The non-invasive coronary flow reserve predicts exercise capacity in patients undergoing cardiac rehabilitation - 09/01/21
Résumé |
Background |
The benefit of exercise on peripheral muscles is established but the exact role of the coronary microcirculation in exercise capacity after cardiac rehabilitation (CR) is unclear.
Objective |
Our aim was to test the relationship between non-invasive coronary flow reserve (CFR) and exercise capacity in patients undergoing CR after acute myocardial infarction (AMI).
Methods |
CFR was performed by transthoracic Doppler echocardiography in the left anterior descending artery 24h after angioplasty (CFR1) and after 20 sessions of CR program (at 4±1 months)(CFR2) in 60 consecutive patients (57±11 years, 30% women) with an anterior AMI successfully treated by primary coronary angioplasty. CFR was performed in a modified parasternale view using intravenous adenosine infusion (0.14mg/kg/min within 2minutes). CR program consisted of a half hour of fractioned exercise added of a half hour session of general gymnastics and bodybuilding. To test the exercise capacity, symptom limited exercise echocardiography was performed just after the CFR2, in a semi-supine position, starting at 25 watts, with 20-25 watts increments of workload every two minutes.
Results |
CFR was measured successfully in all patients, and CFR2 was significantly higher than CFR1 (2.9±0.65 vs. 1.9±0.4, P<0.001). Though CFR1 was correlated to left ventricular systolic function and its improvement at follow-up (all, P<0.01), CFR2 was independently related to exercise capacity (mean workload 100±30 watts, percent maximal heart rate 83±12%, no ischemia, no new wall motion abnormalities in all tests) after adjusting for age, sex, and body mass index (r=0.6, P<0.01).
Conclusion |
CFR predicts exercise capacity in patients undergoing a CR program after AMI. The improvement of CFR contributes to cardiac performance.
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Vol 13 - N° 1
P. 117 - janvier 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.