A Randomized Comparison of Exercise Training in Patients With Normal vs Reduced Ventricular Function
| Autor: | Max Kuhn, Ute Goebbels, Gerald Dziekan, Reto Ratte, Paul Dubach, Jonathan Myers, Peter Muller |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Time Factors Myocardial Infarction Critical Care and Intensive Care Medicine Rehabilitation Centers Ventricular Function Left Ventricular Dysfunction Left Oxygen Consumption Deconditioning Internal medicine medicine Humans Myocardial infarction Derivation Coronary Artery Bypass Exercise Tolerance Ejection fraction Pulmonary Gas Exchange business.industry Lactate threshold Stroke Volume Middle Aged medicine.disease Exercise Therapy medicine.anatomical_structure Bypass surgery Ventricle Exercise Test Cardiology Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | Chest. 113:1387-1393 |
| ISSN: | 0012-3692 |
| DOI: | 10.1378/chest.113.5.1387 |
| Popis: | Exercise training is recommended after myocardial infarction (MI) or bypass surgery in order to improve exercise tolerance. In some patients, the decrement in exercise capacity secondary to deconditioning and the left ventricular stunning associated with MI or coronary artery bypass graft (CABG) spontaneously improves after the event. However, the impact of the status of the left ventricle on these improvements is unknown.Sixty-seven patients 1 month after MI or CABG were randomized to a training (n=34; age, 59+/-7 years) or a control group (n=33; age, 55+/-6 years). Forty-two patients had an ejection fraction50% (22 in the training group and 20 in the control group), and 25 patients had an ejection fraction40% (12 in the exercise group and 13 in the control group). After stabilization for approximately 1 month after the event, patients in the exercise group underwent 8 weeks of twice daily exercise at a residential rehabilitation center, while control patients received usual care. Initially and after 8 weeks, patients in both groups underwent maximal exercise testing with gas exchange and lactate analysis.Exercise training increased peak oxygen consumption (VO2) only in the reduced ejection fraction group (19.4+/-3.0 to 23.9+/-4.8 mL/kg/min; p0.05); the exercise group with normal ventricular function did not change significantly. Changes in VO2 at the lactate threshold paralleled those of peak VO2 for both groups. Conversely, control patients with normal ventricular function increased peak VO2 spontaneously (20.8+/-3.9 to 24.8+/-3.5 mL/kg/min; p0.01), whereas control patients with reduced ventricular function did not improve peak VO2.These data suggest that patients with depressed left ventricular function strongly benefit from rehabilitation, whereas most patients with preserved left ventricular function following MI or CABG tend to improve spontaneously 1 to 3 months after the event. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|