Abstract-Autonomic dysfunction, including baroreceptor attenuation and sympathetic activation, has been reported in patients with myocardial infarction (MI) and has been associated with increased mortality. We tested the hypotheses that exercise training (ET) in post-MI patients would normalize arterial baroreflex sensitivity (BRS) and muscle sympathetic nerve activity (MSNA), and long-term ET would maintain the benefits in BRS and MSNA. Twenty-eight patients after 1 month of uncomplicated MI were randomly assigned to 2 groups, ET (MI-ET) and untrained. A normal control group was also studied. ET consisted of three 60-minute exercise sessions per week for 6 months. We evaluated MSNA (microneurography), blood pressure (automatic oscillometric method), heart rate (ECG), and spectral analysis of RR interval, systolic arterial pressure (SAP), and MSNA. Baroreflex gain of SAP-RR interval and SAP-MSNA were calculated using the ␣-index. At 3 to 5 days and 1 month after MI, MSNA and low-frequency SAP were significantly higher and BRS significantly lower in MI patients when compared with the normal control group. ET significantly decreased MSNA (bursts per 100 heartbeats) and the low-frequency component of SAP and significantly increased the low-frequency component of MSNA and BRS of the RR interval and MSNA. These changes were so marked that the differences between patients with MI and the normal control group were no longer observed after ET. MSNA and BRS in the MI-untrained group did not change from baseline over the same time period. ET normalizes BRS, low-frequency SAP, and MSNA in patients with MI. These improvements in autonomic control are maintained by long-term ET. Key Words: myocardial infarction Ⅲ sympathetic nerve activity Ⅲ exercise training Ⅲ autonomic control Ⅲ baroreflex control P revious studies show that myocardial infarction (MI) is linked to increased sympathetic nervous activity 1,2 and impaired arterial baroreflex sensitivity (BRS). 3 These findings of autonomic dysfunction have been associated with increased mortality in patients after MI. 4 -10 La Rovere et al 7 demonstrated that decreased BRS is associated with cardiac mortality risk. A follow-up of 61 months in uncomplicated post-MI patients with preserved left ventricular function showed that depressed BRS discriminated a subgroup at long-term high risk for cardiovascular mortality. 10 Increased muscle sympathetic nerve activity (MSNA) is an independent predictor of poor prognosis in patients with chronic heart failure, including patients with chronic heart failure after MI. 11 Thus, a therapeutic strategy targeted to the improvement in autonomic control in patients with MI represents an important clinical goal.In patients with cardiovascular disease, studies have shown that physical exercise is an important strategy to improve autonomic function. Exercise training has been shown to decrease MSNA 12 and improve BRS 12-14 in patients with MI. It remains unknown whether the magnitude of change in autonomic control actually normalizes BRS and sy...