Favourable effects of exercise-based Cardiac Rehabilitation after acute myocardial infarction on left atrial remodeling

Francesco Giallauria, Gianluigi Galizia, Rosa Lucci, Mariantonietta D'Agostino, Alessandra Vitelli, Luigi Maresca, Francesco Orio, Carlo Vigorito

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: Left atrial enlargement is an important predictor of cardiovascular outcomes in patients after acute myocardial infarction. While the favourable effect of exercise exercise-based Cardiac Rehabilitation (CR) on postinfarction LV remodeling has been well documented, those on LA remodeling have yet to be defined. This study investigated the effects of CR on LA remodeling in postinfarction patients with moderate left ventricular (LV) dysfunction. Methods: Sixty postinfarction patients were randomised randomized into two groups, each composed of 30 patients: group T (LV ejection fraction (EF) 43.7 ± 4.2%, mean ± SD) entered a 6-month CR program, whereas group C (EF 44.7 ± 4.4%, P = ns) did not. Doppler echocardiography and cardiopulmonary exercise test were performed upon enrolment and at 6-month. Results: At 6-month, trained patients showed a significant (P <0.001) improvement in peak oxygen consumption (ΔVO2peak = + 5.2 ± 2.1 ml/kg/min) and a reduction in LA (ΔLAVMAX = - 1.9 ± 3.7 ml/m2) and in LV volumes (ΔLVEDV = - 3.6 ± 4.4 ml/m2). At 6-month, untrained patients showed LAVMAX (+ 3.6 ± 4.4 ml/m2, P <0.001) and LV dilation (+ 4.2 ± 5.1 ml/m2, P <0.001; group T vs. C, P <0.001); whereas no significant changes in VO2peak were observed. Multiple linear regression analysis showed that age (β = 0.442, P <0.001), inclusion in the training group (β = - 0.599, P <0.001), E/A ratio (β = - 0.210, P = 0.038), LVEDV (β = 0.376, P <0.001), and LVEF (β = - 0.279, P = 0.007) are significant predictors of LA remodeling. Conclusions: Six-month exercise-based CR in postinfarction patients with mild to moderate LV dysfunction induced a favourable LA remodeling.

Original languageEnglish
Pages (from-to)300-306
Number of pages7
JournalInternational Journal of Cardiology
Volume136
Issue number3
DOIs
Publication statusPublished - Aug 21 2009

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Atrial Remodeling
Myocardial Infarction
Exercise
Left Ventricular Dysfunction
Ventricular Remodeling
Doppler Echocardiography
Cardiac Rehabilitation
Exercise Test
Oxygen Consumption
Stroke Volume
Dilatation
Linear Models
Regression Analysis

Keywords

  • Acute myocardial infarction
  • Cardiac rehabilitation
  • Cardiopulmonary exercise test
  • Cardiopulmonary functional capacity
  • Exercise training
  • Left atrial remodeling
  • Left ventricular remodeling

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Favourable effects of exercise-based Cardiac Rehabilitation after acute myocardial infarction on left atrial remodeling. / Giallauria, Francesco; Galizia, Gianluigi; Lucci, Rosa; D'Agostino, Mariantonietta; Vitelli, Alessandra; Maresca, Luigi; Orio, Francesco; Vigorito, Carlo.

In: International Journal of Cardiology, Vol. 136, No. 3, 21.08.2009, p. 300-306.

Research output: Contribution to journalArticle

Giallauria, Francesco ; Galizia, Gianluigi ; Lucci, Rosa ; D'Agostino, Mariantonietta ; Vitelli, Alessandra ; Maresca, Luigi ; Orio, Francesco ; Vigorito, Carlo. / Favourable effects of exercise-based Cardiac Rehabilitation after acute myocardial infarction on left atrial remodeling. In: International Journal of Cardiology. 2009 ; Vol. 136, No. 3. pp. 300-306.
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abstract = "Background: Left atrial enlargement is an important predictor of cardiovascular outcomes in patients after acute myocardial infarction. While the favourable effect of exercise exercise-based Cardiac Rehabilitation (CR) on postinfarction LV remodeling has been well documented, those on LA remodeling have yet to be defined. This study investigated the effects of CR on LA remodeling in postinfarction patients with moderate left ventricular (LV) dysfunction. Methods: Sixty postinfarction patients were randomised randomized into two groups, each composed of 30 patients: group T (LV ejection fraction (EF) 43.7 ± 4.2{\%}, mean ± SD) entered a 6-month CR program, whereas group C (EF 44.7 ± 4.4{\%}, P = ns) did not. Doppler echocardiography and cardiopulmonary exercise test were performed upon enrolment and at 6-month. Results: At 6-month, trained patients showed a significant (P <0.001) improvement in peak oxygen consumption (ΔVO2peak = + 5.2 ± 2.1 ml/kg/min) and a reduction in LA (ΔLAVMAX = - 1.9 ± 3.7 ml/m2) and in LV volumes (ΔLVEDV = - 3.6 ± 4.4 ml/m2). At 6-month, untrained patients showed LAVMAX (+ 3.6 ± 4.4 ml/m2, P <0.001) and LV dilation (+ 4.2 ± 5.1 ml/m2, P <0.001; group T vs. C, P <0.001); whereas no significant changes in VO2peak were observed. Multiple linear regression analysis showed that age (β = 0.442, P <0.001), inclusion in the training group (β = - 0.599, P <0.001), E/A ratio (β = - 0.210, P = 0.038), LVEDV (β = 0.376, P <0.001), and LVEF (β = - 0.279, P = 0.007) are significant predictors of LA remodeling. Conclusions: Six-month exercise-based CR in postinfarction patients with mild to moderate LV dysfunction induced a favourable LA remodeling.",
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AU - Giallauria, Francesco

AU - Galizia, Gianluigi

AU - Lucci, Rosa

AU - D'Agostino, Mariantonietta

AU - Vitelli, Alessandra

AU - Maresca, Luigi

AU - Orio, Francesco

AU - Vigorito, Carlo

PY - 2009/8/21

Y1 - 2009/8/21

N2 - Background: Left atrial enlargement is an important predictor of cardiovascular outcomes in patients after acute myocardial infarction. While the favourable effect of exercise exercise-based Cardiac Rehabilitation (CR) on postinfarction LV remodeling has been well documented, those on LA remodeling have yet to be defined. This study investigated the effects of CR on LA remodeling in postinfarction patients with moderate left ventricular (LV) dysfunction. Methods: Sixty postinfarction patients were randomised randomized into two groups, each composed of 30 patients: group T (LV ejection fraction (EF) 43.7 ± 4.2%, mean ± SD) entered a 6-month CR program, whereas group C (EF 44.7 ± 4.4%, P = ns) did not. Doppler echocardiography and cardiopulmonary exercise test were performed upon enrolment and at 6-month. Results: At 6-month, trained patients showed a significant (P <0.001) improvement in peak oxygen consumption (ΔVO2peak = + 5.2 ± 2.1 ml/kg/min) and a reduction in LA (ΔLAVMAX = - 1.9 ± 3.7 ml/m2) and in LV volumes (ΔLVEDV = - 3.6 ± 4.4 ml/m2). At 6-month, untrained patients showed LAVMAX (+ 3.6 ± 4.4 ml/m2, P <0.001) and LV dilation (+ 4.2 ± 5.1 ml/m2, P <0.001; group T vs. C, P <0.001); whereas no significant changes in VO2peak were observed. Multiple linear regression analysis showed that age (β = 0.442, P <0.001), inclusion in the training group (β = - 0.599, P <0.001), E/A ratio (β = - 0.210, P = 0.038), LVEDV (β = 0.376, P <0.001), and LVEF (β = - 0.279, P = 0.007) are significant predictors of LA remodeling. Conclusions: Six-month exercise-based CR in postinfarction patients with mild to moderate LV dysfunction induced a favourable LA remodeling.

AB - Background: Left atrial enlargement is an important predictor of cardiovascular outcomes in patients after acute myocardial infarction. While the favourable effect of exercise exercise-based Cardiac Rehabilitation (CR) on postinfarction LV remodeling has been well documented, those on LA remodeling have yet to be defined. This study investigated the effects of CR on LA remodeling in postinfarction patients with moderate left ventricular (LV) dysfunction. Methods: Sixty postinfarction patients were randomised randomized into two groups, each composed of 30 patients: group T (LV ejection fraction (EF) 43.7 ± 4.2%, mean ± SD) entered a 6-month CR program, whereas group C (EF 44.7 ± 4.4%, P = ns) did not. Doppler echocardiography and cardiopulmonary exercise test were performed upon enrolment and at 6-month. Results: At 6-month, trained patients showed a significant (P <0.001) improvement in peak oxygen consumption (ΔVO2peak = + 5.2 ± 2.1 ml/kg/min) and a reduction in LA (ΔLAVMAX = - 1.9 ± 3.7 ml/m2) and in LV volumes (ΔLVEDV = - 3.6 ± 4.4 ml/m2). At 6-month, untrained patients showed LAVMAX (+ 3.6 ± 4.4 ml/m2, P <0.001) and LV dilation (+ 4.2 ± 5.1 ml/m2, P <0.001; group T vs. C, P <0.001); whereas no significant changes in VO2peak were observed. Multiple linear regression analysis showed that age (β = 0.442, P <0.001), inclusion in the training group (β = - 0.599, P <0.001), E/A ratio (β = - 0.210, P = 0.038), LVEDV (β = 0.376, P <0.001), and LVEF (β = - 0.279, P = 0.007) are significant predictors of LA remodeling. Conclusions: Six-month exercise-based CR in postinfarction patients with mild to moderate LV dysfunction induced a favourable LA remodeling.

KW - Acute myocardial infarction

KW - Cardiac rehabilitation

KW - Cardiopulmonary exercise test

KW - Cardiopulmonary functional capacity

KW - Exercise training

KW - Left atrial remodeling

KW - Left ventricular remodeling

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