Document Detail


Exercise training without ventricular remodeling in patients with moderate to severe left ventricular dysfunction early after acute myocardial infarction.
MedLine Citation:
PMID:  12559545     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Yoritaka Otsuka; Hiroshi Takaki; Yoshiaki Okano; Toru Satoh; Naohiko Aihara; Takahiro Matsumoto; Yoshio Yasumura; Isao Morii; Yoichi Goto
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  International journal of cardiology     Volume:  87     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-01-31     Completed Date:  2003-05-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  237-44     Citation Subset:  IM    
Affiliation:
Department of Medicine, Division of Cardiology, National Cardiovascular Center, Fujishirodai 5-7-1, Suita, 565-8565, Osaka, Japan.
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MeSH Terms
Descriptor/Qualifier:
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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