Effect of phase 1 cardiac rehabilitation for cardiac autonomic dysfunction and anxiety-depression after acute myocardial infarction─Comparison by the β-blocker administration─ 【本論文は第27 回日本冠疾患学会学術集会(2013 年12 月・和歌 山)にて発表した.】


Background: Cardiac autonomic dysfunction and anxiety-depression is prognostic factors after acute myocardial infarction (AMI). Cardiac rehabilitation (CR) is an effective treatment for cardiac autonomic dysfunction and anxietydepression. Also β-blocker can be expected to have the effect of improving the prognosis of heart disease.

Purpose: This study aim is to verify that effect of the phase 1 cardiac rehabilitation and β-blocker for cardiac autonomic function and anxiety-depression.

Methods: Subjects were AMI patients that discharged after carrying out CR. I have evaluated the heart rate variability (HRV) and HADS at the time of start of CR and discharge. We compared the parameters at the time of start of CR and discharge, and a comparison was made with and without β-blocker.

Results: Subjects were 40 patients (23 patients with β-blocker and 17 patients without β-blocker). Recognizing the improvement in HRV at discharge, also anxiety was reduced. Parasympathetic function was significantly higher in with β-blocker.

Conclusion: This study showed a trend toward improvement in autonomic function and anxiety by Phase 1 CR, and it is showed parasympathetic function improved and anxiety reduction by β-blocker. This study suggests the efficacy of combination therapy by CR and β-blocker.