Left ventricular systolic function and initial exercise capacity—their importance for results of cardiac rehabilitation after acute coronary syndrome

Aim: The aim of this study was to compare initial and final exercise tolerance and to evaluate the determinants of exercise capacity improvement—after three weeks of inpatient cardiac rehabilitation. Methods: A cohort of 494 patients after acute coronary syndrome (ACS), treated with primary coronary...

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Main Authors: Barbara Uznańska-Loch, Ewa Wądołowska, Karina Wierzbowska-Drabik, Urszula Cieślik-Guerra, Jarosław D. Kasprzak, Małgorzata Kurpesa, Tomasz Rechciński
Format: Article
Language:English
Published: Open Exploration Publishing Inc. 2023-08-01
Series:Exploration of Cardiology
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Online Access:https://www.explorationpub.com/uploads/Article/A10124/10124.pdf
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author Barbara Uznańska-Loch
Ewa Wądołowska
Karina Wierzbowska-Drabik
Urszula Cieślik-Guerra
Jarosław D. Kasprzak
Małgorzata Kurpesa
Tomasz Rechciński
author_facet Barbara Uznańska-Loch
Ewa Wądołowska
Karina Wierzbowska-Drabik
Urszula Cieślik-Guerra
Jarosław D. Kasprzak
Małgorzata Kurpesa
Tomasz Rechciński
author_sort Barbara Uznańska-Loch
collection DOAJ
description Aim: The aim of this study was to compare initial and final exercise tolerance and to evaluate the determinants of exercise capacity improvement—after three weeks of inpatient cardiac rehabilitation. Methods: A cohort of 494 patients after acute coronary syndrome (ACS), treated with primary coronary angioplasty (age 60 years ± 10 years, 27.5% women) was studied retrospectively. Possible correlations between improvement and age, gender, body mass index (BMI), left ventricular ejection fraction (LVEF) and the initial exercise capacity (EXT1) were assessed. Results: The highest percentage of patients with improvement (43.6%) was in the medium tercile of LVEF (> 42% but ≤ 50%) and was more likely in the medium tercile of initial exercise tolerance [> 5.7 but ≤ 8.4 metabolic equivalent of tasks (METs)]. Receiver-operator characteristic (ROC) curves were developed and the following cut-off values were found: for LVEF > 43% (this value had 69.6% sensitivity in predicting improvement; the chance of improvement was 2.67 higher than in patients with LVEF ≤ 43%); for EXT1 ≤ 8.4 METs (this value had 70.8% sensitivity, the chance of improvement was 1.86 higher than in the other subgroup). No significant relationship between improvement and gender, age or BMI was found. Conclusions: The combination of LVEF > 43% and EXT1 ≤ 8.4 METs relates to the highest probability of exercise tolerance improvement after cardiac rehabilitation.
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spelling doaj-art-a9e9332944b4467cb0ce7085f9397fdf2025-08-20T03:50:31ZengOpen Exploration Publishing Inc.Exploration of Cardiology2994-55262023-08-0111263410.37349/ec.2023.00004Left ventricular systolic function and initial exercise capacity—their importance for results of cardiac rehabilitation after acute coronary syndromeBarbara Uznańska-Loch0Ewa Wądołowska1Karina Wierzbowska-Drabik2https://orcid.org/0000-0002-7623-5389Urszula Cieślik-Guerra3https://orcid.org/0000-0001-6297-2153Jarosław D. Kasprzak4https://orcid.org/0000-0002-5850-8187Małgorzata Kurpesa5https://orcid.org/0000-0002-8194-0285Tomasz Rechciński6https://orcid.org/0000-0001-7800-785XChair and Department of Cardiology, Medical University of Lodz, 91-347 Lodz, PolandDepartment of Cardiac Rehabilitation, The Biegański Hospital, 91-347 Lodz, PolandDepartment of Internal Diseases and Clinical Pharmacology, Medical University of Lodz, 91-347 Lodz, PolandDepartment of Cardiac Rehabilitation, The Biegański Hospital, 91-347 Lodz, PolandChair and Department of Cardiology, Medical University of Lodz, 91-347 Lodz, PolandChair and Department of Cardiology, Medical University of Lodz, 91-347 Lodz, PolandChair and Department of Cardiology, Medical University of Lodz, 91-347 Lodz, PolandAim: The aim of this study was to compare initial and final exercise tolerance and to evaluate the determinants of exercise capacity improvement—after three weeks of inpatient cardiac rehabilitation. Methods: A cohort of 494 patients after acute coronary syndrome (ACS), treated with primary coronary angioplasty (age 60 years ± 10 years, 27.5% women) was studied retrospectively. Possible correlations between improvement and age, gender, body mass index (BMI), left ventricular ejection fraction (LVEF) and the initial exercise capacity (EXT1) were assessed. Results: The highest percentage of patients with improvement (43.6%) was in the medium tercile of LVEF (> 42% but ≤ 50%) and was more likely in the medium tercile of initial exercise tolerance [> 5.7 but ≤ 8.4 metabolic equivalent of tasks (METs)]. Receiver-operator characteristic (ROC) curves were developed and the following cut-off values were found: for LVEF > 43% (this value had 69.6% sensitivity in predicting improvement; the chance of improvement was 2.67 higher than in patients with LVEF ≤ 43%); for EXT1 ≤ 8.4 METs (this value had 70.8% sensitivity, the chance of improvement was 1.86 higher than in the other subgroup). No significant relationship between improvement and gender, age or BMI was found. Conclusions: The combination of LVEF > 43% and EXT1 ≤ 8.4 METs relates to the highest probability of exercise tolerance improvement after cardiac rehabilitation.https://www.explorationpub.com/uploads/Article/A10124/10124.pdfcardiac rehabilitationacute coronary syndromeejection fractionexercise capacity
spellingShingle Barbara Uznańska-Loch
Ewa Wądołowska
Karina Wierzbowska-Drabik
Urszula Cieślik-Guerra
Jarosław D. Kasprzak
Małgorzata Kurpesa
Tomasz Rechciński
Left ventricular systolic function and initial exercise capacity—their importance for results of cardiac rehabilitation after acute coronary syndrome
Exploration of Cardiology
cardiac rehabilitation
acute coronary syndrome
ejection fraction
exercise capacity
title Left ventricular systolic function and initial exercise capacity—their importance for results of cardiac rehabilitation after acute coronary syndrome
title_full Left ventricular systolic function and initial exercise capacity—their importance for results of cardiac rehabilitation after acute coronary syndrome
title_fullStr Left ventricular systolic function and initial exercise capacity—their importance for results of cardiac rehabilitation after acute coronary syndrome
title_full_unstemmed Left ventricular systolic function and initial exercise capacity—their importance for results of cardiac rehabilitation after acute coronary syndrome
title_short Left ventricular systolic function and initial exercise capacity—their importance for results of cardiac rehabilitation after acute coronary syndrome
title_sort left ventricular systolic function and initial exercise capacity their importance for results of cardiac rehabilitation after acute coronary syndrome
topic cardiac rehabilitation
acute coronary syndrome
ejection fraction
exercise capacity
url https://www.explorationpub.com/uploads/Article/A10124/10124.pdf
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