Objective：To determine whether sarcopenia is a factor associated with early quality of life changes after transcatheter aortic valve implantation (TAVI) in order to explore effective cardiovascular physical therapy for patients with aortic stenosis (AS) undergoing TAVI.

Methods：We evaluated sarcopenia based on AWGS criteria 2014, AS status, and physical function before TAVI in 41 patients with AS, and examined the relationship between sarcopenia and QOL changes before and after TAVI.

Results：Sarcopenia was not associated with QOL change but had lower physical function was significantly lower. Multiple regression analysis showed that symptomatology was associated with lower PCS change and improved MCS change as independent factors (adjusted R2：0.149 and 0.115, respectively), but sarcopenia was not.

Conclusion：cardiovascular physical therapy to improve physical quality of life was important in symptomatic patients before TAVI with or without sarcopenia.

Objective：To examine the relationship between hospitalization-acquired functional decline （HAFD） and sleep quality in patients after transcatheter aortic valve implantation （TAVI）.

Methods：This prospective observational study included patients prescribed physical therapy before TAVI between April 2021 and April 2024. HAFD was defined as a postoperative decrease in the Short Physical Performance Battery （SPPB） score by 1 point or more from the preoperative score. Sleep quality was assessed using the Japanese version of The Richards-Campbell Sleep Questionnaire （J-RCSQ） the first to the third day after surgery. Statistical analysis was performed using multivariate logistic regression analysis with HAFD as the dependent variable and the J-RCSQ score, age, physical frailty, preoperative SPPB score, preoperative Mini-Cog score, and postoperative delirium as independent variables. Multivariate logistic regression analysis was performed using two models, a full model and a submodel, including patients with or without postoperative delirium.

Results：The incidence of HAFD was 40.1% （63 of 157 patients）, and the J-RCSQ scores were significantly lower in the HAFD group compared to those in the Non-HAFD group （49.4±32.8 mm vs 63.8±30.8 mm, P＝0.008）. The preoperative SPPPB score in the HAFD group was significantly higher than that in the Non-HAFD group （9.2±2.5 vs 8.1±3.5 points, P＝0.033）. There were no significant differences in the incidence of postoperative delirium between the two groups （10.5% vs. 13.8%, P＝0.612）. The J-RCSQ score on the first postoperative day was a significant independent variable for HAFD in both the full （OR＝0.981, 95%CI：0.967-0.995, P＝0.007） and submodels （OR＝0.982, 95%CI：0.966-0.997, P＝0.018）.

Conclusion：The J-RCSQ score was identified as an independent predictor of HAFD in patients after TAVI.

Aim：To describe physical therapy intervention for a patient with peripartum cardiomyopathy （PPCM） aimed at improving exercise tolerance and facilitating safe return to housework and childcare activities.

Case： A woman in her 30s with no prior cardiac history was admitted for PPCM after delivering her second child. Following heart failure compensation through medication, cardiovascular physical therapy was initiated on the 10th day of hospitalization. The intervention included progressively increased aerobic exercise （initially 10W for 10 minutes on cycling ergometer, advancing to 30W for 20 minutes） and strength training with careful monitoring of postpartum exercise contraindications and circulatory dynamics. Hospital ambulation was gradually increased from 500 to 6000 steps/day. Housework and childcare activities were assessed using weights equivalent to her child’s body weight （5 kg and 10 kg）, with heart rate monitoring to establish safety thresholds. Comprehensive disease management education was provided.

Results： The patients was discharged on hospital day 27 with significant improvements in 6-minute walk distance （436 to 529 m）, left ventricular ejection fraction （26.6% to 53.2%）, heart failure knowledge scale （11 to 15 points）, and psychological status measured by Edinburgh Postpartum Depression Questionnaire （anxiety： 3 to 1 point, depression： 2 to 0 point） improved. Following discharge, she successfully resumed household and childcare responsibilities without heart failure exacerbation.

Conclusion： Physical therapy intervention for patients with PPCM may contribute to improved exercise tolerance and psychological status while preventing rehospitalization for heart failure. This case demonstrates the importance of tailored activity recommendations based on objective measurements to enable safe return to maternal responsibilities.

This study aimed to elucidate the inhibitory effect of postoperative bleeding tendencies on early mobilization after cardiovascular surgery by investigating 101 surgical cases. Based on the mobilization status on postoperative day 1, patients were categorized into those with potential for early mobilization and those facing difficulties. The subgroup facing difficulties was further classified into those with postoperative bleeding tendencies and those with other contributing factors. The results revealed a significant association between postoperative day 1 bleeding tendencies and difficulties in mobilization, particularly when the hemoglobin level was below 8.9 g/dL. However, a comprehensive evaluation considering individual patient conditions and the impact of transfusions and fluids is essential, especially in the context of early mobilization.