Circulation, Vol 84, 1561-1567, Copyright © 1991 by American Heart Association
M Jette, R Heller, F Landry and G Blumchen
BACKGROUND. This study was designed to determine the controlled effects of
a short-term exercise rehabilitation program on patients with
moderate-to-severe left ventricular dysfunction after a recent myocardial
infarction. METHODS AND RESULTS. Thirty-nine male patients 51 +/- 8 years
old with a large anterior myocardial infarction less than 10 weeks old were
recruited for the study. The patients were randomly assigned to either one
of two training or control groups on the basis of their resting ejection
fraction: training, less than 30%; control, less than 30%; training,
31-50%; or control, 31-50%. Patients were evaluated for filling pressures,
radionuclide ventriculography, heart volume, echocardiography, and work
capacity. Patients who underwent training participated in an intensive
4-week in-hospital exercise program, whereas the control patients were
restricted to a minimal activity program. Results indicated that there were
no significant improvements in resting, submaximal, and maximal hemodynamic
measurements as a result of the program. Mean work capacity and peak oxygen
consumption improved significantly in the less-than-30% training group but
was accompanied by a significant increase in mean pulmonary wedge pressure.
Resting ejection fraction improved markedly in both less-than-30% training
and control patients, but ejection fraction measures were not associated
with work capacity. Training did not cause further deterioration in
ventricular function. CONCLUSIONS. It was concluded that in the present
study, exercise training had little or no effect on hemodynamic
measurements and that the training effects achieved in patients with left
ventricular dysfunction are most likely due to corrected impaired
vasodilation, not necessarily to cardiac function. The importance of using
a control group in this type of study and the wide interindividual
variations in training responses are emphasized.
ARTICLES
Randomized 4-week exercise program in patients with impaired left ventricular function
Klinik Roderbirken fur Herz- und Kreislaufkrankheiten, Leichlingen, FRG.
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