A study presented at the 2015 New York State Society of Anesthesiologists PostGraduate Assembly found that exercise programs aimed at increasing exercise tolerance before a surgical procedure may decrease morbidity and mortality, as reported by Anesthesiology News.
Ruchir Gupta, MD, an anesthesiology professor at Stony Brook University School of Medicine in New York City, and Michael Roizen, MD, an anesthesiologist with the Cleveland Clinic, searched Medline for the terms "heart rate recovery," "exercise capacity," "maximum O2 consumption," "perioperative outcome" and "physical fitness" used in studies between 1965 and 2015. Of more than 62,000 patients total, more than 36,000 underwent only heart rate recovery testing.
Here are four points:
1. In patients 30 to 39 years of age who had abnormal heart rate recovery, defined as a recovery under 42 bpm, surgery led to subsequent death in 24.3 percent of cases, compared with only 1.2 percent in patients who had a heart rate recovery over 42 bpm.
2. In patients over 60 years of age, those with an abnormal heart rate recovery subsequently died in 52.2 percent of cases, compared with only 19 percent of those with heart rate recoveries considered to be normal.
3. Based on their findings, the authors suggested that after undergoing an exercise capacity test expressed in metabolic equivalents and an assessment of baseline heart rate recovery at one, two and five minutes, patients be divided into three groups: a control group, an exercise group performing at suboptimal levels and an exercise group training at lactate threshold. Patients would then undergo a 12-week intervention training program that uses the Bruce protocol.
4. Dr. Gupta said the next step for the researchers is to incorporate some of the newer studies in this review article and implement an exercise program on a small scale with controlled variables to assess for any benefit of the training program.