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European Heart Journal 1996 17(12):1821-1827;
Copyright © 1996 by the European Society of Cardiology.
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© 1996 The European Society of Cardiology

Simple clinical data are useful in predicting effect of exercise training after myocardial infarction

M. Heldal*,, S. Sire{dagger}, L. Sandvik{ddagger} and J. Dale*

*Section of Cardiology, Medical Department, Aker University Hospital Oslo, Norway
{dagger}State Rehabilitation Institute Oslo, Norway
{ddagger}Med Stat Research Lillestrom, Norway

Received 15 January 1996; accepted 21 January 1996.

Correspondence: Dr Magnus Heldal, Medical Department, Aker sykehus, 0514 Oslo, Norway

Abstract

OBJECTIVES: The aim of the present study was to determine whether simple clinical variables can predict the effect of intensive exercise training in an unselected population early after myocardial infarction.

METHODS: Starting 5 weeks after the qualifying myocardial infarction, 105 patients, 68 years old or younger, completed a 4 week period of intensive exercise training. The training effect was defined as an absolute increase in cumulative work at bicycle ergometry. Using univariate and multivariate analysis, 28 variables were tested against the training effect.

RESULTS: The mean exercise capacity increased from 46.7 ± 22.7 kJ to 69.5 ± 311 kJ (P=0.0001). Multivariate analysis identified five independent predictors of the training effect. Myocardial infarct size was associated with a better training effect (P=0.0018), as was male gender (P0.0042) and ability to exercise to exhaustion at the baseline exercise test (P=0.0124). Older age (P=0.0017) and treatment with beta-adrenergic blocking agents (P=0.0241) were associated with a lower effect from training. These five variables explained 33% of the variations in effect from training. Patients suffering in-hospital cardiac complications or congestive heart failure achieved a training effect at least as great as patients without cardiac complications.

CONCLUSIONS: Five simple clinical variables, including infarct size, can assist in the selection of patients for exercise training after myocardial infarction.

Key Words: Exercise training • myocardial infarction • infarct size • predictors


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