Circulation, Vol 74, 350-358, Copyright © 1986 by American Heart Association
AA Ehsani, DR Biello, J Schultz, BE Sobel and JO Holloszy
To determine whether prolonged, intense exercise training can improve left
ventricular function in patients with coronary artery disease, we studied
25 patients, 52 +/- 2 years old (mean +/- SE), who completed a 12 month
program of endurance exercise training and 14 additional patients with
comparable maximal exercise capacities and ejection fractions who did not
exercise. The training program consisted of endurance exercise of
progressively increasing intensity, frequency, and duration. During the
last 3 months the patients were running an average of 18 miles/week, or
doing an equivalent amount of exercise on a cycle ergometer. Maximal
attainable VO2 increased 37% (p less than .001). Of the 10 patients with
effort angina, five became asymptomatic, three experienced less angina, and
two were unchanged after training. Ejection fraction was determined by
equilibrium radionuclide ventriculography. At rest, ejection fraction was
53 +/- 3% before and 54 +/- 3% after training (p = NS). Ejection fraction
did not change during maximal supine exercise before training (52 +/- 3%),
but after training it increased to 58 +/- 3% (p less than .01). During
maximal exercise, systolic blood pressure and the rate-pressure product
were higher after training. The systolic blood pressure-end-systolic volume
relationship was shifted upward and to the left, with an increase in
maximal systolic blood pressure (p less than .001) and a smaller end-
systolic volume (p less than .05), providing evidence for an improvement in
contractile state after training. In patients who did not participate in
training neither this relationship nor the ejection fraction response to
exercise was changed after 12 months.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Improvement of left ventricular contractile function by exercise training in patients with coronary artery disease [published erratum appears in Circulation 1986 Nov;74(5):938]
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