Myocardial Work Assessment in Patients after Coronary Artery Bypass Grafting during Cardiac Rehabilitation
Background: Myocardial work is an innovative echocardiographic tool to assess left ventricular performance. Emerging data have shown the added value of this method for evaluating cardiac function compared to traditional echocardiographic parameters and global longitudinal strain. However, few studie...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/24/7540 |
| _version_ | 1797380559396143104 |
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| author | Francesco Perone Roberta Ancona Fausto di Stasio Vito La Gambina Salvatore Comenale Pinto |
| author_facet | Francesco Perone Roberta Ancona Fausto di Stasio Vito La Gambina Salvatore Comenale Pinto |
| author_sort | Francesco Perone |
| collection | DOAJ |
| description | Background: Myocardial work is an innovative echocardiographic tool to assess left ventricular performance. Emerging data have shown the added value of this method for evaluating cardiac function compared to traditional echocardiographic parameters and global longitudinal strain. However, few studies are present in the literature about the role of myocardial work during cardiac rehabilitation. Our aim was to assess the impact of a rehabilitation program on myocardial work indices in patients with preserved left ventricular ejection fraction and after coronary artery bypass grafting. In addition, we assessed the correlation between baseline myocardial work indices and their change after cardiac rehabilitation, establishing an optimal cut-off value to predict the improvement. Methods: An observational, single-center, and prospective study was conducted. We enrolled patients referred to cardiac rehabilitation after coronary artery bypass grafting and with preserved left ventricular ejection fraction. Before and after the cardiac rehabilitation program, a comprehensive patient assessment was performed, including traditional transthoracic echocardiography, myocardial work analysis, and a six-minute walk test. Results: Eighty-four patients were enrolled; the mean age was 67.96 (±7.42) years and 78.6% were male. The left ventricular ejection fraction was preserved in all patients, and the global longitudinal strain was −16.18 ± 2.55%, the global work index was 1588.56 ± 345 mmHg%, the global constructive work was 1771.27 ± 366.36 mmHg%, the global wasted work was 105.8 ± 72.02 mmHg%, and the global work efficiency was 92.63 ± 3.9% at baseline. After the cardiac rehabilitation program, the global work index, the global constructive work, and the six-minute walk test improved significantly (1588.56 ± 345 vs. 1960.2 ± 377.03 mmHg%, <i>p</i>-value < 0.001; 1771.27 ± 366.36 vs. 2172.01 ± 418.73 mmHg%, <i>p</i>-value < 0.001; 70.71 ± 40.2 vs. 437.5 ± 108.70 m, <i>p</i>-value < 0.001, respectively). Conclusions: Myocardial work indices, specifically global work index and global constructive work, improve after cardiac rehabilitation program in patients undergoing coronary artery bypass grafting with preserved left ventricular ejection fraction. |
| first_indexed | 2024-03-08T20:39:59Z |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-08T20:39:59Z |
| publishDate | 2023-12-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-962dbe7bf00a457ba3ef0ba4b46a08bf2023-12-22T14:16:55ZengMDPI AGJournal of Clinical Medicine2077-03832023-12-011224754010.3390/jcm12247540Myocardial Work Assessment in Patients after Coronary Artery Bypass Grafting during Cardiac RehabilitationFrancesco Perone0Roberta Ancona1Fausto di Stasio2Vito La Gambina3Salvatore Comenale Pinto4Cardiac Rehabilitation Unit, Rehabilitation Clinic “Villa delle Magnolie”, 81020 Castel Morrone, ItalyPediatric Cardiology Unit and ICCU, A.O.R.N. dei Colli, Monaldi Hospital, “L.Vanvitelli” University, 80131 Naples, ItalyCardiac Rehabilitation Unit, Rehabilitation Clinic “Villa delle Magnolie”, 81020 Castel Morrone, ItalyCardiac Rehabilitation Unit, Rehabilitation Clinic “Villa delle Magnolie”, 81020 Castel Morrone, ItalyCardiac Rehabilitation Unit, Rehabilitation Clinic “Villa delle Magnolie”, 81020 Castel Morrone, ItalyBackground: Myocardial work is an innovative echocardiographic tool to assess left ventricular performance. Emerging data have shown the added value of this method for evaluating cardiac function compared to traditional echocardiographic parameters and global longitudinal strain. However, few studies are present in the literature about the role of myocardial work during cardiac rehabilitation. Our aim was to assess the impact of a rehabilitation program on myocardial work indices in patients with preserved left ventricular ejection fraction and after coronary artery bypass grafting. In addition, we assessed the correlation between baseline myocardial work indices and their change after cardiac rehabilitation, establishing an optimal cut-off value to predict the improvement. Methods: An observational, single-center, and prospective study was conducted. We enrolled patients referred to cardiac rehabilitation after coronary artery bypass grafting and with preserved left ventricular ejection fraction. Before and after the cardiac rehabilitation program, a comprehensive patient assessment was performed, including traditional transthoracic echocardiography, myocardial work analysis, and a six-minute walk test. Results: Eighty-four patients were enrolled; the mean age was 67.96 (±7.42) years and 78.6% were male. The left ventricular ejection fraction was preserved in all patients, and the global longitudinal strain was −16.18 ± 2.55%, the global work index was 1588.56 ± 345 mmHg%, the global constructive work was 1771.27 ± 366.36 mmHg%, the global wasted work was 105.8 ± 72.02 mmHg%, and the global work efficiency was 92.63 ± 3.9% at baseline. After the cardiac rehabilitation program, the global work index, the global constructive work, and the six-minute walk test improved significantly (1588.56 ± 345 vs. 1960.2 ± 377.03 mmHg%, <i>p</i>-value < 0.001; 1771.27 ± 366.36 vs. 2172.01 ± 418.73 mmHg%, <i>p</i>-value < 0.001; 70.71 ± 40.2 vs. 437.5 ± 108.70 m, <i>p</i>-value < 0.001, respectively). Conclusions: Myocardial work indices, specifically global work index and global constructive work, improve after cardiac rehabilitation program in patients undergoing coronary artery bypass grafting with preserved left ventricular ejection fraction.https://www.mdpi.com/2077-0383/12/24/7540myocardial workcardiac rehabilitationcoronary artery bypass graftingcoronary artery diseaseechocardiographyglobal longitudinal strain |
| spellingShingle | Francesco Perone Roberta Ancona Fausto di Stasio Vito La Gambina Salvatore Comenale Pinto Myocardial Work Assessment in Patients after Coronary Artery Bypass Grafting during Cardiac Rehabilitation Journal of Clinical Medicine myocardial work cardiac rehabilitation coronary artery bypass grafting coronary artery disease echocardiography global longitudinal strain |
| title | Myocardial Work Assessment in Patients after Coronary Artery Bypass Grafting during Cardiac Rehabilitation |
| title_full | Myocardial Work Assessment in Patients after Coronary Artery Bypass Grafting during Cardiac Rehabilitation |
| title_fullStr | Myocardial Work Assessment in Patients after Coronary Artery Bypass Grafting during Cardiac Rehabilitation |
| title_full_unstemmed | Myocardial Work Assessment in Patients after Coronary Artery Bypass Grafting during Cardiac Rehabilitation |
| title_short | Myocardial Work Assessment in Patients after Coronary Artery Bypass Grafting during Cardiac Rehabilitation |
| title_sort | myocardial work assessment in patients after coronary artery bypass grafting during cardiac rehabilitation |
| topic | myocardial work cardiac rehabilitation coronary artery bypass grafting coronary artery disease echocardiography global longitudinal strain |
| url | https://www.mdpi.com/2077-0383/12/24/7540 |
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