Impact of supervised cardiac rehabilitation on urinary albumin excretion in patients with cardiovascular disease

Abstract

Urinary albumin excretion is a predictor of cardiovascular death. Cardiac rehabilitation (CR) with exercise training (ET) has been shown to improve exercise capacity and prognosis in patients with cardiovascular disease (CVD). However, it remains unclear whether CR reduces urinary albumin excretion in CVD patients. We performed a retrospective, observational study using data obtained from 98 male CVD patients without macroalbuminuria and estimated glomerular fltration rate (eGFR) < 30 mL/minute/1.73 m2 who participated in CR with ET during hospitalization. Twenty-three patients continued supervised ET for 6 months (supervised group) and 75 patients quit supervised ET (non-supervised group). The supervised ET program consisted of 60 minutes of supervised sessions 1-3 times a week and 30-60 minutes of home exercise at least twice a week. Urinary albumin/creatinine ratio (ACR) was signifcantly decreased in the supervised group at 6 months after enrollment (43 , 71 mg/g to 17 , 20 mg/g creatinine, P < 0.05) but not in the non-supervised group. eGFR was unchanged in the supervised group but was signifcantly decreased in the non-supervised group (72, 18 mL/minute/1.73 m2 to 67 ± 17 mL/minute/1.73 m2, P < 0.001). The results of multiple regression analysis showed that only supervised ET was an independent contributor to ?ACR. CR with supervised ET decreased urinary albumin excretion without deterioration of renal function. These fndings suggest that continuation of a supervised ET program is associated with reduction in the development of CVD and reduction in cardiovascular morbidity and mortality in CVD patients.