Effect of Exercise Training on Myocardial Remodeling in Patients With Reduced Left Ventricular Function After Myocardial Infarction

Dubach, Paul; Myers, Jonathan; Dziekan, Gerald; Goebbels, Ute; Reinhart, Walter H.; Vogt, Paul; Ratti, R; Müller, P; Miettunen, Risto; Buser, Peter

doi:10.1161/01.cir.95.8.2060

Cited by 150 publications

(109 citation statements)

References 33 publications

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“…In postinfarction patients with LV dysfunction, ET does not cause any harmful effect on LV volumes 10,15 ; rather, it attenuates the remodeling process. 10 Recent studies, although not aimed at monitoring the LV remodeling process, have …”

Section: Discussionmentioning

confidence: 99%

Antiremodeling Effect of Long-Term Exercise Training in Patients With Stable Chronic Heart Failure

et al. 2003

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Background-The effects of exercise training (ET) on left ventricular (LV) remodeling in chronic heart failure are not definitively established, and the safety of ET in these patients is still debated. Methods and Results-This multicenter study investigated the long-term effect of moderate ET on LV remodeling, work capacity, and quality of life (QoL) in 90 patients with stable chronic heart failure caused by LV systolic dysfunction, randomized to a 6-month ET program (T, nϭ45) or a control group (C, nϭ45). All patients underwent resting echocardiography, a cardiopulmonary exercise test, 6-minute walking test, and QoL assessment at entry and after 6 months. At entry, end-diastolic (EDV) and end-systolic (ESV) volume, ejection fraction, work capacity, peak V O 2 , and walking distance were similar in the 2 groups. After 6 months, LV volumes diminished in T (EDV, from 142Ϯ26 to 135Ϯ26 mL/m 2 , PϽ0.006; ESV, from 107Ϯ24 to 97Ϯ24 mL/m 2 , PϽ0.05) but increased in C (EDV, from 147Ϯ41 to 156Ϯ42 mL/m 2 , PϽ0.01; ESV, from 110Ϯ34 to 118Ϯ34 mL/m 2 , PϽ0.01). Ejection fraction improved in T (PϽ0.001) but was unchanged in C (PϭNS). Significant improvement in work capacity (PϽ0.001), peak V O 2 (PϽ0.006), walking distance (PϽ0.001), and QoL (PϽ0.01) was observed in T but not in C (PϭNS). T showed a trend toward fewer (Pϭ0.05) hospital readmissions for worsening dyspnea in the absence of other adverse cardiac events. Conclusions-In stable chronic heart failure, long-term moderate ET has no detrimental effect on LV volumes and function; rather, it attenuates abnormal remodeling. Furthermore, ET is safe and effective in improving exercise tolerance and QoL. (Circulation. 2003;108:554-559.)

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Section: Discussionmentioning

confidence: 99%

Antiremodeling Effect of Long-Term Exercise Training in Patients With Stable Chronic Heart Failure

et al. 2003

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“…Over the last decades several scientific works were published, which sought to assess the effects of the aerobic physical exercise on VR and the cardiac function of patients suffering from MI, who evolved with LV systolic dysfunction [7][8][9][10][13][14][15][16]. Many of these studies, considered classics and pioneers, continue to be cited in various scientific articles and are selected for composing meta-analyses, despite having been conducted at a time when blocking of neurohumoral activation after MI was not understood as the cornerstone of the treatment of ventricular dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…showed both maintenance of cardiac chamber volumes and function. According to Dubach et al [7]., discrepancies among those several studies could be attributed to factors related to heterogeneity of samples, differences of training intensity, diversity of methodology used in the calculation of chamber volume measurements and ventricular function in VR assessment, or even a combination of these factors. In order to maximize the accuracy in chamber volume measurements, ventricular mass and estimation of cardiac function, in our study a magnetic resonance imaging study was carried out, which provides higher accuracy compared to other imaging methods.…”

Section: Discussionmentioning

confidence: 99%

“…There is a substantial body of evidence documenting global improvement and decreased mortality related to physical exercise in the context of post-myocardial infarction. However, scientific research to assess the effects of physical exercise in the process of VR in patients with anterior wall MI and ventricular dysfunction, showed controversial results [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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Influence of aerobic exercise training on left ventricular remodeling and neurohumoral response in patients with myocardial infarction

Santi¹,

Carvalho²,

Costa³

et al. 2017

Cardiovasc Disord Med

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Purpose: The effects of aerobic training on ventricular remodeling (VR) and neurohumoral activation after myocardial infarction (MI) have not been completely elucidated. It was investigated the influence of aerobic training on physical fitness, on VR and neurohumoral response after MI. Methods:Sixteen patients with anterior wall myocardial infarction were randomized into two groups: training (TG=8) and control (CG=8). TG patients performed moderate-intensity aerobic training. Before and after a 12-week follow-up all patients underwent cardiac magnetic resonance, cardiopulmonary exercise testing and blood sampling for measurement of NT-proBNP. Results:In the follow-up, there was a significant increase in the ΔO2 pulse in the TG (6.4 ± 1.2 to 8.1 ± 1.7; p=0.01), with no significant change in the CG (7.0 ± 2.3 to 6.9 ± 3.0; p>0.99). It was observed an increase of LV mass/EDV ratio from 0.72 ± 0.19 to 0.96 ± 0.30 g.ml-1 (p=0.007) in the CG, but no change in the TG from 0.89 ± 0.33 to 0.96 ± 0.26 g.ml-1 (p=0.54). There was a significant decrease of NT-proBNP at rest and at effort peak in both groups. Conclusion:Aerobic training seems to have a protective effect over the spontaneous process of LV concentric remodeling after myocardial infarction, and it promotes an improvement of the LV systolic performance during dynamic physical effort, without triggering adverse neurohumoral activation.

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“…9 In patients with acute myocardial infarction (AMI), exercise training has the beneficial effects on cardiovascular systems. 10 Cardiac effects include attenuation of postinfarction ventricular remodeling, 11,12 for which brain natriuretic peptide (BNP) is a useful biochemical marker. 13 Vascular effects include an increase in the density of skeletal-muscle capillaries 14 and improvement in endothelialdependent vasodilation, 15,16 which are important determinants for exercise tolerance and symptoms.…”

mentioning

confidence: 99%

Exercise-Induced Hepatocyte Growth Factor Production in Patients After Acute Myocardial Infarction-Its Relationship to Exercise Capacity and Brain Natriuretic Peptide Levels-

Yasuda

Goto

Takaki

et al. 2004

Circ J

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Effect of Exercise Training on Myocardial Remodeling in Patients With Reduced Left Ventricular Function After Myocardial Infarction

Cited by 150 publications

References 33 publications

Antiremodeling Effect of Long-Term Exercise Training in Patients With Stable Chronic Heart Failure

Antiremodeling Effect of Long-Term Exercise Training in Patients With Stable Chronic Heart Failure

Influence of aerobic exercise training on left ventricular remodeling and neurohumoral response in patients with myocardial infarction

Exercise-Induced Hepatocyte Growth Factor Production in Patients After Acute Myocardial Infarction-Its Relationship to Exercise Capacity and Brain Natriuretic Peptide Levels-

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