The effect of cardiac rehabilitation on left ventricular diastolic functions assessed by exercise stress echocardiography in patients with acute coronary syndrome

Yıl 2024, Cilt: 37 Sayı: 1, 37 - 44, 28.01.2024

Fatih Besıroglu Murat Sunbul Beste Ozben Ilker Yagcı Jeyhun Mammadov Nurten Sayar Altug Cıncın Kursat Tıgen Osman Yesıldag Yelda Basaran

https://doi.org/10.5472/marumj.1378522

Öz

Objective: The aim of our study is to investigate the impact of cardiac rehabilitation on left ventricular (LV) diastolic function in acute
coronary syndrome (ACS) patients.
Patients and Methods: Patients were selected consecutively among ACS patients who underwent primary percutaneous intervention
and were found eligible for cardiac rehabilitation program from May 2014 to May 2015. Forty-four patients were included in cardiac
rehabilitation group and recruited to 30 sessions of Phase-3 cardiac rehabilitation program six weeks after discharge. Twenty
consecutive patients were included as control group. LV diastolic functions were assessed by resting and stress echocardiography.
Results: There were not any significant differences in characteristics between the groups. Resting and stress E velocities and resting
lateral e’ velocity significantly increased after rehabilitation program. Left atrial volume index, resting and stress A velocities and
average E/e’ ratios were significantly lower while stress lateral e’ velocity was significantly higher in rehabilitation group after program
compared to controls. The number of patients with diastolic dysfunction decreased after rehabilitation program. Final resting and
stress echocardiography revealed significantly lower frequency of diastolic dysfunction in rehabilitation group.
Conclusion: Cardiac rehabilitation improves diastolic functions in ACS patients, which may be detected by stress echocardiography.

Anahtar Kelimeler

Acute coronary syndrome, Cardiac rehabilitation, Diastolic function, Diastolic stress echocardiography

Kaynakça

• Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics—2015 update: a report from the American Heart Association. Circulation 2015;131:e29-322. doi: 10.1161/CIR.000.000.0000000152.
• Rauch B, Davos CH, Doherty P, et al. The prognostic effect of cardiac rehabilitation in the era of acute revascularization and statin therapy: A systematic review and meta-analysis of randomized and non-randomized studies – The Cardiac Rehabilitation Outcome Study (CROS). Eur J Prev Cardiol 2016;23:1914-39. doi: 10.1177/204.748.7316671181.
• Piepoli MF, Davos C, Francis DP, Coats AJ; ExTraMATCH Collaborative. Exercise training meta-analysis of trials in patients with chronic heart failure (ExTraMATCH). BMJ 2004;328:189. doi: 10.1136/bmj.37938.645220.EE
• McMahon SR, Ades PA, Thompson PD. The role of cardiac rehabilitation in patients with heart disease. Trends Cardiovasc Med 2017;27:420-5. doi: 10.1016/j.tcm.2017.02.005.
• Malfatto G, Branzi G, Osculati G, et al. Improvement in left ventricular diastolic stiffness induced by physical training in patients with dilated cardiomyopathy. J Card Fail 2009;15:327- 3. doi: 10.1016/j.cardfail.2008.10.032.
• Edelmann F, Gelbrich G, Düngen HD, et al. Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction: results of the Ex-DHF (Exercise training in Diastolic Heart Failure) pilot study. J Am Coll Cardiol 2011;58:1780-91. doi: 10.1016/j. jacc.2011.06.054.
• Tokay TS, Yılmaz EF, Eren F, Fak AS, Özdoğan O. The role of myocardial performance index and Nt-proBNP levels as a marker of heart dysfunction in nonalcoholic cirrhotic patients. Marmara Med J 2022; 35: 10-6. doi:10.5472/marumj.1056204
• Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2015;28:1-39. doi: 10.1016/j. echo.2014.10.003.
• Nagueh SF, Smiseth OA, Appleton CP, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2016;29:277-314. doi: 10.1016/j.echo.2016.01.011.
• Dibben GO, Faulkner J, Oldridge N, Rees K, Thompson DR, Zwisler AD, Taylor RS. Exercise-based cardiac rehabilitation for coronary heart disease: a meta-analysis. Eur Heart J 2023;44:452-69. doi: 10.1093/eurheartj/ehac747.
• Møller JE, Pellikka PA, Hillis GS, Oh JK. Prognostic importance of diastolic function and filling pressure in patients with acute myocardial infarction. Circulation 2006;114:438-44. doi: 10.1161/CIRCULATIONAHA.105.601005.
• Lawler PR, Filion KB, Eisenberg MJ. Efficacy of exercise-based cardiac rehabilitation post-myocardial infarction: a systematic review and meta-analysis of randomized controlled trials. Am Heart J 2011;162:571-84. doi: 10.1016/j.ahj.2011.07.017.
• Goel K, Lennon RJ, Tilbury RT, et al. Impact of cardiac rehabilitation on mortality and cardiovascular events after percutaneous coronary intervention in the community. Circulation 2011;123:2344-52. doi: 10.1161/ CIRCULATIONAHA.110.983536.
• Taylor RS, Brown A, Ebrahim S, et al. Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med 2004;116:682-92. doi: 10.1016/j. amjmed.2004.01.009.
• Amundsen BH, Rognmo Ø, Hatlen-Rebhan G, Slørdahl SA. High-intensity aerobic exercise improves diastolic function in coronary artery disease. Scand Cardiovasc J 2008;42:110-7. doi: 10.1080/140.174.30701744477.
• Golabchi A, Basati F, Kargarfard M, Sadeghi M. Can cardiac rehabilitation programs improve functional capacity and left ventricular diastolic function in patients with mechanical reperfusion after ST elevation myocardial infarction?: A double-blind clinical trial. ARYA Atheroscler 2012;8:125-9.
• Hillis GS, Møller JE, Pellikka PA, et al. Noninvasive estimation of left ventricular filling pressure by E/e’ is a powerful predictor of survival after acute myocardial infarction. J Am Coll Cardiol 2004;43:360-7. doi: 10.1016/j.jacc.2003.07.044.
• Acar RD, Bulut M, Ergün S, et al. Does cardiac rehabilitation improve left ventricular diastolic function of patients with acute myocardial infarction? Turk Kardiyol Dern Ars 2014;42:710-6. doi: 10.5543/tkda.2014.76282.
• Wuthiwaropas P, Bellavia D, Omer M, et al. Impact of cardiac rehabilitation exercise program on left ventricular diastolic function in coronary artery disease: a pilot study. Int J Cardiovasc Imaging 2013;29:777-85. doi: 10.1007/ s10554.012.0152-z.
• Soleimannejad K, Nouzari Y, Ahsani A, et al. Evaluation of the effect of cardiac rehabilitation on left ventricular diastolic and systolic function and cardiac chamber size in patients undergoing percutaneous coronary intervention. J Tehran Heart Cent 2014;9:54-8.