Effect of exercise training on left ventricular mechanics after acute myocardial infarction: an exploratory study

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Authors

External Research Organisations

  • Cardiff Metropolitan University
  • Coventry University
  • Liverpool John Moores University
  • University of Warwick
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Details

Original languageEnglish
Pages (from-to)119-124
Number of pages6
JournalAnnals of Physical and Rehabilitation Medicine
Volume61
Issue number3
Early online date31 Jan 2018
Publication statusPublished - May 2018
Externally publishedYes

Abstract

Background: Cardiac rehabilitation (CR) exercise training is beneficial after myocardial infarction (MI). Whilst the peripheral adaptations to training are well defined, little is known regarding the effect on left ventricular (LV) remodelling, particularly LV function. Efficient LV ejection and filling is achieved through deformation and rotation of the myocardium in systole and diastole – LV mechanics. The response of LV mechanics to CR exercise training in MI patients is unknown. Methods: In this observational exploratory study, 36 (of 40 enrolled) male, MI patients completed either 10-weeks of twice-weekly gym based cardiovascular exercise at 60–80% VO2peak (n = 18), or a non-exercise control period (n = 18). Cardiopulmonary exercise testing and speckle tracking echocardiography were performed at baseline and 10 weeks. Results: Compared to the non-exercise group, VO2peak improved with CR exercise training (Difference: +4.28 [95% CI: 1.34 to 7.23] ml.kg−1.min−1, P = 0.01). Neither conventional LV structural or functional indices, nor LV global longitudinal strain, significantly changed in either group. In contrast, LV twist and twist velocity decreased in the exercise group and increased in the non-exercise group (Difference: −3.95° [95% CI: −7.92 to 0.03°], P = 0.05 and −19.2°.s−1 [95% CI: −35.9 to −2.7°.s−1], P = 0.02, respectively). Conclusion: In MI patients who completed CR exercise training, LV twist and twist velocity decreased, whereas these parameters increased in patients who did not exercise. These preliminary data may indicate reverse LV functional remodelling and improved functional reserve. The assessment of LV twist may serve as an indicator of the therapeutic benefit of CR exercise training and should be investigated in larger trials.

Keywords

    Left ventricular remodelling, Left ventricular twist, Longitudinal strain

ASJC Scopus subject areas

Cite this

Effect of exercise training on left ventricular mechanics after acute myocardial infarction: an exploratory study. / McGregor, Gordon; Stöhr, Eric J.; Oxborough, David et al.
In: Annals of Physical and Rehabilitation Medicine, Vol. 61, No. 3, 05.2018, p. 119-124.

Research output: Contribution to journalArticleResearchpeer review

McGregor, G, Stöhr, EJ, Oxborough, D, Kimani, P & Shave, R 2018, 'Effect of exercise training on left ventricular mechanics after acute myocardial infarction: an exploratory study', Annals of Physical and Rehabilitation Medicine, vol. 61, no. 3, pp. 119-124. https://doi.org/10.1016/j.rehab.2018.01.003
McGregor, G., Stöhr, E. J., Oxborough, D., Kimani, P., & Shave, R. (2018). Effect of exercise training on left ventricular mechanics after acute myocardial infarction: an exploratory study. Annals of Physical and Rehabilitation Medicine, 61(3), 119-124. https://doi.org/10.1016/j.rehab.2018.01.003
McGregor G, Stöhr EJ, Oxborough D, Kimani P, Shave R. Effect of exercise training on left ventricular mechanics after acute myocardial infarction: an exploratory study. Annals of Physical and Rehabilitation Medicine. 2018 May;61(3):119-124. Epub 2018 Jan 31. doi: 10.1016/j.rehab.2018.01.003
McGregor, Gordon ; Stöhr, Eric J. ; Oxborough, David et al. / Effect of exercise training on left ventricular mechanics after acute myocardial infarction : an exploratory study. In: Annals of Physical and Rehabilitation Medicine. 2018 ; Vol. 61, No. 3. pp. 119-124.
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abstract = "Background: Cardiac rehabilitation (CR) exercise training is beneficial after myocardial infarction (MI). Whilst the peripheral adaptations to training are well defined, little is known regarding the effect on left ventricular (LV) remodelling, particularly LV function. Efficient LV ejection and filling is achieved through deformation and rotation of the myocardium in systole and diastole – LV mechanics. The response of LV mechanics to CR exercise training in MI patients is unknown. Methods: In this observational exploratory study, 36 (of 40 enrolled) male, MI patients completed either 10-weeks of twice-weekly gym based cardiovascular exercise at 60–80% VO2peak (n = 18), or a non-exercise control period (n = 18). Cardiopulmonary exercise testing and speckle tracking echocardiography were performed at baseline and 10 weeks. Results: Compared to the non-exercise group, VO2peak improved with CR exercise training (Difference: +4.28 [95% CI: 1.34 to 7.23] ml.kg−1.min−1, P = 0.01). Neither conventional LV structural or functional indices, nor LV global longitudinal strain, significantly changed in either group. In contrast, LV twist and twist velocity decreased in the exercise group and increased in the non-exercise group (Difference: −3.95° [95% CI: −7.92 to 0.03°], P = 0.05 and −19.2°.s−1 [95% CI: −35.9 to −2.7°.s−1], P = 0.02, respectively). Conclusion: In MI patients who completed CR exercise training, LV twist and twist velocity decreased, whereas these parameters increased in patients who did not exercise. These preliminary data may indicate reverse LV functional remodelling and improved functional reserve. The assessment of LV twist may serve as an indicator of the therapeutic benefit of CR exercise training and should be investigated in larger trials.",
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AU - Oxborough, David

AU - Kimani, Peter

AU - Shave, Rob

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