Benefits of lifelong exercise training on left ventricular function after myocardial infarction

Abstract

Background Endurance exercise training induces cardio-protective effects, but athletes are not exempted from a myocardial infarction. Evidence from animal studies suggests that exercise training attenuates pathological left ventricular remodelling following myocardial infarction. We tested the hypothesis that lifelong exercise training is related to attenuated pathological left ventricular remodelling after myocardial infarction as evidenced by better left ventricular systolic function in veteran athletes compared to sedentary peers. Design This was a cross-sectional study. Methods Sixty-five males (60 ± 6 years) were included and allocated to four groups based on lifelong exercise training volumes: (a) athletes ( n = 18), (b) post-myocardial infarction athletes (athletes + myocardial infarction, n = 20), (c) sedentary controls ( n = 13), and (d) post-myocardial infarction controls (sedentary controls + myocardial infarction, n = 14). Athletes were lifelong (≥20 years) highly physically active (≥30 metabolic equivalent of task (MET)-h/week), whereas sedentary controls did not meet the exercise guidelines (<10 MET-h/week) for the past 20 years. left ventricular systolic function, diastolic function and wall strain were measured using echocardiography. Results Cardiac enzyme markers (creatine-kinase, creatinine, aspartate transaminase and lactate dehydrogenase) following myocardial infarction and infarct location did not differ between athletes + myocardial infarction and sedentary controls + myocardial infarction. Left ventricular ejection fraction was significantly higher in athletes (61% ± 4), athletes + myocardial infarction (58% ± 4) and sedentary controls (57% ± 6) compared to sedentary controls + myocardial infarction (51% ± 7; p < 0.01). Left ventricular circumferential strain was superior in athletes (-19% (-21% to -17%), athletes + myocardial infarction (-16% (-20% to -12%)), and sedentary controls (-15% (-18% to -14%) compared to sedentary controls + myocardial infarction (-13% (-15% to -8%), p < 0.01). Diastolic function parameters did not differ across groups. Conclusion These findings suggest that lifelong exercise training may preserve left ventricular systolic function and possibly attenuates or minimises the deleterious effects of pathological post-myocardial infarction left ventricular remodelling in veteran athletes.

Early moderate exercise benefits myocardial infarction healing via improvement of inflammation and ventricular remodelling in rats

“…For many years, avoiding physical activity after MI was recommended; however, the current view proposes that moderate exercise training should be a part of cardiac rehabilitation programmes. There is increasing evidence that exercise training, including exercise training before and after infarction, provides promising effects on the repair of the infarcted heart, regardless of the decrease in infarct size and cardiac fibrosis, the attenuation of apoptosis in the myocardium, improvements in ventricular remodelling and inflammation …”

“…There is increasing evidence that exercise training, including exercise training before and after infarction, provides promising effects on the repair of the infarcted heart, regardless of the decrease in infarct size and cardiac fibrosis, the attenuation of apoptosis in the myocardium, improvements in ventricular remodelling and inflammation. [3][4][5][6][7][8][9][10] However, various studies in animals and humans have also shown conflicting results concerning the effects of exercise training, including neutral [11][12][13][14] and adverse [15][16][17] effects, on LV remodelling after MI.…”

Editor’s presentation

“…19 Despite the cardio-protective effects of training, athletes are not exempted from acute coronary syndromes. However, the deleterious effects of MI seem to be reduced by lifelong exercise training, as shown in the study of Maessen et al 20 Thus physical training, protects not only against CV injury, but it also reduced the damage after injury.…”

The Beneficial Role of Exercise Training for Myocardial Infarction Treatment in Elderly

“…Exercise training exerted beneficial effects in the process of cardiopulmonary rehabilitation and LV remodeling in the LV dysfunction patients after MI, and the greatest effects were achieved when exercise began at the post-MI acute phase (Zhang et al, 2016). A cross-sectional study of 65 men (60 ± 6 years) found that lifelong exercise training maintained LV systolic function and probably alleviated or minimized the detrimental effects of LV remodeling after MI in veteran athletes (Maessen et al, 2017). LV end diastolic and systolic volumes had significantly decreased in MI patients after 10 weeks of exercise training (Mc et al, 2016).…”