The Differences in Cardiac Rehabilitation Outcomes by Age in Myocardial Infarction: A Preliminary Study

Abstract

ObjectiveTo determine the age-related changes in cardiac rehabilitation (CR) outcomes, which includes hemodynamic and metabolic factors, in patients with myocardial infarction (MI).MethodsCR was administered for 8 weeks to 32 men (mean age, 54.0±8.8 years) who underwent percutaneous coronary intervention for acute MI between July 2012 and January 2016. The exercise tolerance tests were performed before and after the CR. The results were stratified based on a cut-off age of 55 years.ResultsIn the whole patient group, the hemodynamic variables such as the resting heart rate (HRrest), systolic blood pressure (SBPrest), submaximal HR (HRsubmax), SBP (SBPsubmax), and rate pressure product (RPPsubmax) significantly decreased and the maximal HR (HRmax) and RPP (RPPmax) significantly increased. All metabolic variables displayed significant improvement, to include maximal oxygen consumption (VO2max) and ventilation (VEmax), anaerobic threshold (AT), and the maximal oxygen pulse (O2pulsemax). However, upon stratification by age, those who were younger than 55 years of age exhibited significant changes only in the HRrest and RPPsubmax and those aged 55 years old or greater displayed significant changes in all hemodynamic variables except diastolic BP. Both groups displayed significant increases in the VO2max, VEmax, and AT; the older group also exhibited a significant increase in O2pulsemax. The magnitude of the changes in the hemodynamic and metabolic variables before and after CR, based on age, did not differ between the groups; although, it tended to be greater among the older participants of this study's sample.ConclusionBecause the older participants tended to show greater hemodynamic and metabolic changes due to CR, a more aggressive CR program must be administered to elderly patients with MI.

Comparison of phase 2 cardiac rehabilitation outcomes between patients after transcatheter versus surgical aortic valve replacement

“…Although the functional improvement after CR in our study population may be slightly less than relatively younger patients at CR completion (∼2 METs), 30 our results were still comparable with the functional improvement in other phase 2 CR population (∼1 METs). 31 Our findings are also similar to a small group of TAVR patients who underwent an 11-week combined inpatient and outpatient CR after initial three-week inpatient CR (∼ 1 METs). 32 In contrast, the improvement in exercise duration was higher in the TAVR group and could be due to relatively lower exercise intensity during exercise sessions when compared with SAVR patients.…”

The Age Factor in Cardiac Rehabilitation

“…5 Through comprehensive CR, it will lower myocardial oxygen consumption at submaximal workloads and raise maximum oxygen consumption (VO2max) and anaerobic threshold tolerance in everyday physical activity. 6 While CR programs have shown overall effectiveness, it is recognized that various factors can influence the outcomes of the program. One such factor that warrants particular attention is age.…”

“…Heart-related mortality is reduced by 26%, and hospitalizations are decreased by 20% to 30% as an outcome of CR 5. Through comprehensive CR, it will lower myocardial oxygen consumption at submaximal workloads and raise maximum oxygen consumption (VO2max) and anaerobic threshold tolerance in everyday physical activity 6…”