Effects of Cardiac Rehabilitation on Symptoms and Quality of Life in Cardiopulmonary Exercise Test-Positive Patients With Non-Obstructive Coronary Artery Disease From High Altitudes
Abstract
Objective To assess the effect of cardiac rehabilitation on symptoms and quality of life in patients with coronary artery disease (Non-obCAD) living at high altitudes who have positive results for cardiopulmonary exercise testing.
Methods A randomized controlled study was conducted. Hospitalized patients with suspected coronary heart disease were enrolled for coronary angiography. Based on the angiography findings, patients with Non-obCAD underwent cardiopulmonary exercise testing, and those with positive results were included in the study. With a random number table, patients with positive results for cardiopulmonary exercise testing were assigned to two groups, an experimental group receiving cardiac rehabilitation (individualized exercise plan) plus standard treatment and a control group receiving standard treatment alone. At enrollment and the 3-months follow-up, Seattle Angina Questionnaire (SAQ) and the 36-item Short-Form Health Survey (SF-36) were used to evaluate the patients. The data of the two groups were analyzed and compared to evaluate the effect of cardiac rehabilitation on the symptoms and quality of life in Non-obCAD patients living at high altitudes who have positive results for cardiopulmonary exercise testing.
Results A total of 100 patients were included in the study, with 50 patients in the experimental group and 50 in the control group. The mean age in the experimental group was (55.0±6.8) years, while that in the control group was (56.6±9.1) years. Notably, at the time of enrollment, no significant differences were found between the two groups across all the SAQ measures. However, after 3 months of follow-up, the experimental group scored higher than the control group did in terms of physical limitation (75.6±5.0 vs. 72.1±5.9), angina stability (69.6±6.4 vs. 62.5±9.6), angina frequency (70.8±9.1 vs. 65.3±9.3), treatment satisfaction (79.5±5.0 vs. 76.3±4.7), and disease perception (84.9±5.2 vs. 80.4±3.8), with statistically significant differences between the two groups (P<0.05). At the time of enrollment, the two groups showed no significant differences in any of the SF-36 measures. However, at the 3-month follow-up, the experimental group had better scores than the control group did in physiological functioning (27.4±2.4 vs. 25.8±3.0), role—physical (6.6±1.2 vs. 6.0±0.8), bodily pain (4.7±1.3 vs. 4.1±1.0), general health (20.2±2.2 vs. 19.0±1.8), vitality (15.8±2.1 vs. 14.5±2.1), social functioning (7.2±1.3 vs. 6.4±1.1), role—emotional (5.2±1.1 vs. 4.7±1.2), and mental health (22.9±2.7 vs. 20.8±2.1) (P<0.05).
Conclusion Cardiac rehabilitation is conducive to improvements in symptom and quality of life in Non-obCAD patients in high altitude areas with positive results for cardiopulmonary exercise testing. No adverse cardiovascular events occurred during the rehabilitation period, which validates preliminarily the safety and efficacy of cardiac rehabilitation in this patient population.
Keywords: Cardiopulmonary exercise testing, High altitude, Non-obstructive coronary artery disease, Cardiac rehabilitation, Seattle Angina Questionnaire, 36-item Short-Form Health Survey
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