Left-ventricular function and physical performance on the 6-min walk test in older patients after inpatient cardiac rehabilitation.

OBJECTIVE: The 6-min walk test (6mWT) is widely used to assess physical performance in cardiac rehabilitation settings. Factors affecting the walked distance before starting physical training have been described, whereas information on factors affecting the increase of the walked distance after physical training is still scant. The aim of this study was to verify, in a large sample of elderly patients soon after cardiac surgery, the role of left-ventricular function (LVF) in increases in distances walked after an intensive rehabilitation program. DESIGN: We enrolled 459 patients (300 males and 159 females, mean [+/-SD] age 70 +/- 11 yrs). According to the echographic ejection fraction, patients were classed into two categories, LVF > or = 40% and LVF < 40%. All patients performed the 6mWT at the beginning and end of the rehabilitation program. RESULTS: Longer walked distances before and after the rehabilitation program were significantly associated with preserved or moderately depressed LVF, whereas greater relative increases of the distance walked after the rehabilitation program were significantly associated with poor LVF (P < 0.001 for all). CONCLUSIONS: Among elderly patients admitted as inpatients to an intensive rehabilitation program soon after cardiac surgery, those with poor LVF are most likely to respond more favorably to physical training. Therefore, instead of considering poor LVF a risk for starting physical training in these patients, it should be considered a strong indication, to avoid further physical deconditioning and disability.

Effects of physical activity on blood pressure monitoring and morphometric parameters of the left ventricle and of the abdominal aorta in healthy elderly subjects.

To investigate the effects of physical activity not only on morphometric left ventricular parameters, but also on the abdominal aorta diameter and on blood pressure, we enrolled 100 healthy subjects, 50 males and 50 females, aged between 63 and 91 years (mean 73.3 +/- s.d. 7.7), each divided into two subgroups, sedentary and non sedentary, come to our observation for a diagnostic screening. For each subject an Echography was performed, by using an Acuson 128XP10 apparatus, equipped with a 2 MHz phased array probe, both for the study of the heart and for the study of the abdominal aorta. Then, all the subjects underwent 24 hours blood pressure monitoring by using a P6 Delmar apparatus in order to get mean systolic and diastolic blood pressure. Diastolic blood pressure was significantly related to physical activity (sedentary > non sedentary, P < 0.01), while systolic blood pressure was not; left ventricle and abdominal aorta diameters were both significantly related to sex (males > females, P < 0.001), but left ventricle diameter was significantly related to diastolic blood pressure (P < 0.01), while abdominal aorta diameter was significantly related to systolic blood pressure (P < 0.001). Our data suggest that physical activity might be strongly recommended to control blood pressure.