Effect Of Early Cardiac Rehabilitation On Cardiopulmonary Function In Patients With Acute Myocardial Infarction After Emergency PCI

Objective:The purpose of this study was to investigate the effect of early cardiac rehabilitation on cardiopulmonary function in patients with acute myocardial infarction who underwent emergency PCI.It is also to comprehensively promote the cardiac rehabilitation of patients after PCI,establish out-of-hospital follow-up,and provide a certain basis for the cardiac rehabilitation of patients after PCI in the future.Methods:A total of 104 patients with AMI diagnosed in the Department of Cardiology of a third-class hospital in Yan’an from October 2020 to November 2021were selected and underwent emergency PCI via radial artery.All patients were given oral antiplatelet drugs and lipid-lowering drugs before operation.They were randomly divided into experimental group and control group.The general information of all patients（age,sex,body mass index,smoking history,hypertension,diabetes,number of coronary stents,number of diseased coronary arteries and Killp classification at admission）were collected.Among them,the control group was given routine rehabilitation treatment after PCI,while the experimental group was further given cardiac rehabilitation treatment.The patients in the two groups were reexamined 1 month and 3months after discharge.The indexes of echocardiography during hospitalization and 3months after discharge were compared,and the indexes of cardiopulmonary exercise test1 month and 3 months after discharge were compared between the two groups.at the same time,the indexes of cardiopulmonary exercise test at 1 month and 3 months after discharge in the experimental group were compared.All the collected data were analyzed by SPSS25.0.The difference was statistically significant.Results:The comparison of the general information of the two groups showed that there was no significant difference between the two groups（P>0.05）.There was no significant difference in the results of echocardiography between the two groups at admission（P>0.05）.Three months after discharge,echocardiography showed that the left ventricular end-diastolic anteroposterior diameter of the experimental group was lower than that of the control group,while the left ventricular ejection fraction was significantly higher than that of the control group（P<0.05）.Cardiopulmonary exercise test was performed one month after discharge.There was no significant difference in the mean value of anaerobic threshold heart rate,peak RER,and the M（P25,P75）of peak heart rate,anaerobic threshold RER,minute ventilation,VE/VCO₂slope,ΔVO₂/ΔWR between the two groups（P>0.05）.However,the mean of peak oxygen uptake,peak metabolic equivalent and maximum oxygen pulse in the experimental group were significantly higher than those in the control group.In addition,the M（P25,P75）of anaerobic threshold oxygen uptake and the anaerobic threshold metabolic equivalent in the experimental group were also higher than those in the control group.There was significant difference between the two groups（P<0.05）.Cardiopulmonary exercise test was performed again 3 months after discharge.There was no significant difference in the M（P25,P75）of anaerobic threshold heart rate,peak heart rate,anaerobic threshold RER,minute ventilation,ΔVO₂/ΔWR,and the average value of anaerobic threshold oxygen uptake,anaerobic threshold metabolic equivalent,peak RER between the two groups（P>0.05）.However,the average value of the peak oxygen uptake,peak metabolic equivalent,maximum oxygen pulse and the M（P25,P75）of VE/VCO₂slope in the test group were significantly better than those in the control group（P<0.05）.The indexes of cardiopulmonary exercise at 1 month and 3 months after discharge in the experimental group were compared.With the time of discharge lengthens,there was no significant difference in the M（P25,P75）of anaerobic threshold heart rate,peak heart rate,and the average value of anaerobic threshold RER and peak RER in the experimental group（P>0.05）.However,the mean value of anaerobic threshold oxygen uptake,peak oxygen uptake,anaerobic threshold metabolic equivalent,peak metabolic equivalent,maximal oxygen pulse and the M（P25,P75）of minute ventilation,VE/VCO₂slope,ΔVO₂/ΔWR at 3 months after discharge were significantly higher than those at 1 month after discharge（P<0.05）.Conclusion:1.On the basis of general treatment combined with early cardiac rehabilitation,to a certain extent,emergency PCI in patients with acute myocardial infarction can improve ventricular remodeling and ventricular ejection function.2.Early cardiac rehabilitation for emergency patients undergoing PCI can effectively improve cardiac function and exercise tolerance,and at the same time recover ventilatory function to a certain extent.3.The longer the time of cardiac rehabilitation treatment,the better the recovery effect of cardiac function,exercise endurance and ventilatory function for patients with acute myocardial infarction after emergency PCI.