TY - JOUR
T1 - Effects of exercise training started within 2 weeks after acute myocardial infarction on myocardial perfusion and left ventricular function
T2 - A gated SPECT imaging study
AU - Giallauria, Francesco
AU - Acampa, Wanda
AU - Ricci, Francesca
AU - Vitelli, Alessandra
AU - Maresca, Luigi
AU - Mancini, Maria
AU - Grieco, Alessandra
AU - Gallicchio, Rosj
AU - Xhoxhi, Evgjeni
AU - Spinelli, Letizia
AU - Cuocolo, Alberto
AU - Vigorito, Carlo
PY - 2012/12
Y1 - 2012/12
N2 - Background: Several studies suggested that exercise training might improve myocardial perfusion by inducing coronary vascular adaptations or enhancing collateralization. However, these findings were obtained in patients with chronic coronary artery disease using thallium-201 myocardial perfusion scintigraphy. We evaluated whether a long-term exercise-based cardiac rehabilitation (CR) started early (9 ± 3 days) after ST elevation acute myocardial infarction (STEMI) improves myocardial perfusion and left ventricular (LV) function, evaluated by gated single-photon emission computed tomography (SPECT) imaging. Design: Randomized controlled study. Methods: Fifty patients with recent STEMI were randomized into two groups: 24 enrolled in a 6-month exercise-based CR programme (group T) and 26 discharged with generic instructions for maintaining physical activity and correct lifestyle (group C). All patients underwent cardiopulmonary exercise test and gated SPECT within 3 weeks after STEMI and at 6-month follow up.Results: At follow up, group T showed a significant reduction of stress-induced ischaemia (p <0.01) and an improvement in resting and post-stress wall motion (both p <0.005) and resting (p <0.05) and post-stress wall thickness (p <0.005) score indexes. At follow up, group T showed an improvement in peak oxygen consumption (p <0.0001), O2 pulse (p <0.05), and in the slope of increase in ventilation over carbon dioxide output (p <0.001). No changes in myocardial perfusion parameters, LV function, and cardiopulmonary indexes were observed in group C at follow up.Conclusions: Six months of exercise training early after STEMI reduces stress-induced ischaemia and improves LV wall motion and thickness. Exercise-induced changes in myocardial perfusion and function were associated with the absence of unfavourable LV remodelling and with the improvement of cardiovascular functional capacity.
AB - Background: Several studies suggested that exercise training might improve myocardial perfusion by inducing coronary vascular adaptations or enhancing collateralization. However, these findings were obtained in patients with chronic coronary artery disease using thallium-201 myocardial perfusion scintigraphy. We evaluated whether a long-term exercise-based cardiac rehabilitation (CR) started early (9 ± 3 days) after ST elevation acute myocardial infarction (STEMI) improves myocardial perfusion and left ventricular (LV) function, evaluated by gated single-photon emission computed tomography (SPECT) imaging. Design: Randomized controlled study. Methods: Fifty patients with recent STEMI were randomized into two groups: 24 enrolled in a 6-month exercise-based CR programme (group T) and 26 discharged with generic instructions for maintaining physical activity and correct lifestyle (group C). All patients underwent cardiopulmonary exercise test and gated SPECT within 3 weeks after STEMI and at 6-month follow up.Results: At follow up, group T showed a significant reduction of stress-induced ischaemia (p <0.01) and an improvement in resting and post-stress wall motion (both p <0.005) and resting (p <0.05) and post-stress wall thickness (p <0.005) score indexes. At follow up, group T showed an improvement in peak oxygen consumption (p <0.0001), O2 pulse (p <0.05), and in the slope of increase in ventilation over carbon dioxide output (p <0.001). No changes in myocardial perfusion parameters, LV function, and cardiopulmonary indexes were observed in group C at follow up.Conclusions: Six months of exercise training early after STEMI reduces stress-induced ischaemia and improves LV wall motion and thickness. Exercise-induced changes in myocardial perfusion and function were associated with the absence of unfavourable LV remodelling and with the improvement of cardiovascular functional capacity.
KW - Acute myocardial infarction
KW - cardiac rehabilitation
KW - cardiac remodelling
KW - exercise training
KW - gated single-photon emission computed tomography
KW - myocardial perfusion
KW - oxygen consumption
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U2 - 10.1177/1741826711425427
DO - 10.1177/1741826711425427
M3 - Article
C2 - 21965517
AN - SCOPUS:84873921309
VL - 19
SP - 1410
EP - 1419
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
SN - 2047-4873
IS - 6
ER -