Effects of different rehabilitation modality on cardiopulmonary function in patients with acute coronary syndrome after revascularization

Wanping Chen; Yan Feng; Meili Yu; Zhaoguo Zhang; Jiahui Wu; Wenxian Liu; Wei Gu

doi:10.3389/fcvm.2023.1120665

Effects of different rehabilitation modality on cardiopulmonary function in patients with acute coronary syndrome after revascularization

Front Cardiovasc Med. 2024 Mar 4:10:1120665. doi: 10.3389/fcvm.2023.1120665. eCollection 2023.

Authors

Wanping Chen^#¹, Yan Feng^#¹, Meili Yu², Zhaoguo Zhang², Jiahui Wu¹, Wenxian Liu¹, Wei Gu³

Affiliations

¹ Cardiac Rehabilitation Center, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, School of General Practice and Continuing Education, Capital Medical University, Beijing, China.
² Cardiac Rehabilitation Center, Beijing Hospital of Integrated Traditional Chinese and Western Medicine, Beijing, China.
³ Coronary Heart Disease Center, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

^# Contributed equally.

Abstract

Objective: To investigate the effects of different rehabilitation modalities on cardiopulmonary function in patients with acute coronary syndrome after revascularization.

Methods: Two randomized controlled trials were conducted. All patients were stable for more than 48 h and less than 1 week after revascularization for acute coronary syndrome and were randomly assigned to Group A (home-based rehabilitation group) or Group B (center guided home-based rehabilitation group). The cardiopulmonary exercise test was mainly performed before and 3 months after cardiac rehabilitation (at the end of intervention). The primary endpoints of the study were peak oxygen uptake (VO2peak), and the secondary endpoints were maximum metabolic equivalents (METs), anaerobic threshold exercise load (Load AT), maximal workload (Load max), and anaerobic threshold oxygen uptake (VO2 AT).

Results: A total of 106 patients were included in the study, with 47 patients in Group A (with 6 losses) and 50 patients in Group B (with 3 losses). There were no significant difference between the two groups in terms of age, gender, body mass index (BMI), left ventricular ejection fraction(LVEF), low-density lipoprotein cholesterol(LDL-C),cardiovascular risk factors. In Group A, no significant differences in CPET indices were observed before and after the intervention. In Group B, values of maximum metabolic equivalents (METs), peak heart rate (PHR), anaerobic threshold exercise load (Load AT), maximal workload (Load max), maximum ventilation per minute (VE max), peak oxygen uptake (VO2peak), anaerobic threshold oxygen uptake (VO2 AT) and maximum oxygen pulse (VO2/HRmax) were higher than those before the intervention (P < 0.05). In addition, METs (max), Load AT, Load max, VO2 AT, and VO2peak in Group B were higher than those in group A (P < 0.05). The change rates of VO2peak, METs(max), PHR, Load max, VO2 AT, VE max, VO2/HR(max) in the two groups were significantly different before and after intervention (P < 0.05).

Conclusion: Cardiac exercise rehabilitation is helpful for improving patients' cardiopulmonary endurance and quality of life. Moreover, rehabilitation modalities with regular hospital guidance can improve cardiopulmonary function in a shorter period,which seems to be more effective than a complete home-based rehabilitation model.

Clinical trial registration: http://www.chictr.org.cn, identifier (ChiCTR2400081034).

Keywords: acute coronary syndrome; cardiac rehabilitation; cardiopulmonary exercise test; center guided home-based rehabilitation group; home-based rehabilitation group.

Grants and funding

National Natural Science Foundation of China (81703932); Beijing Municipal Medical Bureau “Young Talents” Fund Project (QML20190605); Science and Technology Development Fund of Beijing Municipal Administration of Traditional Chinese Medicine (JJ-2020-01); Science and Technology Program of Chaoyang District, Beijing (CYSF2027).