temporal pattern in exercise capacity after myocardial infarction in the rat: relationship to left ventricular remodeling. Am J Physiol Heart Circ Physiol 288: H244 -H249, 2005. First published September 9, 2004; doi:10.1152/ajpheart.00042.2004.-After myocardial infarction (MI), there is progressive left ventricular (LV) remodeling and impaired exercise capacity. We tested the hypothesis that LV remodeling results in structural and functional changes that determine exercise impairment post-MI. Rats underwent coronary artery ligation (n ϭ 12) or sham (n ϭ 11) surgery followed by serial exercise tests and echocardiography for 16 wk post-MI. LV pressure-volume relationships were determined using a blood-perfused Langendorff preparation. Exercise capacity was 60% of shams immediately post-MI (P Ͻ 0.05) followed by a recovery to near normal during weeks 5-8. Thereafter, there was a progressive decline in exercise capacity to Ϯ40% of shams (P Ͻ 0.01). At both 8 and 16 wk post-MI, fractional shortening (FS) was reduced and end-diastolic diameter (EDD) was increased (P Ͻ 0.01). However, neither FS nor EDD correlated with exercise at 8 or 16 wk (r 2 Ͻ 0.12, P Ͼ 0.30). LV septal wall thickness was increased at both 8 (P ϭ 0.17 vs. shams) and 16 wk (P ϭ 0.035 vs. shams) post-MI and correlated with exercise at both times (r 2 Ն 0.50 and P Յ 0.02 at 8 and 16 wk). Neither end-diastolic volume nor maximum LV developed pressure at 16 wk correlated with exercise capacity. Exercise capacity follows a biphasic time course post-MI. An immediate decrease is followed by an early recovery phase that is associated with compensatory LV hypertrophy. Subsequently, there is a progressive decrease in exercise capacity that is independent of further changes in LV volume or contractile function. cardiac hypertrophy; exercise capacity; cardiac function; echocardiography AFTER A MYOCARDIAL INFARCTION (MI), there is progressive left ventricular (LV) remodeling that is characterized by LV chamber dilation and contractile dysfunction (17,19). Maximal exercise capacity also decreases post-MI (1,13,18,22). Both the extent of LV remodeling and the impairment in exercise capacity correlate with clinical outcomes in patients with chronic heart failure (5, 7). However, relatively little is known about the relationship between LV remodeling and exercise capacity post-MI. It is possible that LV remodeling is an important determinant of the exercise impairment that occurs after MI. For example, in patients with chronic heart failure due to systolic dysfunction the changes in LV volume, fractional shortening and mass are predictive of exercise capacity (7). On the other hand, exercise capacity often correlates poorly or not at all with central hemodynamics, systolic function, or ventricular volumes in cross-sectional studies (8,9,13,22,23). Thus the role of LV remodeling in the determination of exercise impairment post-MI is not clear.We tested the hypothesis that LV remodeling, as reflected by changes in LV structure and function, is a major determinant of...