| 저자 |
Bo ra Mun1*, Dong Ju Kim1, Min Keun Song1, Hyeng Kyu Park1, Jae Yeong Cho2, Kye Hun Kim2, In Sung Choi1, Jae Young Han1† |
Objective: Echocardiography provides the diagnostic and prognostic information by showing the location and extent of myocardial infarction. A few researches have been conducted on the relationship between echocardiographic parameters and functional exercise capacity, but there is a lack of research on the factors that predict improvement of exercise capacity. Therefore, we aimed to 1) investigate the relationship between echocardiographic parameters and the exercise capacity in patients who participated in cardiac rehabilitation (CR) after acute myocardial infarction (AMI) and 2) determine the echocardiographic parameters that are associated with the change of exercise capacity during 1 year follow-up.
Methods: We retrospectively analyzed 8,735 medical records of Korean Registry of Regional Cardiocerebrovascular Center for Acute Myocardial Infarction (KRAMI) database from July 2016 to September 2018. In this study, 4,476 patients who had undergone a percutaneous coronary intervention (PCI) and had been referred to 11 rehabilitation centers were included. Echocardiography was checked at the time between post-PCI and discharge. Ejection fraction (EF), left ventricular internal dimension in diastole (LVIDd), annular diastolic velocities in septal area (E/e’ septal) and annular diastolic velocities in lateral area (E/e’ lateral) were recorded by cardiac sonographers. Exercise tolerance test was conducted and functional performance scale by Korean Activity Scale/Index (KASI) was checked at 3 assessment points; 1 month (T0), 4 months (T1), 12 months (T2) after AMI attack. ΔValue is used to calculate the change of each exercise capacity and performance scale from values obtained at T0, T1 and T2; ΔValue = (Valuefinal − Valueinitial) / Valueinitial.
Results: ETT was performed in 1,742, 666 and 240 AMI patients at T0, T1 and T2, respectively. KASI was checked in 2,449, 2,136 and 1,372 AMI patients by telesurvey or interview at T0, T1 and T2 (Table 1). Each E/e′ septal and E/e′ lateral showed a negative correlation with METsmax at T0 (r=-0.235, p= 0.000; r =-0.165, p=0.000). E/e′ lateral indicated a moderate negative correlation with KASI at T0 (r=-0.461, p=0.000) (Table 2). When it comes to the relationship between echocardiographic parameters and the change of exercise capacity during 1 year follow-up, E/e′ septal displayed a negative correlation with ΔMETsmax in T2-T0 (r=-0.258, p=0.000). E/e′ lateral was negatively correlated with ΔMETsmax in T2-T0 (r=-0.394, p=0.002) and each ΔKASI in T1-T0 and ΔKASI inT2-T0 (r=-426, p=0.000; r=-0.445, p=0.000) (Table 3).
Conclusion: E/e’ lateral and E/e’ septal might be used as one of the indicators of functional exercise capacity and its change. However, further study would be required to find more predictive echocardiologic parameters correlated with exercise capacity. |
