{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T20:53:18Z","timestamp":1792702398537,"version":"4.5.0"},"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T00:00:00Z","timestamp":1712188800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008126","name":"Jeju National University Hospital","doi-asserted-by":"publisher","award":["JNUH 2019-05"],"award-info":[{"award-number":["JNUH 2019-05"]}],"id":[{"id":"10.13039\/501100008126","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>To maintain efficient myocardial function, optimal coordination between ventricular contraction and the arterial system is required. Exercise-based cardiac rehabilitation (CR) has been demonstrated to improve left ventricular (LV) function. This study aimed to investigate the impact of CR on ventricular-arterial coupling (VAC) and its components, as well as their associations with changes in LV function in patients with acute myocardial infarction (AMI) and preserved or mildly reduced ejection fraction (EF). Effective arterial elastance (E<jats:sub>A<\/jats:sub>) and index (E<jats:sub>A<\/jats:sub>I) were calculated from the stroke volume and brachial systolic blood pressure. Effective LV end-systolic elastance (E<jats:sub>LV<\/jats:sub>) and index (E<jats:sub>LV<\/jats:sub>I) were obtained using the single-beat method. The characteristic impedance (Zc) of the aortic root was calculated after Fourier transformation of both aortic pressure and flow waveforms. Pulse wave separation analysis was performed to obtain the reflection magnitude (RM). An exercise-based, outpatient cardiac rehabilitation (CR) program was administered for up to 6 months. Twenty-nine patients were studied. However, eight patients declined to participate in the CR program and were subsequently classified as the non-CR group. At baseline, E\u2019 velocity showed significant associations with E<jats:sub>A<\/jats:sub>I (beta -0.393; <jats:italic>P<\/jats:italic> = 0.027) and VAC (beta -0.375; <jats:italic>P<\/jats:italic> = 0.037). There were also significant associations of LV global longitudinal strain (LV GLS) with E<jats:sub>A<\/jats:sub>I (beta 0.467; <jats:italic>P<\/jats:italic> = 0.011). Follow-up studies after a minimum of 6 months demonstrated a significant increase in E\u2019 velocity (<jats:italic>P<\/jats:italic> = 0.035), improved EF (<jats:italic>P<\/jats:italic> = 0.010), and LV GLS (<jats:italic>P<\/jats:italic> = 0.001), and a decreased E<jats:sub>A<\/jats:sub>I (<jats:italic>P<\/jats:italic> = 0.025) only in the CR group. Changes in E\u2019 velocity were significantly associated with changes in E<jats:sub>A<\/jats:sub>I (beta -0.424; <jats:italic>P<\/jats:italic> = 0.033). Increased aortic afterload and VA mismatch were associated with a negative impact on both LV diastolic and systolic function. The outpatient CR program effectively decreased aortic afterload and improved LV diastolic and systolic dysfunction in patients with AMI and preserved or mildly reduced EF.<\/jats:p>","DOI":"10.1371\/journal.pone.0300578","type":"journal-article","created":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T17:50:20Z","timestamp":1712253020000},"page":"e0300578","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Impact of cardiac rehabilitation on ventricular-arterial coupling and left ventricular function in patients with acute myocardial infarction"],"prefix":"10.1371","volume":"19","author":[{"given":"Ho-Min","family":"Yoon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4322-0703","authenticated-orcid":true,"given":"Seung-Jae","family":"Joo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ki Young","family":"Boo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4915-9584","authenticated-orcid":true,"given":"Jae-Geun","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joon-Hyouk","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song-Yi","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So Young","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,4,4]]},"reference":[{"key":"pone.0300578.ref001","volume-title":"sex, by country and by region, 2000\u20132019","author":"Global health estimates 2019: deaths by cause, age","year":"2020"},{"key":"pone.0300578.ref002","doi-asserted-by":"crossref","first-page":"e2022057","DOI":"10.4178\/epih.e2022057","article-title":"Epidemiology of myocardial infarction in Korea: hospitalization incidence, prevalence, and mortality.","volume":"44","author":"RB Kim","year":"2022","journal-title":"Epidemiol Health"},{"key":"pone.0300578.ref003","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1093\/eurheartj\/ehaa575","article-title":"2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation","volume":"42","author":"JP Collet","year":"2021","journal-title":"Eur Heart J"},{"key":"pone.0300578.ref004","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1093\/eurheartj\/ehx393","article-title":"2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC).","volume":"39","author":"B Ibanez","year":"2018","journal-title":"Eur Heart J"},{"key":"pone.0300578.ref005","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.4070\/kcj.2019.0194","article-title":"Clinical Practice Guideline for Cardiac Rehabilitation in Korea: Recommendations for Cardiac Rehabilitation and Secondary Prevention after Acute Coronary Syndrome.","volume":"49","author":"C Kim","year":"2019","journal-title":"Korean Circ J"},{"key":"pone.0300578.ref006","doi-asserted-by":"crossref","first-page":"504","DOI":"10.3904\/kjim.2019.110","article-title":"Arterial stiffness and cardiovascular risk","volume":"34","author":"JG Lee","year":"2019","journal-title":"Korean J Intern Med"},{"key":"pone.0300578.ref007","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.atherosclerosis.2015.05.007","article-title":"The role of vascular biomarkers for primary and secondary prevention. 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