Novel approaches to the assessment of cardiorespiratory readiness of patients after coronary artery bypass surgery aimed to the efficient cardiac rehabilitation performance

Cover Page

Cite item

Full Text

Abstract

Aim. To develop novel strategies of patients’ selection and risk stratification after coronary artery bypass surgery before starting aerobic cardiorespiratory training programs.

Material and methods. One hundred thirty seven patients 4 weeks after coronary artery bypass surgery were included in our study. RARE scale (risk of activity related events), ergospirometric test, FIT treadmill score and certain laboratory parameters like hemoglobin and alaninaminotransferase were used.

Results. Logical interdependence is revealed between certain indicators of cardiorespiratory capacity and risk of developing unfavorable events due to aerobic training activities. Comprehensive protocol is developed based on multifactorial regression analysis, which allows to differentiate patients into low and high class of readiness to physical activities, including aerobic cardiorespiratory training programs.

Conclusion. The protocol includes following variables METs, RARE scale, FIT treadmill score, left ventricular ejection fraction, hemoglobin and alaninaminotransferase levels. It is very userfriendly, easy, practical and efficient.

About the authors

Tea T. Kakuchaya

Bakulev National Medical Research Center for Cardiovascular Surgery

Author for correspondence.
Email: ttkakuchaya@mail.ru
ORCID iD: 0000-0001-9383-2073

D. Sci. (Med.), Prof., Bakulev National Medical Research Center for Cardiovascular Surgery

Russian Federation, Moscow

Tamara G. Dzhitava

Bakulev National Medical Research Center for Cardiovascular Surgery

Email: ttkakuchaya@mail.ru
ORCID iD: 0000-0002-6141-2231

Cand. Sci. (Med.), Bakulev National Medical Research Center for Cardiovascular Surgery

Russian Federation, Moscow

Arjanа M. Kuular

Bakulev National Medical Research Center for Cardiovascular Surgery

Email: ttkakuchaya@mail.ru
ORCID iD: 0000-0002-2133-9674

Cand. Sci. (Med.), Bakulev National Medical Research Center for Cardiovascular Surgery

Russian Federation, Moscow

Nona V. Pachuashvili

Bakulev National Medical Research Center for Cardiovascular Surgery

Email: ttkakuchaya@mail.ru

Cand. Sci. (Med.), Bakulev National Medical Research Center for Cardiovascular Surgery

Russian Federation, Moscow

Zarina K. Tokaeva

Bakulev National Medical Research Center for Cardiovascular Surgery

Email: ttkakuchaya@mail.ru
ORCID iD: 0000-0002-8852-8197

Cand. Sci. (Med.), Bakulev National Medical Research Center for Cardiovascular Surgery

Russian Federation, Moscow

References

  1. Messerli FH, Messerli AW, Lüscher TF. Eisenhower's Billion-Dollar Heart Attack – 50 Years Later. N Eng J Med. 2005;353:1205-7.
  2. Кардиореабилитация и вторичная профилактика. Под ред. Д.М. Аронова. М.: ГЭОТАР-Медиа, 2021 [Cardiac Rehabilitation and secondary prevention. Ed. DM Aronov. Moscow: GEOTAR-Media, 2021 (in Russian)].
  3. Lacombe SP, LaHaye SA, Hopkins-Rosseel D, et al. Identifying patients at low risk for activity-related events: the RARE Score. J Cardiopulm Rehabil Prev. 2014;34(3):180-7. doi: 10.1097/HCR.0000000000000045
  4. Schooling CM, Kelvin EA, Jones HE. Alanine transaminase has opposite associations with death from diabetes and ischemic heart disease in NHANES III. Ann Epidemiol. 2012;22(11):789-98.
  5. Schindhelm RK, Dekker JM, Nijpels G, et al. Alanine aminotransferase predicts coronary heart disease events: a 10-year follow-up of the Hoorn Study. Atherosclerosis. 2007;191(2):391-6.
  6. Kogan M, Klempfnerb R, Lotana D, et al. Low ALT blood levels are associated with lower baseline fitness amongst participants of a cardiac rehabilitation program. J Exerc Sci Fit. 2018;16(1):1-4. doi: 10.1016/j.jesf.2017.11.002
  7. Peltz-Sinvani N, Klempfner R, Ramaty E, et al. Low ALT Levels Independently Associated with 22-Year All-Cause Mortality Among Coronary Heart Disease Patients. J Gen Intern Med. 2015;31(2):209-14.
  8. Weiskopf RB, Viele MK, Feiner J, et al. Human cardiovascular and metabolic response to acute, severe isovolemic anemia. JAMA. 1998;279(3):217-21. doi: 10.1001/jama.279.3.217
  9. Mani A, Singh T, Calton R, et al. Cardiovascular response in anemia. Indian J Pediatr. 2005;72:297-300.
  10. Ranucci M, La Rovere MT, Castelvecchio S, et al. Postoperative anemia and exercise tolerance after cardiac operations in patients without transfusion: what hemoglobin level is acceptable? Ann Thorac Surg. 2011;92(1):25-31.
  11. Cuenza LR, Yap EML, Ebba E. Assessment of the prognostic utility of the FIT treadmill score in coronary artery disease patients undergoing cardiac rehabilitation. J Cardiovasc Thorac Res. 2019;11(1):8-13. doi: 10.15171/jcvtr.2019.02
  12. Бокерия Л.А., Какучая Т.Т., Джитава Т.Г., и др. Эффективность современных аэробных интервальных физических тренировок в реабилитации взрослых больных после операций на открытом сердце. Новости сердечно-сосудистой хирургии. 2019;3(3):161-72 [Bockeria LA, Kakuchaya TT, Dzhitava TG, et al. Efficiency of comprehensive aerobic interval trainings in adult patients after open heart surgery. News of Cardiovascular Surgery. 2019;3(3):161-72 (in Russian)]. doi: 10.24022/2588-0284-2019-3-3-161-172
  13. Belardinelli R, Georgiou D, Cianci G, Purcaro A. 10-Year Exercise training in Chronic Heart Failure: A Randomized Controlled Trial. JACC. 2012;60:1521-8.
  14. American College of Sports Medicine. Diretrizes do ACSM para o teste de esforço e sua prescrição. Taranto G, translator. 7th ed. Rio de Janeiro: Guanabara Koogan, 2007.
  15. Moraes RS. Diretriz de Reabilitação Cardíaca. Arq Bras Cardiol. 2005;84(5):431-40.
  16. Fletcher GF, Balady GJ, Amsterdam EA, et al. Exercise standards for testing and training: a statement for healthcare professionals from the American Heart Association. Circulation. 2001;104(14):1694-740. doi: 10.1161/hc3901.095960
  17. Pashkow FJ. Issues in contemporary cardiac rehabilitation: a historical perspective. J Am Coll Cardiol. 1993;21(3):822-34.doi: 10.1016/0735-1097(93)90116-I
  18. American Association of Cardiovascular and Pulmonary Rehabilitation. Diretrizes para reabilitação cardíaca e programas de prevenção secundária. Marx AG, translator. 4th ed. São Paulo: Roca, 2007.
  19. Monpère C, Sellier P, Meurin P, et al. Recommandations de la Société française de cardiologie concernant la pratique de la réadaptation cardiovasculaire chez l’adulte. Version 2. Arch Mal Coeur. 2002;95(10):962-97.
  20. Velasco JA, Cosín J, Maroto JM, et al. Guías de práctica clínica de la Sociedad Española de Cardiología en prevencíon cardiovascular y rehabilitación cardíaca. Rev Esp Cardiol. 2000;53(8):1095-120. doi: 10.1016/S0300-8932(00)75211-0
  21. Santos AAS, Silva AKF, Vanderlei FM. Analysis of agreement between cardiac risk stratification protocols applied to participants of a center for cardiac rehabilitation. Braz J Phys Ther. 2016;20(4):298-305.
  22. Balady GJ, Arena R, Sietsema K, et al. Clinician’s Guide to Cardiopulmonary Exercise Testing in Adults. A Scientific Statement from the American Heart Association. Circulation. 2010;122(2):191-225.
  23. Paul-Labrador M, Vongvanich P, Merz CNB. Risk stratification for exercise training in cardiac patients: do the proposed guidelines work? J Cardiopulm Rehabil. 1999;19(2):118-25.doi: 10.1097/0000848319990300000006
  24. Zoghbi GJ, Sanderson B, Breland J, et al. Optimizing risk stratification in cardiac rehabilitation with inclusion of a comorbidity index. J Cardiopulm Rehabil. 2004;24(1):8-13.
  25. Pavy B, Iliou MC, Meurin P, et al. Safety of exercise training for cardiac patients: results of the French registry of complications during cardiac rehabilitation. Arch Intern Med. 2006;166(21):2329-34.
  26. Vongvanich P, Paul-Labrador MJ, Merz CNB. Safety of medically supervised exercise in a cardiac rehabilitation center. Am J Cardiol. 1996;77(15):1383-5.
  27. Бокерия Л.А., Аронов Д.М. Российские клинические рекомендации. Коронарное шунтирование больных ишемической болезнью сердца. Реабилитация и вторичная профилактика. CardioСоматика. 2016; 7(3-4):5-71 [Bockeria LA, Aronov DM. Russian clinical guidelines. Coronary bypass surgery in patients with ischemic heart disease. Rehabilitation and secondary prevention. Cardiosomatics. 2016;7(3-4):5-71 (in Russian)].
  28. Radford NB, DeFina LF, Leonard D, et al. Cardiorespiratory fitness, coronary artery calcium, and cardiovascular disease events in a cohort of generally healthy middle-age men: results from the Cooper Center Longitudinal Study. Circulation. 2018;137:1888-95. doi: 10.1161/CIRCULATIONAHA.117.032708.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 1.

Download (74KB)
Indexing metadata
3. Fig. 2.

Download (47KB)
Indexing metadata

Copyright (c) 2021 Eco-Vector

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies