Cardiopulmonary exercise testing in cardiac rehabilitation of patients after myocardial infarction

Introduction: Cardiovascular rehabilitation in acute myocardial infarction patients is essential for a safe re-turn to a level of exercise capacity sufficient for daily activities but also has proven effects in reducing car-diovascular mortality and morbidity. In order to con-duct an exercise-based cardiovascular rehabilitation program under optimal conditions, it is important to assess functional capacity by exercise testing before ini-tiating it.

Objective: To establish the usefulness of cardiopulmo-nary exercise testing in the evaluation of acute myocar-dial infarction patients for inclusion in a cardiovascular rehabilitation program.

Methods: Our study included a total of 100 male pati-ents admitted to the Cardiovascular Recovery Clinic of  the Recovery Hospital Iasi, evaluated before the initi-ation of cardiovascular rehabilitation program by car-diopulmonary exercise testing. We assessed the most important functional parameters, including maximum oxygen consumption (VO2 max), oxygen consumption at the anaerobic threshold (AT), respiratory exchange ratio (RER), oxygen pulse (PO). The relation between cardiovascular clinical and pathological profile of pa-tients and changes in ergospirometric parameters was evaluated.

Results: From included subjects, 28% were addressed for cardiovascular rehabilitation after acute myocardial infarction and the others with chronic cardiovascular pathology without acute cardiovascular events. The average age of the study group was 58.4 ± 7.5 years. In cardiopulmonary exercise testing, subjects with acu-te myocardial infarction presented significantly lower VO2 max compared to those in the subgroup witho-ut myocardial infarction (p=0.027) and significantly lower systolic (p=0.012) and diastolic (p=0.03) blood pressure, respectively. In the group of study, 12% of the subjects associated heart failure and presented lower levels of aerobic exercise capacity, AT (p=0.038). Beta-blocker treatment associated significant improvements in VO2 max (p=0.042).

Conclusions: Cardiopulmonary exercise testing plays an important role in assessing patients addressed to cardiovascular rehabilitation after acute myocardial in-farction, allowing the optimization and individualizati-on of exercise-based rehabilitation programs.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)