RELATIONSHIP BETWEEN EXERCISE CAPACITY AND CHANGES OF PULSE WAVE VELOCITY AFTER CARDIAC REHABILITATION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Objective: Guidelines strongly recommend exercise-based cardiac rehabilitation (CR) to reduce cardiovascular mortality in patients with acute myocardial infarction (AMI). Reduction of central aortic systolic pressure, augmentation index, and pulse wave velocity (PWV) after aerobic exercise may be associated with better clinical outcomes after CR. However, the change of pulse wave velocity after CR in patients with AMI has been rarely investigated. Design and Method: Sixty-five patients (age 55.3 ± 10.1 years, 63 men) with AMI who completed the 6-month CR and evaluation program were included in this study. Maximal oxygen uptake (VO2max) during cardiopulmonary exercise (CPX) testing and brachial-ankle PWV (baPWV) were measured before exercise program and after 6 months. Based on the results of baseline CPX testing, each exercise program which included target metabolic equivalent, target heart rate, and exercise duration, was prescribed. Patients were recommended to attend the outpatient CR program which composed of 8 to 12 visits during 4 to 6 weeks. Self-exercise program was educated for each patient who finished or denied the outpatient CR program. Results: After 6 months, VO2max was increased from 28.9 ± 5.79 to 31.7 ± 6.5 mL/kg/min (p < 0.001) and baPWV was decreased from 14.68 ± 2.66 to 13.54 ± 2.92 m/sec (p < 0.001). Changes of baPWV (Delta-baPWV) showed a significant negative correlation with 6-month VO2max (r = -0.339, p = 0.006). Patient were divided into group 1 (n = 32, Delta-baPWV = -1.13 m/sec). Group 1 showed higher 6-month VO2max (33.5 ± 6.7 vs. 29.9 ± 5.9 mL/kg/min; p = 0.023). On logistic regression analysis, 6-month VO2max was a significant determining factor for Delta-baPWV (OR 1.159, 95% CI 1.030–1.305, p = 0.014) after adjustment of age, sex, height and baseline baPWV. Conclusions: Patients with better exercise capacity after CR program showed more decreased PWV.