Key result
A 12-week exercise training program significantly improved left ventricular ejection fraction (median change 6.5% vs -2.0%) and wall motion score index in post-myocardial infarction patients compared to control.
Why the study?
The study was conducted to investigate the impact of exercise training on LV systolic functions assessed by CMR in patients after anterior MI.
Does a 12-week exercise training program improve left ventricular systolic functions assessed by CMR in post-anterior MI patients?
RCT (n=32)
Open-label
Stratified randomization
No
Does a 12-week exercise training program improve left ventricular systolic functions assessed by CMR in post-anterior MI patients?
Absolute Event Rate: 6.5% vs -2%
p-value: p=<0.001
A 12-week moderate-intensity exercise training program significantly improves left ventricular ejection fraction and regional wall motion in post-anterior MI patients as assessed by CMR.
Supports incorporating exercise training into post-anterior MI rehabilitation; extends prior evidence with CMR-assessed systolic function gains.
BACKGROUND: Improvement of functional capacity and mortality reduction in post-MI patients were found to be associated with regular exercise training. The cardiac magnetic resonance (CMR) is considered the most accurate non-invasive modality in quantitative assessment of left ventricular (LV) volumes and systolic functions. Our main objective was to investigate the impact of exercise training on LV systolic functions in patients post anterior MI using CMR. 32 patients on recommended medical treatment 4 week after having a successful primary PCI for an anterior MI were recruited, between May 2018 and May 2019. They were divided into two groups, training group (TG): 16 assigned to a 12 week exercise training program and control group (CG): 16 who received medical treatment without participating in the exercise training program. Treadmill exercise using modified Bruce protocol was done to TG before and after the training program in order to record the resting and maximum HR, metabolic equivalent (MET), and calculate HR reserve. CMR was performed for all patients 4 weeks after PCI and was repeated after completion of the study period to calculate ejection fraction (EF), left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), and wall motion score index (WMSI). RESULTS: 100% were males. 6 patients from CG dropped during follow-up, no statistically significant difference between the two groups regarding age, BMI, smoking status, hypertension, diabetes mellitus and dyslipidemia. Using the CMR, the TG showed significant improvement in EF (36.6 ± 14.2% to 43.1 ± 12.4%; P < 0.001) and WMSI (2.03 ± 0.57 to 1.7 ± 0.49; P < 0.001), without statistically significant change in LV volumes. Regarding CG no significant changes in EF, WMSI, LV volumes were found. There was significant improvement in EF and WMSI change before and after study in TG vs. CG [6.5 (2.3-9.0) vs. - 2.0 (- 6.8 to 1.3), P value < 0.001] and [- 0.3 (- 0.5 to 0.1) vs. 0.1 (- 0.1 to - 0.5), P value 0.001] respectively. CONCLUSIONS: 12 weeks of exercise training program in post-MI patients have a favorable impact on LV global and regional systolic functions without adversely affecting LV remodeling (as assessed by CMR).
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Hasan et al. (2022) conducted an RCT in Anterior Myocardial Infarction (n=32). Exercise training program vs. Standard guideline-directed medical treatment was evaluated on Change in left ventricular ejection fraction (EF) assessed by CMR (p=<0.001). A 12-week exercise training program significantly improved left ventricular ejection fraction (median change 6.5% vs -2.0%) and wall motion score index in post-myocardial infarction patients compared to control.
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