Cardiopulmonary and Metabolic Responses to Early Exercise in Patients After Coronary Arterial Bypass Grafting

Federal University of São Paulo

Status: Unknown

Conditions: Physical Activity; Coronary Artery Bypass Graft Triple Vessel; Acute Myocardial Infarction: Rehabilitation Phase

Treatments: Other: Cycle ergometer exercise rehabilitation protocol

Study type: Interventional

Funder types: Other

Identifiers

NCT02758600

53016216.3.0000.5505

Details and patient eligibility

About

Coronary arterial bypass graft surgery (CABG) is proven safe with improved survival and greater quality of life in patients with coronary arterial disease. Evidences on the cardiovascular and gas-exchanges responses during and right after early exercise-based rehabilitation of this patients are limited. Objective: The investigators aim to analyse breath-by-breath cardiopulmonary and metabolic responses during six-minute walk test (6MWT) and shuttle walk test (SWT) in patients with or without left ventricular dysfunction (LVD) after CABG. In addition, the investigators will investigate oxygen consumption and cardiopulmonary responses during the early exercise-based rehabilitation in the first days after surgery. Methods: According to the left ventricular ejection fraction (LVEF), subjects will be allocated into two groups: with LVD (LVEF < 45%) and without LVD (LVEF > 45%). Patients will be submitted to the 6MWT and SWT linked to portable spirometric-telemetric device before and 6 days after CABG. During the first days after surgery, patients will be evaluated about pulmonary function and respiratory strenght at rest and oxygen consumption during the portable cycle ergometer protocol. Clinical outcomes as time to hospital discharge, pulmonary complications and occurence of arrythmias will be assessed during inpatient time until hospital discharge. Incidence of mortality, hospital readmission and angina recurrence will be evaluated in a one-year follow up.

Enrollment: 30 estimated patients

Sex: All

Ages: 35 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age between 35 to 75 years old;
• Coronary arterial disease proved by coronary angiography
• Elective Coronary arterial bypass grafting

Exclusion criteria

• Pulmonary chronic disease
• Disabling neurological or orthopedic disease
• Morbidity obesity
• Urgency surgery
• Bilateral pleural opening
• Arrhythmias during exercise protocol
• Prolonged mechanical ventilation (>12 hours)
• Inability to comprehend or perform the tests

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Single Group Assignment

Masking: Single Blind

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30 participants in 2 patient groups

LVEF < 45%

Experimental group

Description:

Patients with left ventricular dysfunction will be evaluated before and 6 days after after coronary arterial bypass graft surgery. Postoperatively, subjects will be submitted to a portable cycle ergometer exercise protocol from the first day until hospital discharge.

Treatment:

Other: Cycle ergometer exercise rehabilitation protocol

LVEF > 45%

Experimental group

Description:

Patients without left ventricular dysfunction will be evaluated before and 6 days after after coronary arterial bypass graft surgery. Postoperatively, subjects will be submitted to a portable cycle ergometer exercise protocol from the first day until hospital discharge.

Treatment:

Other: Cycle ergometer exercise rehabilitation protocol