Effect of cardiac rehabilitation program on left ventricular systolic and diastolic function in patients with mechanical reperfusion after ST-segment elevation myocardial infarction

Abstract

objective: to assess Effect of cardiac rehabilitation program on left ventricular systolic and diastolic function in patients with mechanical reperfusion after ST-segment elevation myocardial infarction. Study design: prospective controlled trial. Study setting: the cardiac rehabilitation unit of the cardiology department at Ain Shams university hospitals. Patients&methods: 60 patients were divided into two equal groups, (rehab. group) ) which included 30 patients who underwent CRP and (control group) which included 30 patients who were unable to attend structured CRP. transthoracic Doppler and tissue Doppler echocardiography was done all patients before and after the program for evaluation of L.V. systolic and diastolic functions. Results : Rehab. Group showed no significant difference In regarding LVEF% , E wave velocity, E` velocity, A` velocity ,E`/A` ratio or E /E` ratio At follow up while A wave velocity showed a significant increase (pre: 0.69 ± 0.15 m\s post: 0.73 ± 0.13,p.value=0.015) and E /A ratio a significant decrease (pre: 1.17 ± 0.34 vs post :01.09 ± 0.24 ,p. value=0.052). Control group showed no significant difference In echocardiographic indices of L.v. systolic or diastolic function except significantly increase in A` velocity (pre: 0.09 ± 0.03 m\s vs post: 0.10 ±0.03 m\s, p-value=0.016). There was no statistically significant difference between both groups regarding angiographic data(p-value= 0.916 ).the number of active smokers showed a significant regression in rehab group at follow up(p-value=0.032) while in control group showed no significant changes( p-value=0.292),Body mass index showed no statistically significant changes at follow up in both groups(rehab .group :pre30.48±4.72 vs post 30.43±4.66, p. value=0.546 ,control group :pre 30.25 ± 3.91 vs post 30.34 ± 3.72, p. value=0.928) Conclusion: 12 weeks CRP didn`t significantly affect LV systolic or diastolic function in patients with STEMI after revascularization either by PCI or CABG. But it was very effective as regard to smoking cessation as there was a significant reduction in number of active smokers in rehabilitation group at the end of our study. Key words: cardiac rehabilitation program, left ventricular, systolic, diastolic ,mechanical reperfusion , ST-segment elevation, myocardial infarction