Influence of physical training on cardiac performance in patients with coronary artery disease and exercise-induced left ventricular dysfunction.

摘要

OBJECTIVE: The aim of the study was to assess the influence of physical training on systolic and diastolic left ventricular (LV) function using seismocardiography (SCG) and its relationship to the exercise capacity in CAD patients with exercise-induced LV dysfunction. METHODS AND RESULTS: Eighty men aged 52.5 +/- 7.5 y with stable CAD were assigned to either a control group (CG, n = 40) or a training group (TG, n = 40).TG patients underwent a 4.5-month training programme (TP). Before and at the end of the study all patients underwent a cardiopulmonary test (CPET) and SCG. After TP the following CPET parameters improved significantly: duration (776 +/-120 vs. 879 +/- 89 s, P<0.001), METs (8 +/- 2 vs. 10 +/- 1, P<0.01), maxVO2 (22 +/- 4 vs. 25 +/- 3 ml/kg/min, P < 0.001). During SCG performed before (SCG(REST)) and immediately after each CPET (SCG(CPET)) the following variables improved significantly, but only in TG patients: the pre-ejection period (PEP; 126 +/- 15 vs. 119 +/- 14, P < 0.05 ms), PEP/LVETratio (PEP/LV ejection time, ms; 0.42 +/- 0.08 vs. 0.38 +/- 0.06, P < 0.05). There was a negative correlation between training-induced changes in maxVO2 and PEP(CPET) (r =-0.4, P = 0.01) and PEP/LVET(CPET) (r =-0.52, P = 0.001), and a positive correlation between maxVO2 and LVET(CPET) (r = 0.51, P = 0.01). After TP, there was also a negative correlation between maxVO2 and isovolumetric relaxation time (ms; r =-0.46, P = 0.01). CONCLUSIONS: The training programme resulted in a significant improvement in the physical capacity and cardiac performance in CAD patients with exercise-induced left ventricular dysfunction. An improvement of systolic left ventricular function suggested an increase in exercise capacity.