Department of Cardiac Rehabilitation and Noninvasive Electrocardiology, Institute of Cardiology, Warszawa, Poland.
Cardiol J. 2010;17(2):136-42.
The study's aim was to examine the effect of exercise training on left ventricular diastolic function (LVDF) and whether LVDF could predict an improvement in exercise capacity (EC) in post-myocardial infarction patients.
Forty-eight males, aged 56.4 +/- 7.2 years, with preserved left ventricular systolic function (LVSF) and mild diastolic dysfunction (the ratio of transmitral early left ventricular filling velocity to early diastolic mitral annulus velocity E/E' > 8 as the average of the septal and lateral annulus velocities), were assigned to either a training group (TG, n = 32) or controls (n = 16). Before, and at the end of the study, all patients underwent a cardiopulmonary test and echocardiography with tissue Doppler imaging (TDI).
After a 4.5-month training program, maximal oxygen consumption increased significantly in TG (26.66 +/- 3.88 vs. 28.79 +/- 5.00 mL/kg/min, p < 0.0001). TDI-derived E/E' did not change after the training program. After dividing TG according to septal E/E's > 10 and < 10 and lateral E/E'l > 8 and < 8, exercise capacity improved significantly only in patients with E/E's < 10 and E/E'l < 8.
A 4.5-month training program in post-myocardial infarction patients with preserved LVSF and mild diastolic dysfunction led to improved exercise capacity only in TG. The diastolic function did not change significantly. The improvement in exercise capacity was significantly greater in patients with a better LVDF measured by TDI.
本研究旨在探讨运动训练对左心室舒张功能（LVDF）的影响，以及 LVDF 是否可预测心肌梗死后患者运动能力（EC）的改善。
48 名男性，年龄 56.4±7.2 岁，左心室收缩功能（LVSF）正常，舒张功能轻度障碍（二尖瓣前向血流 E 峰与舒张早期二尖瓣环运动速度 E'的比值 E/E'＞8，为室间隔和侧壁环运动速度的平均值），分为训练组（TG，n=32）和对照组（n=16）。所有患者在研究前后均进行心肺运动试验和组织多普勒超声心动图检查。
经过 4.5 个月的训练计划后，TG 组最大摄氧量显著增加（26.66±3.88 比 28.79±5.00 mL/kg/min，p＜0.0001）。TDI 衍生的 E/E'在训练计划后没有改变。根据室间隔 E/E'＞10 和＜10 以及侧壁 E/E'l＞8 和＜8 将 TG 分组后，只有 E/E'＜10 和 E/E'l＜8 的患者运动能力显著改善。
心肌梗死后 LVSF 正常和轻度舒张功能障碍患者进行 4.5 个月的训练计划仅能改善 TG 的运动能力。舒张功能没有明显变化。TDI 测量的 LVDF 较好的患者运动能力改善更显著。
