Aerobic Training after Myocardial Infarction: Remodeling Evaluated by Cardiac Magnetic Resonance

Abstract

BackgroundNumerous studies show the benefits of exercise training after myocardial infarction (MI). Nevertheless, the effects on function and remodeling are still controversial. ObjectivesTo evaluate, in patients after (MI), the effects of aerobic exercise of moderate intensity on ventricular remodeling by cardiac magnetic resonance imaging (CMR). Methods26 male patients, 52.9 ± 7.9 years, after a first MI, were assigned to groups: trained group (TG), 18; and control group (CG), 8. The TG performed supervised aerobic exercise on treadmill twice a week, and unsupervised sessions on 2 additional days per week, for at least 3 months. Laboratory tests, anthropometric measurements, resting heart rate (HR), exercise test, and CMR were conducted at baseline and follow-up.ResultsThe TG showed a 10.8% reduction in fasting blood glucose (p = 0.01), and a 7.3-bpm reduction in resting HR in both sitting and supine positions (p < 0.0001). There was an increase in oxygen uptake only in the TG (35.4 ± 8.1 to 49.1 ± 9.6 mL/kg/min, p < 0.0001). There was a statistically significant decrease in the TG left ventricular mass (LVmass) (128.7 ± 38.9 to 117.2 ± 27.2 g, p = 0.0032). There were no statistically significant changes in the values of left ventricular end-diastolic volume (LVEDV) and ejection fraction in the groups. The LVmass/EDV ratio demonstrated a statistically significant positive remodeling in the TG (p = 0.015). ConclusionsAerobic exercise of moderate intensity improved physical capacity and other cardiovascular variables. A positive remodeling was identified in the TG, where a left ventricular diastolic dimension increase was associated with LVmass reduction.

Is Physical Therapy the Early Solution for Post-Acute Myocardial Infarction Patients? A Meta-Analysis

“…In a study by Chen et al (2015), beneficial changes have been noticed after kinesiotherapy in 610 out of 834 patients. 9 Even though the heterogeneity of the studies was low compared with the outcomes of other studies, only the studies of Chen et al 9 and Izeli et al 13 did not cross the "no effect" line, therefore being statistically significant for our meta-analysis. However, the study of Izeli et al had to be dismissed due to its inappropriate design and limitations (Figure 3).…”

“…However, the study of Izeli et al had to be dismissed due to its inappropriate design and limitations (Figure 3). 13 The question whether the implementation of an exercise program within one week at most after the cardiac event would be beneficial for post-AMI patients could not be elucidated because there were no relevant data identified in the medical literature.…”

Percepção de homens após infarto agudo do miocárdio

“…Esse achado está em conformidade com estudos que elencaram resultados positivos advindos de um programa equilibrado de atividade física. Dentre os quais podem ser citados: aumento da expectativa de vida, prevenção de eventos cardíacos, melhora da função cardíaca e do remodelamento cardíaco, redução de placas ateroscleróticas (28) ; modificação dos fatores de risco cardiovascular e redução da frequência cardíaca de repouso (31) ; redução da morbidade e mortalidade, com aumento da qualidade de vida (29) ; diminuição da isquemia estresse-induzida e aumento da capacidade cardiovascular funcional (32) ; redução de re-estenose coronariana tardia (33) ; redução da progressão da doença e influência positiva sobre a função endotelial coronariana (34) ; redução de internações hospitalares (35) .…”

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“…There has been an enormous development in the treatment of cardiovascular disease in Poland, with cardiac rehabilitation playing an important role. The main goals of cardiac rehabilitation are to reduce disease progression, facilitate the return to full physical fitness, improve mental wellbeing and help patients continue their normal life [12][13][14][15][16][17][18][19][20].…”