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Early Cardiac Rehabilitation Improves Carotid Arterial Stiffness in Patients with Myocardial Infarction
Clinical Interventions in Aging ( IF 3.5 ) Pub Date : 2024-03-14 , DOI: 10.2147/cia.s452362 Bogusława Ołpińska 1 , Rafał Wyderka 1, 2 , Maria Łoboz-Rudnicka 1 , Barbara Brzezińska 1 , Krystyna Łoboz-Grudzień 1 , Joanna Jaroch 1, 2
Clinical Interventions in Aging ( IF 3.5 ) Pub Date : 2024-03-14 , DOI: 10.2147/cia.s452362 Bogusława Ołpińska 1 , Rafał Wyderka 1, 2 , Maria Łoboz-Rudnicka 1 , Barbara Brzezińska 1 , Krystyna Łoboz-Grudzień 1 , Joanna Jaroch 1, 2
Affiliation
Background: 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.
中文翻译：
早期心脏康复可改善心肌梗死患者的颈动脉僵硬度
背景：关于心脏康复（CR）对心肌梗死（MI）患者颈动脉僵硬度（CAS）的影响知之甚少。
患者和方法：康复组（B）包括 90 例接受 CR 的 MI 患者，对照组（K）包括 30 例未参加 CR 的 MI 患者，健康组包括 38 名无心血管危险因素的患者。 CR 前后使用回声跟踪确定 CAS。
结果：在基线时，MI (B+K) 患者的 CAS 参数平均值显着较高：β-硬度指数（7.1 vs 6.4，p = 0.004）、Peterson 弹性模量（96 kPa vs 77 kPa，p < 0.001） ) 和 PWV-beta (6.1 m/s vs 5.2 m/s, p < 0.001) 高于健康人。年龄（β：r = 0.242，p = 0.008；EP：r = 0.250，p = 0.006；PWV-β：r = 0.224，p = 0.014）和血压：SBP（EP：r = 0.388，PWV-β： r = 0.360)、DBP (AC: r = 0.225) 和 PP (PWV-beta: r = 0.221) 与 CAS 初始参数呈正相关。 Beta 硬度指数（Rho=− 0.26，p = 0.04）和 PWV-beta（Rho = 0.29，p = 0.03）与以 MET 表示的峰值运动能力呈反比。 CR 后，β-刚度指数平均值（6.2 vs 7.1，p = 0.016）、EP（78 kPa vs 101 kPa，p = 0.001）和 PWV-beta（5.4 m/s vs 6.2 m/s，p = 0.001） B组中的CAS参数显着低于K组。B组中，CR后CAS参数显着下降。单变量分析表明，基线收缩压 < 120 mm Hg（OR = 2.74，p = 0.009）和左心室射血分数 < 43%（OR = 5.05，p）的患者 CR 后 CAS 改善的可能性显着更高。 = 0.005）。
结论：在 MI 患者中，CR 对 CAS 参数产生有益影响。 CAS 的改善是通过基线时较低的 SBP 和 LVEF 来预测的。
更新日期：2024-03-14
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.
中文翻译：
早期心脏康复可改善心肌梗死患者的颈动脉僵硬度
背景：关于心脏康复（CR）对心肌梗死（MI）患者颈动脉僵硬度（CAS）的影响知之甚少。
患者和方法：康复组（B）包括 90 例接受 CR 的 MI 患者，对照组（K）包括 30 例未参加 CR 的 MI 患者，健康组包括 38 名无心血管危险因素的患者。 CR 前后使用回声跟踪确定 CAS。
结果：在基线时，MI (B+K) 患者的 CAS 参数平均值显着较高：β-硬度指数（7.1 vs 6.4，p = 0.004）、Peterson 弹性模量（96 kPa vs 77 kPa，p < 0.001） ) 和 PWV-beta (6.1 m/s vs 5.2 m/s, p < 0.001) 高于健康人。年龄（β：r = 0.242，p = 0.008；EP：r = 0.250，p = 0.006；PWV-β：r = 0.224，p = 0.014）和血压：SBP（EP：r = 0.388，PWV-β： r = 0.360)、DBP (AC: r = 0.225) 和 PP (PWV-beta: r = 0.221) 与 CAS 初始参数呈正相关。 Beta 硬度指数（Rho=− 0.26，p = 0.04）和 PWV-beta（Rho = 0.29，p = 0.03）与以 MET 表示的峰值运动能力呈反比。 CR 后，β-刚度指数平均值（6.2 vs 7.1，p = 0.016）、EP（78 kPa vs 101 kPa，p = 0.001）和 PWV-beta（5.4 m/s vs 6.2 m/s，p = 0.001） B组中的CAS参数显着低于K组。B组中，CR后CAS参数显着下降。单变量分析表明，基线收缩压 < 120 mm Hg（OR = 2.74，p = 0.009）和左心室射血分数 < 43%（OR = 5.05，p）的患者 CR 后 CAS 改善的可能性显着更高。 = 0.005）。
结论：在 MI 患者中，CR 对 CAS 参数产生有益影响。 CAS 的改善是通过基线时较低的 SBP 和 LVEF 来预测的。
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