Assessment of various parameters using simple non-invasive tests in patients with cardiovascular diseases with or without cardiac rehabilitation

Abstract

Cardiac rehabilitation (CR) improves cardiac function and exercise capacity in patients with cardiovascular disease (CVD). Simpler techniques are needed for use by physicians in the examination room to assess the usefulness of CR. We enrolled 46 consecutive CVD patients in a CR program (CR group) and prospectively followed them for 3 months. We compared them to 18 age-, gender- and body mass index-matched CVD patients without CR (non-CR group). Various parameters were measured at baseline and after 3 months using 3 simple non-invasive tests: severity of atherosclerosis [arterial velocity pulse index and arterial pressure volume index (API)] were determined using PASESA®, an autonomic nerve total activity amount index and a coefficient of variation of the R–R interval (CVRR) were determined using eHEART®, and peripheral resistance index, pressure rate product, stroke volume and cardiac index were determined using nico®]. There were no significant differences in patient characteristics including percentages (%) of ischemic heart disease and heart failure between the non-CR and CR groups. Systolic blood pressure (SBP), diastolic BP, heart rate and API at baseline significantly decreased and CVRR at baseline significantly increased after 3 months in the CR group, but not in the non-CR group. In addition, ΔAPI (Δ = the value after 3 months minus the value at baseline) was positively associated with ΔSBP in the CR group. In conclusion, CR significantly decreased BP and improved atherosclerosis and sympathetic nerve activity. These findings suggest that simple non-invasive tests may be useful for assessing the effects of CR.

Cardiac rehabilitation in patients with cardiovascular disease leads various hemodynamic parameters obtained using simple non-invasive tests to their appropriate levels

“…We wrapped a cuff around the left upper arm of sitting patients and measured the brachial BP oscillometrically using PASESA® after at least 5 min of rest [4] , [5] . AVI, API, SBP, DBP and HR were collected.…”

“…Inflation is performed by an automatic pump system and deflation is controlled by an automatic pressure-release valve. Bilateral brachial PRP, SV, CI, and mean TPR were analyzed by a nico PS-501® [4] , [6] . We calculated absolute (| rt.…”

“…In addition, Bigger recommended that high-frequency (HF) power should be based on at least 1 min of recording, while low-frequency (LF) power required at least 2.5 min [8] . Using eHEART®, we evaluated parameters of heart rate variability (HRV), such as CVRR, HF, LF, and the ratio of LF to HF (LF/HF) [4] , [9] . The fluctuations of R-R intervals were integrated on the HF band (0.15–0.40 Hz) and the LF band (0.05–0.15 Hz).…”

“…Comprehensive cardiac rehabilitation (CR) has been shown to improve cardiac function and prognosis in patients with cardiovascular disease (CVD) [1] , [2] . Recently, we reported that a 3-month CR program significantly decreased blood pressure (BP) [3] and improved atherosclerosis and sympathetic nerve as assessed by 3 simple non-invasive tests: BP and severity of atherosclerosis [arterial velocity pulse index (AVI) and arterial pressure volume index (API)] were determined using PASESA® (AVE-1500, Shisei Datum, Tokyo, Japan), an index of total autonomic nerve activity and a coefficient of variation of the R-R interval (CVRR) were determined using eHEART® (Parama-Tec, Fukuoka, Japan), and absolute and relative differences in BP between arms, pressure rate product (PRP), mean total peripheral resistance index (TPR), stroke volume (SV), and cardiac index (CI) were determined using nico® (Parama-Tec, Fukuoka, Japan) [4] . These 3 easy-to-use devices, PASESA® [5] , nico PS-501® (North Parama Inc., Tokyo, Japan) [6] and eHEART® [7] , are currently available for clinical use in Japan.…”

“…We concluded that these simple non-invasive devices may be useful for assessing the effectiveness of CR. In addition, since we followed the patients for only 3 months [4] , we considered a longer follow-up period (12 months) in this study. Therefore, we evaluated whether 12 months of comprehensive CR improved various hemodynamic parameters obtained using simple non-invasive tests in patients with CVD.…”