Effect of Cardiac Rehabilitation on Left Ventricular Remodeling After Acute Anterior Wall ST Segment Elevation Myocardial Infarction Treated by Late PCI Using 3D Echocardiography: A Randomized Study

Background: Cardiac rehabilitation (CR) has emerged as a comprehensive intervention including several facets and disciplines, with the primary objective of inhibiting the advancement of cardiovascular disease in individuals diagnosed with conditions of the heart and promoting overall health restoration. The objective of this research was to assess the effect of CR on the process of left ventricular (LV) remodeling, specifically using three-dimensional echocardiography (3D-ECHO) after an episode of acute ST-segment elevation myocardial infarction (STEMI). Methods: This randomized controlled trial (RCT) was carried out on sixty patients who suffered recently from acute STEMI and treated with delayed percutaneous intervention (PCI). Patients were randomized in a parallel manner into two equal groups: group one: entered a CR program plus the standard medical treatment, and group two: did not receive the rehabilitation program and followed up only with standard medical treatment. All patients received invasive management and were subsequently referred for PCI and coronary angiography of the infarct-related artery, namely the left anterior descending artery (LAD), with the placement of drug-eluting stents within twenty-four hours of symptom onset. Results: Metabolic equivalent (METS) and Exercise duration were significantly higher in group one than group two at follow-up. Also, variances among follow-up and baseline METS were significantly higher at follow-up research in group one while it was insignificantly variant between follow-up and baseline researches research in group two. There was no important variant among Heart Rate Recovery (HRR) one min after exercise among both groups at the baseline, but it was significantly higher in group one than group two at follow-up. HRR two min after exercise at follow-up was significantly higher than at baseline in group one while it was insignificantly variant among follow-up and baseline in group two. LVESV was insignificantly variant among follow-up and baseline after rehabilitation in group 1 while was significantly higher at follow-up after than baseline in group two. There was no important variance in Ejection fraction (EF) among follow-up and baseline following rehabilitation in group one, however, in group 2, EF was considerably greater at follow-up compared to baseline. Conclusions: CR has been shown to have a convenient impact on LV and exercise capacity Remodeling in individuals with STEMI who have had delayed PCI. The delayed commencement of CR was shown to be correlated with a higher degree of LV remodeling. The use of three-dimensional electrocardiography (3D-ECG) has the potential to provide significant insights into LV function and remodeling.