Exercise performance of the high risk acute myocardial infarction patient after cardiac rehabilitation.
Sixty-five subjects with a recent acute myocardial infarction (AMI), 50 men and 15 women aged 39 to 79 years (mean 62 +/- 9), were entered into a 12-week phase II cardiac rehabilitation program. Group I subjects were those with an ejection fraction greater than 40% (mean 56) and group II subjects were those with an ejection fraction less than 40% (mean 28). Subjects were further classified into those with or without myocardial ischemia (Ia, IIa and Ib, IIb, respectively) based on a treadmill stress test before entry. Work performance during the training sessions was similar for all subgroups, although group IIb had the lowest values for work rate and time of exercise for each individual activity. Subgroup analysis, as determined by a pre- and postprogram treadmill stress test, showed there was no significant difference in time of exercise, peak oxygen consumption and change in submaximal heart rate (decrease) for groups Ia, Ib or IIa. However, group IIb had poor performance in time of exercise (delta = 2 +/- 2 minutes), peak oxygen consumption (delta = 3 +/- 5 ml/min) and submaximal heart rate (delta = 0.4 +/- 17 beats/min) compared with the 3 other subgroups. These subjects also did not demonstrate an improvement of these values in the posttraining period. Patients who have had AMI and have both significant left ventricular dysfunction and myocardial ischemia did not have an adequate training response after 12 weeks of a formal phase II cardiac rehabilitation program.(ABSTRACT TRUNCATED AT 250 WORDS)
Arvan
S
S
University of Pittsburgh, School of Medicine, Pennsylvania.
D000328:Adult; D000368:Aged; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D009203:Myocardial Infarction / Q000503:physiopathology / Q000534:rehabilitation*; D010101:Oxygen Consumption; D005082:Physical Exertion; D011877:Radionuclide Imaging; D012307:Risk Factors; D013318:Stroke Volume; D013997:Time Factors