The impact of ambulatory rehabilitation to change of the effort parameters after myocardial infarction in patients of different physical capacity

Introduction: the aim of the study was an attempt to verify the impact of cardiac training on the effort parameters in patients of different physical capacity. Material and methods: the study included 61 ambulatory patients after hospital treatment due to acute myocardial infarction. Two different groups was separated on the base of the first treadmill test: a group of 28 patients of low tolerance (3.17 ± 0.67 MET) and a group of 33 persons of higher effort tolerance (7,21 ± 1,85 MET). For estimation of physical efficiency before and after completing 24 training sessions (8 weeks) treadmill test with perceiving fatigue in Borg scale, measurement of ejection fraction, NYHA classification of heart failure, CCS classification coronary heart disease and BMI were performed. The students t-test was used to analyze the data. Results: after training physical efficiency increased significantly 5,36 ± 2,48 MET vs. 7,48 ± 2,61 MET (p < 0.001) in all patients. Significant differences were observed in two groups: patients of low effort tolerance 3.17 ± 0.67 vs. 5,63 ± 1.83 (p < 0,001) and patients of higher effort tolerance 7,21 ± 1,85 vs. 9,06 ± 2,07 (p < 0.001). The value of the EF significantly increased only in the group of low tolerance 55,20% ± 10.04 vs. 57,70% ± 10,57 (p < 0.05). There were no significant changes in the level of fatigue at the top of treadmill, in the scale of the NYHA , CCS and BMI in both groups. Conclusions: Significant improvement of physical efficiency in both groups was observed, but ejection fraction was increased only in patients of low effort tolerance. Cardiac ambulatory rehabilitation should be recommended especially for patients of low effort tolerance after myocardial infarction.