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Myocardial infarction is related with endothelial function, arterial stiffness and autonomic nervous system dysfunction, but also with arterial hypertension. Hypertension by itself is also related with endothelial function, arterial stiffness and autonomic nervous system dysfunction.
Primary aim of study is to investigate how complex cardiac rehabilitation influence endothelial function, arterial stiffness and autonomic nervous system activity according to presence or absence arterial hypertension.
Secondary aim is to obtain correlation between methods for the assessment of particular disorders and intercorrelation between different disorders for example endothelial function and autonomic nervous system activity.
We expect that in study groups PWV will improve better that in control group. 5% of the limit value of p <0.05.
We expect that in study groups AASI will improve better that in control group. 5% of the limit value of p <0.05.
We expect that in study groups AI will improve better that in control group. 5% of the limit value of p <0.05.
We expect that time and frequency parameters of HRV will increase in study group. 5% of the limit value of p <0.05.
We expect that parameters of HRT will improve in study group. 5% of the limit value of p <0.05.
We expect improvement in RHI in study group. 5% of the limit value of p <0.05.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CR with AH | Patients after ACS with arterial hypertension treat with comprehensive cardiac rehabilitation |
| |
| N-CR with AH | Patients after ACS with arterial hypertension don't treat with comprehensive cardiac rehabilitation. | ||
| CR without AH | Patients after ACS without arterial hypertension treat with comprehensive cardiac rehabilitation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| comprehensive cardiac rehabilitation | Other | Standard program of comprehensive cardiac rehabilitation CR with physical activity, behavioral intervention, risk factor modification and intervention. |
| Measure | Description | Time Frame |
|---|---|---|
| Arterial stiffness - Pulse wave velocity (PWV) | Arterial stiffness will be obtained by measuring carotid-femoral pulse wave velocity using Complior device. | 24 month |
| Arterial stiffness - Ambulatory arterial stiffness index (AASI) | AASI index will be calculated by non-commercial software using data from ambulatory blood pressure monitoring. | 24 month |
| Arterial stiffness - Augmentation index (AI) | AI will be calculated by EndoPAT2000 system. | 24 month |
| Measure | Description | Time Frame |
|---|---|---|
| Heart rate variability (HRV) | HRV parameters in time and frequency domain will be calculated by software Cardioscan 12. | 24 month |
| Heart rate turbulence (HRT) | HRT parameters will be calculated by Cardioscan 10 software. |
| Measure | Description | Time Frame |
|---|---|---|
| Endothelial function - Reactive hyperaemia index(RHI) | RHI parameter of microvascular endothelial function will be calculated by EndoPAT2000 system. | 24 month |
| Endothelial function - VEGF-A, ADMA | Group of 40 patient will be involved in sub-study with assessment of 2 markers of endothelial function: Vascular Endothelial Growth Factor A (VEGF-A) will be obtained by ELISA method to assess collateral circulation development during ischemia. Asymmetric dimethylarginine (ADMA) will be obtained by ELISA method to assess the ability of the synthesis of nitric oxide. |
Inclusion Criteria:
Exclusion Criteria:
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Patient after troponin-positive acute coronary syndrome (ACS) with or without arterial hypertension.
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| Name | Affiliation | Role |
|---|---|---|
| Malgorzata Kurpesa, Professor | Departament of Cardiology Medical University of Lodz | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Departament of Cardiology | Lodz | Łódź Voivodeship | 91-347 | Poland |
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| ID | Term |
|---|---|
| D054058 | Acute Coronary Syndrome |
| D006973 | Hypertension |
| ID | Term |
|---|---|
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D014652 | Vascular Diseases |
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VEGF-A, ADMA, NT-proBNP, creatinine, uric acid, LDL, HDL, total cholesterol, trigliceride, ALT,GGTP, CRP, fibrinogen,
| 24 month |
| 24 month |