Three months exercise training in patients with moderate left ventricular systolic dysfunction after myocardial infarction induced a reduction in NT-pro-BNP levels, an improvement of exercise capacity and early left ventricular diastolic filling, without negative left ventricular remodelling. Whether the reduction of NT-pro-BNP levels could be useful as a surrogate marker of favourable left ventricular remodelling at a later follow-up remains to be further explored.

Long-term exercise training is useful for maintaining or improving the beneficial results of the standard 3-month exercise training programme on cardiovascular capacity and HRR. This observation may bear beneficial prognostic effects on patients after AMI.

Materials and Methods:We studied three groups of patients after AMI: Group A (control group): 15 patients, who followed a standard in-hospital CRP of 3 weekly sessions of 2 months duration; Group B (study group): 15 patients, who were enrolled in a home-based CRP of similar duration and were monitored by TC with the aid of an ecg-device (Sorin Life Watch CG 6106); Group C (second control group): 15 patients, who followed a home-based CRP without ecgmonitoring by TC. All patients performed a symptom-limited exercise testing at the beginning of the CRP. Psychometric data (STAI-Y1, STAI-Y2, BDI) were also evaluated. At the end of the CRP all patients underwent repeated exercise testing and psychometric evaluation.Results: TC applied to the home-based CRP was associated with a good compliance to the program. Compared to Group C, in Group B we observed an increase of maximal heart rate, exercise duration, maximal work-load, and an improvement of anxiety, a trend to reduction of depression, and an improvement of quality of life. These results were very similar to Group A patients following a hospital-based CRP. Conclusions: TC improves compliance, functional capacity and psychological profile of patients undergoing a home-based CRP, compared to patients enrolled in a homebased CRP without ecg-monitoring by Telecardiology.

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Conclusions: Long term maintenance of CRP seems to be the best way to achieve a reduction of long term smoking habit and maintain adherence to prescription in patients after AMI. Counselling and behavioural intervention should also be extended to family members in order to maximize the benefit of secondary prevention.