EAMI—Exercise Training in Anterior Myocardial Infarction: An Ongoing Multicenter Randomized Study : Preliminary Results on Left Ventricular Function and Remodeling

Abstract

To determine the effects of a 6-month exercise training program on left ventricular (LV) function and remodeling, 49 consecutive patients (pts) with first Q anterior myocardial infarction (51 ± 8 years), in I-II NYHA class, were studied 4 to 8 weeks after the acute episode and 6 months later by 2D-ECHO and upright bicycle ergometric test. At entry, pts were randomly allocated to physical training (T = 25pts) or control (C = 24pts). Global endocardial surface area (ESA), LV volumes and EF, extent of abnormal wall motion (%WMA), of regional dilatation (%REG DIL), and the shape distortion (DIST) index were analyzed. After 6 months, a significant increase in work capacity (4,589 ± 1,417 to 5,379 ± 1,485 KPM/min, p<0.03) and in lactic anaerobic threshold (45 ± 13 to 63 ± 15 W, p<0.01) was observed only in T. Initial ESA, EDV, EF, %WMA, %REG DIL, and DIST index were similar and they did not change after 6 months in both groups. However, pts with <40%EF had greater (p<0.0001) EDV and %WMA with marked DIST index at entry and showed further (p<0.01) deterioration after 6 months both in C and in T (EDV, ml/ m 2 Erlebacher JA Weiss JL Weisfeldt ML Bulkley BH Early dilatation of the infarcted segment in acute transmural myocardial infarction: role of infarct expansion in acute left ventricular enlargement.. J Am Coll Cardiol. 1984; 4: 201-208 Abstract Full Text PDF PubMed Scopus (209) Google Scholar : 68 ± 12 to T7 ± 18 in C, 71 ± 12 to 74 ± 18 in T; %REG DIL: 39 ± 20 to 49 ± 24 in C, 32 ± 12 to 35 ± 23 in T; DIST index: 0.16 ± 0.07 to 0.21 ± 0.09 in C, 0.2 ± 0.07 to 0.22 ± 0.1 in T). These variables did not change in pts with >40%EF. Thus, from these preliminary data, pts with <40%EF at entry are prone to further global and regional LV deterioration. Physical training does not seem to increase this spontaneous deterioration. To determine the effects of a 6-month exercise training program on left ventricular (LV) function and remodeling, 49 consecutive patients (pts) with first Q anterior myocardial infarction (51 ± 8 years), in I-II NYHA class, were studied 4 to 8 weeks after the acute episode and 6 months later by 2D-ECHO and upright bicycle ergometric test. At entry, pts were randomly allocated to physical training (T = 25pts) or control (C = 24pts). Global endocardial surface area (ESA), LV volumes and EF, extent of abnormal wall motion (%WMA), of regional dilatation (%REG DIL), and the shape distortion (DIST) index were analyzed. After 6 months, a significant increase in work capacity (4,589 ± 1,417 to 5,379 ± 1,485 KPM/min, p<0.03) and in lactic anaerobic threshold (45 ± 13 to 63 ± 15 W, p<0.01) was observed only in T. Initial ESA, EDV, EF, %WMA, %REG DIL, and DIST index were similar and they did not change after 6 months in both groups. However, pts with <40%EF had greater (p<0.0001) EDV and %WMA with marked DIST index at entry and showed further (p<0.01) deterioration after 6 months both in C and in T (EDV, ml/ m 2 Erlebacher JA Weiss JL Weisfeldt ML Bulkley BH Early dilatation of the infarcted segment in acute transmural myocardial infarction: role of infarct expansion in acute left ventricular enlargement.. J Am Coll Cardiol. 1984; 4: 201-208 Abstract Full Text PDF PubMed Scopus (209) Google Scholar : 68 ± 12 to T7 ± 18 in C, 71 ± 12 to 74 ± 18 in T; %REG DIL: 39 ± 20 to 49 ± 24 in C, 32 ± 12 to 35 ± 23 in T; DIST index: 0.16 ± 0.07 to 0.21 ± 0.09 in C, 0.2 ± 0.07 to 0.22 ± 0.1 in T). These variables did not change in pts with >40%EF. Thus, from these preliminary data, pts with <40%EF at entry are prone to further global and regional LV deterioration. Physical training does not seem to increase this spontaneous deterioration.