Left ventricular diastolic function: Effects of high‐intensity exercise after acute myocardial infarction

Objectives Reduced left ventricular (LV) diastolic function indicates poor prognosis after acute myocardial infarction (AMI). Our aim was to study whether a twelve‐week high‐intensity interval training program could improve diastolic function in patients with a relatively recent AMI. Design Twenty‐eight patients (mean age 56 (SD 8) years) with a recent AMI performed high‐intensity interval training twice a week for 12 weeks. Each training session consisted of four 4‐minute bouts at 85%‐95% of peak heart rate, separated by 4‐minute active breaks. A cardiopulmonary exercise test was performed to determine peak oxygen uptake (VO 2peak ). Echocardiography was performed at rest and during an upright bicycle exercise test. Results There was a significant increase in mitral annulus early diastolic velocity ( e ′) at peak exercise (75 W) from baseline to follow‐up (7.9 (1.5) vs. 8.4 (1.7) cm/s, P = .012), but no change in e ′ at rest (7.1 (1.9) vs. 7.3 (1.7) cm/s, P = .42). There was a significant increase in VO 2peak (mean (SD), 35.2 (7.3) vs. 38.9 (7.4) ml/kg/min, P < .001). e ′ at peak exercise correlated with VO 2peak both at baseline and follow‐up ( r = 0.50, P = .007, and r = 0.41, P = .032). Conclusion The present study shows that LV diastolic function during exercise is related to VO 2peak . We also found an improvement of diastolic function after exercise training, even in a population with a relatively well preserved systolic and diastolic function. The results demonstrate the importance of obtaining measurements during exercise when evaluating the effects of exercise interventions.