Clinical Interventions in Aging (Mar 2024)

Early Cardiac Rehabilitation Improves Carotid Arterial Stiffness in Patients with Myocardial Infarction

  • Ołpińska B,
  • Wyderka R,
  • Łoboz-Rudnicka M,
  • Brzezińska B,
  • Łoboz-Grudzień K,
  • Jaroch J

Journal volume & issue
Vol. Volume 19
pp. 471 – 480

Abstract

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Bogusława Ołpińska,1 Rafał Wyderka,1,2 Maria Łoboz-Rudnicka,1 Barbara Brzezińska,1 Krystyna Łoboz-Grudzień,1 Joanna Jaroch1,2 1Department of Cardiology, T Marciniak Lower Silesian Specialist Hospital, Emergency Medicine Center, Wrocław, Poland; 2Faculty of Medicine, University of Science and Technology, Wrocław, PolandCorrespondence: Bogusława Ołpińska, Department of Cardiology, T Marciniak Lower Silesian Specialist Hospital, Emergency Medicine Center, Ul. Generała Augusta Fieldorfa 2, Wrocław, 54-049, Poland, Email [email protected]: Little is known about the effect of cardiac rehabilitation (CR) on carotid arterial stiffness (CAS) in patients with myocardial infarction (MI).Patients and Methods: Rehabilitation group (B) included 90 patients with MI subjected to CR, control group (K) consisted of 30 patients with MI not participating in CR, and healthy group comprised 38 persons without cardiovascular risk factors. CAS was determined using echo-tracking before and after CR.Results: At baseline, patients with MI (B+K) presented with significantly higher mean values of CAS parameters: beta-stiffness index (7.1 vs 6.4, p = 0.004), Peterson’s elastic modulus (96 kPa vs 77 kPa, p < 0.001) and PWV-beta (6.1 m/s vs 5.2 m/s, p < 0.001) than healthy persons. Age (beta: r = 0.242, p = 0.008; EP: r = 0.250, p = 0.006; PWV-beta: r = 0.224, p = 0.014) and blood pressure: SBP (EP: r = 0.388, PWV-beta: r = 0.360), DBP (AC: r = 0.225) and PP (PWV-beta: r = 0.221) correlated positively with the initial parameters of CAS. Beta-stiffness index (Rho=− 0.26, p = 0.04) and PWV-beta (Rho = 0.29, p = 0.03) correlated inversely with peak exercise capacity expressed in METs. After CR, mean values of beta-stiffness index (6.2 vs 7.1, p = 0.016), EP (78 kPa vs 101 kPa, p = 0.001) and PWV-beta (5.4 m/s vs 6.2 m/s, p = 0.001) in group B were significantly lower than in group K. In group B, CAS parameters decreased significantly after CR. Univariate analysis demonstrated that the likelihood of an improvement in CAS after CR was significantly higher in patients with baseline systolic blood pressure < 120 mm Hg (OR = 2.74, p = 0.009) and left ventricular ejection fraction < 43% (OR = 5.05, p = 0.005).Conclusion: In patients with MI, CR exerted a beneficial effect on CAS parameters. The improvement in CAS was predicted by lower SBP and LVEF at baseline.Keywords: carotid arterial stiffness, managed care after myocardial infarction, acute coronary syndrome, echo-tracking

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