The influence of combined aerobic and resistance training on left ventricle function in patients after acute myocardial infarction

Czech version

Authors: L. Elbl ¹; V. Chaloupka ¹; I. Tomášková ¹; F. Jedlička ¹; S. Nehyba ¹; P. Kala ²; J. Schildberger ²; M. Poloczek ²; O. Boček ²
Authors‘ workplace: Oddělení funkčního vyšetřování, FN Brno, pracoviště Bohunice, přednosta doc. MUDr. Václav Chaloupka, CSc. ¹; Interní kardiologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jindřich Špinar, CSc., FESC ²
Published in: Vnitř Lék 2005; 51(2): 190-197
Category: Original Contributions

Overview

Objective of the Research:
Presented research was focused on the evaluation of the influence of combined aerobic training with resistance exercise performed within early controlled ambulatory rehabilitation on the left ventricle function in patients after the first acute myocardial infarction.

Patients and Methods:
109 patients (18 women, 91 men) at the age of 58 ± 9 years were enrolled into the study. 34 patients (38 ± 6 %) exhibited decreased ejection fraction (EF) < 50 %. The time interval from the occurrence of myocardial infarction to the beginning of the rehabilitation was 31 ± 7 days, in patients after aortocoronary bypass surgery 45 ± 19 days. Patients were examined using rest and dynamic exercise stress echocardiography and spiroergometry before the rehabilitation as well as after it. The evaluated parameters were as follows: rest and stress ejection fractions, left ventricle (LV) volumes, LV wall motion index (WMI_LV) and peak volume of oxygen consumption (pVO₂). Training programme proceeded for 8 weeks. Aerobic training was performed at the level of 60 % pVO₂and after 2 weeks it was completed with resistance exercise.

Results:
After the rehabilitation the two subgroups of patients exhibited significantly increased pVO₂and improved stress tolerance. In the subgroup with decreased EF a slight improvement of both rest (38 ± 6 % vs. 45 ± 6 %; p < 0.007) and stress EF values (50 ± 7 % vs. 55 ± 6 %; p < 0.001) was observed. The same improvement was achieved also in the WMI_LV parameter. Values of LV end-diastolic volume (EDV) were significantly higher (p < 0.001) in the subgroup with decreased EF, neither rest EDV values nor stress ones were increased in any subgroup after rehabilitation. Significant relationship between the change of rest and stress EF and change of pVO₂ in patients with decreased EF (r = 0.36; p < 0.01 and 0.43; p < 0.001, respectively) was seen.

Conclusions:
Combined aerobic training and resistance exercise carried out within early rehabilitation are safe and they did not impair the process of LV remodelation. These conclusions apply to the patients with mild and moderate LV systolic dysfunction. The importance of the present findings must be evaluated in long-term prospective observation.

Key words:
acute myocardial infarction – early rehabilitation – resistance exercise – left ventricular remodelation

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