Hung J, Gordon E P, Houston N, Haskell W L, Goris M L, DeBusk R F
Am J Cardiol. 1984 Nov 1;54(8):943-50. doi: 10.1016/s0002-9149(84)80123-x.
The effects of exercise training on exercise myocardial perfusion and left ventricular (LV) function in the first 6 months after clinically uncomplicated acute myocardial infarction (AMI) were assessed in 53 consecutive men aged 55 +/- 9 years. Symptom-limited treadmill exercise with thallium myocardial perfusion scintigraphy and symptom-limited upright bicycle ergometry with equilibrium gated radionuclide ventriculography were performed 3, 11 and 26 weeks after AMI by 23 men randomized to training and 30 randomized to no training. Peak cycle capacity increased in both groups between 3 and 26 weeks (p less than 0.01), but reached higher levels in trained than in untrained patients (803 +/- 149 vs 648 +/- 182 kg-m/min, p less than 0.01). Reversible thallium perfusion defects were significantly more frequent at 3 than at 26 weeks: 59% and 36% of patients, respectively (p less than 0.05), without significant inter-group differences. Values of LV ejection fraction at rest, submaximal and peak exercise did not change significantly in either group. The increase in functional capacity, i.e., peak treadmill or bicycle workload, that occurred 3 to 26 weeks after infarction was significantly correlated with the increase in peak exercise heart rate (p less than 0.001), but not with changes in myocardial perfusion or LV function determined by radionuclide techniques. Changes in myocardial perfusion or LV function do not appear to account for the improvement in peak functional capacity that occurs within the first 6 months after clinically uncomplicated AMI.
对53名年龄在55±9岁的连续男性患者进行了评估，以研究运动训练对临床症状不复杂的急性心肌梗死（AMI）后前6个月运动心肌灌注和左心室（LV）功能的影响。23名随机分配至训练组的男性患者和30名随机分配至非训练组的男性患者在AMI后3周、11周和26周分别进行了症状限制的平板运动试验及铊心肌灌注闪烁扫描，以及症状限制的直立自行车测力计运动试验及平衡门控放射性核素心室造影。两组患者在3周和26周之间的峰值循环能力均有所增加（p<0.01），但训练组患者达到的水平高于未训练组患者（803±149 vs 648±182 kg-m/min，p<0.01）。可逆性铊灌注缺损在3周时比26周时明显更常见：分别为59%和36%的患者（p<0.05），两组间无显著差异。两组患者静息、次极量和峰值运动时的左心室射血分数值均无显著变化。梗死3至26周后出现的功能能力增加，即平板运动或自行车工作量峰值，与峰值运动心率的增加显著相关（p<0.001），但与放射性核素技术测定的心肌灌注或左心室功能变化无关。心肌灌注或左心室功能的变化似乎并不能解释临床症状不复杂的AMI后前6个月内出现的峰值功能能力改善。
