Effect of Cardiac Rehabilitation Program on Right Ventricular Function after Acute Inferior Wall Myocardial Infarction

Background: Right ventricular (RV) dysfunction commonly follows acute inferior wall myocardial infarction (IWMI), especially in cases involving RV infarction. Objective: To evaluate impact of a cardiac rehabilitation (CR) program on RV function in patients with acute IWMI using speckle tracking echocardiography (STE) to measure RV longitudinal strain. Patients and Methods: A prospective cohort study was conducted on 50 patients with acute IWMI, treated with primary percutaneous coronary intervention (PCI). RV function was assessed using traditional echocardiographic measures and STE-derived RV global longitudinal strain (GLS) within 48 hours of admission and after a 3-month CR program. Patients were divided into two groups: 25 participated in CR program, and 25 served as controls. Key parameters included tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (FAC), RV free wall strain (RV FWS), and RV GLS. Results: At baseline, RV FWS and RV GLS were impaired in 90% and 82% of entire population, respectively. After 3 months, both groups showed significant improvements in TAPSE (p < 0.001) and FAC (p < 0.001). Notably, CR group exhibited greater improvements in RV FWS (-3.78±2.61% vs. -1.19±2.63%, p=0.001) and RV GLS (-4.93±3.63% vs. -0.16±8.30%, p=0.007) compared to controls. Conclusion: CR program significantly enhanced RV function, as evidenced by improvements in RV FWS and RV GLS, compared to conventional care. This highlights importance of CR in improving functional recovery post-IWMI.