THE IMPACT OF AMBULATORY CARDIAC REHABILITATION ON INDICATORS OF CARDIAC FUNCTION PATIENTS AFTER PERCUTANEOUS CORONARY INTERVENTION

Uvod: Pacijenti sa koronarnom bolesti srca uz stalne simptome i smanjenju kvalitetu života su inicirani za revaskularizaciju. Perkutana koronarna intervencija je najčešća metoda revaskularizacije. Kod ovih pacijenata dolazi do promjena u pokazateljima srčane funkcije i nalazima ergometrijskog testiranja i ehokardiografije. Vježbe i rehabilitacija su važne metode za snižavanje rizičnih faktora koronarne bolesti srca i poboljšanje ishoda liječenja i kvalitete života. Stoga je cilj rada istražiti utjecaj ambulantne kardiološke rehabilitacije na pokazatelje srčane funkcije kod osoba nakon perkutane koronarne intervencije (PCI). Metode: U ovoj konhortnoj prospektivnoj studiji, 50 muških ispitanika podvrgnutih perkutanoj koronarnoj intervenciji su jednako podijeljeni u dvije grupe: pokusna skupina (provodi ambulantnu kardiološku rehabilitaciju nakon PCI) i kontrolna skupina ( bez rehabilitacije nakon PCI). Svi ispitanicima u obje skupine su prošli ergometrijsko testiranje i ehokardiografiju. Ambulantni kardiološki rehabilitacijski program se odvija kroz 5 tjedana, 3 puta tjedno u trajanju od 60 minuta. Pokazatelji srčane funkcije tijekom ergometrije i ehokardiografije su mjereni prije i poslije rehabilitacije u pokusnoj skupini i uspoređivani s mjerenjima u kontrolnoj skupini u isto vrijeme. Rezultati: U ovoj studiji, testirano je 50 ispitanika (25 + 25), 25 u rehabilitacijskoj grupi i 25 u kontrolnoj. Prosječna dob u rehabilitacijskoj skupini je bila 58 ± 9, a u kontrolnoj 56 ± 7. Rehabilitacijski program vježbi je doveo do promjena nakon PCI u pokusnoj skupini u ehokardiografskom nalazu kod parametara TAPSE (p = 0,0337), E/A (p = 0,0005), E/E` (p = 0,0031) te ergometrijskom testiranju u gotovo svim parametrima; trajanju opterećenja (p = 0,000), maksimalnoj brzini otkucaja srca ( p = 0,003), maksimalnog sistoličkog krvnog tlaka (p = 0,008), maksimalnog dijastoličkog tlaka (p = 0,000), potrošnji kisika (p = 0,004) i promjenama pulsa nakon 1 minute oporavka (p = 0,00). u ostalim parametrima nije bilo značajne statističke promjene u obje skupine. Bilježi se značajan pad kardiovaskularnih rizičnih čimbenika: hiperlipidemije (p = 0,02) i pušenje (p = 0,00). Zaključak: Ambulantni kardiološki rehabilitacijski program pokazuje pozitivne promjene srčanih pokazatelja nakon PCI djelujući i na smanjenje kardiovaskularnih rizičnih čimbenika.Background: Patients with coronary artery disease with persistent symptoms and reduced quality of life have been initiated for revascularization. Percutaneous coronary intervention is the most common method of revascularization. In these patients, the changes in the parameters of cardiac function and the findings of exercise testing and echocardiography. The exercises and rehabilitation are important methods for the reduction of risk factors of coronary heart disease and improve treatment outcomes and quality of life. Therefore, the aim of this paper to investigate the impact of outpatient cardiac rehabilitation on indicators of cardiac function in patients after percutaneous coronary intervention (PCI).Therefore, the objective of this study was to investigate the impact of ambulatory cardiac rehabilitation on indication of cardiac function in those patients after percutaneous coronary intervention (PCI). Methods: In this cohort based prospective study, 50 male patients undergoing percutaneous coronary intervention were equally divided in two groups: the experimental group (carried ambulatory cardiac rehabilitation after PCI) the control group (without rehabilitation after PCI). All patients from both groups underwent ergometric testing and echocardiography. Ambulatory cardiac rehabilitation program was carried out for 5 weeks, three times a week for 60 minutes. The indicators of cardiac function during ergometry and echocardiography were measured before and after rehabilitation in the test group and compared with the measurements in the control group at the same time. Results: In this study, 50 subjects were tested (25 + 25), 25 in test group and 25 in the control group. The average age of the rehabilitation group was 58 ± 9 and in the control 56 ± 7. Rehabilitation excercise programme led to change after PCI of the test group in the echocardiographic report on parametars TAPSE (p = 0.0337), E / A (p = 0.0031) and execise testing in almost all parameters; exercise capacity (p = 0.000), maximum heart rate (p = 0.003), maximum systolic blood pressure (p = 0.008), maximum diastolic pressure (p = 0.000), oxygen consumption (p = 0.0004) and pulse rate changes after 1 minute of recovery (p = 0.00). There were no statistically significant changes for other parameters in both groups. There has been recorded a significant decrease of cardiovascular risk factors: hyperlipidemia (p = 0.02), smoking (0.00). Conclusion: Ambulatory cardiac rehabilitation program shows positive changes in cardiac indicators after PCI and effecting the decrease of cardiovascular risk factors