HAEMODYNAMIC RESPONSE DURING EXERCISE TESTING IN PATIENTS WITH CORONARY ARTERY DISEASE UNDERGOING A CARDIAC REHABILITATION PROGRAMME
Journal Title: Biology of Sport - Year 2011, Vol 28, Issue 3
Abstract
Haemodynamic monitoring during exercise testing is seldom used during cardiac rehabilitation. The aim was to evaluate haemodynamic changes using the cardiac impedance method during exercise testing in patients after percutaneous coronary interventions and coronary artery bypass grafting during cardiac rehabilitation. Thirty (25 M; 5 F) patients were included in the programme. The group was divided according to ejection fraction (EF): low – below 50%, normal – equal to or above 50%. The exercise test was performed simultaneously with a four-electrode impedance cardiogram before and after rehabilitation. ECG, blood pressure, thoracic impedance, first derivative dz/dt, stroke volume (SV) and cardiac output were recorded. Contractility index (Heather index – HI) and vascular peripheral resistance were calculated. The pattern of haemodynamic changes was normal in 24 patients. The deflection points for HI and SV trend patterns were observed among patients with low EF. The contractility index decreased 90 s before maximal exercise and after the next 30-60 s a deflection point was observed in SV curve trends. In 24 patients with normal EF the contractility index trends did not decrease and SV trends increased until the end of exercise or a deflection point was not noted. The deflection points of the contractility index and SV curves were observed before the clinical indications for exercise test termination appeared in patients with a low ejection fraction. Impedance cardiography may indicate the threshold of the workload during real-time exercise testing.
Authors and Affiliations
J. Siebert, D. Zielińska, B. Trzeciak, S. Bakuła
Keywords
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