Short-term haemodynamic evolution and late follow-up of post-infarct patients with left ventricular dysfunction undergoing a physical training programme

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Deutscher übersetzter Titel:Kurzfristige haemodynamische Entwicklung und spaetere Nachuntersuchung von Infarktpatienten mit linksventrikulaerer Funktionsstoerung, die an einem koerperlichen Trainingsprogramm teilnahmen
Autor:Tavazzi, L.; Ignone, G.
Erschienen in:European heart journal
Veröffentlicht:12 (1991), 6, S. 657-665, Lit.
Format: Literatur (SPOLIT)
Publikationstyp: Zeitschriftenartikel
Medienart: Gedruckte Ressource
Sprache:Englisch
ISSN:0195-668X, 1522-9645
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Erfassungsnummer:PU199805301685
Quelle:BISp

Abstract des Autors

The aims of this study were to investigate the short-term haemodynamic changes occurring in post-infarct patients with left ventricular dysfunction undergoing a physical training programme and the prognostic implications of such changes. Ninety-five male patients with no evidence of congestive heart failure, consecutively admitted for exercise testing with heamodynamic monitoring in the supine position, in whom exercise pulmonary artery diastolic pressure (PAdP) exceeded 20 mm Hg were enrolled in an in-hospital one-month physical training programme. After training all patients' exercise capacity increased by 24% (P<0.001) with no change of PAdP. At matched work load, heart rate decreased (126+/-21 vs 120+/-19 bt/min, P<0.05) as did PAdP (27+/-5 vs 25+/-6 mm Hg, P<0.05) and A-VO2 difference increased (9.5+/-1.7 vs 10+/-1.6 ml%, P<0.01). Similar results were observed in a subset of patients with exercise PAdP >30 mmHg (30 patients). In 11 patients with inadequate cardiac output neither heart rate nor PAdP decreased after training and a disproportionate increase in blood pressure was noted. Clinical follow-up ranged from 1 to 8 years (62+/-32 months). Seven deaths, 12 reinfarctions and 14 coronary artery bypass graftings occurred. The modifications, after training in work capacity, heart rate and PAdP, were not predictive of events. In conclusion: 1) short-term vigorous physical training is feasable and safe in postinfarct patients with left ventricular dysfunction and no evidence of congestive heart failure; 2) in such patients haemodynamic response to physical training does not seem to be prognostically relevant; 3) in a few subsets chronic exercise may be not beneficial. Verf.-Referat