Prediction parameters of left ventricular diastolic dysfunction improvement in patients after acute coronary syndrome

ABSTRACT

Objectives

The aim of this study was to examine the effects of comprehensive cardiac rehabilitation (CCR) in patients after acute coronary syndrome (ACS) resolved by percutaneous coronary intervention (PCI) on left ventricular diastolic dysfunction (LVDD) and to extract the parameters that have the greatest influence on LVDD improvement.

Methods

The study included 85 subjects who were divided into intervention (N = 56) and control (N = 29) groups depending on CCR attendance. Initially and after 12 weeks, patients of both groups were subjected to echocardiography to assess LVDD, as well as CPET to assess improvement in functional capacity.

Results

The study showed that 23 patients (27.1%) of both groups demonstrated the improvement of LVDD degree. The improvement of the LVDD degree in the intervention group was significant, whereas in the control group, it did not change (a one-degree improvement in 22 (39.3%) patients of the intervention group (p < 0.001) and only 1 (3.4%) (p > 0.05) in the control group). Multivariate binary logistic regression showed that key parameters in LVDD improvement were participation in the CCR, E/A ratio and haemoglobin value. We created a model, for prediction of LVDF improvement, with a cut-off value of 33 (area = 0.9, p < 0.0005), a sensitivity of 87.0% and a specificity of 85.5%.

Conclusions

CCR can be used as an effective non-pharmacological measure to improve LVDD and functional capacity in patients after ACS. The statistical model may have practical application in prediction of clinical benefit in such a group of patients.

KEYWORDS:

• Cardiac rehabilitation
• coronary artery disease
• exercise testing
• echocardiography
• diastolic dysfunction

Acknowledgments

The authors would like to thank the Cardiac Rehabilitation Department of ICVDV (Sremska Kamenica, Serbia) and the patients who devoted their time to participating in this study as well as to Prof Dragić Banković for great support in data statistical analysis.

Disclosure statement

No potential conflict of interest was reported by the author(s).