| Exercise training without ventricular remodeling in patients with moderate to severe left ventricular dysfunction early after acute myocardial infarction. | |
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MedLine Citation:
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PMID: 12559545 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The purpose of this study was to determine whether or not patients with moderate to severe left ventricular (LV) dysfunction benefit from exercise training starting early after acute myocardial infarction (AMI) without deteriorating LV remodeling. METHODS: We investigated changes in exercise capacity and LV end-diastolic dimension (LVDd by two-dimensional echocardiography) before and after exercise training in 126 patients after AMI. Patients were divided into three groups according to LV ejection fraction (EF) at the beginning of exercise training: 74 patients with LVEF>/=45% (Group H), 35 patients with 35%</=LVEF<45% (Group M), and 17 patients with LVEF<35% (Group L). Exercise training was prescribed at a moderate intensity (50-60% of heart rate reserve or Karvonen's equation). Exercise capacity was assessed by peak work rate (WR) and peak oxygen uptake (VO(2)) by upright cardiopulmonary exercise test before and after 3 months of exercise training. LVDd was measured before and at 27+/-10 months of follow-up period. RESULTS: At the baseline, Group L had a significantly lower LVEF (H 55+/-7 vs. M 40+/-3 vs. L 30+/-3%, P<0.05), significantly greater LVDd (49+/-6 vs. 52+/-7 vs. 56+/-6 mm, P<0.05), and a higher incidence of anterior infarction (P<0.01) compared with Groups H and M, whereas there were no difference in age, sex, coronary risk factors, the incidence of multivessel disease, prior myocardial infarction, peak WR or peak VO(2) among the three groups. After 3 months of exercise training, exercise capacity increased significantly (all P<0.01) in all groups. The magnitudes of the increases in peak VO(2) (%Deltapeak VO(2): 18+/-20 vs. 15+/-19 vs. 18+/-17%, NS) and peak WR (%Deltapeak WR: 17+/-17 vs. 16+/-14 vs. 15+/-13%, NS) were similar among the three groups. In addition, there was no significant correlation between %Deltapeak VO(2) and baseline LVEF. No increase in LVDd was observed in any group at follow-up (H 48+/-5 to 49+/-4 mm vs. M 53+/-8 to 52+/-8 mm vs. L 57+/-5 to 57+/-7 mm, NS in each group). CONCLUSION: Patients with moderate to severe LV dysfunction benefit from exercise training starting early after AMI without deteriorating LV remodeling, with a similar magnitude of improvement in exercise capacity to that in patients with mild LV dysfunction. |
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Authors:
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Yoritaka Otsuka; Hiroshi Takaki; Yoshiaki Okano; Toru Satoh; Naohiko Aihara; Takahiro Matsumoto; Yoshio Yasumura; Isao Morii; Yoichi Goto |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: International journal of cardiology Volume: 87 ISSN: 0167-5273 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2003 Feb |
Date Detail:
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Created Date: 2003-01-31 Completed Date: 2003-05-29 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: Ireland |
Other Details:
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Languages: eng Pagination: 237-44 Citation Subset: IM |
Affiliation:
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Department of Medicine, Division of Cardiology, National Cardiovascular Center, Fujishirodai 5-7-1, Suita, 565-8565, Osaka, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Analysis of Variance Cohort Studies Echocardiography Exercise Therapy / methods* Exercise Tolerance Female Heart Function Tests Humans Male Middle Aged Myocardial Infarction / diagnosis*, rehabilitation* Probability Prognosis Risk Assessment Sampling Studies Severity of Illness Index Stroke Volume Treatment Outcome Ventricular Dysfunction, Left / diagnosis*, rehabilitation Ventricular Remodeling |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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