ISSN 2415-3060 e-ISSN 2522-4972
Article Vol. 10, No. 2, 2025 / Pages: 8-16

Features of functional recovery in obese patients with acute myocardial infarction

24.12.2024 Received
28.03.2025 Revised
29.05.2025 Accepted

Abstract

The increasing prevalence of obesity within the general population necessitates the development of effective rehabilitation strategies for post-myocardial infarction patients with excess body weight. The aim of this study was to determine the impact of obesity on the functional recovery of patients undergoing rehabilitation following acute myocardial infarction. The rehabilitation outcomes of patients experiencing their first-ever acute myocardial infarction were analysed. These individuals had been admitted to a specialised cardiac intensive care and resuscitation unit, receiving treatment in accordance with established clinical protocols. The cohort included patients with class I obesity as well as those with a normal body weight. The rehabilitation programme lasted for three months and comprised physical activity, dietary habit modification, psychological support, and educational interventions aimed at preventing cardiovascular diseases. Recovery efficacy was assessed using body mass index, myocardial functional status, physical endurance level (six-minute walk test), and quality of life (SF-36). The findings demonstrated a positive effect of the rehabilitation measures on patients’ functional recovery. However, it was confirmed that individuals with obesity exhibited less pronounced improvements in quality of life (r = 0.77; p < 0.05), poorer adaptation to physical exertion, and slower recovery of haemodynamic parameters compared with patients of normal weight. Excess body weight was found to complicate the rehabilitation process, reduce its effectiveness, and prolong the recovery period. This underscores the rationale for a personalised rehabilitation approach that takes into account the degree of heart failure, pre-morbid physical fitness, and comorbidities. The results obtained may be applied to the development of individualised rehabilitation programmes aimed at improving treatment efficacy, reducing complication risks, and enhancing quality of life in post-myocardial infarction patients

Keywords:
acute coronary syndrome; heart failure; body mass index; rehabilitation; quality of life; exercise tolerance

[1] Bachani AM, Bentley JA, Kautsar H, Neill R, Trujillo AJ. Suggesting global insights to local challenges: Expanding financing of rehabilitation services in low and middle-income countries. Front Rehabil Sci. 2024;5:1305033. DOI: 10.3389/fresc.2024.1305033

[2] Thakker R, Khan M, Al-Hemyari B. Cardiac rehabilitation after hospitalisation for acute coronary syndrome. Curr Cardiol Rep. 2023;25(12):1699–703. DOI: 10.1007/s11886-023-02010-5

[3] Korol S, Wsół A, Puchalska L, Reshetnik A. Medication adherence and its impact on the average life expectancy after stsegment elevation myocardial infarction: The results of the Ukrainian STIMUL registry. Wiad Lek. 2022;75(3):563–9.

[4] Ades PA, Savage PD. The treatment of obesity in cardiac rehabilitation: A review and practical recommendations. J Cardiopulm Rehabil Prev. 2021;41(5):295–301. DOI: 10.1097/HCR.0000000000000637

[5] den Uijl I, Ter Hoeve N, Sunamura M, Stam HJ, Boersma E, Lenzen MJ, et al. Cardiac rehabilitation designed for patients with obesity: OPTICARE XL RCT results on health-related quality of life and psychosocial well-being. Disabil Rehabil. 2023;45(6):1046–55. DOI: 10.1080/09638288.2022.2050428

[6] Wang Y, Chien CW, Xu Y, Tung TH. Effect of exercise-based cardiac rehabilitation on left ventricular function in Asian patients with acute myocardial infarction after percutaneous coronary intervention: A meta-analysis of randomised controlled trials. Healthcare (Basel). 2021;9(6):774. DOI: 10.3390/healthcare9060774

[7] Barnason S, Schuelke S, Miller JN, Miller JJ, Johnson Beller R. Behavioral weight loss interventions for overweight and obese cardiac rehabilitation patients: A systematic review. West J Nurs Res. 2023;45(12):1165–72. DOI: 10.1177/01939459231209735

[8] Schon C, Felismino A, de Sá J, Corte R, Ribeiro T, Bruno S. Efficacy of early cardiac rehabilitation after acute myocardial infarction: Randomized clinical trial protocol. PLOS One. 2024;19(3):e0300855. DOI: 10.1371/journal.pone.0300855

[9] Brown TM, Pack QR, Aberegg E, Brewer LC, Ford YR, Forman DE, et al. Core components of cardiac rehabilitation programs: 2024 update: A scientific statement from the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation. 2024;150(18):e328–47. DOI: 10.1161/ CIR.0000000000001289

[10] Khanna D, Peltzer C, Kahar P, Parmar MS. Body mass index (BMI): A screening tool analysis. Cureus. 2022;14(2):e22119. DOI: 10.7759/cureus.22119

[11] Amato MC, Giordano C. Visceral adiposity index: An indicator of adipose tissue dysfunction. Int J Endocrinol. 2014;2014:730827. DOI: 10.1155/2014/730827

[12] El-Menyar A, Zubaid M, AlMahmeed W, Sulaiman K, AlNabti A, Singh R, et al. Killip classification in patients with acute coronary syndrome: Insight from a multicenter registry. Am J Emerg Med. 2012;30(1):97–103. DOI: 10.1016/j. ajem.2010.10.011

[13] McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. 2023 focused update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2023;44(37):3627–39. DOI: 10.1093/eurheartj/ehad195

[14] Giannitsi S, Bougiakli M, Bechlioulis A, Kotsia A, Michalis LK, Naka KK. 6-minute walking test: A useful tool in the management of heart failure patients. Ther Adv Cardiovasc Dis. 2019;13:1753944719870084. DOI: 10.1177/1753944719870084

[15] Huber A, Oldridge N, Höfer S. International SF-36 reference values in patients with ischemic heart disease. Qual Life Res. 2016;25(11):2787–98. DOI: 10.1007/s11136-016-1316-4

[16] Tereshkevych GT. Fundamentals of bioethics and biosafety. Ternopil: TSMU; 2018. 400 P.

[17] Law of Ukraine No. 123/96-BP. On Medicinal Products [Internet]. 1996 April 4 [cited 2025 March 8]. Available from: https://zakon.rada.gov.ua/laws/show/123/96-вр#Text

[18] Directive of the European Parliament and of the Council 2001/20/EC. On the Approximation of the Laws, Regulations and Administrative Provisions of the Member States Relating to the Implementation of Good Clinical Practice in the Conduct of Clinical Trials on Medicinal Products for Human Use [Internet]. 2001 April 4 [cited 2025 March 8]. Available from: http://data.europa.eu/eli/dir/2001/20/oj

[19] Convention for the protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine: Convention on Human Rights and Biomedicine (ETS No. 164) [Internet]. 1999 December 1 [cited 2025 March 8]. Available from: https://www.coe.int/en/web/conventions/full-list?module=treatydetail&treatynum=164

[20] WMA Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Participants. [Internet]. [cited 2025 March 8]. Available from: https://www.wma.net/policies-post/wma-declaration-of-helsinki/

[21] Global Health Ethics [Internet]. [cited 2025 March 8]. Available from: https://www.who.int/health-topics/ethics-andhealth

[22] Good Clinical Practice [Internet]. [cited 2025 March 8]. Available from: https://www.ema.europa.eu/en/humanregulatory-overview/research-development/compliance-research-development/good-clinical-practice

[23] Order of the Ministry of Health of Ukraine No. 690. On Approval of the Procedure for Conducting Clinical Trials of Medicinal Products and the Expert Evaluation of Clinical Trial Materials, and of the Model Regulations on Ethics Committees [Internet]. 2009 September 23 [cited 2025 March 8]. Available from: https://zakon.rada.gov.ua/laws/ show/z1010-09#Text

[24] Fetisov VS. Statistical data analysis package STATISTICA. Nizhyn: M. Gogol NDU; 2018. 114 P.

[25] Jones D, Spirito A, Sartori S, Vogel B, Edens M, Kamaleldin K, et al. Prognostic impact of in-stent restenosis in normal weight, overweight, and obese patients undergoing percutaneous coronary intervention. Catheter Cardiovasc Interv. 2024;103(2):260–7. DOI: 10.1002/ccd.30939

[26] Husaini M, Deych E, Waken RJ, Sells B, Lai A, Racette SB, et al. Intensive versus traditional cardiac rehabilitation: Mortality and cardiovascular outcomes in a 2016-2020 retrospective medicare cohort. Circ Cardiovasc Qual Outcomes. 2023;16(12):e010131. DOI: 10.1161/CIRCOUTCOMES.123.010131

[27] Chaves G, Turk-Adawi K, Supervia M, Santiago de Araújo Pio C, Abu-Jeish AH, Mamataz T, et al. Cardiac rehabilitation dose around the world: Variation and correlates. Circ Cardiovasc Qual Outcomes. 2020;13(1):e005453. DOI: 10.1161/CIRCOUTCOMES.119.005453

[28] Savarese G, Becher PM, Lund LH, Seferovic P, Rosano GM, Coats AJ. Global burden of heart failure: A comprehensive and updated review of epidemiology. Cardiovasc Res. 2023;118(17):3272–87. DOI: 10.1093/cvr/cvac013

[29] Shahim B, Kapelios CJ, Savarese G, Lund LH. Global public health burden of heart failure: An updated review. Card Fail Rev. 2023;9:e11. DOI: 10.15420/cfr.2023.05

[30] Sun M, Ding Y, Chen K, He Y, Zhang Y, Zhuo Y, et al. The therapeutic efficacy of guided therapy for PCI after acute myocardial infarction: A meta-analysis. Medicine (Baltimore). 2023;102(47):e36183. DOI: 10.1097/ MD.0000000000036183

[31] Janssens GN, van der Hoeven NW, Lemkes JS, Everaars H, van de Ven PM, Marques KMJ, et al. 1-year outcomes of delayed versus immediate intervention in patients with transient ST-segment elevation myocardial infarction. JACC Cardiovasc Interv. 2019;12(22):2272–82. DOI: 10.1016/j.jcin.2019.07.018

[32] Chichareon P, Modolo R, Collet C, Tenekecioglu E, Vink MA, Oh PC, et al. Efficacy and safety of stents in ST-segment elevation myocardial infarction. J Am Coll Cardiol. 2019;74(21):2572–84. DOI: 10.1016/j.jacc.2019.09.038

[33] Rodriguez-Palomares JF, Gavara J, Ferreira-González I, Valente F, Rios C, Rodríguez-García J, et al. Prognostic value of initial left ventricular remodeling in patients with reperfused STEMI. JACC Cardiovasc Imaging. 2019;12(12):2445– 56. DOI: 10.1016/j.jcmg.2019.02.025

[34] Yokoyama H, Higuma T, Endo T, Nishizaki F, Hanada K, Yokota T, et al. Prognostic impact of body mass index and culprit lesion calcification in patients with acute myocardial infarction. Heart Vessels. 2019;34(12):1909–16. DOI: 10.1007/s00380-019-01439-5

[35] Manoharan MP, Raja R, Jamil A, Csendes D, Gutlapalli SD, Prakash K, et al. Obesity and coronary artery disease: An updated systematic review 2022. Cureus. 2022;14(9):e29480. DOI: 10.7759/cureus.29480

[36] Calabrò P, Moscarella E, Gragnano F, Cesaro A, Pafundi PC, Patti G, et al. Effect of body mass index on ischemic and bleeding events in patients presenting with acute coronary syndromes (from the START-ANTIPLATELET Registry). Am J Cardiol. 2019;124(11):1662–8. DOI: 10.1016/j.amjcard.2019.08.030

[37] Pokrajac-Bulian A, Ambrosi-Randić N. Illness perception in overweight and obese patients with cardiovascular diseases. Eat Weight Disord. 2020;25(1):69–78. DOI: 10.1007/s40519-018-0506-1

[38] Backhaus SJ, Kowallick JT, Stiermaier T, Lange T, Koschalka A, Navarra JL, et al. Culprit vessel-related myocardial mechanics and prognostic implications following acute myocardial infarction. Clin Res Cardiol. 2020;109(3): 339–49. DOI: 10.1007/s00392-019-01514-x

[39] larke JD, Kennedy R, Duarte Lau F, Lancaster GI, Zarich SW. Invasive evaluation of the microvasculature in acute myocardial infarction: Coronary flow reserve versus the index of microcirculatory resistance. J Clin Med. 2019;9(1): 86. DOI: 10.3390/jcm9010086

[40] Munyombwe T, Hall M, Dondo TB, Alabas OA, Gerard O, West RM, et al. Quality of life trajectories in survivors of acute myocardial infarction: A national longitudinal study. Heart. 2020;106(1):33–9. DOI: 10.1136/heartjnl-2019-315510

APA Style
Zhukova, Yu., Zak, M., & Chelengirov, V. (2025). Features of functional recovery in obese patients with acute myocardial infarction. Ukrainian Journal of Medicine, Biology and Sports, 10(2) , 8-16. https://doi.org/10.63341/ujmbs/2.2025.08
Vancouver Style
Zhukova Yu, Zak M, Chelengirov V. Features of functional recovery in obese patients with acute myocardial infarction. Ukr J Med Biol Sport. 2025;10(2):8–16. doi:10.63341/ujmbs/2.2025.08

What are you looking for?