Influence of Aerobic Training on The Mechanics of Ventricular Contraction After Acute Myocardial Infarction: A Pilot Study

Abstract

The study of myocardial contractility, based on the new anatomical concepts that govern cardiac mechanics, represents a promising strategy of analysis of myocardial adaptations related to physical training in the context of post-infarction.We investigated the influence of aerobic training on physical capacity and on the evaluation parameters of left ventricular contraction mechanics in patients with myocardial infarction.Thirty-one patients (55.1 ± 8.9 years) who had myocardial infarction in the anterior wall were prospectively investigated in three groups: interval training group (ITG) (n = 10), moderate training group (MTG) n = 10) and control group (CG) (n = 10). Before and after 12 weeks of clinical follow-up, patients underwent cardiopulmonary exercise testing and cardiac magnetic resonance imaging. The trained groups performed supervised aerobic training on treadmill, in two different intensities.A statistically significant increase in peak oxygen uptake (VO2) was observed in the ITG (19.2 ± 5.1 at 21.9 ± 5.6 ml/kg/min, p < 0.01) and in the MTG 18.8 ± 3.7 to 21.6 ± 4.5 ml/kg/min, p < 0.01). The GC did not present a statistically significant change in peak VO2. A statistically significant increase in radial strain (STRAD) was observed in the CG: basal STRAD (57.4 ± 16.6 to 84.1 ± 30.9%, p < 0.05), medial STRAD (57.8 ± 27, 9 to 74.3 ± 36.1%, p < 0.05) and apical STRAD (38.2 ± 26.0 to 52.4 ± 29.8%, p < 0.01). The trained groups did not present a statistically significant change of the radial strain.The present study points to a potential clinical application of the parameters of ventricular contraction mechanics analysis, especially radial strain, to discriminate post-infarction myocardial adaptations between patients submitted or not to aerobic training programs.

Efeito de diferentes modalidades de treinamento físico no consumo de oxigênio de pico em pacientes pós-infarto agudo do miocárdio: uma revisão sistemática e metanálise

“…As a result, six studies were included in the quantitative analysis. 30 - 35 Two of these were included twice 30 , 32 because they met eligibility criteria for two comparisons between groups: aerobic exercise of moderate intensity vs. control and aerobic exercise of high intensity vs. control. Additionally, two studies met the eligibility criteria for comparison of combined exercise vs. control (aerobic training).…”

“…31 , 33 - 35 Aerobic exercise was the most prevalent modality among the six studies (66%) and two of the four studies of aerobic exercise were included twice, because they investigated different exercise intensities. Moderate intensity was used in three of these four studies (75%), 30 , 32 , 33 and high intensity was used in three studies (75%). 30 , 32 , 35 Combined exercise was used in two studies (34%), both of which used high intensity aerobic exercise as part of combined exercise.…”

“…Moderate intensity was used in three of these four studies (75%), 30 , 32 , 33 and high intensity was used in three studies (75%). 30 , 32 , 35 Combined exercise was used in two studies (34%), both of which used high intensity aerobic exercise as part of combined exercise. 31 , 34 …”

The Beneficial Role of Exercise Training for Myocardial Infarction Treatment in Elderly

“…LV end diastolic and systolic volumes had significantly decreased in MI patients after 10 weeks of exercise training (Mc et al, 2016). Following acute MI, patients who participated in interval training or MIT for 12 weeks significantly increased their VO 2 peak (Santi et al, 2018). In summary, exercise training effectively promoted cardiac circulation by improving cardiac performance in MI patients.…”

“…Interval training also had a more beneficial effect in improving VO 2 peak from 31.6 ± 5.8 to 36.2 ± 8.6ml kg −1 min −1 as compared to the usual care rehabilitation, which was from 32.2 ± 6.7 to 34.7 ± 7.9ml kg −1 min −1 (Moholdt et al, 2012). After 12 weeks of interval training, the VO 2 peak had increase from 19.2 ± 5.1 to 21.9 ± 5.6 ml kg −1 min −1 in 31 patients (55.1 ± 8.9 years) with MI in the anterior wall (Santi et al, 2018). Thus, participation in interval exercise had unique advantages as compared to other types of exercise training for MI patients, which needs further research in the future.…”