Exercise-Induced Increase in Baroreflex Sensitivity Predicts Improved Prognosis After Myocardial Infarction
Key result
Exercise training that induced an increase in baroreflex sensitivity ≥3 ms/mm Hg significantly reduced 10-year cardiac mortality compared to nonresponders and nontrained patients (0% vs 23%, P=0.04).
Why the study?
Does a 4-week endurance training period reduce cardiac mortality in male patients surviving a first uncomplicated MI?
Population
95 consecutive male patients surviving a first uncomplicated MI
Comparison
4-week endurance training period vs No training
Design
RCT, randomly assigned
Follow-up
10-year
Authors
Discussion
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Implication
Supports measuring baroreflex sensitivity response to identify post-MI exercise beneficiaries; extends evidence linking vagal gains to survival.
Key Points
- To determine whether exercise training-induced increases in baroreflex sensitivity, an autonomic marker of vagal activity, reduce long-term cardiac mortality following a first myocardial infarction.
- Randomized trial of 95 consecutive male patients surviving a first uncomplicated myocardial infarction assigned to 4 weeks of endurance training or no training.
- Baseline evaluations included baroreflex sensitivity, age, infarction site, and left ventricular ejection fraction, followed by clinical tracking over 10 years.
- At 4 weeks, baroreflex sensitivity increased by 26% in trained patients (P=0.04) but did not change in nontrained controls.
- During 10-year follow-up, cardiac mortality was 0% (0 of 16) in trained responders with a baroreflex sensitivity gain ≥ 3 ms/mm Hg compared to 23% (18 of 79) among nonresponders and nontrained patients (P=0.04).
- Overall cardiac mortality was 4% among all responders versus 24% among nonresponders irrespective of training status (P=0.04).
Study Design
Type
RCT (n=95)
Randomization
Randomized
Structured PICO
Does a 4-week endurance training period reduce cardiac mortality in male patients surviving a first uncomplicated MI?
P
Population
95 consecutive male patients surviving a first uncomplicated MI
I
Intervention
4-week endurance training period
C
Comparator
No training
O
Outcome
Cardiac mortality during a 10-year follow-uphard clinical
Main Result
Absolute Event Rate: 0% vs 23%
p-value: p=0.04
Post-MI exercise training improves long-term survival specifically in patients who exhibit an exercise-induced increase in vagal activity as measured by baroreflex sensitivity.
Cite This Study
Rovere et al. (2002) conducted an RCT in Post-myocardial infarction (n=95). Endurance training vs. No training was evaluated on Cardiac mortality (p=0.04). Exercise training that induced an increase in baroreflex sensitivity ≥3 ms/mm Hg significantly reduced 10-year cardiac mortality compared to nonresponders and nontrained patients (0% vs 23%, P=0.04).