Effects of Cardiac Rehabilitation Program on Obese and Non-Obese Patients with Coronary Artery Disease

Abstract

Cardiac rehabilitation and exercise training have beneficial effects on cardiovascular disease (CVD) risk factors such as improving plasma lipids, insulin sensitivity, exercise capacity, and lowering mortality, most of studies found a significant reduction in risk factors among active coronary artery disease (CAD) patients compared to sedentary patients. The present study was done to assess the effects of cardiac rehabilitation program (CRP) in obese and non-obese patients with CAD after total revascularization either by PCI or CABG. The study was conducted on 60 patients recruited in the period between March; 2015 to December; 2015, from the cardiac rehabilitation clinic in the cardiology department- Ain Shams University Hospital. All study subjects were enrolled in cardiac rehabilitation program for three months twice weekly. All patients were subjected to full history taking and physical examinations, body mass index (BMI) calculations, lipid profile (total cholesterol, TG, HDL, LDL), fasting blood sugar (FBS), trans-thoracic echocardiography, functional capacity obtained from exercise stress test. All above data were taken before and after three months of CRP. The study patients were divided into two groups according to their BMI; BMI ˂ 30 kg/m2 were the non-obese group (29 patients) and BMI ≥ 30 kg/m2 were the obese group (31 patients). Comparing data of the whole cohort before and after CRP, showed significant improvement regarding smoking, BMI, systolic blood pressure(SBP) and diastolic blood pressure (DBP), functional capacity, lipid profile, FBS, left ventricular ejection fraction (LVEF) and left ventricular end systolic dimension (LVESD). In comparison between both groups (obese versus no-obese) at baseline, our study found functional capacity was significantly higher in non-obese patients than in obese patients, and LDL level was significantly higher in obese patients, while there was no significant difference between both groups regarding total cholesterol, TG, HDL, FBS, LVEF, LVESD and LV end diastolic dimension. In obese group, our study found that there was significant improvement in BMI, SBP, DBP, functional capacity, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, FBS at the end of CRP but there was no significant change in LVEF, LVESD, LVEDD. In non-obese group, our study found that there was a significant improvement in BMI, functional capacity, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, FBS, LVEF and LVESD at the end of CRP but there was no significant change in SBP, DBP and LVEDD. So, the present study found that involvement of patients in cardiac rehabilitation program improve their risk factors, functional capacity, lipid profile and echocardiographic parameters and hence cardiac rehabilitation program should be implemented in routine management of patients with coronary artery disease.