title: Effects of exercise training started within 2 weeks after acute myocardial infarction on myocardial perfusion and left ventricular function: a gated SPECT imaging study.
abstract: BACKGROUND
  Several studies suggested that exercise training might improve myocardial perfusion by inducing coronary vascular adaptations or enhancing collateralization. However, these findings were obtained in patients with chronic coronary artery disease using thallium-201 myocardial perfusion scintigraphy. We evaluated whether a long-term exercise-based cardiac rehabilitation (CR) started early (9 ± 3 days) after ST elevation acute myocardial infarction (STEMI) improves myocardial perfusion and left ventricular (LV) function, evaluated by gated single-photon emission computed tomography (SPECT) imaging.
  
  
  METHODS
  Randomized controlled study.
  
  
  METHODS
  Fifty patients with recent STEMI were randomized into two groups: 24 enrolled in a 6-month exercise-based CR programme (group T) and 26 discharged with generic instructions for maintaining physical activity and correct lifestyle (group C). All patients underwent cardiopulmonary exercise test and gated SPECT within 3 weeks after STEMI and at 6-month follow up.
  
  
  RESULTS
  At follow up, group T showed a significant reduction of stress-induced ischaemia (p < 0.01) and an improvement in resting and post-stress wall motion (both p < 0.005) and resting (p < 0.05) and post-stress wall thickness (p < 0.005) score indexes. At follow up, group T showed an improvement in peak oxygen consumption (p < 0.0001), O(2) pulse (p < 0.05), and in the slope of increase in ventilation over carbon dioxide output (p < 0.001). No changes in myocardial perfusion parameters, LV function, and cardiopulmonary indexes were observed in group C at follow up.
  
  
  CONCLUSIONS
  Six months of exercise training early after STEMI reduces stress-induced ischaemia and improves LV wall motion and thickness. Exercise-induced changes in myocardial perfusion and function were associated with the absence of unfavourable LV remodelling and with the improvement of cardiovascular functional capacity.
authors.affiliation: Department of Clinical Medicine, Cardiovascular and Immunological Sciences. Cardiac Rehabilitation Unit, University of Naples Federico II, via S. Pansini 5, Naples, Italy. giallauria@libero.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Giallauria
authors.forename: Wanda
authors.initials: W
authors.lastname: Acampa
authors.forename: Francesca
authors.initials: F
authors.lastname: Ricci
authors.forename: Alessandra
authors.initials: A
authors.lastname: Vitelli
authors.forename: Luigi
authors.initials: L
authors.lastname: Maresca
authors.forename: Maria
authors.initials: M
authors.lastname: Mancini
authors.forename: Alessandra
authors.initials: A
authors.lastname: Grieco
authors.forename: Rosj
authors.initials: R
authors.lastname: Gallicchio
authors.forename: Evgjeni
authors.initials: E
authors.lastname: Xhoxhi
authors.forename: Letizia
authors.initials: L
authors.lastname: Spinelli
authors.forename: Alberto
authors.initials: A
authors.lastname: Cuocolo
authors.forename: Carlo
authors.initials: C
authors.lastname: Vigorito
mesh_terms: D000328:Adult; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography; D016009:Chi-Square Distribution; D003326:Coronary Circulation; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000534:rehabilitation*; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D010101:Oxygen Consumption; D011237:Predictive Value of Tests; D012123:Pulmonary Ventilation; D020127:Recovery of Function; D012307:Risk Factors; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling