Improvement of Cardiorespiratory Fitness, Ischemic Threshold, And Quality of Life in Patients with Coronary Ectasia After a Cardiac Rehabilitation Program

Background and Aim: Coronary ectasia (CE) is a condition found in various types of heart diseases. It is characterized by alterations in coronary blood flow, endothelial dysfunction, arterial thrombosis, ischemia, arrhythmias, and heart failure. It has been shown that cardiac rehabilitation (CR) based on concurrent training has resulted in anti-inflammatory effects at the coronary endothelium level, as well as cardiovascular, pulmonary, and muscular adaptations that increases peak oxygen consumption (VO2 peak). However, this effect is unknown in patients with CE. The aim of this study is to determine the effects of a cardiac rehabilitation program on cardiorespiratory fitness, ischemic threshold, and quality of life in patients with coronary ectasia. Materials and Methods: A quasi-experimental study was conducted in phase II of the CR program. Patients of both genders, aged over 18 years, with all types of stable heart diseases, cardiac interventions, and the presence of intracardiac devices were included, while patients with contraindications for cardiopulmonary exercise testing or the CR program were excluded. Results: Nineteen patients with an average age of 64.6 ± 7.7 years were included, with 84% being male. 78% had a history of ischemic heart disease. After the program, a statistically significant gain was observed for VO2 peak (p<0.001), METs-load (p<0.001), oxygen pulse (p=0.005), obtained from a cardiopulmonary test in a BTL CardioPoint-Ergo and Pisto XP model; and health-related quality of life obtained from the SF-36 questionnaire (p=0.003). A non-significant decrease was observed for the VE/VCO2 slope (p=0.412). The presence of ischemic threshold was noted in six patients, of which three showed remissions. No adverse events associated with CR were observed. Conclusions: Cardiac rehabilitation programs based on concurrent physical training are safe and promote improvements in cardiorespiratory fitness, prognostic ergoespirometric variables, possible ischemic threshold remission, symptom relief, and improve quality of life in patients with coronary ectasia associated with other types of heart disease.