Acar Rezzan Deniz, Bulut Mustafa, Ergün Sunay, Yesin Mahmut, Eren Hayati, Akçakoyun Mustafa
Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, İstanbul, Turkey.
Turk Kardiyol Dern Ars. 2014 Dec;42(8):710-6. doi: 10.5543/tkda.2014.76282.
We aimed to observe the effect of cardiac rehabilitation (CR) on left ventricular diastolic function in patients with acute myocardial infarction (AMI) and revascularization by percutaneous coronary intervention (PCI).
82 patients were enrolled the study; 42 who were participating in a CR program, and 40 who did not maintain the program as a control group. Measurements of mitral inflow included the peak early filling (E-wave) and late diastolic filling (A-wave) velocities, the E/A ratio, deceleration time (DT) of early filling velocity and mitral A-wave duration. The early diastolic annular velocity has been expressed as e' with PW tissue Doppler imaging. The mitral inflow E velocity to tissue Doppler e' (E/e') was calculated and isovolumic relaxation time (IVRT) was measured. Measurements of pulmonary venous waveforms included peak systolic (S) velocity, peak anterograde diastolic (D) velocity and the time difference between the duration of the atrial reversal (Ar) and mitral A-wave duration (Ar-A).
E/A and septal e' were better with the CR group than the control group. (p=0.048 vs p=0.006 respectively). The difference between E/e' measurements were not statistically significant (p=0.138). The left ventricular diastolic function of patients were partially improved with cardiac rehabilitation. There was no association between infarct-related artery (IRA) and diastolic functional measurements of the left ventricle in the individuals. Only hypertension was found significantly associated with E/A (p=0.000).
CR improves septal e' and E/A significantly in patients with AMI and revascularized successfully by PCI, especially in those with hypertension.
我们旨在观察心脏康复（CR）对急性心肌梗死（AMI）患者经皮冠状动脉介入治疗（PCI）后左心室舒张功能的影响。
82例患者纳入本研究；42例参加CR计划，40例未参加该计划作为对照组。二尖瓣血流测量包括早期充盈峰值（E波）和舒张晚期充盈（A波）速度、E/A比值、早期充盈速度减速时间（DT）和二尖瓣A波持续时间。舒张早期环周速度用PW组织多普勒成像表示为e'。计算二尖瓣血流E速度与组织多普勒e'（E/e'）的比值，并测量等容舒张时间（IVRT）。肺静脉波形测量包括收缩期峰值（S）速度、舒张期正向峰值（D）速度以及心房逆向持续时间（Ar）与二尖瓣A波持续时间之间的时间差（Ar-A）。
CR组的E/A和室间隔e'优于对照组。（分别为p = 0.048和p = 0.006）。E/e'测量值之间的差异无统计学意义（p = 0.138）。心脏康复使患者左心室舒张功能得到部分改善。个体中梗死相关动脉（IRA）与左心室舒张功能测量之间无关联。仅发现高血压与E/A显著相关（p = 0.000）。
CR显著改善了AMI且成功接受PCI再血管化治疗患者的室间隔e'和E/A，尤其是高血压患者。
