Key result
A novel composite index outperformed the standard peak VO2 ≥ 1 mL/kg/min criterion in recognizing clusters of exercise capacity improvement after cardiac rehabilitation (C-statistic 91.7% vs 72.3%).
Why the study?
Relationships among predictors of improvement in exercise capacity after cardiac rehabilitation programs in patients after acute myocardial infarction needed investigation.
Does a composite index better evaluate exercise capacity improvement after cardiac rehabilitation in patients after myocardial infarction compared to peak VO2 alone?
Observational (n=41)
Does a composite index better evaluate exercise capacity improvement after cardiac rehabilitation in patients after myocardial infarction compared to peak VO2 alone?
A novel composite index of cardiopulmonary exercise test variables outperforms peak VO2 alone in evaluating exercise capacity improvement after cardiac rehabilitation in post-MI patients.
May refine post-MI rehabilitation response assessment; hypothesis-generating and requires prospective validation before practice change.
OBJECTIVE: We investigated relationships among predictors of improvement in exercise capacity after cardiac rehabilitation programs in patients after acute myocardial infarction. METHODS: We carried out a secondary analysis of data from 41 patients with a left ventricular ejection fraction ≥ 40% who underwent cardiac rehabilitation after the first myocardial infarction. Participants were assessed using a cardiopulmonary exercise test and stress echocardiography. A cluster analysis was performed, and the principal components were analyzed. RESULTS: Two distinct clusters with significantly different ( P = .005) proportions of response to treatment (peak VO 2 ≥ 1 mL/kg/min) were identified among patients. The first principal component explained 28.6% of the variance. We proposed an index composed of the top 5 variables from the first component to represent the improvement in exercise capacity. The index was the average of scaled O 2 uptake and CO 2 output at peak exercise, minute ventilation at peak, load achieved at peak exercise, and exercise time. The optimal cutoff for the improvement index was 0.12, which outperformed the peak VO 2 ≥ 1 mL/kg/min criterion in recognizing the clusters, with a C-statistic of 91.7% and 72.3%, respectively. CONCLUSION: The assessment of change in exercise capacity after cardiac rehabilitation could be improved using the composite index.
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Nemati et al. (2023) conducted an observational in Acute myocardial infarction (n=41). Composite index for evaluating exercise capacity improvement vs. Peak VO2 ≥ 1 mL/kg/min criterion was evaluated on Recognizing clusters of exercise capacity improvement. A novel composite index outperformed the standard peak VO2 ≥ 1 mL/kg/min criterion in recognizing clusters of exercise capacity improvement after cardiac rehabilitation (C-statistic 91.7% vs 72.3%).
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