Impact Of CPET-based Home Cardiac Rehabilitation On Cardiopulmonary Function And Quality Of Life In Patients Undergoing PCI For Acute Myocardial Infarction

Objective This paper aims to investigate the effects of home cardiac rehabilitation（CR）therapy based on cardiopulmonary exercise test（CPET）guidance on cardiopulmonary function and quality of life of patients after PCI for acute myocardial infarction,which is expected to benefit patients from CR and provide a basis for home cardiac rehabilitation therapy for patients after PCI for myocardial infarction.Methods 1.This study selected 96 post-PCI patients who were admitted to the Cardiovascular Medicine Department of Ordos Central Hospital from November 2021 to September 2022 and who matched the inclusion and exclusion criteria as the study population.Using a random number table method,patients were randomly divided into experimental and control groups.2.The general data of the included patients were collected,including age,sex,body mass index,blood lipids,blood pressure,whether hypertensive disease was combined,whether diabetes mellitus was combined,whether cerebral infarction was combined,whether heart failure was combined,whether cancer was combined,whether chronic obstructive pulmonary disease was combined,the number of coronary artery lesions and the number of stents placed.3.The control group was given the following interventions:Post-PCI conventional treatment.The experimental group was given the following interventions:Cardiac rehabilitation treatment for 6 months after 1 month of discharge from the hospital on top of the conventional treatment.4.All patients underwent cardiac ultrasound,cardiopulmonary exercise test and Seattle Angina Scale assessment at 1 month after discharge,and the cardiac ultrasound,cardiopulmonary exercise test and Seattle Angina Scale assessment were repeated 6 months after the intervention.5.The cardiac ultrasound results,cardiopulmonary exercise test indexes and Seattle Angina Scale scores were compared in the experimental group before and after the intervention（intra-group comparison）.In the control group,cardiac ultrasound results,cardiopulmonary exercise test indices,and Seattle Angina Scale scores were compared before and after the intervention（intra-group comparison）.The above indicators and scores were compared between the two groups before the intervention（between-group comparison）,and then the above indicators and scores were compared between the two groups after the intervention（between-group comparison）.At the end of the study,the difference between the above indicators and scores of patients in the two groups was compared（difference between pre-intervention and post-intervention）.Results 1.The general data of the patients in the two groups were compared,and the differences were not statistically significant（P>0.05）.2.The LVEF,LVEDD,the indexes of cardiopulmonary exercise test and the scores of each dimension of SAQ were compared between the two groups of patients before the intervention,and the differences were not statistically significant（P>0.05）.3.（1）.After 6 months of intervention,the left ventricular ejection fraction（LVEF）of the patients in the experimental group was higher than before,and the difference was statistically significant（P<0.05）.The left ventricular end-diastolic diastolic diameter（LVEDD）was lower than before,and the difference was statistically significant（P<0.05）.In the control group,the left ventricular ejection fraction（LVEF）was higher than before,and the difference was statistically significant（P<0.05）.LVEDD did not change significantly from before,and the difference was not statistically significant（P>0.05）.At the end of the study,there was no statistically significant difference in LV end-diastolic anteroposterior diameter between the two groups（P>0.05）,and there was a statistically significant difference in LV ejection fraction（P<0.05）.The differences in cardiac ultrasound indices between the two groups at the end of the study were compared:LVEDD:-0.10 mm（-3.00,2.00）in the control group and-2.00 mm（-3.00,1.75）in the experimental group,P>0.05,the differences were not statistically significant.LVEF:2.00%（0.00,3.00）in the control group and 4.00%（1.00,5.00）in the experimental group,P<0.05,with statistically significant differences.（2）.Through the 6-month intervention treatment,the peak oxygen uptake,peak oxygen pulse,peak metabolic equivalent,and anaerobic threshold metabolic equivalent of the experimental group were significantly improved compared with the previous ones,and the difference was statistically significant（P<0.05）.The ventilatory equivalent for carbon dioxide slope（VE/VCO₂slope）was lower than before,and the difference was statistically significant（P<0.05）.In the control group,peak oxygen uptake,peak oxygen pulse,peak metabolic equivalent,and anaerobic threshold metabolic equivalent were significantly higher than before,and the differences were statistically significant（P<0.05）.The ventilatory equivalent for carbon dioxide slope was lower than before,and the difference was statistically significant（P<0.05）.At the end of the study,the differences in peak oxygen uptake,peak oxygen pulse,peak metabolic equivalent,anaerobic threshold metabolic equivalent,and VE/VCO₂slope were statistically significant between the two groups（P<0.05）.The differences in cardiopulmonary function indexes between the two groups were compared at the end of the study:The differences in peak oxygen uptake,anaerobic threshold metabolic equivalent,peak metabolic equivalent,maximum oxygen pulse and VE/VCO₂slope were statistically significant（P<0.05）.（3）.Through the 6-month intervention treatment,the scores of the dimensions of physical limitation（PL）,angina stability（AS）,angina frequency（AF）,treatment satisfaction（TS）,and disease perception（DP）on the Seattle Rating Scale（SAQ）in the experimental group were significantly improved compared with those before the intervention.The differences were statistically significant（P<0.05）.In the control group,the scores of PL,AS,AF,TS,and DP on the Seattle Assessment Scale（SAQ）were significantly higher than those before the intervention,and the differences were statistically significant（P<0.05）.At the end of the study,the differences in PL,AS,AF,TS,and DP were statistically significant（P<0.05）when comparing the two groups of patients.At the end of the study,the comparison of the difference between the two groups of patients’SAQ scores in each dimension:The differences had statistical significance（P<0.05）when comparing the differences between the above indicators of PL,AS,AF,TS,and DP.Conclusion The combination of CPET-based home cardiac rehabilitation therapy on top of general treatment can improve ventricular remodeling and ventricular ejection function to a certain extent in patients undergoing PCI for acute myocardial infarction,effectively improve cardiopulmonary function and exercise tolerance,and improve the quality of life of patients.