Does cardiac rehabilitation improve left ventricular diastolic function of patients with acute myocardial infarction? 2014

Rezzan Deniz Acar, and Mustafa Bulut, and Sunay Ergün, and Mahmut Yesin, and Hayati Eren, and Mustafa Akçakoyun
Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, İstanbul, Turkey. denizacar_1999@yahoo.com.

OBJECTIVE We aimed to observe the effect of cardiac rehabilitation (CR) on left ventricular diastolic function in patients with acute myocardial infarction (AMI) and revascularization by percutaneous coronary intervention (PCI). METHODS 82 patients were enrolled the study; 42 who were participating in a CR program, and 40 who did not maintain the program as a control group. Measurements of mitral inflow included the peak early filling (E-wave) and late diastolic filling (A-wave) velocities, the E/A ratio, deceleration time (DT) of early filling velocity and mitral A-wave duration. The early diastolic annular velocity has been expressed as e' with PW tissue Doppler imaging. The mitral inflow E velocity to tissue Doppler e' (E/e') was calculated and isovolumic relaxation time (IVRT) was measured. Measurements of pulmonary venous waveforms included peak systolic (S) velocity, peak anterograde diastolic (D) velocity and the time difference between the duration of the atrial reversal (Ar) and mitral A-wave duration (Ar-A). RESULTS E/A and septal e' were better with the CR group than the control group. (p=0.048 vs p=0.006 respectively). The difference between E/e' measurements were not statistically significant (p=0.138). The left ventricular diastolic function of patients were partially improved with cardiac rehabilitation. There was no association between infarct-related artery (IRA) and diastolic functional measurements of the left ventricle in the individuals. Only hypertension was found significantly associated with E/A (p=0.000). CONCLUSIONS CR improves septal e' and E/A significantly in patients with AMI and revascularized successfully by PCI, especially in those with hypertension.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009203 Myocardial Infarction NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION). Cardiovascular Stroke,Heart Attack,Myocardial Infarct,Cardiovascular Strokes,Heart Attacks,Infarct, Myocardial,Infarction, Myocardial,Infarctions, Myocardial,Infarcts, Myocardial,Myocardial Infarctions,Myocardial Infarcts,Stroke, Cardiovascular,Strokes, Cardiovascular
D003971 Diastole Post-systolic relaxation of the HEART, especially the HEART VENTRICLES. Diastoles
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013318 Stroke Volume The amount of BLOOD pumped out of the HEART per beat, not to be confused with cardiac output (volume/time). It is calculated as the difference between the end-diastolic volume and the end-systolic volume. Ventricular Ejection Fraction,Ventricular End-Diastolic Volume,Ventricular End-Systolic Volume,Ejection Fraction, Ventricular,Ejection Fractions, Ventricular,End-Diastolic Volume, Ventricular,End-Diastolic Volumes, Ventricular,End-Systolic Volume, Ventricular,End-Systolic Volumes, Ventricular,Fraction, Ventricular Ejection,Fractions, Ventricular Ejection,Stroke Volumes,Ventricular Ejection Fractions,Ventricular End Diastolic Volume,Ventricular End Systolic Volume,Ventricular End-Diastolic Volumes,Ventricular End-Systolic Volumes,Volume, Stroke,Volume, Ventricular End-Diastolic,Volume, Ventricular End-Systolic,Volumes, Stroke,Volumes, Ventricular End-Diastolic,Volumes, Ventricular End-Systolic
D015150 Echocardiography, Doppler Measurement of intracardiac blood flow using an M-mode and/or two-dimensional (2-D) echocardiogram while simultaneously recording the spectrum of the audible Doppler signal (e.g., velocity, direction, amplitude, intensity, timing) reflected from the moving column of red blood cells. Doppler Echocardiography,Echocardiography, Continuous Doppler,Echocardiography, Two-Dimensional Doppler,2-D Doppler Echocardiography,2D Doppler Echocardiography,Continuous Doppler Echocardiography,Doppler Echocardiography, 2-D,Doppler Echocardiography, 2D,Doppler Echocardiography, Continuous,Doppler Echocardiography, Two-Dimensional,Echocardiography, 2-D Doppler,Echocardiography, 2D Doppler,Two-Dimensional Doppler Echocardiography,2 D Doppler Echocardiography,Doppler Echocardiography, 2 D,Doppler Echocardiography, Two Dimensional,Echocardiography, 2 D Doppler,Echocardiography, Two Dimensional Doppler,Two Dimensional Doppler Echocardiography
D015906 Angioplasty, Balloon, Coronary Dilation of an occluded coronary artery (or arteries) by means of a balloon catheter to restore myocardial blood supply. Angioplasty, Coronary Balloon,Angioplasty, Transluminal, Percutaneous Coronary,Coronary Angioplasty, Transluminal Balloon,Percutaneous Transluminal Coronary Angioplasty,Balloon Dilation, Coronary Artery,Transluminal Coronary Balloon Dilation,Angioplasties, Coronary Balloon,Balloon Angioplasties, Coronary,Balloon Angioplasty, Coronary,Coronary Balloon Angioplasties,Coronary Balloon Angioplasty
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes

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