Exercise training following myocardial infarction improves myocardial perfusion assessed by thallium-201 scintigraphy.
OBJECTIVE
We assessed the effects of a 6-week exercise programme on the thallium-201 myocardial perfusion characteristics of patients following myocardial infarction.


METHODS
Twenty-five patients presenting with a first acute myocardial infarction were randomised into two groups: (i) those undergoing a supervised exercise training programme over 6 weeks (n=15) and (ii) a control group who did not attend the exercise programme (n=10). All underwent three sequential stress thallium myocardial perfusion scans at 10 days, 6 weeks and 3 months after infarction. The stress conditions were identical on each occasion. The images were analysed using a polar plot with a computer assisted algorithm comparing stress and redistribution data. Values for extent, severity and percentage redistribution of the thallium images were generated.


RESULTS
A total of 29 perfusion defects were identified, 18 in the exercise group and 11 in the control group. Over 3 months in the exercise group the mean extent of the stress image defect fell from 109+/-64 to 95+/-51 pixels (P<0.05) while in the control group there was an increase from 133+/-57 to 144+/-57 pixels (P=ns). Stress defect severity fell in the exercise group from 581+/-417 to 494+/-346 S.D. (P<0.05) but increased in the control group from 765+/-494 to 877+/-543 S.D. (P=ns). On redistribution imaging in the exercise group a significant decrease was observed in both extent (94+/-56 to 76+/-43 pixels (P<0.05)) and severity (541+/-387 to 438+/-291 S.D. (P<0.05)) of the defects. However in the control group no significant change was observed for extent (125+/-54 to 125+/-52 pixels) or severity (745+/-485 to 820+/-503 S.D.) of the redistribution defects (P=ns). Reversibility of the defects increased slightly in both the exercise group (from 14.6+/-17 to 17.5+/-20%) and the control group (5.2+/-5 to 9.6+10%) (P=ns).


CONCLUSIONS
Following myocardial infarction a 6-week exercise programme improves myocardial perfusion characteristics. An exercise programme should be integrated into cardiac rehabilitation protocols for patients after infarction.
Gunning
Mark G
MG
Department of Cardiology, University College London Medical School, London, UK. gunningmark@hotmail.com
Walker
Judith
J
Eastick
Sian
S
Bomanji
Jamshed B
JB
Ell
Peter J
PJ
Walker
J Malcolm
JM
D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000628:therapy*; D015425:Myocardial Reperfusion; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012720:Severity of Illness Index; D013794:Thallium Radioisotopes
D019275:Radiopharmaceuticals; D013794:Thallium Radioisotopes