RESUMO
AIM: The purpose of this study was to clarify whether type 2 diabetic patients with coronary disease are subject to similar benefits on heart rate recovery (HRR) as non-diabetic coronary individuals after cardiac rehabilitation, assessing separately male and female subjects separately. METHODS: Data used for the analyses were from an eight-week phase II cardiac rehabilitation including 284 patients with ischemic heart disease who were managed at Tehran Heart Center between July 2004 and January 2006. The heart rate parameters were compared between diabetic and non-diabetic subjects before and after cardiac rehabilitation. Diabetic and non-diabetic patients had similar age and left ventricular ejection fraction. RESULTS: Among men, non-diabetic patients achieved greater improvement in peak heart rate and HRR. Additionally, lower resting heart rate was found in non-diabetic men after rehabilitation. In women > or = 50 years, there was no significant difference between diabetic and non-diabetic. The non-diabetic women < 50 years showed significantly higher peak heart rate and HRR compared with diabetics women. CONCLUSION: These results indicate that the benefit of cardiac rehabilitation in HRR is significantly lower in type 2 diabetic men. Improvement of HRR is not associated with diabetic status in women > or = 50 years. The response to cardiac rehabilitation in women may appear to be more influenced by age at menopause rather than diabetes mellitus.
Assuntos
Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/reabilitação , Diabetes Mellitus Tipo 2/complicações , Terapia por Exercício/métodos , Frequência Cardíaca , Idoso , Algoritmos , Estudos de Casos e Controles , Estudos de Coortes , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/fisiopatologia , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/fisiopatologia , Feminino , Hospitais de Ensino , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Menopausa , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Sexuais , Estatísticas não ParamétricasRESUMO
AIM: Exercise capacity after training has been reported to improve after cardiac rehabilitation (CR) in patients with coronary artery disease (CAD). The purpose of this study was to evaluate the effect of different sessions of an exercise-based CR program on exercise capacity in CAD patients after elective percutaneous transluminal coronary angioplasty (PTCA). METHODS: In a university hospital, 440 patients who were enrolled in an exercise-based CR program (phase 2) after elective PTCA, were retrospectively evaluated. Two hundred-eighty-six subjects were categorized based on the completion of CR sessions (group A, B and C completing 5, 10 and 24 sessions, respectively). The main outcome measures were exercise training energy expenditure (ETEE) and treadmill velocity of first and last session of CR. Pearson's chi(2) test, Kruskall-Wallis test, paired Student's t test and multivariate analysis were used. RESULTS: All patients showed significant improvements in ETEE and treadmill velocity from baseline to follow-up sessions. A significant group effect on exercise parameters was detected between all the three CR groups (P<0.0001). On follow-up, the ETEE and treadmill velocity had statistically significant correlation with the number of completed sessions, age and gender (P<0.001). CONCLUSION: The present study indicated that improvement in exercise capacity occurs in both gender from baseline to the last session, regardless of clinical characteristics of patients with PTCA. When controlled for other factors, calorie expenditure and treadmill velocity was independently associated with the number of completed sessions, age and gender.
