{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T04:50:03Z","timestamp":1791348603648,"version":"4.3.1"},"reference-count":47,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2021,9,9]],"date-time":"2021-09-09T00:00:00Z","timestamp":1631145600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Centre of Postgraduate Medical Education, Warsaw, Poland","award":["501-1-10-14-15"],"award-info":[{"award-number":["501-1-10-14-15"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Cardiac rehabilitation (CR) is indicated in all patients after acute myocardial infarction (AMI) to improve prognosis and exercise capacity (EC). Previous studies reported that up to a third of patients did not improve their EC after CR (non-responders). Our aim was to assess the cardiac and peripheral mechanisms of EC improvement after CR using combined exercise echocardiography and cardiopulmonary exercise testing (CPET-SE). The responders included patients with an improved EC assessed as a rise in peak oxygen uptake (VO2) \u2265 1 mL\/kg\/min. Peripheral oxygen extraction was calculated as arteriovenous oxygen difference (A-VO2Diff). Out of 41 patients (67% male, mean age 57.5 \u00b1 10 years) after AMI with left ventricular ejection fraction (LVEF) \u2265 40%, 73% improved their EC. In responders, peak VO2 improved by 27% from 17.9 \u00b1 5.2 mL\/kg\/min to 22.7 \u00b1 5.1 mL\/kg\/min, p &lt; 0.001, while non-responders had a non-significant 5% decrease in peak VO2. In the responder group, the peak exercise heart rate, early diastolic myocardial velocity at peak exercise, LVEF at rest and at peak exercise, and A-VO2Diff at peak exercise increased, the minute ventilation to carbon dioxide production slope decreased, but the stroke volume and cardiac index were unchanged after CR. Non-responders had no changes in assessed parameters. EC improvement after CR of patients with preserved LVEF after AMI is associated with an increased heart rate response and better peripheral oxygen extraction during exercise.<\/jats:p>","DOI":"10.3390\/jcm10184083","type":"journal-article","created":{"date-parts":[[2021,9,9]],"date-time":"2021-09-09T12:20:37Z","timestamp":1631190037000},"page":"4083","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Mechanisms of Exercise Capacity Improvement after Cardiac Rehabilitation Following Myocardial Infarction Assessed with Combined Stress Echocardiography and Cardiopulmonary Exercise Testing"],"prefix":"10.3390","volume":"10","author":[{"given":"Krzysztof","family":"Smarz","sequence":"first","affiliation":[{"name":"Centre of Postgraduate Medical Education, Department of Cardiology,  Grochowski Hospital, 04-073 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomasz","family":"Jaxa-Chamiec","sequence":"additional","affiliation":[{"name":"Centre of Postgraduate Medical Education, Department of Cardiology,  Grochowski Hospital, 04-073 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beata","family":"Zaborska","sequence":"additional","affiliation":[{"name":"Centre of Postgraduate Medical Education, Department of Cardiology,  Grochowski Hospital, 04-073 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9838-8669","authenticated-orcid":false,"given":"Maciej","family":"Tysarowski","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Hartford Hospital, University of Connecticut School of Medicine, Hartford, CT 06106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrzej","family":"Budaj","sequence":"additional","affiliation":[{"name":"Centre of Postgraduate Medical Education, Department of Cardiology,  Grochowski Hospital, 04-073 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.ahj.2008.03.017","article-title":"Peak aerobic capacity predicts prognosis in patients with coronary heart disease","volume":"156","author":"Keteyian","year":"2008","journal-title":"Am. 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