Abstract
Lan C, Chen S-Y, Chiu S-F, Hsu C-J, Lai J-S, Kuan P-L. Poor functional recovery may indicate restenosis in patients after coronary angioplasty. Arch Phys Med Rehabil 2003;84:1023-7. Objective:To investigate whether poor response to exercise training can detect restenosis in asymptomatic patients after percutaneous transluminal coronary angioplasty (PTCA). Design:Case-control study. Setting:A hospital-based outpatient cardiac rehabilitation program in Taiwan. Participants:Sixteen patients aged 49.7±7.8 years who had undergone PTCA and completed a 3-month exercise program. Patients were separated into a restenosis group (n=7; age, 46.4±9.8y) and a nonrestenosis group (n=9; age, 52.3±12.9y), according to their angiography follow-up results. The interval between PTCA and angiography ranged from 6 months to 2 years. Intervention:Bicycle exercise workouts were conducted 3 times a week during rehabilitation, with exercise intensity adjusted to each patient’s ventilatory threshold. Main Outcome Measures:A graded exercise test with gas analysis was conducted before training, at 6 weeks and at 3 months after training, to evaluate the sequential changes of cardiorespiratory function. Results:After 3 months of training, the nonrestenosis group showed an increase of 30.4% in peak oxygen uptake (Vo2peak, P<.05), 13.7% in peak oxygen pulse (P<.05), 22.2% in peak rate-pressure product (P<.05), and 13.6% in peak work rate (P<.05). Most of the improvement occurred within the first 6 weeks of training. The restenosis group did not show significant increase in these variables. At the ventilatory threshold, the nonrestenosis group also displayed a significant increase of V̇o2, oxygen pulse, and work rate. However, the restenosis group showed no improvement after training. Conclusion:Functional recovery appears to be a good indicator of restenosis for patients after PTCA. A poor response to exercise can be noted within 6 weeks of training in PTCA patients with restenosis.
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