title: Ambulatory cardiac rehabilitation improves pulsatile arterial hemodynamics: a pilot trial.
abstract: BACKGROUND
  In patients with coronary heart disease, both arterial stiffness and wave reflections are increased and predict unfavorable cardiovascular events. Cardiac rehabilitation has the goal to reduce risk factors and slow the progression of the disease. The aim of this study was to prospectively determine the impact of an ambulatory cardiac rehabilitation program on pulsatile hemodynamics.
  
  
  METHODS
  Male patients after coronary interventions, bypass surgery, or acute coronary syndromes underwent exercise and resistance training. Before and after the program, pulsatile hemodynamics was measured. Exercise capacity was assessed with an incremental cycle ergometer protocol. A detailed two-dimensional and Doppler echocardiogram was obtained for systolic and diastolic left ventricular function.
  
  
  RESULTS
  A total of 27 men participated in the study. After the intervention (n = 24), carotid-femoral pulse wave velocity decreased significantly from 8.7 (standard deviation (SD): 1.7) to 7.9 (SD: 1.9) m/s (p = 0.019), and augmentation index normalized for a heart rate of 75/min decreased significantly from 20.4 (SD: 8.7) to 17.5 (SD: 8.1; p = 0.017).
  
  
  CONCLUSIONS
  The results suggest that a structured ambulatory rehabilitation program may improve pulsatile hemodynamics in coronary artery disease (CAD) patients.
authors.affiliation: CardioVital Institute of Preventive and Rehabilitation Medicine, Grieskirchnerstraße 49, 4600, Wels, Austria, michael.pfob@medifit-wels.at.
authors.forename: Michael
authors.initials: M
authors.lastname: Pfob
authors.forename: Norbert
authors.initials: N
authors.lastname: Mürzl
authors.forename: Erich
authors.initials: E
authors.lastname: Müller
authors.forename: Bernd
authors.initials: B
authors.lastname: Eber
authors.forename: Thomas
authors.initials: T
authors.lastname: Weber
mesh_terms: D054058:Acute Coronary Syndrome / Q000503:physiopathology / Q000534:rehabilitation; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D015906:Angioplasty, Balloon, Coronary / Q000534:rehabilitation*; D001026:Coronary Artery Bypass / Q000534:rehabilitation*; D003327:Coronary Disease / Q000503:physiopathology* / Q000534:rehabilitation*; D018450:Disease Progression; D005080:Exercise Test; D005081:Exercise Therapy; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000534:rehabilitation*; D063177:Pulse Wave Analysis; D055070:Resistance Training; D012307:Risk Factors; D059289:Vascular Stiffness / Q000502:physiology*