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European Heart Journal 1996 17(10):1511-1521;
Copyright © 1996 by the European Society of Cardiology.
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© 1996 The European Society of Cardiology

Does appropriate endurance exercise training improve cardiac function in patients with prior myocardial infarction?

H. Adachi*, A. Koike{dagger}, T. Obayashi*, S. Umezawa{ddagger}, A. Niwa*, F. Marumo{dagger} and M. Hiroe{dagger}

*Musashino Red Cross Hospital Tokyo, Japan
{dagger}The Second Department of Internal Medicine, Tokyo Medical and Dental University Tokyo, Japan
{ddagger}Yokosuka Kyosai Hospital Kanagawa-ken, Japan

revised 15 January 1996; accepted 13 February 1996.

Akira Koike, The Second Department of Internal Medicine, Tokyo Medical and Dental University, 5–45 Yushima 1-chome, Bunkyo-ku, Tokyo 113, Japan.

Abstract

OBJECTIVE: The objective of the present study was to determine whether appropriate endurance exercise training improves cardiac function in patients with prior myocardial infarction.

METHODS: Methods Twenty-nine patients with prior myocardial infarction were divided into three groups (Group 1: control, Group 2: low-intensity training, Group 3: high-intensity training). Low and high training intensities were determined according to the gas exchange threshold of each patient. The patients in Groups 2 and 3 performed 15 min of home-based physical training safely, twice a day, 5 days a week for 2 months. Prior to and following this training, each patient performed two constant work rate tests (moderate and heavy intensity) and a symptom-limited incremental exercise test.

RESULTS: Heart rates at rest and during exercise were decreased significantly after 2 months in all three groups. Stroke volume at rest increased significantly after 2 months only in Group 3. Stroke volume after 6 min of heavy intensity exercise increased significantly in Groups 2 and 3. However, the ejection fraction at 6 min of heavy-intensity exercise increased significantly only in Group 3. The maximal work rate attained during incremental exercise testing increased significantly in Groups 2 and 3. This parameter did not significantly change in the control group.

CONCLUSIONS: Effects of physical training on maximal exercise capacity were noted in both exercise training groups. However, improvement in cardiac function (such as stroke volume), both at rest and during exercise, was noted only in the high-intensity training group. Our results suggest that relatively high-intensity training may improve exercise capacity and cardiac function of patients with prior myocardial infarction.

(Eur Heart J 1996; 17: 1511–1521)

Key Words: Stroke volume • cardiac output • constant work rate exercise • exercise capacity


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