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Baseline subendocardial viability ratio influences left ventricular systolic improvement with cardiac rehabilitation [Anatol J Cardiol]
Anatol J Cardiol. 2017; 17(1): 37-43 | DOI: 10.14744/AnatolJCardiol.2016.7009  

Baseline subendocardial viability ratio influences left ventricular systolic improvement with cardiac rehabilitation

Emre Aslanger1, Benjamin Assous2, Nicolas Bihry2, Florence Beauvais3, Damien Logeart3, Alain Cohen Solal3
1Department of Cardiology, Yeditepe University Hospital; Ýstanbul-Turkey
2Department of Cardiology, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP); Paris-France
3Department of Cardiology, UMR-S 942, Université Paris Diderot, DHU FIRE, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP); Paris-France

Objective: Subendocardial viability ratio (SEVR), defined as diastolic to systolic pressure-time integral ratio, is a useful tool reflecting the balance between coronary perfusion and arterial load. Suboptimal SEVR creating a supply–demand imbalance may limit favorable cardiac response to cardiac rehabilitation (CR). To explore this hypothesis, we designed a study to analyze the relationship between baseline SEVR and response to CR in patients with coronary artery disease (CAD).
Methods: In this prospectively study, after baseline arterial tonometry, echocardiography, and cardiopulmonary exercise tests (CPETs), patients undergone 20 sessions of CR. Post-CR echocardiographic and CPET measurements were obtained for comparison.
Results: Final study population was comprised of fifty subjects. Study population was divided into two subgroups by median SEVR value (1.45, interquartile range 0.38). Although both groups showed significant improvements in peak VO2, significant improvements in oxygen pulse (πO2) (from 16.1±3.4 to 19.1±4.8 mL O2.kg–1.beat–1; p<0.001) and stroke volume index (from 31±5 to 35±6 mL; p=0.008) were observed in only the patients in the above-median subgroup. The change in πO2 was also significantly higher in the above-median SEVR subgroup (2.9±3.3 vs. 0.5±2.4; p=0.007).
Conclusion: Our study shows that baseline supply–demand imbalance may limit systolic improvement response to CR in patients with CAD. (Anatol J Cardiol 2017; 17: 37-43)

Keywords: arterial tonometry, cardiac rehabilitation, coronary artery disease, exercise training; subendocardial viability ratio


Emre Aslanger, Benjamin Assous, Nicolas Bihry, Florence Beauvais, Damien Logeart, Alain Cohen Solal. Baseline subendocardial viability ratio influences left ventricular systolic improvement with cardiac rehabilitation. Anatol J Cardiol. 2017; 17(1): 37-43

Corresponding Author: Emre Aslanger, Türkiye


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