The Assessment of Cardiac Rehabilitation on Echocardiographic Parameters of Left Ventricular Systolic Function in Patients Treated by Primary Percutaneous Coronary Intervention due to Acute ST-Segment Elevation Myocardial Infarction: A Randomized Clinical Trial
Article Type:
Research/Original Article (دارای رتبه معتبر)
Abstract:
Background
The exact effects of cardiac rehabilitation on the left ventricular (LV) systolic function have still remained controversial.
Objectives
The aim of this randomized clinical trial was to assess the effects of cardiac rehabilitation on echocardiographic parameters of LV systolic function in patients treated by Primary Percutaneous Coronary Intervention (PPCI) due to acute ST-segment Elevation Myocardial Infarction (STEMI).
Patients and
Methods
After estimating 50 patients as the total sample size according to previous studies and type of the current study, the patients with acute STEMI who were treated by PPCI in our academic centers and had LV ejection fraction (EF) of 35 - 49% were divided into two groups via permuted block randomization method. The first group (n = 25) underwent an 8-week comprehensive cardiac rehabilitation program. Meanwhile, the controls (n = 25) were just instructed on risk factor management. All patients underwent echocardiographic examination during the first week after acute STEMI and 10 weeks later. The measured parameters included LVEF, stroke volume (SV), LV end-diastolic diameter/volume (LVEDD/LVEDV), LV end-systolic diameter (LVESD/LVESV), fractional shortening (FS), LV mass, and mean global longitudinal LV strain (εLL). The SPSS, version 18.0, was used for data analysis and P values less than 0.05 were considered to be statistically significant.
Results
The mean age of the participants was 53.68 ± 6.9, ranging from 38 ± 71 years old; 58% of the patients were men with an approximately similar distribution in both groups. The comparison of changes in variables before and after the rehabilitation period between exercise and control groups illustrated a significant increase in LVEF (mean percentage changes: 13.56 ± 15.98% vs. 2.86 ± 8.46%; P = 0.005) and mean global εLL (16.39 ± 14.97% vs. 2.62 ± 9.98%; P
Conclusions
Early exercise-based cardiac rehabilitation program in patients revascularized by PPCI after acute STEMI could have beneficial effects on LV systolic function with no adverse effect on LV remodeling.
Language:
English
Published:
International Cardiovascular Research Journal, Volume:11 Issue: 4, Dec 2017
Page:
130
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