ASSOCIATION OF ARTERIAL STIFFNESS WITH LEFT VENTRICULAR FUNCTION AND THE IMPACT OF CARDIAC REHABILITATION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

Abstract

Objective: Arterial stiffness has an important role in the pathophysiology of coronary artery disease and heart failure. The association of arterial stiffness with left ventricular (LV) function and the impact of cardiac rehabilitation in patients with acute myocardial infarction (AMI) were investigated in this study. Design and method: Echocardiographic indexes of LV volumes, systolic function, and diastolic function were measured in the usual way. Effective arterial elastance (EA) and index (EAI) was calculated from stroke volume measured using LV outflow waveform. The exercise-based, outpatient cardiac rehabilitation (CR) program, which was composed of 8 to 12 visits during 4 weeks to 6 months, was provided, and the follow-up (F/U) echocardiographic study was done after 6 months. Results: Twenty-nine patients (age 58.7+/-10.2 years) with AMI were enrolled, but 8 patients denied CR program. At baseline, EAI was significantly associated with E’ (beta -0.379, P = 0.035) and LV global longitudinal strain (GLS) (beta 0.458, P = 0.014). F/U echocardiographic data showed decreased EAI (from 0.95+/-0.24 to 0.85+/-0.28 mmHg/ml/m2, P = 0.039), increased E’ (from 6.34+/-2.34 to 7.40+/-2.86 cm/sec, P = 0.032), and improved LV GLS (from -13.7+/-2.8 to -16.6+/-3.0%, P <0.001) in patients with CR program, but not in patients without CR program. Changes of EAI was significantly associated with changes of E’ (beta -0.396, P = 0.048). Conclusions: Arterial stiffness was associated with LV dysfunction in AMI patients. The CR improved the arterial stiffness and LV dysfunction.