ABSTRACT
Enhanced external counterpulsation [EECP] is a noninvasive technique used for patients with refractory angina pectoris. There are controversial data on the effectiveness of EECP in improving patients with refractory stable angina. The aim of the present study was to evaluate the effectiveness and safety of EECP for the treatment of patients with refractory angina pectoris. Twenty consecutive patients with refractory angina pectoris were treated with EECP, and their symptoms, echocardiographic measures, treadmill exercise test parameters, and Canadian Cardiovascular Society Class were evaluated before and immediately after EECP. The patients were followed up for 6months post treatment. There were significant differences regarding total exercise time before and after treatment [p value < 0.001]. The patients showed a significant reduction in angina classes III and IV immediately after EECP [p value < 0.001]; for most of the patients, these beneficial effects were sustained for 6 months [p value = 0.010]. There was no significant improvement in the echocardiographic parameters. EECP decreased symptoms and increased total exercise time in our study population. These beneficial effects were sustained for 6 months
Subject(s)
Humans , Female , Male , Counterpulsation , Exercise Test , EchocardiographyABSTRACT
Exercise and rehabilitation are important methods for decreasing the risk factors of coronary artery disease [CAD]. We aimed to evaluate the effect of the cardiac rehabilitation [CR] exercise program on the cardiac structure and physiology in patients undergoing percutaneous coronary intervention [PCI]. In this randomized controlled study, 146 patients with CAD were divided equally into two groups: case group [undertaking CR after PCI] and control group [without rehabilitation after PCI]. All the patients in the case group underwent echocardiography [before and after CR], and echocardiography was performed for the control group simultaneously. The CR exercise program encompassed 24 sessions, twice or three times a week, with each session lasting between 15 and 45 minutes, depending on the individual patient's tolerance. Left ventricular [LV] ejection fraction, LV diastolic function, LV end-systolic and diastolic diameter, and right ventricular [RV] end-diastolic diameter were measured in the CR group before and after rehabilitation and compared to those in the control group at the same times. In this study, 146 patients [46 female and 100 male] were evaluated: 73 in the rehabilitation group and 73 in the control group. The mean age of the patients in the CR and control groups was 58.05 +/- 10.27 and 56.76 +/- 10.07 years, respectively. The CR exercise program had useful effects on LV diastolic function after PCI. The distribution of LV diastolic dysfunction after the CR exercise program was changed significantly only in the CR group [p value = 0.043]. In the CR group, normal, grade I, grade II, and grade III LV diastolic dysfunction were observed in 20.5%, 69.8%, 6.8%, and 2.7%, respectively. This distribution was changed respectively to 30.1%, 61.6%, 5.4%, and 2.7% following CR, which showed a significant improvement due to CR in LV diastolic function, most prominently in the patients with grade I diastolic dysfunction [p value = 0.390]. There was no significant change in LV and RV diameter before and after rehabilitation, while the ejection fraction increased significantly [p value < 0.05] in both groups. The RC exercise program can be effective in the augmentation of LV diastolic dysfunction after PCI, without significant changes in LV diameters
ABSTRACT
Heart rate recovery [HRR] after exercise test and resting heart rate are shown to be important predicitive risk factors for cardiovascular and all-cause mortality in individuals with CVD. Therefore the purpose of this study is comparison of the effects of selected aerobic continues and interval exercise training on resting heart rate and heart rate recovery after 1,2 and 3 minutes in POST CABG patients. Twenty four POST CABG patients [22 men, 2 women with mean age: 57.04 +/- 8.42 and mean BMI: 27.17 +/- 2.98 kg/m2] were divided to a selected aerobic continues training, 30-60 min and intensity of 70-85% of HR maximum [n=12] and an aerobic interval training with three interval [9- 15 min], 27-45 min and intensity of 75-90% of HR maximum [n=12]. They perform the exercise protocols three times per week for 8 weeks. Result of pair T test showed, there are significant differences between pre and post resting heart rate after continues and interval training [respectively, p=0.034, p=0.013]. Continues and interval exercise training have significant effects on heart rate recovery in 1,2 and three minutes after exercise [continues; tl: p=0.049, t2: p=0.033, t3: p=0.005. interval; tl: p=0.033, t2: p=0.038, T3: p=0.018]. Also there are not any significant differences between the effect of continues and interval exercise training on resting heart rate [p-0.311] HRR [tl:0.181, t2: 0.885, t3:953] after program. Both continuous and interval exercise training program improves resting heart rate and HRR minute's 1,2 and 3 in Post CABG patients and there are not any significant differences between two methods. This indicates the positive effects of exercise training on vageus tone and autonomic nervous system
ABSTRACT
Systolic blood pressure recovery [rSBP] is of prognostic value for predicting the survival and co-morbidity rate in patients with coronary artery disease [CAD]. This study investigated the association between rSBP and exercise indices after complete cardiac rehabilitation program [CR] in a population-based sample of patients undergoing coronary artery bypass grafting [CABG]. The sample population consisted of 352 patients who underwent pure CABG. The patients underwent standard symptom-limited exercise testing immediately before and also after the completion of the CR sessions. rSBP was defined the ratio of the systolic blood pressure at 3 minutes in recovery to the systolic blood pressure at peak exercise. An abnormal baseline rSBP after exercise was a strong predictor of exercise parameters in the last session, including metabolic equivalents [beta = -0.617, SE = 0.127, p value < 0.001] and peak O2 consumption [beta = 1.950, SE = 0.363, p value < 0.001] measured in the last session adjusted for baseline exercise characteristics, demographics, function class, and left ventricular ejection fraction. The current study strongly emphasizes the predictive role of baseline rSBP after exercise in evaluating exercise parameters following CR. This baseline index can predict abnormal METs value, peak O2 consumption, post-exercise heart rate, and heart rate recovery after a 24-session CR program
Subject(s)
Humans , Male , Female , Blood Pressure , Exercise , Rehabilitation , Coronary Artery Disease , Coronary Disease , Coronary Artery BypassABSTRACT
Uncompleted Cardiac Rehabilitation [CR] schedule may lead to recurrence of cardiac events and its-related re-hospitalization, decreased quality of life and increased risk of co-morbidities. Current study came to address the effects of a complete exercise-based CR program on physical function and cardiac parameters to clarify whether different sessions could result in better health condition. Data were collected prospectively on 16 consecutive patients who underwent coronary artery bypass graft surgery and enrolled in an exercise-based CR program the charts of the patients who attended 10 sessions of CR were reviewed as the case group [n = 8] and those who participated in at least 20 sessions of program were reviewed as the control group [n = 8]. Both groups received services of a multi-disciplinary CR and cardiac parameters were measured at baseline, as well as at the completion of 10 and 20 sessions. It was revealed significant increases from baseline to fo1lols.-up for metabolic equivalents in both groups after attending CR programs; however increases of this index were higher following 20 sessions adjusted for baseline characteristics. Resting heart rate was significantly decrease in the group underwent completed CR program in the presence of main confounders; however this parameter was significantly unchanged in another group. Participation in complete CR program is necessary to make achieving optimal improvement in vital indices such as metabolic equivalents and resting heart rate and therefore incomplete CR sessions may not warrant this efficacy
ABSTRACT
The objective of this study was to evaluate the effect of a hospital-based cardiac rehabilitation program on heart rate recovery [HRR] in patients who received percutaneous coronary intervention [PCI] or coronary artery bypass grafting [CABG]. Two hundred forty patients, who completed 24 sessions of a cardiac rehabilitation program [phase 2] after PCI [n=62] or CABG [n=178] at the rehabilitation department of Tehran Heart Center were included in the present study. Demographic and clinical characteristics and exercise capacity at baseline and at follow-up were compared between the two groups. The main outcome measurements were: Resting heart rate, peak heart rate, and HRR. All the patients showed significant improvements in heart rate parameters from the baseline to the last sessions. The profile of atherosclerotic risk factors [except for diabetes mellitus] was similar between the PCI and CABG subjects. After eight weeks of cardiac rehabilitation, HRR increased averagely about 17 and 21 bpm among the CABG and PCI patients, respectively [p=0.019]. The results of the present study were indicative of an increase in HRR over 1 minute in patients irrespective of their initial revascularization modality [i.e. PCI or CABG] after the completion of cardiac rehabilitation. Be that as it may, the PCI patients achieved greater improvement in HRR by comparison with the CABG patients