Document Detail

Effect of exercise training in supervised cardiac rehabilitation programs on prognostic variables from the exercise tolerance test.
MedLine Citation:
PMID:  18471449     Owner:  NLM     Status:  MEDLINE    
Meta-analyses showed that exercise training decreased mortality in patients after myocardial infarction, but no single adequately powered trial has shown this benefit. The purpose of this study was to evaluate the effect of cardiac rehabilitative exercise training on prognostic variables derived from the exercise tolerance test and whether these changes had an effect on predicted cardiovascular and all-cause mortality using externally validated risk scores. Two hundred ten consecutive patients who completed a 12-week cardiac rehabilitation program were analyzed. Peak MET level, heart rate recovery, chronotropic index, Duke prognostic score, and Cleveland Clinic Foundation risk score obtained at program entry and exit were compared. All prognostic variables and risk score-derived predicted 5-year mortality rates improved significantly after cardiac rehabilitation. Exercise capacity increased by 32% (6.6 +/- 2.7 to 8.7 +/- 2.9 METS; p <0.0001), heart rate recovery increased by 20% (15 +/- 9 to 18 +/- 10 beats/min; p <0.0001), and chronotropic index increased by 11% (56 +/- 22% to 62 +/- 22%; p <0.0001). Duke prognostic score 5-year predicted cardiovascular mortality rate decreased by 33% (6 +/- 4% to 4 +/- 2%; p <0.0001), and Cleveland Clinic Foundation risk score 5-year predicted total mortality rate decreased by 40% (5 +/- 7% to 3 +/- 5%; p <0.0001). These improvements remained significant in high-risk subgroups. When controlled for age, gender, diabetes, MET level achieved, ejection fraction, and beta-blocker use, changes remained significant (p <0.0001) for each outcome measure. In conclusion, exercise training in supervised cardiac rehabilitation programs significantly improved exercise capacity, measures of chronotropic dynamics, and prognostic risk scores. These differences translate into a decrease in predicted mortality.
Brian J Adams; John G Carr; Al Ozonoff; Michael S Lauer; Gary J Balady
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-03-17
Journal Detail:
Title:  The American journal of cardiology     Volume:  101     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-12     Completed Date:  2008-06-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1403-7     Citation Subset:  AIM; IM    
Department of Medicine, Section of Cardiology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA.
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MeSH Terms
Confidence Intervals
Exercise Test
Exercise Therapy / methods*
Exercise Tolerance / physiology*
Follow-Up Studies
Heart Diseases / mortality,  physiopathology,  rehabilitation*
Heart Rate / physiology
Massachusetts / epidemiology
Middle Aged
Retrospective Studies
Risk Factors
Stroke Volume / physiology
Survival Rate / trends

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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