Very short/short-term benefit of inpatient/outpatient cardiac rehabilitation programs after coronary artery bypass grafting surgery.

Spiroski D, Andjić M, Stojanović OI, Lazović M, Dikić AD,
Ostojić M, Beleslin B, Kostić S, Zdravković M, Lović D

Clin Cardiol. 2017 May;40(5):281-286. doi: 10.1002/clc.22656. Epub 2017 Jan 11.

BACKGROUND: Exercise-based rehabilitation is an important part of treatment
patients following coronary artery bypass graft (CABG) surgery.
HYPOTHESIS: To evaluate effect of very short/short-term exercise training on
cardiopulmonary exercise testing (CPET) parameters.
METHODS: We studied 54 consecutive patients with myocardial infarction (MI)
treated with CABG surgery referred for rehabilitation. The study population
consisted of 50 men and 4 women (age 57.72 ± 7.61 years, left ventricular
ejection fraction 55% ± 5.81%), who participated in a 3-week clinical and 6-month
outpatient cardiac rehabilitation program. The Inpatient program consisted of
cycling 7 times/week and daily walking for 45 minutes. The outpatient program
consisted mainly of walking 5 times/week for 45 minutes and cycling 3 times/week.
All patients performed symptom-limited CPET on a bicycle ergometer with a ramp
protocol of 10 W/minute at the start, for 3 weeks, and for 6 months.
RESULTS: After 3 weeks of an exercise-based cardiac rehabilitation program,
exercise tolerance improved as compared to baseline, as well as peak respiratory
exchange ratio. Most importantly, peak VO2 (16.35 ± 3.83 vs 17.88 ± 4.25
mL/kg/min, respectively, P < 0.05), peak VCO2 (1.48 ± 0.40 vs 1.68 ± 0.43,
respectively, P < 0.05), peak ventilatory exchange (44.52 ± 11.32 vs
52.56 ± 12.37 L/min, respectively, P < 0.05), and peak breathing reserve
(52.00% ± 13.73% vs 45.75% ± 14.84%, respectively, P < 0.05) were also improved.
The same improvement trend continued after 6 months (respectively, P < 0.001 and
P < 0.0001). No major adverse cardiac events were noted during the rehabilitation
CONCLUSIONS: Very short/short-term exercise training in patients with MI treated
with CABG surgery is safe and improves functional capacity.