P83 Different Protocols for Early Cardiac Rehabilitation Modulate the Vascular Function of Individuals Undergoing Coronary Artery Bypass Grafting: Randomized Clinical Trial

Abstract

Background

Cardiac rehabilitation with aerobic exercises is the first strategy as a non-pharmacological treatment in the postoperative period of individuals undergoing coronary artery bypass grafting (CABG) to improve functional capacity and vascular health. However, other exercise modalities remain uncertain as to the same benefits. Purpose: To evaluate the effect of different modalities of exercise, such as early cardiac rehabilitation, on subjects submitted to CABG on the percentage of flow-mediated dilatation (FMD) of the brachial artery and vascular resistance.

Methods

A randomized clinical trial in which 15 patients (62.7±6.5years) underwent CABG were randomly assigned to the following groups: isometric (IG, Handgrip Jamar Ò), ventilatory muscle training (VG, Power-Breathe Ò) and control (CG, conventional respiratory and motor physiotherapy). All patients received physical attendance twice a day (20 minutes/session) for a consecutive week after the CABG (hospital admission). Endothelial function was assessed through the technique FMD before and after (~7 days) admission to CABG. The doppler ultrasound videos were analyzed by CardiovascularSuite Ò software to measure %FMD. Statistics: Generalized estimation equation, followed by Bonferroni post-hoc (p < 0.05).

Results

Systolic, diastolic and mean arterial pressure (SBP/DBP/MAP, respectively) was of 133, 76, 95 mmHg. The groups presented %FMD before and after intervention of: IG 9,2–2,7% p = 0,71; VG 9,7–10,9% p = 0,82; CG 10,4 – 2,9% p = 0,15 and medium flow of: IG 245,5 – 207,6 mL/min p = 0,84; VG 83,7 – 58,7 mL/min p = 0,04; CG 94,6 – 101,2 mL/min p = 0,89.

Conclusions

Different protocols for early cardiac rehabilitation modulate the vascular function of individuals undergoing CABG.