Strong correlation between the gain in METs-load and training volumen after a cardiac rehabilitation program

JA Lara-Vargas, Mexican Society for Heart Care (SOMECCOR), Emeritus Fellow; Mexican Society of Cardiology (SMC), Fellow
Carlos A. Palomeque-Ramos, Cardiac Rehabilitation Service, Cardiac Surgery Division, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
José-Ik Yahalcab-Zamora, Cardiac Rehabilitation Service, Cardiac Surgery Division, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Javier E. Pereira-Rodríguez, Centro de Estudios e Investigación FISICOL, Cúcuta, Santander, Colombia
Javier M. Ávalos-Ríos, Cardiofit, Centro de Rehabilitación Cardiaca y Cardiología Deportiva, Mexico City, Mexico
Lidia V. Rodríguez-González, Cardiofit, Centro de Rehabilitación Cardiaca y Cardiología Deportiva, Mexico City, Mexico
EA Leyva-Valadez, Mexican Society for Heart Care (SOMECCOR), Fellow
Mezthly González-Bonilla, Cardiac Rehabilitation Service, Cardiac Surgery Division, Centro Médico Nacional 20 de Noviembre, Mexico City, Mexico
Víctor J. Lastra-Silva, Cardiofit, Centro de Rehabilitación Cardiaca y Cardiología Deportiva, Mexico City, Mexico
Luis Camas-Trujillo, Cardiofit, Centro de Rehabilitación Cardiaca y Cardiología Deportiva, Mexico City, Mexico

Objectives: The cardiac rehabilitation program (CRP) is an interdisciplinary therapeutic strategy that improves cardiovascular fitness (CVFit) with an impact on survival. It is not enough evidence that this gain is associated with the quantification of training volume (TV). Our hypothesis is that this gain in metabolic equivalent of task (METs) depends on exercise training dose. We aim to correlate the level of TV with METs achieved in patients with cardiovascular disease after a CRP. Methods: The CRP program consisted of 3 weekly sessions (30 min session of aerobic [AR] training between 65-85% of the reserve heart rate plus 30 min of kinesiotherapy) and interdisciplinary nutrition, psychology and preventive education care, for 4-6 weeks. METs were evaluated according to the initial and post-CRP exercise test. TV was calculated in each AR session in kcal/wk multiplied by the number of weeks completed. Pearson correlation (r) was performed and was considered positive if r > 0.10 and significant if p < 0.05. Results: Quasi-experimental study with 552 patients, predominantly male (73%), median age 61 years, and average LVEF 43%. METs increased post-CRP, with a median differential (Delta-METs) of 3.09, while the TV median was calculated at 733.53 kcal/wk, with a strong positive correlation between both (r = 0.8867; p < 0.001). Conclusion: The greater the volume of AR resistance training achieved, calculated in kcal/wk, the greater the adaptive gain in CVFit measured in METs. The above makes it essential to carefully calculate TV because the progression of the intensity, duration, and/or frequency of training could help in optimizing the results of a CRP.

Keywords: Training volume. Cardiac rehabilitation. Metabolic equivalent of tasks. Delta-metabolic equivalent of tasks. Cardiovascular disease.