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08.11.2017 | Original Article

Predictors of improvements in exercise capacity during cardiac rehabilitation in the recovery phase after coronary artery bypass graft surgery versus acute myocardial infarction

verfasst von: Yuji Suzuki, Kenichi Ito, Kazuya Yamamoto, Noriyuki Fukui, Hidetoshi Yanagi, Kazufumi Kitagaki, Harumi Konishi, Tetsuo Arakawa, Michio Nakanishi, Yoichi Goto

Erschienen in: Heart and Vessels | Ausgabe 4/2018

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Abstract

This study aimed to elucidate the predictors of improvements in exercise capacity during cardiac rehabilitation (CR) in the recovery phase after coronary artery bypass graft surgery (CABG) versus acute myocardial infarction (AMI). We studied 152 patients (91 after AMI and 61 after CABG) who participated in a 3-month CR program. All patients underwent a cardiopulmonary exercise test, blood tests, maximal quadriceps isometric strength (QIS) measurement, and bioelectrical impedance body composition measurement at the beginning and end of the 3-month CR program. At baseline, the percentage of predicted peak oxygen uptake (%pred-PVO₂), maximal QIS, and hemoglobin (Hb) were significantly lower, while C-reactive protein (CRP) was significantly higher, in the CABG than the AMI group. After the 3-month CR, %change in PVO₂ (%ΔPVO₂) was significantly greater in the CABG than the AMI group (18 ± 15% vs 11 ± 12%, P < 0.01). At univariate analysis, baseline plasma brain natriuretic peptide (BNP), %change in maximal QIS after CR (%Δ maximal QIS), and change in plasma hemoglobin (ΔHb) significantly correlated with %ΔPVO₂ in the CABG group, whereas only baseline %pred-PVO₂ did so in the AMI group. Multiple regression analysis revealed that the same factors were independent and significant predictors of %ΔPVO₂ in the CABG and AMI groups. The predictors of improvements in exercise capacity after CR differed between patients after CABG or AMI. Specifically, in CABG patients both enhancing QIS and correcting anemia may contribute to greater improvements in exercise capacity after CR, while a more effective CR program should be designed for CABG patients with high baseline BNP.

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Titel: Predictors of improvements in exercise capacity during cardiac rehabilitation in the recovery phase after coronary artery bypass graft surgery versus acute myocardial infarction
verfasst von: Yuji Suzuki
Kenichi Ito
Kazuya Yamamoto
Noriyuki Fukui
Hidetoshi Yanagi
Kazufumi Kitagaki
Harumi Konishi
Tetsuo Arakawa
Michio Nakanishi
Yoichi Goto
Publikationsdatum: 08.11.2017
Verlag: Springer Japan
Erschienen in: Heart and Vessels / Ausgabe 4/2018
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI: https://doi.org/10.1007/s00380-017-1076-2

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Predictors of improvements in exercise capacity during cardiac rehabilitation in the recovery phase after coronary artery bypass graft surgery versus acute myocardial infarction

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