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Is applying the same exercise-based inpatient program to normal and reduced left ventricular function patients the

Renata Gonçalves Mendes1, Rodrigo Polaquini Simões, Fernando de Souza Melo Costa

  • 1Cardiopulmonary Physiotherapy Laboratory, Nucleus of Research in Physical Exercise, Federal University of Sao Carlos , Sao Paulo , Brazil .

Disability and Rehabilitation
|May 9, 2013
PubMed

Insights

Patients undergoing coronary artery bypass graft (CABG) surgery showed different cardiac autonomic responses to inpatient exercise programs based on left ventricular function (LVF). Reduced LVF led to a more pronounced response, suggesting tailored exercise prescriptions post-CABG.

Area of Science:

  • Cardiology
  • Exercise Physiology
  • Autonomic Nervous System Function

Background:

  • Coronary artery bypass graft (CABG) surgery is a common procedure for managing coronary artery disease.
  • Left ventricular function (LVF) can be normal or reduced post-CABG, potentially influencing recovery and response to rehabilitation.
  • Cardiac autonomic response plays a crucial role in cardiovascular health and recovery after cardiac surgery.

Purpose of the Study:

  • To compare the cardiac autonomic response to a standardized inpatient exercise program in post-CABG patients with normal versus reduced left ventricular function (LVF).
  • To determine if the same exercise protocol elicits similar autonomic adjustments in these two patient groups.

Main Methods:

  • Forty-four post-CABG patients were divided into normal LVF (LVFN) and reduced LVF (LVFR) groups based on left ventricular ejection fraction (LVEF).
  • An inpatient progressive exercise program was initiated on post-operative day 1 (PO1) and continued until discharge.
  • Heart rate variability (HRV) indices were measured at rest and during exercise (range of motion, ambulation) to assess cardiac autonomic response.

Main Results:

  • During ambulation, patients with reduced LVF (LVFR) exhibited significantly lower heart rate variability (HRV) indices compared to those with normal LVF (LVFN).
  • The change in HRV from rest to ambulation was also attenuated in the LVFR group for both linear and non-linear HRV measures.
  • On PO1, only intra-group differences between rest and exercise were observed for heart rate parameters.

Conclusions:

  • The same inpatient exercise protocol resulted in a more attenuated cardiac autonomic response in post-CABG patients with normal LVF compared to those with reduced LVF.
  • These findings highlight the importance of tailoring inpatient exercise volume based on individual left ventricular function in the early recovery phase after CABG.
  • Prescribing exercise according to LVF is crucial for optimizing rehabilitation outcomes in post-CABG patients.
Abstract

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