Very short/short-term benefit of inpatient/outpatient cardiac rehabilitation programs after coronary artery bypass grafting surgery

Clin Cardiol. 2017 May;40(5):281-286. doi: 10.1002/clc.22656. Epub 2017 Jan 11.

Abstract

Background: Exercise-based rehabilitation is an important part of treatment patients following coronary artery bypass graft (CABG) surgery.

Hypothesis: To evaluate effect of very short/short-term exercise training on cardiopulmonary exercise testing (CPET) parameters.

Methods: We studied 54 consecutive patients with myocardial infarction (MI) treated with CABG surgery referred for rehabilitation. The study population consisted of 50 men and 4 women (age 57.72 ± 7.61 years, left ventricular ejection fraction 55% ± 5.81%), who participated in a 3-week clinical and 6-month outpatient cardiac rehabilitation program. The Inpatient program consisted of cycling 7 times/week and daily walking for 45 minutes. The outpatient program consisted mainly of walking 5 times/week for 45 minutes and cycling 3 times/week. All patients performed symptom-limited CPET on a bicycle ergometer with a ramp protocol of 10 W/minute at the start, for 3 weeks, and for 6 months.

Results: After 3 weeks of an exercise-based cardiac rehabilitation program, exercise tolerance improved as compared to baseline, as well as peak respiratory exchange ratio. Most importantly, peak VO2 (16.35 ± 3.83 vs 17.88 ± 4.25 mL/kg/min, respectively, P < 0.05), peak VCO2 (1.48 ± 0.40 vs 1.68 ± 0.43, respectively, P < 0.05), peak ventilatory exchange (44.52 ± 11.32 vs 52.56 ± 12.37 L/min, respectively, P < 0.05), and peak breathing reserve (52.00% ± 13.73% vs 45.75% ± 14.84%, respectively, P < 0.05) were also improved. The same improvement trend continued after 6 months (respectively, P < 0.001 and P < 0.0001). No major adverse cardiac events were noted during the rehabilitation program.

Conclusions: Very short/short-term exercise training in patients with MI treated with CABG surgery is safe and improves functional capacity.

Keywords: cardiac rehabilitation; cardiopulmonary exercise testing; coronary artery bypass grafting; exercise training.

MeSH terms

  • Aged
  • Ambulatory Care*
  • Cardiac Rehabilitation / adverse effects
  • Cardiac Rehabilitation / methods*
  • Cardiology Service, Hospital*
  • Cardiorespiratory Fitness
  • Coronary Artery Bypass / adverse effects
  • Coronary Artery Bypass / rehabilitation*
  • Exercise Test
  • Exercise Therapy* / adverse effects
  • Exercise Tolerance
  • Female
  • Humans
  • Inpatients*
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / physiopathology
  • Myocardial Infarction / surgery*
  • Outpatients*
  • Recovery of Function
  • Registries
  • Time Factors
  • Treatment Outcome