Interaction between exercise training and ejection fraction in predicting prognosis after a first myocardial infarction

Giuseppe Specchia, Stefano De Servi, Aldo Scirè, Jole Assandri, Carlo Berzuini, Luigi Angoli, Maria Teresa La Rovere, Franco Cobelli

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Abstract

Background: Although recent meta-analysis trials have shown that exercise training may improve survival after myocardial infarction, the mechanism of this beneficial effect is still unknown. The purpose of this study was to detect possible interactions between exercise training and predictors of prognosis after a first myocardial infarction. Methods and Results: Patients with uneventful clinical courses after a first myocardial infarction were randomly assigned to a 4-week training period (125 patients, group 1) or to a control group (131 patients, group 2). Before randomization, all patients underwent a symptom-limited exercise test (28±2 days after myocardial infarction), 24-hour Holter monitoring, and coronary arteriography (31±3 days after the acute episode). After a mean follow-up period of 34.5 months, 18 patients had cardiac deaths (5 in group 1 and 13 in group 2). Multivariate analysis by Cox regression model showed that ejection fraction was the only independent prognostic indicator (P=.03). Evidence existed of an interaction between ejection fraction and exercise training, showing an effect of physical training on survival that depended on the patient's ejection fraction. Among patients with ejection tractions 40%, the estimated risks for trained and untrained patients were similar. Conclusions: These data show that exercise training may prolong survival in post-myocardial infarction patients with depressed left ventricular function. A randomized trial in such patients seems warranted.

Original languageEnglish
Pages (from-to)978-982
Number of pages5
JournalCirculation
Volume94
Issue number5
Publication statusPublished - 1996

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Keywords

  • exercise
  • myocardial infarction
  • prognosis
  • ventricles

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Specchia, G., De Servi, S., Scirè, A., Assandri, J., Berzuini, C., Angoli, L., Rovere, M. T. L., & Cobelli, F. (1996). Interaction between exercise training and ejection fraction in predicting prognosis after a first myocardial infarction. Circulation, 94(5), 978-982.