Effect of Physical Training on the Magnitude of Left Ventricular Ischaemic Dysfunction in
Patients with Chronic Ischaemic Heart Disease
Meluzín J., Jančík J., Siegelová J., Panovský R., Homolka J., Podrábská J., Müllerová J.
I. interní-kardioangiologická klinika Fakultní nemocnice u sv. Anny, Brno, přednosta prof. MUDr. J. Toman, CSc. Klinika funkční diagnostiky a rehabilitace Fakultní nemocnice u sv. Anny, Brno, přednosta prof. MUDr. J. Siegelová, DrSc. Oddělení nukleární medicíny Fakultní nemocnice Brno, pracoviště Bohunice, přednosta doc. MUDr. J. Prášek, CSc. |
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Summary:
Twenty-two patients with chronic ischaemic heart disease (IHD) and reversible myocardial ischaemia after a load as recorded by single photon emission computed tomography (SPECT) participated
in an eight-week rehabilitation programme. Before exercise their efficiency was tested by spiroergometric examinatin and the patients were randomized into two groups. Group A (10 patients)
took exercise at the level of the anaerobic threshold (high intensity training), group B (12 patients) trained at the level of the 60 % anaerobic threshold (low intensity training). The exercise
unit including the warming up and relaxation stage lasted 50 minutes and was repeated three
times per week. Before and after the rehabilitation programme in all patients spiroergometry was
performed as well as exercise pulsed tissue Doppler echocardiography to evaluate regional systolic and diastolic left ventricular function in the ischaemic area, localized beforehand by the
SPECT. The following parameters were evaluated by echocardiograpphy: the peak velocity of
motion in the ischaemic area in systole (Si), the peak velocity of motion in the ischaemic area in
early diastole (Ei) ad in atrial contraction (Ai), and the ratio Ei/Ai was calculated. With the
exception of the decline of the value at rest Ai from 8,4 ± 1.3 cm/sec to 7.3 ± 1.3 cm/s(p < 005) in the
exercising group A none of the parameters of left ventricular regional function changed significantly after an eight-week rehabilitation programme. The maximal performance achieved in spiroergometry increased however after rehabilitation in group A ( from 145 ± 36 W to 162 ± 39 W, p <
0.01) as well as in group B (from 112 ± 36W to 122 ± 36W, p < 0.05). I It may be concluded that
a rehabilitation programme of high and low intensity improved the load tolerance during spiroergometry but did not lead to significant improvement of regional systolic and diastolc left ventricular function in the area of reversible ischaemia.
Key words:
Physical training - Myocardial ischaemia - Doppler tisue echocardiography
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