In patients with ischaemic heart disease, prolonged exercise training up to 60 minutes inducing myocardial ischaemia was well tolerated without evidence of myocardial injury or significant arrhythmias.
RCT (n=22)
Does prolonged exercise training above the ischaemic threshold cause myocardial injury, arrhythmias, or left ventricular dysfunction in patients with ischaemic heart disease?
Prolonged and repeated exercise training up to 60 minutes above the ischaemic threshold appears to be well tolerated without causing myocardial injury or arrhythmias in patients with ischaemic heart disease.
AIMS: To evaluate the innocuousness of intense and prolonged exercise training above the threshold for myocardial ischaemia (1 mm ST-segment depression). METHODS AND RESULTS: Twenty-two patients with ischaemic heart disease (IHD) were randomized to exercise training either at a target intensity that induced myocardial ischaemia (ischaemic group) or that adhered to current guidelines (control group). Training was progressively increased to 60 min under continuous electrocardiographic (ECG) monitoring. Cardiac troponin T (cTnT) was measured at various intervals. Ambulatory ECG monitoring was performed before and after 6 weeks of training and left ventricular function was evaluated in the ischaemic group after at least 6 weeks of training. The ischaemic group had myocardial ischaemia during the first 20, 40, and 60 min exercise sessions for 12.3 +/- 6.8, 29.0 +/- 12.9, and 49.8 +/- 2.2 min, respectively, with ST-segment depression ranging from 1.0 to 2.1 mm. No patient in either group demonstrated significant arrhythmias or increased cTnT. The ischaemic group had preserved left ventricular function. CONCLUSION: In patients with IHD, prolonged and repeated ischaemic training sessions up to 60 min can be well tolerated without evidence of myocardial injury, significant arrhythmias, or left ventricular dysfunction.
Noël et al. (Sat,) conducted a rct in Ischaemic heart disease (IHD) (n=22). Exercise training inducing myocardial ischaemia vs. Exercise training adhering to current guidelines was evaluated on Myocardial injury (cTnT), significant arrhythmias, and left ventricular function. In patients with ischaemic heart disease, prolonged exercise training up to 60 minutes inducing myocardial ischaemia was well tolerated without evidence of myocardial injury or significant arrhythmias.