CLINICAL STUDY: RADIONUCLIDE IMAGING
Exercise training improves biventricular oxidative metabolism and left ventricular efficiency in patients with dilated cardiomyopathy
Kira Q. Stolen, MS*,
Jukka Kemppainen, MD*,
Heikki Ukkonen, MD* ,
Kari K. Kalliokoski, PhD*,
Matti Luotolahti, MD ,
Pertti Lehikoinen, PhD*,
Helena Hämäläinen, MD ,
Tiina Salo, MD ,
K. E. Juhani Airaksinen, MD ,
Pirjo Nuutila, MD* and
Juhani Knuuti, MD*,*
* Turku PET Centre, University of Turku and Turku University Central Hospital, Turku, Finland
Departments of Clinical Physiology, University of Turku and Turku University Central Hospital, Turku, Finland
Departments of Medicine, University of Turku and Turku University Central Hospital, Turku, Finland
Social Insurance Institution, Turku, Finland
Manuscript received May 31, 2002;
revised manuscript received July 10, 2002,
accepted August 26, 2002.
* Reprint requests and correspondence: Prof. Juhani Knuuti, Turku PET Centre, P.O. BOX 52, FIN-20521 Turku, Finland. juhani.knuuti{at}tyks.fi
OBJECTIVES: The aim of this study was to determine the effect of exercise training on myocardial oxidative metabolism and efficiency in patients with idiopathic dilated cardiomyopathy (DCM) and mild heart failure (HF).
BACKGROUND: Exercise training is known to improve exercise tolerance and quality of life in patients with chronic HF. However, little is known about how exercise training may influence myocardial energetics.
METHODS: Twenty clinically stable patients with DCM (New York Heart Association classes I through III) were prospectively separated into a training group (five-month training program; n = 9) and a non-trained control group (n = 11). Oxidative metabolism in both the right and left ventricles (RV and LV) was measured using [11C]acetate and positron emission tomography. Myocardial work power was measured using echocardiography. Myocardial efficiency for forward work was calculated as myocardial work power per mass/LV oxidative metabolism.
RESULTS: Significant improvements were noted in exercise capacity (VO2) and ejection fraction in the training group, whereas no changes were observed in the non-trained group. Exercise training reduced both RV and LV oxidative metabolism and elicited a significant increase in LV forward work efficiency, although no significant changes were observed in the non-trained group.
CONCLUSIONS: Exercise training improves exercise tolerance and LV function. This is accompanied by a decrease in biventricular oxidative metabolism and enhanced forward work efficiency. Therefore, exercise training elicits an energetically favorable improvement in myocardial function and exercise tolerance in patients with DCM.
|
Abbreviations and Acronyms
| | BP | | blood pressure | | DCM | | dilated cardiomyopathy | | HF | | heart failure | | HR | | heart rate | | kmono | | [11C]acetate clearance rate | | LV | | left ventricle or ventricular | | NYHA | | New York Heart Association | | PET | | positron emission tomography | | ROI | | region of interest | | RV | | right ventricle or ventricular | | VO2 | | oxygen uptake |
|
This article has been cited by other articles:

|
 |

|
 |
 
L. H. Opie and J. Knuuti
The adrenergic-Fatty Acid load in heart failure.
J. Am. Coll. Cardiol.,
October 27, 2009;
54(18):
1637 - 1646.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
H. Ukkonen, J. Sundell, and J. Knuuti
Effects of CRT on myocardial innervation, perfusion and metabolism
Europace,
November 1, 2008;
10(suppl_3):
iii114 - iii117.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. Beer, D. Wagner, J. Myers, J. Sandstede, H. Kostler, D. Hahn, S. Neubauer, and P. Dubach
Effects of Exercise Training on Myocardial Energy Metabolism and Ventricular Function Assessed by Quantitative Phosphorus-31 Magnetic Resonance Spectroscopy and Magnetic Resonance Imaging in Dilated Cardiomyopathy
J. Am. Coll. Cardiol.,
May 13, 2008;
51(19):
1883 - 1891.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
H. J. Eisen
Exercise Training and Myocardial Energetics in Patients With Heart Failure: When More Is Less
J. Am. Coll. Cardiol.,
May 13, 2008;
51(19):
1892 - 1895.
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J Knuuti and F M Bengel
Positron emission tomography and molecular imaging
Heart,
March 1, 2008;
94(3):
360 - 367.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
L. Mueller, J. Myers, W. Kottman, U. Oswald, C. Boesch, N. Arbrol, and P. Dubach
Exercise capacity, physical activity patterns and outcomes six years after cardiac rehabilitation in patients with heart failure
Clinical Rehabilitation,
October 1, 2007;
21(10):
923 - 931.
[Abstract]
[PDF]
|
 |
|

|
 |

|
 |
 
P. A. Watson, J. E. B. Reusch, S. A. McCune, L. A. Leinwand, S. W. Luckey, J. P. Konhilas, D. A. Brown, A. J. Chicco, G. C. Sparagna, C. S. Long, et al.
Restoration of CREB function is linked to completion and stabilization of adaptive cardiac hypertrophy in response to exercise
Am J Physiol Heart Circ Physiol,
July 1, 2007;
293(1):
H246 - H259.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
K. Yoshinaga, I. G. Burwash, J. A. Leech, H. Haddad, C. B. Johnson, R. A. deKemp, L. Garrard, L. Chen, K. Williams, J. N. DaSilva, et al.
The Effects of Continuous Positive Airway Pressure on Myocardial Energetics in Patients With Heart Failure and Obstructive Sleep Apnea
J. Am. Coll. Cardiol.,
January 30, 2007;
49(4):
450 - 458.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
M. -L. Sveen, T. D. Jeppesen, S. Hauerslev, T. O. Krag, and J. Vissing
Endurance training: An effective and safe treatment for patients with LGMD2I
Neurology,
January 2, 2007;
68(1):
59 - 61.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. Ventura-Clapier, B. Mettauer, and X. Bigard
Beneficial effects of endurance training on cardiac and skeletal muscle energy metabolism in heart failure
Cardiovasc Res,
January 1, 2007;
73(1):
10 - 18.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. C. Hannukainen, P. Nuutila, J. Kaprio, O. J Heinonen, U. M. Kujala, T. Janatuinen, T. Ronnemaa, J. Kapanen, M. Haaparanta-Solin, T. Viljanen, et al.
Relationship between local perfusion and FFA uptake in human skeletal muscle--no effect of increased physical activity and aerobic fitness
J Appl Physiol,
November 1, 2006;
101(5):
1303 - 1311.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. J. Bax, T. Abraham, S. S. Barold, O. A. Breithardt, J. W.H. Fung, S. Garrigue, J. Gorcsan III, D. L. Hayes, D. A. Kass, J. Knuuti, et al.
Cardiac Resynchronization Therapy: Part 2--Issues During and After Device Implantation and Unresolved Questions
J. Am. Coll. Cardiol.,
December 20, 2005;
46(12):
2168 - 2182.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
J. Sundell, E. Engblom, J. Koistinen, A. Ylitalo, A. Naum, K. Q. Stolen, R. Kalliokoski, S. G. Nekolla, K. E. J. Airaksinen, J. J. Bax, et al.
The effects of cardiac resynchronization therapy on left ventricular function, myocardial energetics, and metabolic reserve in patients with dilated cardiomyopathy and heart failure
J. Am. Coll. Cardiol.,
March 17, 2004;
43(6):
1027 - 1033.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
R. J. Gropler
Noninvasive measurements of myocardial oxygen consumption--can we do better?
J. Am. Coll. Cardiol.,
February 5, 2003;
41(3):
468 - 470.
[Full Text]
[PDF]
|
 |
|
|