Abstract 16976: Respiratory Muscle Trainings Started in Acute Period of Complicated Myocardial Infarction in Patients with Pulmonary Hypertension
Background: Positive effects of physical exercises as a part of comprehensive rehabilitation after acute myocardial infarction (MI) are well known. Patients with MI and concomitant heart failure (HF) with pulmonary hypertension (PH) often can't take part in physical trainings. Purpose: To study the effect of respiratory muscles trainings (RMT) in patients with acute MI and concomitant HF and PH.
Methods: 87 MI patients 68,1±4,3 years old were randomized to either an exercise training group (EG) or to a control group (CG). Patients were on their 3-5 day of MI and had NYHA III-IV class . The EG participated in a RMT with gradual increase of inspire and expire resistance. RMT were started at the hospital on the 3-5 day after MI and were continued for 12 months at home by patients themselves. Trainings were held for 20-30 minutes 1-2 times every day.
Results: In 1 year the distance of 6 minute walk test increased significantly in EG (262,2±9,22 m in EG vs 277,1±9,1 m in CG at baseline, p>0,05; in 1 year 285±8,7m vs 275,3±9,28 m p<0,01). Peak VO2 also increased significantly in EG (3,95±1,71 ml/kg/min in EG vs 3,96±1,72 ml/kg/min in CG at baseline, p>0,05; in 1 year 6,84±1,55 vs 4,61±1,16 ml/kg/min, p<0,01). RMT helped to stabilize mean pulmonary pressure (56,1±10,3 mm Hg in TG vs 56,8±7,7 mm Hg in CG at baseline, p>0,05 and 54,4±7,7 mm Hg in TG vs 79,7±9,2mm Hg in CG in 12 months,p<0,01). There was a statistically significant increase in the maximal inspiratory mouth pressure in most of patients, from 4,23 kPa ± 1,12 vs 4,19 kPa ± 1,11,p>0,05 at baseline to 5,6 kPa ± 0,8 vs 4,1 kPa ± 1,1; p < 0,01 in 12 months). Health related quality of life measured by SF-36 increased in both groups, but results in physical functioning, bodily pain, vitality, role emotional scales were significantly higher in EG patients. In a year there was 3 lethal outcomes in EG vs 8 inCG. EG patients had significantly less hospitalizations because of HF progression (7,8% in EG vs 14,6% in CG) and pneumonias (2,1% vs 15,3%).
Conclusion: RMT in patients with MI and HF with PH can be started at their acute period. It improves physical capacity, stabilize pulmonary pressure, increase health-related quality of life and decrease number of hospitalizations during first year after MI.
- © 2011 by American Heart Association, Inc.