Key result
Supervised physical training after uncomplicated MI reduces LV basal rotation by ~21% versus usual care.
Why the study?
Physical exercise provides clinical benefits after myocardial infarction, but its impact on left ventricular contraction mechanics remained to be investigated.
Does a supervised physical training program alter left ventricular contraction mechanics in patients after an uncomplicated acute myocardial infarction?
RCT (n=53)
Does a supervised physical training program alter left ventricular contraction mechanics in patients after an uncomplicated acute myocardial infarction?
Absolute Event Rate: -5.9% vs -7.5%
p-value: p=0.03
Supervised physical training after an uncomplicated AMI significantly impacts LV torsional mechanics, which may represent a ventricular 'torsion reserve'.
Supports supervised post-MI training to modulate LV mechanics; extends evidence on torsional reserve beyond strain parameters.
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.
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Lima et al. (2022) conducted an RCT in Uncomplicated post-acute myocardial infarction (n=53). Supervised physical training program vs. Usual orientations for physical exercise was evaluated on Left ventricular basal rotation (p=0.03). A supervised physical training program after uncomplicated myocardial infarction significantly reduced left ventricular basal rotation (-5.9 vs -7.5 degrees; P=0.03) compared to usual care.
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