[The impact of exercise rehabilitation on left ventricular remodeling and systolic function in acute myocardial infarction patients].

ABSTRACT

OBJECTIVE: To investigate the influence of rehabilitation on left ventricular remodeling and systolic function in acute myocardial infarction patients. METHODS: Patients meeting the inclusion criteria with uneventful clinical course after a first myocardial infarction were randomly assigned to a 3-month exercise training period (exercise group, n = 35) or a control group (n = 29). Before randomization, all patients underwent NT-proBNP test, 2-dimensional echocardiography, and submaximal exercise test. RESULTS: (1) At baseline, there were no significant differences in NT-proBNP, left ventricular end-diastolic diameter (LVDd) and left ventricular ejection fraction (LVEF) between the exercise and control groups. After 3 months, a significant decrease in NT-proBNP was observed only in the exercise group [from (845.29 +/- 93.48) ng/L to (335.64 +/- 246.14) ng/L, P < 0.05], but not in the control group [from (1091.62 +/- 101.78) ng/L to (1099.83 +/- 168.75) ng/L, P > 0.05) and there was significant difference in NT-proBNP level between the two groups after 3 months (P < 0.01). The LVDd increased in the control group [from (50.9 +/- 5.8) to (52.6 +/- 5.4) mm, P < 0.05] but not in the exercise group [from (50.7 +/- 4.5) to (50.3 +/- 3.9) mm, P > 0.05] and there was significant difference in LVDd between the two groupsafter 3 months (P < 0.05). Conversely, LVEF improved in the exercise group [from (55.0 +/- 8.6)% to (60.0 +/- 8.0)%, P < 0.05] but not in the control group (P > 0.05) and there was significant difference in LVEF between the two groups after 3 months (P < 0.05). (2) NT-proBNP was inversely correlated with LVEF. CONCLUSIONS: Rehabilitation exercise training under instructions based on family condition in the early and recovery stage of AMI can lower the NT-proBNP level, improve ejection fraction, and prevent the increase of left ventricular end-diastolic diameter. Therefore, it may reduce unfavorable remodeling response and improve cardiac systolic function hereafter.