Influence of physical training after a myocardial infarction on left
ventricular contraction mechanics
Abstract
BACKGROUND: Physical exercise adds benefits improving evolution
of the ischemic heart disease, enhancing individual functional capacity
and preventing ventricular remodeling. In this study we investigated the
impact of a program of physical training started after an uncomplicated
post-acute myocardial infarction (AMI) on the mechanics of left
ventricle (LV) contraction. METHODS: A total of 53 patients
were included, 27 of whom were randomized to a supervised training
program (TRAINING group), and 26 to a CONTROL group, who received usual
orientations for physical exercise after AMI. All patients underwent
cardiopulmonary stress testing and an echocardiogram with speckle
tracking technique to measure several parameters of LV contraction
mechanics at 1 month and 5 months after AMI. RESULTS: No
significant difference in the analysis of LV longitudinal, radial and
circumferential strain parameters between groups after the training
period was found. After the training program, analysis of torsional
mechanics demonstrated a reduction in the LV basal rotation of the
TRAINING group in comparison to the CONTROL group (TRAINING, -5.9±2.3 vs
CONTROL, -7.5±2.9 o; P=0.03), and in the basal
rotational velocity ( TRAINING, -53.6±18.4 vs CONTROL, -68.8±22.1 º/s;
P=0.01), twist velocity (TRAINING, 127.4±32.2 vs CONTROL,
149.9±35.9 vs º/s; P=0.02) and torsion (TRAINING, 2.4±0.4 vs
CONTROL, 2.8±0.8 vs º/cm; P=0.02). CONCLUSIONS: Physical
activity did not cause a significant improvement in LV longitudinal,
radial and circumferential deformation parameters. However, the exercise
had a significant impact on the LV torsional mechanics, composed
particularly of a reduction in basal rotation, twist velocity, torsion
and torsional velocity which can be interpreted as a ventricular
“torsion reserve” in this population.