Evaluation of prescription of exercise, for rehabilitation of coronary artery disease patients by myocardial scintigraphy

Arq Bras Cardiol. 2008 Oct;91(4):223-8, 245-51. doi: 10.1590/s0066-782x2008001600007.
[Article in English, Portuguese]

Abstract

Background: It is advisable that the intensity of the exercises for rehabilitation of patients with coronary artery disease does not cause myocardial ischemia.

Objective: Compare the capacity of myocardial tomographic scintigraphy with the electrocardiogram capacity in ischemia detection during rehabilitation session.

Methods: Twenty six patients with coronary artery disease, undergoing the rehabilitation program and with previous scintigraphy, with transient hypo-uptake have been administered a new injection of MIBI-Tc-99m during a training session when they were also monitored with dynamic electrocardiography. The rest scintigraphies, after ergometric treadmill test and rehabilitation session, were assessed in a semi-quantitative way using scores from 0 to 4 to classify each one of the chosen segments (0 = normal; 1 = discrete hypo-uptake; 2 = moderate; 3 = intense; 4 = lack of uptake).

Results: The means of the total scores found were: at rest = 12.9; after treadmill test = 19.3; after rehabilitation session = 15.1. There were statistically significant differences among them. An individual assessment showed that in 14 cases (53.8 %) hypo-uptake to some degree was identified during rehabilitation and in 12 cases (46.6%) it was not. Monitoring with the Holter system didn't show in any of the cases a ST segment depression equal or greater than 1mm.

Conclusion: The exercises prescribed for patients with coronary artery disease, according to recommendations found in the literature, may trigger myocardial ischemia, assessed by scintigraphy during a rehabilitation session.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / rehabilitation*
  • Electrocardiography
  • Exercise / physiology*
  • Exercise Test
  • Humans
  • Male
  • Middle Aged
  • Myocardial Ischemia / diagnostic imaging*
  • Myocardial Ischemia / prevention & control
  • Radiopharmaceuticals
  • Rest
  • Technetium Tc 99m Sestamibi
  • Tomography, Emission-Computed, Single-Photon / standards

Substances

  • Radiopharmaceuticals
  • Technetium Tc 99m Sestamibi