Impact of cardiac rehabilitation on left ventricular diastolic function and exercise capacity in patients treated with percutaneous coronary intervention after acute coronary event.

ABSTRACT

BACKGROUND: Study examines the influence of cardiac rehabilitation program (CR) on left ventricular diastolic dysfunction (LVDD), functional capacity and major cardiovascular risk factors (CVRF) in patients after with PCI resolved acute coronary syndrome (ACS). METHODS: We performed a non-randomised study included a total of 85 subjects after resolved ACS, with left ventricular ejection fraction (LVEF) ≥ 45% and LVDD, without heart failure. Subjects were divided into control (N = 29) and intervention group (N = 56), depending on CR program attendance consisted of exercise training sessions for 12 weeks, 3 times per/week, 30 min per session. Initially and after 12 weeks, patients were subjected to echocardiography to assess LV filling pressure (E/e') as well as CPET to asses improvement in peak VO2. RESULTS: Initially subjects were similar in CVRF, LVDD and CPET parameters (p > 0.05). Following CR, the intervention group demonstrated a significant improvement in E/e' (8.0 ± 3.0 vs 7.0 ± 2.2; p < 0.05), compared to the control group (8.4 ± 3.0 vs 9.0 ± 3.1; p > 0.05), as well as a significant improvement in peak VO2 (23.2 ± 5.0 ml/kg/min vs 24.8 ± 5.8 ml/kg/min; p < 0.001). Control group also exhibited significant worsening in peak VO2 without CR (23.0 ± 4.0 vs 21.2 ± 4.1 ml/kg/min; p = 0.02). CVRF improved in both groups, except for glycaemia levels and body mass index, which improved only in the intervention group (p < 0.001). CONCLUSIONS: Following ACS treated with PCI, CR had a positive effect on major CVRFs, the degree of LVDD and exercise capacity and should be considered as effective tool to reduce morbidity in such patients.