. Objective were to assess the association between physical activity levels 6-12 months after heart valve surgery and (1) survival, (2) hospital readmission 18-24 months after surgery and (3) participation in exercise-based cardiac rehabilitation.
  
  
  
  Prospective cohort study with registry data from The CopenHeart survey, The Danish National Patient Register and The Danish Civil Registration System of 742 eligible patients. Physical activity was quantified with the International Physical Activity Questionnaire and analysed using Kaplan-Meier analysis and Cox regression and logistic regression methods.
  
  
  
  Patients with a moderate to high physical activity level had a reduced risk of mortality (3 deaths in 289 patients, 1%) compared with those with a low physical activity level (13 deaths in 235 patients, 5.5%) with a fully adjusted HR of 0.19 (95% CI 0.05 to 0.70). In contrast, physical activity level was not associated with the risk of hospital readmission. Patients who participated in exercise-based cardiac rehabilitation (n=297) were more likely than the non-participants (n=200) to have a moderate or high physical activity level than a low physical activity level (fully adjusted OR: 1.52, 95% CI 1.03 to 2.24).
  
  
  
  Moderate to high levels of physical activity after heart valve surgery are positively associated with higher survival rates and participation in cardiac rehabilitation.
authors.affiliation: Department of Physiotherapy and Occupational Therapy, Holbæk Hospital, Holbæk, Denmark National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
authors.forename: K
authors.initials: K
authors.lastname: Lund
authors.affiliation: Department of Cardiology, The Heart Center, Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: K L
authors.initials: KL
authors.lastname: Sibilitz
authors.affiliation: Department of Cardiology, The Heart Center, Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: S K
authors.initials: SK
authors.lastname: Berg
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
authors.forename: L C
authors.initials: LC
authors.lastname: Thygesen
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark Institute of Health Research, University of Exeter Medical School, Exeter, UK.
authors.forename: R S
authors.initials: RS
authors.lastname: Taylor
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark Department of Cardiology, The Heart Center, Rigshospitalet-Copenhagen University Hospital, Copenhagen, Denmark Knowledge Center for Rehabilitation and Palliative Care, National Institute of Public Health, University of Southern Denmark, Odense University Hospital, Odense, Denmark.
authors.forename: A D
authors.initials: AD
authors.lastname: Zwisler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000072038:Cardiac Rehabilitation / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality / Q000534:rehabilitation*; D016009:Chi-Square Distribution; D003718:Denmark; D015444:Exercise; D005081:Exercise Therapy; D005260:Female; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006351:Heart Valves / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D016016:Proportional Hazards Models; D011446:Prospective Studies; D020127:Recovery of Function; D012042:Registries; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult