Impact of exercise training on myocardial contractile functions assessed by cardiac magnetic resonance in post-myocardial infarction patients.
Impact of exercise training on myocardial contractile functions assessed by cardiac magnetic resonance in post-myocardial infarction patients.
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DOI：
10.1186/s43044-022-00288-4
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发表时间：
2022-06-23
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心肌梗死后患者功能能力的改善和死亡率的降低与定期运动训练有关。心脏磁共振（CMR）被认为是定量评估左心室（LV）容量和收缩功能最准确的非侵入性方法。我们的主要目的是利用CMR研究运动训练对心肌梗塞前路患者左室收缩功能的影响。在2018年5月至2019年5月期间，招募了32名在成功进行前路心肌梗死初级PCI治疗4周后接受推荐药物治疗的患者。他们被分为两组，训练组（TG）： 16人接受为期12周的运动训练计划，对照组（CG）： 16人接受药物治疗而不参加运动训练计划。在训练计划前后采用改良布鲁斯方案进行跑步机运动，以记录静息和最大HR、代谢当量（MET），并计算HR储备。所有患者在PCI术后4周进行CMR，并在研究结束后重复计算射血分数（EF）、左室收缩末容积（LVESV）、左室舒张末容积（LVEDV）和壁运动评分指数（WMSI）。100%为男性。随访期间有6例CG患者下降，两组在年龄、BMI、吸烟情况、高血压、糖尿病、血脂异常等方面差异无统计学意义。使用CMR， TG显着改善EF（36.6±14.2%）至43.1±12.4%,P < 0.001)和WMSI(2.03±0.57至1.7±0.49,P < 0.001)，无统计学意义的变化。在CG方面，EF、WMSI、LV体积未见明显变化。TG与CG比较，研究前后EF和WMSI变化有显著改善[分别为6.5（2.3-9.0）对- 2.0 (- 6.8 - 1.3)，P值< 0.001]和[- 0.3（- 0.5 - 0.1）对0.1 (- 0.1 - 0.5)，P值< 0.001]。心肌梗死后患者12周的运动训练计划对左室整体和局部收缩功能有良好的影响，但对左室重塑没有不利影响（CMR评估）。
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). 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. 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).