Changes in Rate-Pressure Product with Physical Training of Individuals with Coronary Artery Disease

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Abstract
The purpose of this study was to evaluate the effect of two factors—progression of coronary artery disease and physical training of individuals with coronary artery disease—on rate-pressure product (RPP). Subjects received a resting ECG and exercise test using the Balke protocol. We established three groups, one Experimental (E, n = 71) and two Control (C-1, n = 26; C-2, n = 24). Subjects in Groups E and C-1 had initial tests confirming coronary artery disease; subjects in Group C-2 had initial tests within normal limits. Subjects in Group E received treatment consisting of regular aerobic exercise with controlled intensity, frequency, and duration. Subjects in Groups C-1 and C-2 received no regular exercise. After a 10- to 12-month period, all subjects received a second resting ECG and exercise test using the Balke protocol. Changes in estimated maximal aerobic capacity (V̇o2max), maximal RPP, and submaximal RPP from initial to final tests were analyzed for all groups. Descriptive statistics were done. The lack of significant changes in estimated V̇o2max or in RPP in the Control Groups indicated no effect of progression of the disease or testing procedure familiarity. The estimated V̇o2max for Group E increased significantly (p < .01). Rate-pressure product increased significantly (p < .01) in maximal exercise and decreased significantly (p < .01) in submaximal exercise. This finding suggests that physiological changes both in exercising skeletal muscle and the myocardium play a role in the symptomatic improvements and increased maximal work capacities in individuals with coronary artery disease after regular aerobic exercise. Physical therapists can apply these principles when assessing and training patients with coronary artery disease.

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