Document Detail


Effects of long-term exercise training on autonomic control in myocardial infarction patients.
MedLine Citation:
PMID:  22025377     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Autonomic dysfunction, including baroreceptor attenuation and sympathetic activation, has been reported in patients with myocardial infarction (MI) and has been associated with increased mortality. We tested the hypotheses that exercise training (ET) in post-MI patients would normalize arterial baroreflex sensitivity (BRS) and muscle sympathetic nerve activity (MSNA), and long-term ET would maintain the benefits in BRS and MSNA. Twenty-eight patients after 1 month of uncomplicated MI were randomly assigned to 2 groups, ET (MI-ET) and untrained. A normal control group was also studied. ET consisted of three 60-minute exercise sessions per week for 6 months. We evaluated MSNA (microneurography), blood pressure (automatic oscillometric method), heart rate (ECG), and spectral analysis of RR interval, systolic arterial pressure (SAP), and MSNA. Baroreflex gain of SAP-RR interval and SAP-MSNA were calculated using the α-index. At 3 to 5 days and 1 month after MI, MSNA and low-frequency SAP were significantly higher and BRS significantly lower in MI patients when compared with the normal control group. ET significantly decreased MSNA (bursts per 100 heartbeats) and the low-frequency component of SAP and significantly increased the low-frequency component of MSNA and BRS of the RR interval and MSNA. These changes were so marked that the differences between patients with MI and the normal control group were no longer observed after ET. MSNA and BRS in the MI-untrained group did not change from baseline over the same time period. ET normalizes BRS, low-frequency SAP, and MSNA in patients with MI. These improvements in autonomic control are maintained by long-term ET. These findings highlight the clinical importance of this nonpharmacological therapy based on ET in the long-term treatment of patients with MI.
Authors:
Daniel G Martinez; José C Nicolau; Rony L Lage; Edgar Toschi-Dias; Luciana D N J de Matos; Maria Janieire N N Alves; Ivani C Trombetta; Valdo J Dias da Silva; Holly R Middlekauff; Carlos E Negrão; Maria U P B Rondon
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-10-24
Journal Detail:
Title:  Hypertension     Volume:  58     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-18     Completed Date:  2012-01-03     Revised Date:  2012-03-22    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1049-56     Citation Subset:  IM    
Affiliation:
Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / pharmacology
Autonomic Nervous System Diseases / complications,  prevention & control*
Baroreflex / physiology*
Confounding Factors (Epidemiology)
Exercise Therapy*
Female
Heart Rate / drug effects
Hemodynamics
Humans
Male
Middle Aged
Muscle, Skeletal / innervation
Myocardial Infarction / physiopathology,  rehabilitation*
Reflex, Abnormal
Treatment Outcome
Grant Support
ID/Acronym/Agency:
R01 HL084525/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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