Cardiac Rehabilitation Improves Myocardial Blood Flow Reserve as Assessed by Positron Emission Tomographic Myocardial Perfusion Imaging

Makaryus, John N.; Tobe, Lauren; Alharbi, Mervat; Kim, Diana; Ershova, Svetlana; Robi, Amsale; Bokhari, Sabahat

doi:10.1016/s0735-1097(14)61017-2

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“…Also, it has been observed that CR has a direct influence on the myocardium, and it increases the myocardial perfusion which in turn increases the exercise capacity. This was confirmed by cardiac magnetic resonance imaging and quantitative positron emission tomography myocardial flow reserve (PET-MFR) assessments [ 33 34 35 36 ]. These previous studies have shown that CR has a significant benefit in recovery of LV function after LV remodeling.…”

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confidence: 88%

The Effect of Cardiac Rehabilitation Exercise Training on Cardiopulmonary Function in Ischemic Cardiomyopathy With Reduced Left Ventricular Ejection Fraction

2016

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ObjectiveTo observe the effect and safety of cardiac rehabilitation (CR) exercise in ischemic cardiomyopathy and to compare the results between patients with preserved left ventricular ejection fraction (LVEF) and reduced LVEF.MethodsPatients with ischemic cardiomyopathy with LVEF <50% were included as subjects. The patients were classified into the preserved LVEF (pLVEF; LVEF 41%–49%) group and the reduced LVEF (rLVEF; LVEF ≤40%) group. Patients underwent hourly aerobic exercise training sessions with an intensity of 60%–85% of heart rate reserve, three times a week for 6 weeks. Graded exercise test and transthoracic echocardiogram were performed in all study patients before and after completion of the CR exercise program.ResultsAfter completion of the CR exercise program, both groups (pLVEF, n=30; rLVEF, n=18) showed significant increases in LVEF and VO2max. In the pLVEF group, LVEF and VO2max increased from 45.1%±4.8% to 52.5%±9.6% (p<0.001) and from 24.1±6.3 to 28.1±8.8 mL/kg/min (p=0.002), respectively. In the rLVEF group, LVEF and VO2max increased from 29.7%±7.7% to 37.6%±10.3% (p<0.001) and from 17.6±4.7 to 21.2±5.1 mL/kg/min (p<0.001), respectively. Both groups completed their exercise program safely.ConclusionIn both groups, patients with ischemic cardiomyopathy who completed a 6-week supervised CR exercise program demonstrated remarkable improvements in cardiopulmonary function. This result implies that neither of the two groups showed higher efficacy in comparison to each other, but we can conclude that CR exercise in the rLVEF group was as effective and safe as that in the pLVEF group.

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