title: Left ventricular remodelling in patients with moderate systolic dysfunction after myocardial infarction: favourable effects of exercise training and predictive role of N-terminal pro-brain natriuretic peptide.
abstract: OBJECTIVE
  To investigate the effects of exercise training (ET) on left ventricular (LV) volumes, cardiopulmonary functional capacity and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in postinfarction patients with moderate LV dysfunction.
  
  
  METHODS
  Sixty-one postinfarction patients were randomized into two groups: group T [n=30, LV ejection fraction (EF) 41.6+/-11.3%, mean+/-SD] entered a 6-month ET programme, whereas group C (n=31, EF 42.0+/-7.6%, P=NS) did not. NT-proBNP assay, Doppler-echocardiography and cardiopulmonary exercise test were performed upon enrolment and at sixth months.
  
  
  RESULTS
  At sixth months, trained patients showed an improvement in workload (+26%, P<0.001), Vo2peak (+31%, P<0.001), LV end-diastolic volume index (LVEDVI; -9%, P<0.001), a reduction in NT-proBNP (-71%, P<0.001) and a significant correlation between changes in NT-proBNP and in LVEDVI (r=0.858, P<0.001). Baseline NT-proBNP correlated with changes in LVEDVI in both trained (r=0.673, P<0.001) and untrained (r=0.623, P<0.001) patients. Group C showed unfavourable LVEDVI dilation (+8%, P<0.001; T vs. C group, P<0.001) and a smaller reduction in NT-proBNP (-40%, P<0.001; T vs. C group, P<0.001).
  
  
  CONCLUSIONS
  Six month ET induced a favourable LV remodelling and a marked fall in NT-proBNP that could predict LV remodelling in postinfarction patients with moderate LV dysfunction.
authors.affiliation: Cardiac Rehabilitation Unit , Department of Clinical Medicine, Cardiovascular and Immunological Sciences, University of Naples Federico II, Naples, Naples, Italy. giallauria@libero.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Giallauria
authors.forename: Plinio
authors.initials: P
authors.lastname: Cirillo
authors.forename: Rosa
authors.initials: R
authors.lastname: Lucci
authors.forename: Mario
authors.initials: M
authors.lastname: Pacileo
authors.forename: Anna
authors.initials: A
authors.lastname: De Lorenzo
authors.forename: Mariantonietta
authors.initials: M
authors.lastname: D'Agostino
authors.forename: Sabino
authors.initials: S
authors.lastname: Moschella
authors.forename: Marianna
authors.initials: M
authors.lastname: Psaroudaki
authors.forename: Domenico
authors.initials: D
authors.lastname: Del Forno
authors.forename: Francesco
authors.initials: F
authors.lastname: Orio
authors.forename: Dino Franco
authors.initials: DF
authors.lastname: Vitale
authors.forename: Massimo
authors.initials: M
authors.lastname: Chiariello
authors.forename: Carlo
authors.initials: C
authors.lastname: Vigorito
mesh_terms: D015150:Echocardiography, Doppler; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000534:rehabilitation*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013599:Systole; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000534:rehabilitation*; D020257:Ventricular Remodeling
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain