Background <p>Exercise training is generally discouraged in patients with severe symptomatic aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) due to safety concerns. However, whole-body vibration (WBV) exercise could offer a novel approach to improve exercise capacity and quality of life, though its effects remain unclear in this population.</p> Methods <p>Thirty patients with AS scheduled for TAVI were prospectively and randomly assigned to either the WBV group (12 sessions, 30&#xa0;min each over 4&#xa0;weeks) or a control group. Assessments of cardiopulmonary exercise testing (CPET), 6-min walking distance (6MWD) and health-related quality of life (HRQoL) questionnaires were conducted at baseline (V1), one day before TAVI (V2) and at short-term follow-up (V3). WBV was conducted between V1 and V2.</p> Results <p>For the analysis at V1 and V2 16 patients in the WBV group and 14 in the control group were included. Mean age was 79.7 ± 5.22&#xa0;years, with a mean aortic valve area of 0.75 ± 0.21 cm<sup>2</sup>. Peak V’O<sub>2</sub> increased by 0.3&#xa0;mL*min<sup>-1</sup>*kg<sup>-1</sup> in the WBV group versus a decrease of − 1.4&#xa0;mL*min<sup>-1</sup>*kg<sup>-1</sup> in the control group (difference, 1.7&#xa0;mL*min<sup>-1</sup>*kg<sup>-1</sup>; 95% CI, [0.2 to 3.2], <i>p</i> = 0.03). Peak power improved by 5.1 W in the WBV group compared to a decline of − 4.5 W in the control group (difference, 9.6 W; 95% CI, [2.1 to 17.1], <i>p</i> = 0.01). The WBV group also showed a non-significant improvement in 6MWD (34&#xa0;m vs. − 8&#xa0;m in the control group; difference, 42&#xa0;m; 95% CI, [-10 to 93], <i>p</i> = 0.11). No serious adverse events occurred in the WBV group.</p> Conclusion <p>This pilot study demonstrated that a WBV exercise program is feasible, safe, and showed potential to preserve exercise capacity as well as physical performance in AS patients scheduled for TAVI.</p> Graphical Abstract <p></p>

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Safety and effectiveness of oscillatory whole-body vibration training on exercise capacity and physical performance in aortic valve stenosis patients prior to transcatheter aortic valve implantation: a randomized clinical trial

  • Johannes Klaus,
  • Felix Gerhardt,
  • Stephan Nienaber,
  • Victor Mauri,
  • Kathrin Möllenhoff,
  • Richard Nies,
  • Elmar Kuhn,
  • Stephen Gerfer,
  • Ilija Djordjevic,
  • Samuel Lee,
  • Henning Guthoff,
  • Christos Iliadis,
  • Stephan Baldus,
  • Christopher Hohmann,
  • Matti Adam,
  • Hendrik Wienemann

摘要

Background

Exercise training is generally discouraged in patients with severe symptomatic aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) due to safety concerns. However, whole-body vibration (WBV) exercise could offer a novel approach to improve exercise capacity and quality of life, though its effects remain unclear in this population.

Methods

Thirty patients with AS scheduled for TAVI were prospectively and randomly assigned to either the WBV group (12 sessions, 30 min each over 4 weeks) or a control group. Assessments of cardiopulmonary exercise testing (CPET), 6-min walking distance (6MWD) and health-related quality of life (HRQoL) questionnaires were conducted at baseline (V1), one day before TAVI (V2) and at short-term follow-up (V3). WBV was conducted between V1 and V2.

Results

For the analysis at V1 and V2 16 patients in the WBV group and 14 in the control group were included. Mean age was 79.7 ± 5.22 years, with a mean aortic valve area of 0.75 ± 0.21 cm2. Peak V’O2 increased by 0.3 mL*min-1*kg-1 in the WBV group versus a decrease of − 1.4 mL*min-1*kg-1 in the control group (difference, 1.7 mL*min-1*kg-1; 95% CI, [0.2 to 3.2], p = 0.03). Peak power improved by 5.1 W in the WBV group compared to a decline of − 4.5 W in the control group (difference, 9.6 W; 95% CI, [2.1 to 17.1], p = 0.01). The WBV group also showed a non-significant improvement in 6MWD (34 m vs. − 8 m in the control group; difference, 42 m; 95% CI, [-10 to 93], p = 0.11). No serious adverse events occurred in the WBV group.

Conclusion

This pilot study demonstrated that a WBV exercise program is feasible, safe, and showed potential to preserve exercise capacity as well as physical performance in AS patients scheduled for TAVI.

Graphical Abstract