Influence of exercise training on left ventricular diastolic function and its relationship to exercise capacity in patients after myocardial infarction.
BACKGROUND
The study's aim was to examine the effect of exercise training on left ventricular diastolic function (LVDF) and whether LVDF could predict an improvement in exercise capacity (EC) in post-myocardial infarction patients.


METHODS
Forty-eight males, aged 56.4 +/- 7.2 years, with preserved left ventricular systolic function (LVSF) and mild diastolic dysfunction (the ratio of transmitral early left ventricular filling velocity to early diastolic mitral annulus velocity E/E' > 8 as the average of the septal and lateral annulus velocities), were assigned to either a training group (TG, n = 32) or controls (n = 16). Before, and at the end of the study, all patients underwent a cardiopulmonary test and echocardiography with tissue Doppler imaging (TDI).


RESULTS
After a 4.5-month training program, maximal oxygen consumption increased significantly in TG (26.66 +/- 3.88 vs. 28.79 +/- 5.00 mL/kg/min, p < 0.0001). TDI-derived E/E' did not change after the training program. After dividing TG according to septal E/E's > 10 and < 10 and lateral E/E'l > 8 and < 8, exercise capacity improved significantly only in patients with E/E's < 10 and E/E'l < 8.


CONCLUSIONS
A 4.5-month training program in post-myocardial infarction patients with preserved LVSF and mild diastolic dysfunction led to improved exercise capacity only in TG. The diastolic function did not change significantly. The improvement in exercise capacity was significantly greater in patients with a better LVDF measured by TDI.
Korzeniowska-Kubacka
Iwona
I
Department of Cardiac Rehabilitation and Noninvasive Electrocardiology, Institute of Cardiology, Warszawa, Poland. drkubacka@wp.pl
Bilińska
Maria
M
Michalak
Ewa
E
Kuśmierczyk-Droszcz
Beata
B
Dobraszkiewicz-Wasilewska
Barbara
B
Piotrowicz
Ryszard
R
D001794:Blood Pressure; D003971:Diastole; D015150:Echocardiography, Doppler; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D010101:Oxygen Consumption; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D016277:Ventricular Function, Left