Assessment of the Heart's Left and Right Ventricles (EF and TAPSE) in CABG Surgery Patients before and after Cardiac Rehabilitation

Abstract

Background: Post-coronary artery bypass grafting (post-CABG) is a beneficial procedure for cardiac patients. However, without an appropriate cardiac rehabilitation (CR) program, patient care may be inadequate, leading to recurrent hospitalizations and heart failure. This study aims to assess the effects of a CR program on left ventricular ejection fraction (LVEF) and tricuspid annular plane systolic excursion (TAPSE) measures in post-CABG patients at Amir-almomenin, kordkuy Hospital, Golestan, Iran. Methods: This descriptive-analytic study included 100 patients who underwent post-CABG surgery in the second half of 2020, and whose complete information was available in their medical files. An echocardiologist assessed the LVEF and TAPSE of the patients. After one month of CR procedures, these measures were reevaluated and recorded. The CR program consisted of 5 to 10 sessions of physiotherapy per patient, with 2 or 3 sessions conducted per week. It involved a four-phase therapy that included light sports activities such as running and jogging on a treadmill at a CR clinic. Data analysis was performed using SPSS software version 18. Results: The data analysis of this study suggests that implementing a CR program for post- CABG patients can have beneficial effects. CR significantly increased the patients' LVEF, but the increase in TAPSE was not statistically significant. Furthermore, both male and female patients showed improved LVEF after the CR program. There was a non-significant inverse relationship between hospitalization duration and LVEF. Statistically, older patients had a significantly longer duration of hospitalization compared to younger patients. Conclusion: Completion of a cardiac rehabilitation program leads to significant improvement in left ventricular function, while the improvement in right ventricular function is relatively modest. Moreover, a significant proportion of patients were able to resume their normal daily activities after completing the rehabilitation phase.

Sex differences in the physiological responses to cardiac rehabilitation: a systematic review

“…Adherence was 70% for men and 68% for women 12 t-test and ANCOVA Weinberger 2014 [ 86 ] Patients with PTCA, CABG, MI, valve replacement, CAD, CHF, angina or cardiomyopathy n = 1138 (843 men, 295 women) Not described ≥ 7weeks; average 11 weeks CR completion: 49% Adherence was 11.5 weeks for men and 11.4 weeks for women 12 Other (Logistic regression) Willenheimer 1998 [ 38 ] Patients with HF and ejection fraction < 45% n = 33 (27 men, 6 women) Aerobic 16 Weeks CR completion: 91% Adherence for men was 78% and for 67% women 12 t-test Wise 2012 [ 51 ] Patients with CHF (NYHA level I-III) also diagnosed with CAD, cardiomyopathy, valvular disease, and or/tachycardia n = 232 (172 men, 60 women) Aerobic and Strength 12 Weeks + median of 4 extra weeks CR completion: 100% All patients attended at least 40% of sessions. 11 Other (Wilcoxon) Zahedi 2022 [ 74 ] Patients with MI and PCI n = 30 (23 men, 7 women) Aerobic 5 Weeks CR completion: 100% 9 Other (Wilcoxon) Zahedi 2023 [ 73 ] Patients with CABG n = 100 (67 men, 33 women) Aerobic 4 weeks CR completion: 100% 11 Other (Wilcoxon) …”

“…Eight studies comparing left ventricular ejection fraction in HD patients reported equal improvements between the sexes or no improvements at all after CR [ 28 , 32 , 49 , 50 , 52 , 71 – 73 ] with a single study finding that men improved to a greater degree than women (only 5 weeks of CR) [ 74 ]. While three studies investigating HR at rest showed a greater improvement in men after CR [ 49 , 72 , 75 ], the majority of the articles investigating HR at rest showed no sex difference or no improvement in either sex [ 27 , 28 , 30 , 31 , 39 , 47 , 50 , 57 , 59 , 64 , 71 , 76 – 80 ].…”