Document Detail


Effects of moderate exercise training on thallium uptake and contractile response to low-dose dobutamine of dysfunctional myocardium in patients with ischemic cardiomyopathy.
MedLine Citation:
PMID:  9494025     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: There is evidence that exercise training can induce myocardial and coronary adaptations in both animals and humans. However, the significance of these potentially important changes remains to be determined in patients with ischemic heart disease and left ventricular (LV) systolic dysfunction. METHODS AND RESULTS: To investigate whether exercise training can improve thallium uptake and the contractile response to low-dose dobutamine of dysfunctional myocardium, 46 patients (42 men, 4 women; mean age, 57+/-9 years) with chronic coronary artery disease and impaired LV systolic function (ejection fraction < 40%) were randomly assigned to two groups. The exercise group (n = 26) underwent exercise training at 60% of peak oxygen uptake for 8 weeks. The control group (n = 20) was not exercised. At baseline and after 8 weeks all patients underwent an exercise test with gas exchange analysis and stress echocardiography using low-dose dobutamine (5 to 10 microg/kg per minute) followed by thallium myocardial scintigraphy. Coronary angiography was performed in 23 patients at baseline and after 8 weeks. After 8 weeks, peak oxygen uptake increased significantly only in trained patients (24%). Significant improvements in the contractile response to dobutamine and thallium activity were observed in trained patients (28% and 31%, respectively; trained versus control: P<.001 for both). In a subgroup of trained patients, both improvements were correlated with an increase in the coronary collateral score (P<.005 and P<.001, respectively). CONCLUSIONS: Moderate exercise training improves both thallium activity and the contractile response of dysfunctional myocardium to low doses of dobutamine in patients with ischemic cardiomyopathy. The implication of this study is that even a short-term exercise training may improve quality of life by improvement of LV systolic function during mild-to-moderate physical activity in patients with ischemic cardiomyopathy.
Authors:
R Belardinelli; D Georgiou; L Ginzton; G Cianci; A Purcaro
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  97     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1998 Feb 
Date Detail:
Created Date:  1998-03-10     Completed Date:  1998-03-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  553-61     Citation Subset:  AIM; IM    
Affiliation:
Divisione di Cardiologia I, Istituto Cardiologica G.M. Lancisi, Ancona, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adaptation, Physiological
Adrenergic beta-Agonists / diagnostic use
Aged
Collateral Circulation
Dobutamine / diagnostic use
Echocardiography
Exercise Therapy*
Female
Humans
Male
Middle Aged
Myocardial Contraction*
Myocardial Ischemia / physiopathology*,  radionuclide imaging,  therapy*
Statistics, Nonparametric
Thallium Radioisotopes / diagnostic use
Ventricular Function, Left
Chemical
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/Thallium Radioisotopes; 34368-04-2/Dobutamine

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


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