title: Cardiovascular adaptations to exercise training after uncomplicated acute myocardial infarction.
abstract: OBJECTIVE
  This study examined the cardiovascular adaptations of an exercise training program and evaluated the role of peripheral vasodilator capacity in contributing to these adaptations after myocardial infarction.
  
  
  METHODS
  A total of 44 consecutive patients with uncomplicated myocardial infarction underwent 3 wks of exercise training. Controls (n = 12) with comparable myocardial infarction were selected from our database and were restricted to a program with minimal activity. All patients performed cardiopulmonary exercise testing with hemodynamic measurements. Forearm and calf reactive hyperemic flow were measured by venous occlusive plethysmography as indices of peripheral vasodilator capacity.
  
  
  RESULTS
  Despite no change in arteriovenous oxygen difference at peak exercise after training, training resulted in significant increases in oxygen consumption, cardiac output, and stroke volume and a significant decrease in systemic vascular resistance at peak exercise (overall, P < 0.05). Calf reactive hyperemic flow increased significantly after training (P < 0.001), but forearm reactive hyperemic flow did not. Furthermore, increase in calf reactive hyperemic flow after training had a positive correlation with increases in peak cardiac output, stroke volume, and oxygen consumption after training and an inverse correlation with peak systemic vascular resistance.
  
  
  CONCLUSIONS
  Exercise training improved exercise tolerance by improving hemodynamic responses to exercise after myocardial infarction. This improved exercise performance was linked to a training-induced increase in calf vasodilator capacity.
authors.affiliation: Second Department of Internal Medicine, Kansai Medical University, Moriguchi City, Osaka, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Motohiro
authors.forename: Fumio
authors.initials: F
authors.lastname: Yuasa
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Hattori
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Sumimoto
authors.forename: Masaharu
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Mutsuhito
authors.initials: M
authors.lastname: Kaida
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Jikuhara
authors.forename: Makoto
authors.initials: M
authors.lastname: Hikosaka
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Sugiura
authors.forename: Toshiji
authors.initials: T
authors.lastname: Iwasaka
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology*; D002302:Cardiac Output / Q000502:physiology; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005542:Forearm / Q000098:blood supply; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000534:rehabilitation*; D010101:Oxygen Consumption / Q000502:physiology; D010991:Plethysmography; D012039:Regional Blood Flow; D014655:Vascular Resistance / Q000502:physiology