|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
|
|
|
|||||||||
|
|||||||||||
|
J Am Coll Cardiol, 1988; 12:362-372 © 1988 by the American College of Cardiology Foundation |
Department of Medicine, University of Alberta, Edmonton, Canada.
To determine whether the extent of left ventricular dysfunction and the degree of shape distortion can predict outcome in survivors of moderate-sized anterior Q wave myocardial infarction who are undergoing exercise training, these variables were measured by two-dimensional echocardiography before and after 12 weeks of a low level exercise training program starting 15 weeks after infarction in 13 patients (7 in group 1 and 6 in group 2) and 12 weeks apart in 24 matched control patients without training. By the end of training, the functional class score had increased in group 2 (from 2.25 to 2.67, p less than 0.005) but had not changed in group 1. Further discrimination of groups 1 and 2 was provided by an initial asynergy (akinesia or dyskinesia, or both) less than 18% or greater than or equal to 18%. Compared with group 1, group 2 had greater initial asynergy (32 versus 6%, p less than 0.001), expansion index (asynergic/normal endocardial segment length: 1.8 versus 1.6, p less than 0.025) and peak shape distortion index (12.2 versus 1.0 mm, p less than 0.005) but lower ejection fraction (43 versus 59%, p less than 0.05) and thinning ratio (asynergic/normal wall thickness: 0.61 versus 0.74, p less than 0.05). These variables did not change with training in group 1. However, in group 2, training caused significant increase in asynergy (from 32 to 40%, p less than 0.05), expansion index (from 1.8 to 2.0, p less than 0.01) and peak shape distortion (from 12.2 to 20.9 mm, p less than 0.05) associated with a decrease in thinning ratio (from 0.61 to 0.51, p less than 0.001) and ejection fraction (from 43 to 30%, p less than 0.005). Initial values for these variables were similar for corresponding control groups but did not change over the 12 weeks. Thus, patients with greater than or equal to 18% left ventricular asynergy on the initial echocardiogram showed more shape distortion, expansion and thinning before exercise training and developed further functional and topographic deterioration with training.
This article has been cited by other articles:
|
|
 |
|
  M. C. de Waard, J. van der Velden, V. Bito, S. Ozdemir, L. Biesmans, N. M. Boontje, D. H.W. Dekkers, K. Schoonderwoerd, H. C.H. Schuurbiers, R. d. Crom, et al. Early Exercise Training Normalizes Myofilament Function and Attenuates Left Ventricular Pump Dysfunction in Mice With a Large Myocardial Infarction Circ. Res., April 13, 2007; 100(7): 1079 - 1088. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Yoshinari, H. Yaoita, K. Maehara, and Y. Maruyama Different therapeutic responses to treadmill exercise of heart failure due to ischemia and infarction in rats Cardiovasc Res, February 1, 2005; 65(2): 457 - 468. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. L. Pina, C. S. Apstein, G. J. Balady, R. Belardinelli, B. R. Chaitman, B. D. Duscha, B. J. Fletcher, J. L. Fleg, J. N. Myers, and M. J. Sullivan Exercise and Heart Failure: A Statement From the American Heart Association Committee on Exercise, Rehabilitation, and Prevention Circulation, March 4, 2003; 107(8): 1210 - 1225. [Full Text] [PDF]
|
|
|
|
 |
|
 B. I. Jugdutt and V. Menon Beneficial Effects of Therapy on the Progression of Structural Remodeling During Healing After Reperfused and Nonreperfused Myocardial Infarction: Different Effects on Different Parameters Journal of Cardiovascular Pharmacology and Therapeutics, June 1, 2002; 7(2): 95 - 107. [Abstract] [PDF]
|
|
|
|
|
|
U. Wisloff, J. P. Loennechen, S. Currie, G. L. Smith, and O. Ellingsen Aerobic exercise reduces cardiomyocyte hypertrophy and increases contractility, Ca2+ sensitivity and SERCA-2 in rat after myocardial infarction Cardiovasc Res, April 1, 2002; 54(1): 162 - 174. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L TAVAZZI and P GIANNUZZI Physical training as a therapeutic measure in chronic heart failure: time for recommendations Heart, July 1, 2001; 86(1): 7 - 11. [Full Text] [PDF]
|
|
|
|
 |
|
 Recommendations for exercise training in chronic heart failure patients Eur. Heart J., January 2, 2001; 22(2): 125 - 135. [PDF]
|
|
|
|
 |
|
 K. T. Spencer, K. Collins, C. Korcarz, R. Fentzke, R. M. Lang, and J. M. Leiden Effects of exercise training on LV performance and mortality in a murine model of dilated cardiomyopathy Am J Physiol Heart Circ Physiol, July 1, 2000; 279(1): H210 - H215. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Hambrecht, S. Gielen, A. Linke, E. Fiehn, J. Yu, C. Walther, N. Schoene, and G. Schuler Effects of Exercise Training on Left Ventricular Function and Peripheral Resistance in Patients With Chronic Heart Failure: A Randomized Trial JAMA, June 21, 2000; 283(23): 3095 - 3101. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Jain, R. Liao, S. Ngoy, P. Whittaker, C. S. Apstein, and F. R. Eberli Angiotensin II receptor blockade attenuates the deleterious effects of exercise training on post-MI ventricular remodelling in rats Cardiovasc Res, April 1, 2000; 46(1): 66 - 72. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. J. Gibbons, K. Chatterjee, J. Daley, J. S. Douglas, S. D. Fihn, J. M. Gardin, M. A. Grunwald, D. Levy, B. W. Lytle, R. A. O'Rourke, et al. ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Chronic Stable Angina) J. Am. Coll. Cardiol., June 1, 1999; 33(7): 2092 - 2197. [Full Text] [PDF]
|
|
|
|
|
|
R. J. Shephard and G. J. Balady Exercise as Cardiovascular Therapy Circulation, February 23, 1999; 99(7): 963 - 972. [Full Text] [PDF]
|
|
|
|
|
|
P. Giannuzzi, P. L. Temporelli, U. Corra, M. Gattone, A. Giordano, L. Tavazzi, and f. t. E. S. Group Attenuation of Unfavorable Remodeling by Exercise Training in Postinfarction Patients With Left Ventricular Dysfunction : Results of the Exercise in Left Ventricular Dysfunction (ELVD) Trial* Circulation, September 16, 1997; 96(6): 1790 - 1797. [Abstract] [Full Text]
|
|
|
|
|
|
P. Dubach, J. Myers, G. Dziekan, U. Goebbels, W. Reinhart, P. Vogt, R. Ratti, P. Muller, R. Miettunen, and P. Buser Effect of Exercise Training on Myocardial Remodeling in Patients With Reduced Left Ventricular Function After Myocardial Infarction : Application of Magnetic Resonance Imaging Circulation, April 15, 1997; 95(8): 2060 - 2067. [Abstract] [Full Text]
|
|
|
|
|
|
D. M. Mancini, D. Henson, J. L. Manca, L. Donchez, and S. Levine Benefit of Selective Respiratory Muscle Training on Exercise Capacity in Patients With Chronic Congestive Heart Failure Circulation, January 15, 1995; 91(2): 320 - 329. [Abstract] [Full Text]
|
|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
