Cardiovascular function during early recovery from acute myocardial infarction.

Abstract

Fifty patients with acute myocardial infarction were studied serially to evaluate the extent and nature of functional cardiovascular impairment and the time course of recovery. Reinfarction or death occurred in six patients. Peak workload during bicycle exercise in a subgroup of 25 patients with maximal initial test and complete follow-up increased from 334 to 409 kpm/min (P less than 0.01) bwtween three and six weeks. There was further significant (P less than 0.01) improvement between three and six months from 438 to 488 kpm/min. The incidence of ischemia at a constant workload decreased between three and six weeks without any significant changes in heart rate or blood pressure. Mean cardiac output during exercise at three months was 6.5 and at six months 7.8 L/min (P less than 0.05). Corresponding values for stroke volume were 61 and 72 ml (P less than 0.05). The data suggest that in clinically stable patients there is an early improvement of the relation between myocardial oxygen supply and demand and a late improvement of functional capacity associated with increased stroke volume and cardiac output.

40years of cardiac rehabilitation and secondary prevention in post-cardiac ischaemic patients. Are we still in the wilderness?

“…Haskell and DeBusk confirmed these observations using symptom limited exercise tests at weeks 3, 7, and 11 after uncomplicated myocardial infarction [19]. Similar results were also seen by Wohl et al at 3 and 6 weeks after myocardial infarction [20]. Jelinek et al's exercise testing regimen became the basis for their multi-disciplinary outpatient cardiac rehabilitation clinic [21].…”

Aerobic training enhances muscle deoxygenation in early post-myocardial infarction

“…non-training) group. It is possible that cardiovascular responses and aerobic capacity may be gradually improved over the natural time course in early after onset of MI patients (Wohl et al 1977 ). Therefore, peripheral factors and their relationship to the improvement of aerobic capacity may be altered without exercise training.…”

Cardiocirculatory adjustments to exercise following myocardial infarction in rats

“…Several clinical studies have documented significant changes in the cardiovascular response to exercise weeks to months after acute myocardial infarction (13,19,31). However, in these studies evidence of LV dysfunction was employed as criteria for exclusion from exercise testing and regional vascular adjustments during exercise in the course of MI were not investigated due to the obvious methodical problems in patients.…”