Dyslipidemia worsens a prognosis in patients with chronic heart ischemic disease, who underwent myocardial infarction. Therefore, new methods, besides drugs, are being sought, for optimizing a serum concentration of lipid fractions.
The aim: An effect of 6-month of ambulatory long-term cardiac rehabilitation on the lipidogram fractions concentration in patients with chronic heart ischemic disease treated with simvastatin, as well as a correlation between lipids changes and cardiac training intensity was assessed.
Material and method: Rehabilitation was performed in 66 patients with previous myocardial infarction treated invasively (27 CABG and 39 PTCA), who constituted group I. A control group (group II) consisted of 32 patients with previous myocardial infarction also treated invasively (24 CABG and 8 PTCA), but not subjected to rehabilitation. The two analyzed groups did not differ significantly from each other as to age, applied drug regimen, current clinical status, echocardiographic parameters and BMI values. Group I was subjected to 6-month cardiac rehabilitation program, comprising 45-minute training on cycle ergometer (three times per week) and generally improving exercises (2 times per week). Blood concentration of lipidogram fractions was assessed: total cholesterol (TC), HDL- and LDL-cholesterol, and triglicerides (TG) at the onset and upon completion of the rehabilitation cycle.
Results: The both patient groups were comparable concerning the initial concentration of the lipid fractions. After finishing the rehabilitation program, in the group I, a statistically significant reduction of TC, LDL and TG concentration was found out. In addition, a significant increase of HDL concentration was noted. In contrary, in the group II (without rehabilitation), the only significant change concerned a concentration of HDL fraction, which decreased. Furthermore, in the group I, it was noted a negative, statistically significant correlation between intensity of cardiac training, expressed by training workload and delta of work, and a difference in blood concentration of triglicerides, measured just before the training onset and after the program was finished.
Conclusion: It was revealed that long-term ambulatory cardiac rehabilitation has a profitable effect on serum concentration of the all lipid fractions in patients with chronic heart ischemic disease cured with simvastatin, regardless of training intensity. It was also ascertained that an extent of changes in triglicerides serum concentration was related to an intensity of the cardiac training applied to the patients.