scholarly journals Cardiac Rehabilitation and Physical Performance in Patients after Myocardial Infarction: Preliminary Research

2021 ◽  
Vol 10 (11) ◽  
pp. 2253
Author(s):  
Agnieszka Grochulska ◽  
Sebastian Glowinski ◽  
Aleksandra Bryndal
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Rehabilitation ◽  
Physical Performance ◽  
Stress Test ◽  
Maximal Oxygen Consumption ◽  
Exercise Stress Test ◽  
Health Condition ◽  
Exercise Stress ◽  
Test Time ◽  
Before And After

(1) Background: Cardiovascular diseases, in particular, myocardial infarction (MI), are the main threats to human health in modern times. Cardiac rehabilitation (CR), and especially increased physical activity, significantly prevent the consequences of MI. The aim of this study was to assess physical performance in patients after MI before and after CR. (2) Methods: 126 patients after MI were examined. They were admitted to the cardiac rehabilitation ward twice: in the 3rd month after MI, and then in the 6th month after the last rehabilitation session. CR lasted 20 treatment days (4 weeks with 5 treatment days and 2 days’ break). The exercise stress test on the treadmill and a 6-minute walk test (6MWT) were used to assess physical performance. Patients were assigned to an appropriate rehabilitation model due to their health condition. (3) Results: In the studied group, the exercise stress test time and the metabolic equivalent of task (MET), the maximal oxygen consumption (VO2max), and 6MWT score increased significantly (p = 0.0001) at two time-points of observation. (4) Conclusion: CR significantly improves physical performance in patients after MI.

P331Effect of exercise stress test on platelet function in patients with recent acute myocardial infarction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Dalcoquio ◽  
M A Santos ◽  
L S Alves ◽  
F B B Arantes ◽  
L Ferreira-Santos ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Platelet Function ◽  
Stress Test ◽  
Area Under The Curve ◽  
Exercise Stress Test ◽  
Cardiopulmonary Exercise Test ◽  
Exercise Stress ◽  
Platelet Aggregability ◽  
Cardiopulmonary Exercise

Abstract Background Exercise-based cardiac rehabilitation for coronary artery disease (CAD) is associated with lower cardiovascular mortality. On the other hand, acute strenuous exercise has been linked to cardiovascular complications such as acute myocardial infarction (AMI) and sudden cardiac death. One of the pathophysiological mechanisms involved in these outcomes might be an increase in platelet aggregability after exercise. Although previous studies showed higher platelet aggregability after exercise among stable CAD patients on aspirin treatment, there is no data regarding the effect of exercise on platelet activity in post-AMI patients on dual anti-platelet therapy (DAPT). Purpose To evaluate the effect of high-intensity exercise on platelet aggregability in sedentary post-AMI patients on DAPT. Methods Platelet function was analyzed immediately before and after maximal cardiopulmonary exercise test (CPET) on cycle ergometer utilizing a personalized ramp protocol and aiming to achieving peak exercise in around 10 min. The CPET was done within 31±4 days after uncomplicated AMI. Platelet aggregability was assessed by Multiplate®ADPtest (MP-ADP) and Multiplate® ASPItest (MP-ASPI) measured as area under the curve (AUC). Reticulated platelets were measured concomitantly to MP-ADP e MP-ASPI using a fully automated flow cytometer (Sysmex XN-2000®) to determine absolute immature platelet count (IPC) per 103/microliter. Continuous variables were expressed as means ±standard deviation or as median and 25th–75th percentiles if not Gaussian distributed. Comparisons between the pre- and post-CPET assessments were performed using Wilcoxon signed rank test. Results We analyzed 81 sedentary patients (mean age 58.3±10.1 years-old, 76.5% men) after AMI (50.6% with ST-elevation myocardial infarction, mean left ventricular ejection fraction after index event 55±11.7%, 98.8% on statin and 85.5% on beta-blocker treatment). Platelet aggregability, either by MP-ADP or MP-ASPI, and IPC were significantly increased after CPET (table). Platelet function after CPET Before CPET After CPET p-value Multiplate® ADPtest (AUC) – median (25th–75th percentiles) 32.0 (22.0–48.5) 37.0 (26.0–55.2) 0.003 Multiplate® ASPItest (AUC) – median (25th–75th percentiles) 17.0 (12.7–22.0) 22.0 (16.7–28.0) <0.001 Immature platelet count (103/microliter) – median (25th–75th percentiles) 9.5 (6.8–13.8) 9.6 (6.6–16.5) 0.006 CPET: cardiopulmonary exercise test; AUC: area under the curve. Conclusion On this post-AMI population, platelet was hyperactivated after exercise stress test despite the use of DAPT. These findings suggest that, even when properly treated, post-AMI patients might be at higher risk of ischemic complications after high-intensity exercises, reinforcing the importance of tailoring exercise prescription in this population. Acknowledgement/Funding Sao Paulo Research Foundation, FAPESP

Exercise performance in children and adolescents after the Ross procedure

2006 ◽  
Vol 16 (1) ◽  
pp. 40-47 ◽  
Author(s):  
Bradley S. Marino ◽  
Sara K. Pasquali ◽  
Gil Wernovsky ◽  
John R. Bockoven ◽  
Michael McBride ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Exercise Performance ◽  
Stress Test ◽  
Ideal Body Weight ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Ross Procedure ◽  
Stress Tests ◽  
Primary Indication ◽  
Before And After

Objectives:The Ross procedure is increasingly utilized in the treatment of aortic valvar disease in children and adolescents. Our purpose was to compare pre- and post-operative exercise state in this population.Methods:We included patients who underwent the Ross procedure at our institution between January, 1995, and December, 2003, and in whom we had performed pre- and post-operative exercise stress tests. We used a ramp bicycle protocol to measure consumption of oxygen and production of carbon dioxide. Cardiac output was estimated from effective pulmonary blood flow by the helium acetylene re-breathing technique.Results:We studied 26 patients, having a median age at surgery of 15.7 years, with a range from 7.5 to 24.1 years. The primary indication for surgery in two-thirds was combined aortic stenosis and insufficiency. Median time from the operation to the post-operative exercise stress test was 17.4 months, with a range from 6.7 to 30.2 months. There was a trend toward lower maximal consumption of oxygen after the procedure, at 36.3 plus or minus 7.6 millilitres per kilogram per minute (83.9% predicted) as opposed to 38.6 plus or minus 8.4 millilitres per kilogram per minute (88.5% predicted, p equal to 0.06). Patients after the procedure, however, had significantly increased adiposity, so that there was no difference in maximal consumption of oxygen indexed to ideal body weight before and after the operation. In 20 of the patients, aerobic capacity improved or was stable after the operation. There was no post-operative chronotropic impairment.Conclusions:In the majority of patients following the Ross procedure, exercise performance is stable and within the normal range of a healthy age and sex matched population, despite sedentary lifestyles and increased adiposity.

scholarly journals Prognostic value of symptom limited versus low level exercise stress test before discharge in patients with myocardial infarction treated with thrombolytics

Heart ◽  
1999 ◽  
Vol 82 (2) ◽  
pp. 199-203 ◽  
Author(s):  
K Jensen-Urstad ◽  
B A Samad ◽  
F Bouvier ◽  
J Hulting ◽  
J Hojer ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Prognostic Value ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Low Level

The prognostic significance of improvement in exercise capacity in heart failure patients who participate in cardiac rehabilitation programme

2018 ◽  
Vol 25 (4) ◽  
pp. 354-361 ◽  
Author(s):  
Avi Sabbag ◽  
Israel Mazin ◽  
David Rott ◽  
Ilan Hay ◽  
Nelly Gang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Rehabilitation ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Cardiovascular Fitness ◽  
Rehabilitation Programme ◽  
Exercise Stress ◽  
Cardiac Rehabilitation Programme ◽  
Heart Failure Patients ◽  
Baseline Fitness

Introduction There are limited contemporary data regarding the association between improvement in cardiovascular fitness in heart failure patients who participate in a cardiac rehabilitation programme and the risk of subsequent hospitalisations. Methods The study population comprised 421 patients with heart failure who participated in our cardiac rehabilitation programme between the years 2009 and 2016. All were evaluated by a standard exercise stress test before initiation, and underwent a second exercise stress test on completion of 3 ± 1 months of training. Participants were dichotomised by fitness level at baseline, according to the percentage of predicted age and sex norms achieved. Each group was further divided according to its degree of functional improvement, between the baseline and the follow-up exercise stress test. Major improvement was defined as improvement above the median value in each group. The combined primary endpoint was cardiac hospitalisation or all-cause mortality. Results A total of 211 (50%) patients had low baseline fitness (<73% (median)) for age and sex-predicted metabolic equivalents of task value. Compared to patients with higher fitness, those with a low baseline fitness were more commonly smokers, had diabetes and were obese ( P < 0.05 for all). Multivariable Cox proportional hazard regression analysis showed that, independent of baseline capacity, an improvement of 5% of predicted fitness was associated with a corresponding 10% reduced risk of cardiac hospitalisation or all-cause mortality ( P < 0.001). Conclusion In heart failure patients participating in a cardiac rehabilitation programme, improved cardiovascular fitness is associated with reduced mortality or cardiac hospitalisation risk during long-term follow-up, independent of baseline fitness.

scholarly journals Motivation, Psychological Distress and Exercise Adherence Following Myocardial Infarction

2006 ◽  
Vol 12 (1) ◽  
pp. 21-32 ◽  
Author(s):  
Mary Angela Ljubic ◽  
Frank P. Deane ◽  
Robert P. Zecchin ◽  
Robert Denniss
Keyword(s):  
Myocardial Infarction ◽  
Telephone Interview ◽  
Stress Test ◽  
Exercise Adherence ◽  
Exercise Stress Test ◽  
Good Health ◽  
Self Report ◽  
Exercise Stress ◽  
Functional Improvement ◽  
Adherence Rate

AbstractFifty patients with myocardial infarction were recruited from a hospital based Cardiac Education and Assessment Program (CEAP) in Sydney, Australia. The Exercise Motivation Inventory-2 (EMI-2) and the Depression, Anxiety and Stress Scale (DASS) were administered prior to commencement in the program and re-administered by telephone interview at 5-month followup. Four exercise adherence measures were completed: attendance, exercise stress test, self-report ratings and a 7-day activity recall interview. There was a 46% adherence rate for MI patients during the hospital based CEAP. Of those individuals who completed CEAP, 91% obtained functional improvement on the exercise stress test. For the 38 patients who were followed-up by telephone interview at 5 months, 71% were exercising according to CEAP prescription. Higher levels of anxiety were associated with lower levels of self-reported exercise adherence. The 3 strongest motivations for exercise in this group of MI patients were all health related; wanting to be free from illness, maintaining good health and recovering from the effects of coronary heart disease. The discussion highlights the implications of these findings for cardiac rehabilitation programs and the need for empirically driven guidelines for measuring exercise adherence.

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