Author + information
- Salah El Demerdash1,
- Hazem Khorshid1,
- Iman Salah1,
- Mohamed Ahmed Abdel-Rahman1 and
- Alaa Mabrouk Salem Omar2
Ischemic heart diseases including stable angina & acute events, represent a huge burden on both the individual & the society and represents an important source of disability.
We aimed to identify the effect of cardiac rehabilitation program (CRP) on the ischemic burden in patients with ischemic heart disease (IHD) unsuitable for coronary revascularization.
Forty patients with IHD who were unfit for coronary revascularization were recruited. All patients were subjected to sophisticated CRP protocols, including patient education, nutritional, medical, psychological and sexual counseling and group smoking cessation. All patients participated in low intensity exercise program twice weekly. The patient’s symptoms, vitals and medications were evaluated at each visit and clinical and laboratory data, echocardiography and stress myocardial perfusion imaging (SPECT) were evaluated before and 3 months after the end of the study.
The mean age was 56.8±3.1 years and only 2 patients (5%) were females. 22(55%) patients were diabetic, 21 (53%) were hypertensive and 30 (75%) were smokers. It was found that 3 months after completion of CRP, there was a significant decrease in BMI (30.3±2.9 vs. 31.2±1.9, p<0.001), and mean blood pressure (93.4±11 vs. 105±10.6 mmHg, p<0.001). There was also a favorable effect on lipid profile and a significant improvement of the functional capacity in terms of NYHA functional class (2.1±0.62 vs. 1.4±0.6, p<0.001). Despite that wall motion score index did not significantly change after CRP, there was a strong trend towards a better ejection fraction (53.7±7.8 vs. 54.5±6.3 %, p=0.06) and significant improvement of Canadian cardiovascular class (1.42±0.6 vs. 1.95±0.5, p<0.001) post CRP. Importantly, the difference between the SPECT-derived summed segmental scores at peak stress and at rest (SDS) was significantly lower after CRP (4.4±3 vs. 7.2±3, p<0.001).
Participation in cardiac rehabilitation program improves ischemic burden in patients with IHD who are unfit or not suitable for conventional cardiac revascularization. In addition the decreased ischemic burden, functional capacity, hemodynamic and metabolic profiles also improves for this group of patients and thus, cardiac rehabilitation should be implemented for routine management of those patients.