| 저자 |
Jae-Gyeong Jeong2*, Jae-Eun Lee1, Seung-Hwan Jung2, Hyun-Woo Jung1, Seong-Hun Kim2, Ae-Ryung Kim2†, Jong-Moon Hwang2, Tae-Du Jung1 |
Introduction
Cardiovascular disease (CVD), including acute myocardial infarction (AMI), are a major global health problem. Although the rate of mortality declines with the development of treatment and management strategies for AMI, there is growing interest in CVD prevention and management following AMI. Likewise, the importance of cardiac rehabilitation (CR) in the management and prevention of CVD has been highlighted and is being implemented in many countries.
Several studies show that Left ventricular ejection fraction (LVEF) is used as a prognostic factor for AMI. Commonly, an LVEF ≥ 55 is known as a normal limit. Thus, the purpose of the current study is to investigate the results of CR on physical function according to LVEF values (≥55 vs <55).
Methods
All AMI patients referred to the Cardiac Health and Rehabilitation Center (CHRC) were informed about CR and followed for 2years on an outpatient basis from July 2012 to December 2015. Patients who were divided into a ‘Normal initial LVEF group (≥55)’ and ‘Low initial LVEF group (<55)’. All patients took home-based self-exercise as CR programs of CHRC and some of them received hospital-based supervised exercise training three times a week for 2 months. All patients were evaluated for inbody and physical capacity at baseline, after 2 months of exercise training, and at 6 months, 1 year, and 2 years of follow-up.
Results
General characteristics and baseline CPET of the study group are shown in Table 1. There were no significant differences between the groups for age, sex, weight, body mass index, and RHR. For baseline CPET, there were also no significant differences for physical capacity and exercise tolerance between the groups.
In both group, there were several significant differences point from baseline for VO2max, MET, ET, 3RPE, RPPmax, and in Low EF group, there was significant difference from baseline for HRmax at 2 year. (Table 2.) The patterns of change between the two groups were similar, but there was a no significant group difference by time interaction. In addition, when the two groups were compared at each time point, there were no significant differences.
Discussion
This retrospective study investigated the long-term effects of CR on physical capacity according to LVEF in patients with AMI over a 2-year period. With regards to physical capacity, there were significant differences within the groups for VO2max, MET, ET, 3RPE, RPPmax compared with baseline. This shows that exercise-based rehabilitation for coronary heart disease led to improvement in physical capacity. But there were no significant differences between the groups divided based on LVEF, which indicates that initial LVEF does not reflect the changes of physical capacity in CR patients.
Conclusion
In conclusion, there was a no significant difference in physical capacity according to early LVEF, although, CR was effective in improving exercise capacity even in AMI patients with low LVEF. |
