Systematic Evaluation and Meta-analysis of the Effects of Phase I Cardiac Rehabilitation on Heart Function of Patients after Percutaneous Coronary Intervention
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Keywords

Cardiac rehabilitation
PCI
Exercise
Cardiac function
Systematic evaluation

DOI

10.26689/jcnr.v9i6.10985

Submitted : 2025-06-05
Accepted : 2025-06-20
Published : 2025-07-05

Abstract

Objective: To systematically evaluate the impact of phase I cardiac rehabilitation exercise prescriptions on cardiac function levels in patients after coronary intervention. Methods: Seven Chinese and English databases, including Cochrane Library, PubMed, Web of Science, ESC (European Society of Cardiology), and CNKI, as well as professional association websites, were searched using computers, with manual searching as a complement. Relevant literature published from the establishment of the database to February 2025 was retrieved. Two researchers independently screened the literature, extracted data, and evaluated the quality of the literature. Meta-analysis was performed using RevMan 5.3 software. Results: A total of 8 articles were included, involving 843 patients. Meta-analysis results showed that compared with routine nursing, phase I cardiac rehabilitation exercise prescriptions helped increase the 6-minute walking distance in patients after coronary intervention [MD = 0.84, 95% CI (0.57, 1.10), P < 0.001], increase the level of left ventricular ejection fraction in patients after coronary intervention [MD = 0.67, 95% CI (0.33, 1.00), P < 0.001], and cardiac rehabilitation combined with respiratory rehabilitation exercise could improve the level of left ventricular ejection fraction in patients after coronary intervention [MD = 0.58, 95% CI (0.40, 0.76), P < 0.001]. Conclusion: The implementation of phase I cardiac rehabilitation exercise prescriptions can help improve cardiac function levels in patients after coronary intervention. However, the standardization of outcome evaluation indicators needs to be improved, and the long-term effects of rehabilitation still require verification through a large number of high-quality studies.

References

National Center for Cardiovascular Diseases, 2024, Report on Cardiovascular Health and Diseases in China 2023, thesis, Peking Union Medical College Press, Beijing.

Wang H, Zhang H, Zou Z, 2023, Changing Profiles of Cardiovascular Disease and Risk Factors in China: A Secondary Analysis for the Global Burden of Disease Study 2019. Chinese Medical Journal, 136(20): 2431–2441.

Moghei M, Pesah E, Turk-Adawi K, et al., 2019, Funding Sources and Costs to Deliver Cardiac Rehabilitation Around the Globe: Drivers and Barriers. International Journal of Cardiology, 276: 278–286.

National Health Commission of the People’s Republic of China, 2022, China Health Statistics Yearbook 2022, thesis, Peking Union Medical College Press, Beijing.

Ma L, Wang Z, Fan J, et al., 2022, Summary of the Report on Cardiovascular Health and Diseases in China 2021. Chinese Journal of Interventional Cardiology, 30(7): 481–496.

Zhang B, Xu Y, 2010, New Definition of Elective PCI for Acute ST-Segment Elevation Myocardial Infarction – Timely Thrombolysis to Open Coronary Arteries. International Journal of Cardiovascular Disease, 37(3): 132–133.

Fleg JL, Lakatta EG, 1997, Role of Muscle Loss in the Age-Associated Reduction in VO2 Max. Journal of Applied Physiology, 83(6): 1947–1953.

Writing Group of Report on Cardiovascular Health and Diseases in China, 2021, Report on Cardiovascular Health and Diseases in China 2020 Officially Published. Chinese Journal of Cardiovascular Medicine, 26(3): 276.

American Association of Cardiovascular & Pulmonary Rehabilitation, 2021, Rehabilitation Guidelines for Cardiac Rehabilitation Programs. Human Kinetics, Champaign, IL.

Prevention Group of Chinese Medical Association Cardiology Branch, Cardiovascular Disease Professional Committee of Chinese Association of Rehabilitation Medicine, 2015, Chinese Expert Consensus on Exercise Therapy for Patients With Coronary Heart Disease. Chinese Journal of Cardiology, 43(7): 575–588.

Liu Q, Wang Y, Yan N, 2021, Current Status and Progress of Cardiac Rehabilitation After Acute Myocardial Infarction PCI. Clinical Medical Progress, 11(10): 4523–4528.

Kim C, Sung J, Lee J, et al., 2019, Clinical Practice Guideline for Cardiac Rehabilitation in Korea. Annals of Rehabilitation Medicine, 43(3): 355–443.

European Association of Cardiovascular Prevention and Rehabilitation Committee for Science Guidelines, 2010, Secondary Prevention Through Cardiac Rehabilitation: Physical Activity Counselling and Exercise Training: Key Components of the Position Paper From the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation. European Heart Journal, 31(16): 1967–1974.

Anderson JL, Adams CD, Antman EM, et al., 2007, ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction. Journal of the American College of Cardiology, 50(7): e1–e157.

Zhou M, 2021, Current Status, Development, and Reflections on Cardiac Rehabilitation for Cardiovascular Diseases. Journal of Practical Cardio-Cerebral-Pneumal Vascular Disease, 29(9): 6–9.

Chinese Medical Association Cardiology Branch, Cardiovascular Disease Professional Committee of Chinese Association of Rehabilitation Medicine, Cardio-Cerebral Vascular Disease Professional Committee of China Gerontological Society, 2013, Chinese Expert Consensus on Coronary Heart Disease Rehabilitation and Secondary Prevention. Chinese Journal of Cardiology, 41(4): 267–275.

Hu D, 2015, Chinese Guidelines for Cardiovascular Disease Rehabilitation/Secondary Prevention – (2015 Edition). Beijing Science and Technology Press, Beijing.

Che L, Dai C, Liu W, et al., 2022, Chinese Expert Consensus on Tiered Diagnosis and Treatment of Cardiac Rehabilitation. Chinese Journal of Interventional Cardiology, 30(8): 561–572.

Cardiovascular Disease Professional Committee of Chinese Association of Rehabilitation Medicine, 2018, Essentials of Chinese Guidelines for Cardiac Rehabilitation and Secondary Prevention 2018. Chinese Journal of Internal Medicine, 57(11): 802–810.

Qian Y, 2023, The Effect of Early Cardiac Rehabilitation on Cardiac Function and Prognosis of Patients With Acute Myocardial Infarction After PCI, thesis, Jianghan University.

Zheng B, Jin J, Yu M, et al., 2021, Summary of Best Evidence for Exercise Rehabilitation During Hospitalization for Patients With Acute Myocardial Infarction After PCI. Chinese Journal of Modern Nursing, 27(1): 31–37.

Haykowsky M, Scott J, Esch B, et al., 2011, A Meta-Analysis of the Effects of Exercise Training on Left Ventricular Remodeling Following Myocardial Infarction: Start Early and Go Longer for Greatest Exercise Benefits on Remodeling. Trials, 12: 92.

Ren Y, Tian T, Wei G, et al., 2024, Efficacy of Comprehensive Phase I Cardiac Rehabilitation for Patients With ST-Segment Elevation Myocardial Infarction After Emergency Percutaneous Coronary Intervention. Journal of Practical Medicine, 40(5): 682–687.

Taylor JL, Bonikowske AR, Olson TP, 2021, Optimizing Outcomes in Cardiac Rehabilitation: The Importance of Exercise Intensity. Front Cardiovasc Med, 8: 734278.

Li S, 2020, The Effect of Cardiopulmonary Exercise Testing Guided Cardiac Rehabilitation on Cardiopulmonary Reserve Function and Prognosis of Patients With Coronary Heart Disease. China Medical Engineering, 28(02): 94–96.

Chen L, Liu Z, Gao J, et al., 2022, Effects of Exercise Rehabilitation on Cardiopulmonary Function and Prognosis of Patients After PCI. Journal of Clinical Cardiovascular Diseases, 38(07): 577–581.

Chinese Society of Cardiology, Editorial Board of Chinese Journal of Cardiology, 2019, Guidelines for the Diagnosis and Treatment of Acute ST-Segment Elevation Myocardial Infarction (2019). Chinese Journal of Cardiology, 47(10): 766–783.

Jin J, Chen J, Shen W, et al., 2010, Analysis of Factors Associated With Cardiovascular Adverse Events After Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction. Chinese Journal of Cardiology, 38(02): 143–147.

Jian X, Ye X, Lu H, et al., 2020, Comparison of Safety of 6-Minute Walk Test at Different Times for Patients With Phase I Cardiac Rehabilitation After PCI. Journal of Nursing Science, 35(7): 84–86.

Jia F, Wang F, 2022, Application of Phase I Cardiac Rehabilitation Exercise in Post-Emergency PCI Nursing of Patients With Acute Myocardial Infarction. Nursing Research, 36(10): 1868–1870.

Zhu H, Ye Z, Chen Q, et al., 2019, Research Progress on Resistance Factors and Intervention Strategies of Cardiac Rehabilitation Participation Among Patients With Acute Myocardial Infarction. Nursing and Rehabilitation, 18(9): 34–38.

Yang M, Zhang H, Li Q, et al., 2019, The Impact of an Intelligent Management Model Based on the Internet of Things Platform on the Prognosis of Patients With Coronary Heart Disease After Revascularization. Journal of Clinical Cardiology, 35(09): 814–818.

Abtahi F, Tahamtan M, Homayouni K, et al., 2017, Assessment of the Effect of Cardiac Rehabilitation on Echocardiographic Parameters of Left Ventricular Systolic Function in Patients Treated With Primary Percutaneous Coronary Intervention Due to Acute ST-Segment Elevation Myocardial Infarction: A Randomized Clinical Trial. International Cardiovascular Research Journal, 11(4): 130–136.

Chen M, Liang X, Kong L, et al., 2020, Effect of Baduanjin Sequential Therapy on Quality of Life and Cardiac Function in Patients With AMI After PCI: A Randomized Controlled Trial. Evidence-Based Complementary and Alternative Medicine, 2020(1): 8171549.

Liao Y, 2020, Effects of Personalized Cardiac Rehabilitation Training on Cardiac Function Recovery and Cardiovascular Adverse Events After Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction. Heilongjiang Medical Journal, 44(12): 1733–1735.

Bai F, Zhu L, Kong Y, et al., 2020, Study on the Benefits of Cardiac Rehabilitation for Patients With Coronary Heart Disease After Percutaneous Coronary Intervention. Chinese Journal of Integrative Medicine on Cardio-/Cerebrovascular Disease, 18(3): 466–469.

Chen Q, Chen L, Guo X, et al., 2020, Effects of Cardiac Rehabilitation on Endothelial Function, Cardiac Function, and Psychological Cognition in Patients With Acute Myocardial Infarction After Percutaneous Coronary Intervention. Chinese Journal of Geriatrics, 40(19): 4037–4041.

Jiang M, Hua M, Zhang X, et al., 2021, Effect Analysis of Kinetic Energy Progressive Exercise in Patients With Acute Myocardial Infarction After Percutaneous Coronary Intervention: A Randomized Trial. Annals of Palliative Medicine, 10(7): 7823831–7827831.

Zhou Y, Liang Y, Shu C, et al., 2023, Effects of Early Cardiac Rehabilitation Exercise on Cardiac Function and Daily Living Ability in Elderly Patients With Acute Myocardial Infarction After Percutaneous Coronary Intervention. China Modern Medicine, 30(35): 61–64 + 69.

Xu Y, Dong Z, Zhang J, 2023, Application Effect of Phase I Cardiac Rehabilitation Exercise in Post-PCI Nursing of Patients With Acute Myocardial Infarction. Baotou Medical Journal, 47(2): 54–56.