Determinants of improvement in exercise capacity in patients undergoing cardiac rehabilitation.
In order to identify patients who benefit most from a cardiac rehabilitation program, we studied retrospectively all patients who completed a 3-month comprehensive cardiac rehabilitation program during a 2-year period. Questionnaires regarding physical exercise habits were sent to 122 patients and returned by 117 (96%) of them (53 post-acute myocardial infarction, 50 post-coronary artery bypass surgery, 14 post-infarction and surgery, 2 post-angioplasty). Exercise capacity (subset of 66 patients) improved by 19% after rehabilitation (7.8 +/- 3.1 to 9.3 +/- 2.7 METs, p < 0.0001). Univariate and multivariate analysis identified initial exercise capacity as the only independent variable predicting improvement in exercise performance (inverse relationship) (r2 = 0.24, p < 0.0001). The improvement was not related to age, sex, left ventricular function or time from cardiac event to rehabilitation. Patients recovering from both infarction and coronary artery bypass surgery showed a greater improvement (delta exercise capacity 2.8 +/- 1.4 METs) than patients after myocardial infarction alone (delta exercise capacity 0.8 +/- 2 METs, p < 0.02). Improvement was sustained for up to 2 years after completion of the program.
Shiran
A
A
Department of Cardiology, Lady Davis Carmel Medical Center, Haifa, Israel.
Kornfeld
S
S
Zur
S
S
Laor
A
A
Karelitz
Y
Y
Militianu
A
A
Merdler
A
A
Lewis
B S
BS
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000534:rehabilitation*; D001026:Coronary Artery Bypass / Q000534:rehabilitation*; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000534:rehabilitation*; D010342:Patient Acceptance of Health Care; D010809:Physical Fitness / Q000502:physiology; D012189:Retrospective Studies