Evaluation of the pulse pressure index at the peak of exercise before and after cardiac rehabilitation

As a new supplementary therapeutic option, cardiac rehabilitation (CR) is getting more attention every day. Several studies have proved its positive impact on qualitative criteria; but few studies have been done on quantitative criteria. The purpose of the present study is to evaluate the impact of CR on non-invasive measurement of maximum cardiac output by Pulse Pressure index (PPI) at the peak of exercise.
This is a non-randomized prospective cohort study conducted in Hamadan, Iran in 2015. One hundred eligible patients who had undergone coronary artery bypass surgery participated in our study, after obtaining cardiologist permission and informed consent. The PPI was measured at the peak of exercise before and after standard CR program.
Mean PPI was not significantly different before and after CR. PPI was significantly increased in patients younger than 60 years old (P = 0.022). In contrast to hypertensive patients, PPI increased significantly after CR in non-hypertensive patients (P = 0.002). PPI was significantly increased in non-diabetic patients after CR (P = 0.046), but not in diabetic individuals. Other variables did not show any statistically significant effect on PPI in response to CR.
Findings from our study revealed that PPI is associated with vascular atherosclerosis, as well as cardiac output; Positive effects of CR diminish in older, diabetic and hypertensive patients with more progressive atherosclerosis.