Impact of Exercise-Based Cardiac Rehabilitation on the Mid-Term Outcomes of Patients After Acute Myocardial Infarction Treated With Current Acute-Phase Management and Optimal Medical Therapy

Kyuno, Etsushi; Iso, Yoshitaka; Tsujiuchi, Miki; Maeda, Atsuo; Miyazawa, Ryo; Kowaita, Hitoshi; Kitai, Hitomi; Sato, Tokutada; Ebato, Mio; Sambe, Takeyuki; Suzuki, Hiroshi

doi:10.1016/j.hlc.2021.03.268

Cited by 4 publications

(4 citation statements)

References 25 publications

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“…Impaired ventilatory efficiency could reflect a higher left ventricular remodeling and neurohormonal activation [46]. Ventilatory efficiency could be improved after CR in patients after AMI as a result of an improved pulmonary and cardiac function during exercise [47].…”

Section: Discussionmentioning

confidence: 99%

Mechanisms of Exercise Capacity Improvement after Cardiac Rehabilitation Following Myocardial Infarction Assessed with Combined Stress Echocardiography and Cardiopulmonary Exercise Testing

Smarż

Jaxa-Chamiec

Zaborska

et al. 2021

JCM

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Cardiac rehabilitation (CR) is indicated in all patients after acute myocardial infarction (AMI) to improve prognosis and exercise capacity (EC). Previous studies reported that up to a third of patients did not improve their EC after CR (non-responders). Our aim was to assess the cardiac and peripheral mechanisms of EC improvement after CR using combined exercise echocardiography and cardiopulmonary exercise testing (CPET-SE). The responders included patients with an improved EC assessed as a rise in peak oxygen uptake (VO2) ≥1 mL/kg/min. Peripheral oxygen extraction was calculated as arteriovenous oxygen difference (A-VO2Diff). Out of 41 patients (67% male, mean age 57.5 ± 10 years) after AMI with left ventricular ejection fraction (LVEF) ≥40%, 73% improved their EC. In responders, peak VO2 improved by 27% from 17.9 ± 5.2 mL/kg/min to 22.7 ± 5.1 mL/kg/min, p < 0.001, while non-responders had a non-significant 5% decrease in peak VO2. In the responder group, the peak exercise heart rate, early diastolic myocardial velocity at peak exercise, LVEF at rest and at peak exercise, and A-VO2Diff at peak exercise increased, the minute ventilation to carbon dioxide production slope decreased, but the stroke volume and cardiac index were unchanged after CR. Non-responders had no changes in assessed parameters. EC improvement after CR of patients with preserved LVEF after AMI is associated with an increased heart rate response and better peripheral oxygen extraction during exercise.

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Section: Discussionmentioning

confidence: 99%

Mechanisms of Exercise Capacity Improvement after Cardiac Rehabilitation Following Myocardial Infarction Assessed with Combined Stress Echocardiography and Cardiopulmonary Exercise Testing

Smarż

Jaxa-Chamiec

Zaborska

et al. 2021

JCM

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“…CPET was performed using cycle or treadmill ergometers in 110 athletes, as previously described [ 9 , 14 ]. The remaining four athletes did not undergo CPET because of sports-related injuries.…”

Section: Methodsmentioning

confidence: 99%

Cardiac Structure and Cardiorespiratory Fitness in Young Male Japanese Rugby Athletes

Iso

Kitai

Ichimori

et al. 2023

JCDD

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Limited data are available on athlete’s heart for rugby athletes. This study aimed to investigate cardiac structure and its relationship with cardiorespiratory fitness in young Japanese rugby athletes. A prospective cross-sectional study using echocardiography and cardiopulmonary exercise testing (CPET) was conducted on 114 male collegiate rugby players. There was a higher prevalence of increased left ventricular (LV), atrial, and aortic dimensions in the young athletes than that in previously published reports, whereas the wall thickness was within the normal range. Anthropometry and CPET analyses indicated that the forwards and backs presented muscular and endurance phenotypes, respectively. Indexed LV and aortic dimensions were significantly larger in the backs than in the forwards, and the dimensions significantly correlated with oxygen uptake measured by CPET. On the four-tiered classification for LV hypertrophy, abnormal LV geometry was found in 16% of the athletes. Notably, the resting systolic blood pressure was significantly higher in athletes with concentric abnormal geometry than in the other geometry groups, regardless of their field positions. Japanese young athletes may exhibit unique phenotypes of cardiac remodeling in association with their fitness characteristics. The four-tiered LV geometry classification potentially offers information regarding the subclinical cardiovascular risks of young athletes.

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“…e difference was not statistically significant (MD � 5.27, 95% CI: −1.18 to 11.73, P � 0.11) (Figure 7). Evidence-Based Complementary and Alternative Medicine been proven to play a positive role in controlling disease risk factors such as coronary heart disease, heart failure, acute myocardial infarction after PCI, and heart transplantation [23,24]. However, few reports are available on patients receiving exercise rehabilitation after RFA, and the rehabilitation effect is still unknown.…”

Section: Changes In the Quality Of Lifementioning

confidence: 99%

Efficacy of Exercise Rehabilitation in Patients with Atrial Fibrillation after Radiofrequency Ablation: A Meta-Analysis of Randomized Controlled Trials

Zhang

Ren

Tang

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Background and Aims. Radiofrequency ablation is a commonly used treatment for paroxysmal atrial fibrillation (AF), but postoperative rehabilitation exercises are needed to reverse left ventricular structural and functional abnormalities. This meta-analysis aimed to evaluate the intervention effect of exercise training in patients with AF after radiofrequency ablation. Methods. A systematic literature search was conducted to identify articles in PubMed, MEDLINE, EMBASE, and the Cochrane Library from January 1, 2010 to December 1, 2021. The mean difference with 95% CI was pooled for continuous variables. We used Review Manager 5.3 for the standard meta-analysis. This study followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results. Ten randomized controlled trials (RCTs) were included, with a total of 892 patients with AF. The quality of one study was grade A, and the rest were grade B. The results of the meta-analysis showed that the improvement of 6 min walking distance (MD = 34.42, 95% CI: 3.20 to 65.63, P = 0.03 ), peak oxygen uptake (MD = 1.96, 95% CI: 1.14 to 2.78, P < 0.001 ), left ventricular ejection fraction (LVEF) (MD = 0.09, 95% CI:0.01–0.17, P = 0.02 ), resting heart rate (MD = −4.50, 95% CI: −8.85 to −0.14, P = 0.04 ), and physical component summary (PCS) (MD = 3.00, 95% CI: 0.46 to 5.54, P = 0.02 ) in the experimental group was significantly better than that of the control group, and the difference was statistically significant. Conclusion. Exercise training can improve the level of exercise endurance and cardiac function in patients. However, the results were limited by the quantity and quality of the studies. Large samples and high-quality studies are still needed to verify its long-term efficacy.

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Impact of Exercise-Based Cardiac Rehabilitation on the Mid-Term Outcomes of Patients After Acute Myocardial Infarction Treated With Current Acute-Phase Management and Optimal Medical Therapy

Cited by 4 publications

References 25 publications

Mechanisms of Exercise Capacity Improvement after Cardiac Rehabilitation Following Myocardial Infarction Assessed with Combined Stress Echocardiography and Cardiopulmonary Exercise Testing

Mechanisms of Exercise Capacity Improvement after Cardiac Rehabilitation Following Myocardial Infarction Assessed with Combined Stress Echocardiography and Cardiopulmonary Exercise Testing

Cardiac Structure and Cardiorespiratory Fitness in Young Male Japanese Rugby Athletes

Efficacy of Exercise Rehabilitation in Patients with Atrial Fibrillation after Radiofrequency Ablation: A Meta-Analysis of Randomized Controlled Trials

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