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Early Cardiac Rehabilitation Improves Carotid Arterial Stiffness in Patients with Myocardial Infarction
Bogusława Ołpińska1, Rafał Wyderka1,2, Maria Łoboz-Rudnicka1
1Department of Cardiology, T Marciniak Lower Silesian Specialist Hospital, Emergency Medicine Center, Wrocław, Poland.
Insights
Cardiac rehabilitation (CR) significantly reduces carotid arterial stiffness (CAS) in patients after myocardial infarction (MI). Lower baseline systolic blood pressure and left ventricular ejection fraction predict CAS improvement following CR.
Area of Science:
- Cardiovascular Medicine
- Rehabilitation Science
- Vascular Physiology
Background:
- Carotid arterial stiffness (CAS) is a marker of cardiovascular risk.
- The impact of cardiac rehabilitation (CR) on CAS in myocardial infarction (MI) patients remains understudied.
Purpose of the Study:
- To investigate the effect of CR on CAS in patients with MI.
- To identify predictors of CAS improvement after CR.
Main Methods:
- A study involving 90 MI patients undergoing CR (group B), 30 MI patients not in CR (group K), and 38 healthy controls.
- CAS was measured using echo-tracking before and after the CR intervention.
Main Results:
- Patients with MI exhibited higher baseline CAS than healthy individuals.
- CR significantly reduced CAS parameters (beta-stiffness index, Peterson's elastic modulus, PWV-beta) in group B compared to group K.
- Lower baseline systolic blood pressure (<120 mm Hg) and left ventricular ejection fraction (<43%) predicted greater CAS improvement after CR.
Conclusions:
- Cardiac rehabilitation demonstrates a beneficial effect on carotid arterial stiffness in patients with myocardial infarction.
- Baseline systolic blood pressure and left ventricular ejection fraction are significant predictors of CAS improvement post-CR.
Background:
Little is known about the effect of cardiac rehabilitation (CR) on carotid arterial stiffness (CAS) in patients with myocardial infarction (MI).
Patients And Methods:
Rehabilitation group (B) included 90 patients with MI subjected to CR, control group (K) consisted of 30 patients with MI not participating in CR, and healthy group comprised 38 persons without cardiovascular risk factors. CAS was determined using echo-tracking before and after CR.
Results:
At baseline, patients with MI (B+K) presented with significantly higher mean values of CAS parameters: beta-stiffness index (7.1 vs 6.4, p = 0.004), Peterson's elastic modulus (96 kPa vs 77 kPa, p < 0.001) and PWV-beta (6.1 m/s vs 5.2 m/s, p < 0.001) than healthy persons. Age (beta: r = 0.242, p = 0.008; EP: r = 0.250, p = 0.006; PWV-beta: r = 0.224, p = 0.014) and blood pressure: SBP (EP: r = 0.388, PWV-beta: r = 0.360), DBP (AC: r = 0.225) and PP (PWV-beta: r = 0.221) correlated positively with the initial parameters of CAS. Beta-stiffness index (Rho=-0.26, p = 0.04) and PWV-beta (Rho = 0.29, p = 0.03) correlated inversely with peak exercise capacity expressed in METs. After CR, mean values of beta-stiffness index (6.2 vs 7.1, p = 0.016), EP (78 kPa vs 101 kPa, p = 0.001) and PWV-beta (5.4 m/s vs 6.2 m/s, p = 0.001) in group B were significantly lower than in group K. In group B, CAS parameters decreased significantly after CR. Univariate analysis demonstrated that the likelihood of an improvement in CAS after CR was significantly higher in patients with baseline systolic blood pressure <120 mm Hg (OR = 2.74, p = 0.009) and left ventricular ejection fraction <43% (OR = 5.05, p = 0.005).
Conclusion:
In patients with MI, CR exerted a beneficial effect on CAS parameters. The improvement in CAS was predicted by lower SBP and LVEF at baseline.
