Article

OBJECTIVE: To assess whether exercise volume during phase II rehabilitation
affects long-term clinical benefits in patients with coronary artery disease. Prospective randomized clinical trial with long-term follow-up. SETTING:
Hospital outpatient clinic. SUBJECTS: Coronary artery disease patients (age 65
+/- 9 years, 82% males) attending a phase II rehabilitation programme were
randomized into two groups of exercise volumes: 40- versus 60-minute training
sessions. Patients exercised for three days per week for seven weeks, at 65% of
baseline oxygen uptake capacity. Next, they were followed up for 18 months. Out
of 165 patients with coronary artery disease who completed the exercise
intervention, 119 attended the 18-month follow-up assessment. MAIN MEASUREMENTS:
Body anthropometrics, resting haemodynamics, blood lipid profile, glycaemia, and
C-reactive protein level, smoking behaviour, habitual physical activity,
cardiovascular disease incidence and mortality. RESULTS: In total population, a
significant worsening of various cardiovascular disease risk factors was found at
18 months follow-up (P<0.05), and few patients (27% of total group) adhered to
the recommended minimal physical activity level. No difference in change of body
anthropometrics, resting haemodynamics, blood lipid profile, glycaemia, and
C-reactive protein level, and smoking behaviour was seen between different
exercise volumes (P>0.05). In addition, total cardiovascular disease incidence
(13% versus 22% in 40- versus 60-minute group, respectively) and habitual
physical activity were not different between groups (P>0.05). CONCLUSION: In
patients with coronary artery disease following cardiac rehabilitation, the
cardiovascular disease risk profile worsened significantly during long-term
follow-up. A smaller exercise volume during phase II rehabilitation generated
equal long-term clinical benefits compared to a greater exercise volume.

Langue : ANGLAIS