BackgroundThe goal of cardiac rehabilitation programs is not only to prolong life but also to improve physical functioning, symptoms, well-being, and health-related quality of life (HRQL). The aim of this study was to document the long-term effect of a 1-month inpatient cardiac rehabilitation intervention on HRQL in Austria.MethodsPatients (N = 487, 64.7% male, age 60.9 ± 12.5 SD years) after myocardial infarction, with or without percutaneous interventions, coronary artery bypass grafting or valve surgery underwent inpatient cardiac rehabilitation and were included in this long-term observational study (two years follow-up). HRQL was measured with both the MacNew Heart Disease Quality of Life Instrument [MacNew] and EuroQoL-5D [EQ-5D].ResultsAll MacNew scale scores improved significantly (p < 0.001) and exceeded the minimal important difference (0.5 MacNew points) by the end of rehabilitation. Although all MacNew scale scores deteriorated significantly over the two year follow-up period (p < .001), all MacNew scale scores still remained significantly higher than the pre-rehabilitation values. The mean improvement after two years in the MacNew social scale exceeded the minimal important difference while MacNew scale scores greater than the minimal important difference were reported by 40-49% of the patients.Two years after rehabilitation the mean improvement in the EQ-5D Visual Analogue Scale score was not significant with no significant change in the proportion of patients reporting problems at this time.ConclusionThese findings provide a first indication that two years following inpatient cardiac rehabilitation in Austria, the long-term improvements in HRQL are statistically significant and clinically relevant for almost 50% of the patients. Future controlled randomized trials comparing different cardiac rehabilitation programs are needed.

These findings provide evidence that the improvements in HRQL and risk factors following cardiac rehabilitation in Austria are clinically important. HRQL should become a standard outcome parameter in cardiac rehabilitation.

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Eight women and 4 men, mean age 71.1 years, examined by a clinical check-up participated in a bicycle ergometer training program (12 weeks with 3 training sessions per week). Symptom limited ergometric bicycle tests were performed before and after the training period. The training work load was continuously controlled by maintaining the training heart rate according to 60% of the maximum work load of the first test. To hold the training heart rate (HR) on a constant level the work load had to be increased systematically during the whole training period up to 180% of the level at the beginning. The working time in each training session was increased from 2 X 10 mm at the beginning up to 2 X 20 min after the sixth week. The maximum work load (+ 16%) and the maximum oxygen uptake (+ 11%) increased significantly. The submaximal HR decreased significantly. In contrast there was no significant difference in maximum HR and maximal change of base excess between the initial exercise test and the control study at the end of the training program. This indicates that the increased exercise capacity represents a real endurance training effect and not only an increase in the degree of exhaustion. We conclude that also in healthy people between 67-76 years a significant endurance effect is possible when the training work load and training time is increased systematically according to the rules of training sciences.