Phase II Cardiac Rehabilitation in NYHA Class II Heart Failure After Mitral Valve Replacement: A Case Report

Fauzia Shafa Rachmania; Farid Rahman; Kadek Agustini Aryani

doi:10.24843/mifi.000001816

Authors

Fauzia Shafa Rachmania Professional Program, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Central Java, Indonesia Author
Farid Rahman Professional Program, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Central Java, Indonesia Author
Kadek Agustini Aryani Integrated Cardiac Service Department, Prof. dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia Author

DOI:

https://doi.org/10.24843/mifi.000001816

Keywords:

Cardiac Rehabilitation, Heart Failure, Mitral Valve Replacement, Exercise Therapy, Six-Minute Walk Test

Abstract

Background: Patients with heart failure following mitral valve replacement (MVR) frequently experience reduced functional capacity and exercise intolerance. Phase II cardiac rehabilitation is recommended to improve aerobic capacity; however, evidence in post-MVR heart failure patients remains limited in real-world settings.

Objective: To evaluate the safety and effectiveness of structured phase II cardiac rehabilitation in a patient with NYHA class II heart failure following MVR.

Methods: This single-case report followed CARE guidelines. A 40-year-old female underwent baseline assessment at week 3 after post-operative stabilization and completed a 4-week supervised rehabilitation program (12 sessions, 3–5 sessions/week). The intervention consisted of FITT-based aerobic exercise (walking, treadmill, ergocycle) at 60–70% HRmax. The primary outcome was the Six-Minute Walk Test (6MWT), while secondary outcomes included metabolic equivalents (METs), Borg scale, heart rate, and blood pressure.

Results: The 6MWT distance increased from 407 m to 438 m (Δ +31 m; +7.6%), approaching the minimal clinically important difference, indicating clinically meaningful improvement. METs increased from 4.6 to 4.9, and Borg scale decreased from 7 to 6, reflecting reduced perceived exertion. Hemodynamic parameters remained stable throughout the intervention, with no adverse events observed.

Conclusion: Phase II cardiac rehabilitation was safe and demonstrated functional improvement in this case of post-MVR heart failure. These findings suggest potential clinical benefits, although further controlled studies are required.