Jose Antonio Citalan JimenezCentro Medico Nacional 20 de Noviembre, Mexico
Title: Myocardial efficiency index in patients with heart disease after a cardiac rehabilitation program
The myocardial efficiency index (MEI) correlates the myocardial oxygen consumption (MVO2) with the maximum oxygen consumption (VO2max), this index provides information about thrdiovascular efficiency (CVEf). In athletes, the MEI improves after a microcycle training, however in patients with cardiovascular disease undergoing cardiac rehabilitation program (CRP), IEM behavior could be a good estimator related to the improvement training period. The objective of this study was to determine the myocardial efficiency index behavior in patients with heart disease and high cardiovascular risk (HCVR) after a CRP. Methods: An ambilective, descriptive, analytical, non-randomized cohort study was conducted. Patients with heart disease of mixed etiology and HCVR admitted to a CRP for 4-6 weeks were selected. All patients performed a maximal exercise test in band before and after the CPR. Thresholds of VO2 peak, METs-load, double product (DP), and MEI were determined. A cutoff point for the MEI was established using a ROC curve with a value of 7.37, area under the curve: 0.68 (95% CI = 0.61-0.76, p < 0.001), sensitivity 0.60, and 1-specificity 0.35.
Results: A total of 193 patients with a mean age of 62.3 years were included, predominantly men (66.2%). Percentages changes in the MEI: ?27.1% (p < 0.001), METs: -43.1% (p < 0.001), DP: 5.7% (p < 0.01), and MVO2: 8.3% (p < 0.01) were observed at the end of CRP. Conclusions: Significant change in the MEI was observed after CRP associated to CVEf im¬provement, suggesting that this parameter could be considered as a good clinical tool in the CRP care programs.
Dr. Antonio Citalán completed his cardiology studies at the Hospital Central Sur de Alta Especialidad de Pemex by the National Autonomous University of Mexico. Subsequently, he completed the High Specialty in Cardiac Rehabilitation at the “20 de Noviembre National Medical Center and the High Specialty in Interventional Cardiology, at the Central Military Hospital in Mexico City.