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The Impacts of Cardiac Rehabilitation Program on Echocardiographic Parameters in Coronary Artery Disease Patients with Left Ventricular Dysfunction

DOI: 10.1155/2013/201713

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Abstract:

Introduction. The accurate impact of exercise on coronary artery disease (CAD) patients with left ventricular dysfunction is still debatable. We studied the effects of cardiac rehabilitation (CR) on echocardiography parameters in CAD patients with ventricular dysfunction. Methods. Patients with CAD who had ventricular dysfunction were included into an exercise-based rehabilitation program and received rehabilitation for eight weeks. All subjects underwent echocardiography before and at the end of the rehabilitation program. The echocardiography parameters, including left ventricular ejection fraction (LVEF), LV end-diastolic (LVEDD) and end-systolic diameters (LVESD), and peak exercise capacity measured in metabolic equivalents (METs), were assessed. Results. Seventy patients (mean age = 57.5 ± 10.2 years, 77.1% males) were included into the study. At the end of rehabilitation period, the LVEF increased from 45.14 ± 5.77% to 50.44 ± 8.70% ( ), and the peak exercise capacity increased from 8.00 ± 2.56 to 10.08 ± 3.00 METs ( ). There was no significant change in LVEDD (54.63 ± 12.96 to 53.86 ± 8.95 mm, ) or in LVESD (38.91 ± 10.83 to 38.09 ± 9.04 mm, ) after rehabilitation. Conclusion. Exercise training in postmyocardial infarction patients with ventricular dysfunction could have beneficial effects on cardiac function without adversely affecting LV remodeling or causing serious cardiac complications. 1. Introduction Coronary artery diseases (CAD) are the leading cause of mortality in elderly individuals in developing countries. They account for nearly 50 percent of all deaths per year in Iran [1]. Also, they cause significant morbidity and impair the patient’s quality of life [2, 3]. Various echocardiographic parameters have been shown to provide cardiac dysfunction in CAD patients, such as left ventricular volumes and ejection fraction which are strongly related to prognosis of cardiac diseases [4]. Cardiac rehabilitation (CR) is an acceptable treatment strategy adding to the basic medical plan for the patients with CAD. A multifactorial rehabilitation program includes six basic cores which are (1) baseline patient assessment, (2) nutritional counseling and weight management, (3) aggressive coronary risk-factor management, (4) psychosocial management, (5) physical activity counseling, and (6) exercise training. Several studies showed the beneficial effects of CR for CAD patients [5]. According to previous meta-analyses on the effects of exercise-based rehabilitation in patients with CAD, a reduction in total and cardiac mortality and morbidity occurred

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