The Effect of Cardiac Rehabilitation Exercise Training on Cardiopulmonary Function in Ischemic Cardiomyopathy With Reduced Left Ventricular Ejection Fraction

Abstract

ObjectiveTo observe the effect and safety of cardiac rehabilitation (CR) exercise in ischemic cardiomyopathy and to compare the results between patients with preserved left ventricular ejection fraction (LVEF) and reduced LVEF.MethodsPatients with ischemic cardiomyopathy with LVEF <50% were included as subjects. The patients were classified into the preserved LVEF (pLVEF; LVEF 41%–49%) group and the reduced LVEF (rLVEF; LVEF ≤40%) group. Patients underwent hourly aerobic exercise training sessions with an intensity of 60%–85% of heart rate reserve, three times a week for 6 weeks. Graded exercise test and transthoracic echocardiogram were performed in all study patients before and after completion of the CR exercise program.ResultsAfter completion of the CR exercise program, both groups (pLVEF, n=30; rLVEF, n=18) showed significant increases in LVEF and VO2max. In the pLVEF group, LVEF and VO2max increased from 45.1%±4.8% to 52.5%±9.6% (p<0.001) and from 24.1±6.3 to 28.1±8.8 mL/kg/min (p=0.002), respectively. In the rLVEF group, LVEF and VO2max increased from 29.7%±7.7% to 37.6%±10.3% (p<0.001) and from 17.6±4.7 to 21.2±5.1 mL/kg/min (p<0.001), respectively. Both groups completed their exercise program safely.ConclusionIn both groups, patients with ischemic cardiomyopathy who completed a 6-week supervised CR exercise program demonstrated remarkable improvements in cardiopulmonary function. This result implies that neither of the two groups showed higher efficacy in comparison to each other, but we can conclude that CR exercise in the rLVEF group was as effective and safe as that in the pLVEF group.

Different outcomes of a cardiac rehabilitation programme in functional parameters among myocardial infarction survivors according to ejection fraction

“…Although the importance of EBCR after an AMI is well established, several factors which pertain to its optimal application have not yet been fully ascertained [11, 12, 17]. Importantly, AMI survivors with a reduced ejection fraction (EF) represent a higher-risk subgroup [3] and in some series are referred less often for these programmes [8, 18, 19]. Additionally, the impact of EBCR across different ranges of EF has been the focus of heightened interest [8, 19].…”

“…Importantly, AMI survivors with a reduced ejection fraction (EF) represent a higher-risk subgroup [3] and in some series are referred less often for these programmes [8, 18, 19]. Additionally, the impact of EBCR across different ranges of EF has been the focus of heightened interest [8, 19]. This stems from the fact that, although there are currently numerous parameters of potential interest in the prognostic assessment after an AMI, EF remains the most important parameter in terms of clinical decision-making and overall prognosis [3, 20].…”

“…This stems from the fact that, although there are currently numerous parameters of potential interest in the prognostic assessment after an AMI, EF remains the most important parameter in terms of clinical decision-making and overall prognosis [3, 20]. Among the higher-risk subset of patients with a reduced EF, optimising strategies to reduce residual risk are of paramount relevance [2, 7, 19, 21].…”

Efficacy of risk stratification protocols and clinical, physical, and biochemical parameters to previse signals and symptoms during cardiovascular rehabilitation programs

“…The sample size was based on rMSSD index [36] because it presents the highest sample number necessary for this study, compared with the other main variables [6 minutes walking test [37] and tumor necrosis factor (TNF)-alpha [38] ]. A standard deviation of 17 ms, alpha risk of 5%, and beta of 80% was considered for the calculus, which resulted in 44 subjects.…”

The Beneficial Role of Exercise Training for Myocardial Infarction Treatment in Elderly

“…In a cohort study, 37 patients (mean age, 66 years) with MI underwent a 5-week CR program, and the results indicated that cardiac rehabilitation improved QoL, exercise capacity, and autonomic modulation (Fallavollita et al, 2016). Kim et al suggested that a 6-week CR exercise program with an intensity of 60-85% heart rate reserve improved cardiopulmonary function in patients with ischemic cardiomyopathy (Kim et al, 2016). Patients with a home-based walking program showed an obvious improvement of functional capacity, increasing their inspiratory muscle endurance (PTHmax) and maximal inspiratory pressure (MIP) in 15 and 60 days following MI (Matos-Garcia et al, 2017).…”