Adachi H, Koike A, Obayashi T, Umezawa S, Aonuma K, Inada M, Korenaga M, Niwa A, Marumo F, Hiroe M
Musashino Red Cross Hospital, Tokyo, Japan.
Eur Heart J. 1996 Oct;17(10):1511-21. doi: 10.1093/oxfordjournals.eurheartj.a014715.
The objective of the present study was to determine whether appropriate endurance exercise training improves cardiac function in patients with prior myocardial infarction.
Twenty-nine patients with prior myocardial infarction were divided into three groups (Group 1: control, Group 2: low-intensity training, Group 3: high-intensity training). Low and high training intensities were determined according to the gas exchange threshold of each patient. The patients in Groups 2 and 3 performed 15 min of home-based physical training safely, twice a day, 5 days a week for 2 months. Prior to and following this training, each patient performed two constant work rate tests (moderate and heavy intensity) and a symptom-limited incremental exercise test.
Heart rates at rest and during exercise were decreased significantly after 2 months in all three groups. Stroke volume at rest increased significantly after 2 months only in Group 3. Stroke volume after 6 min of heavy-intensity exercise increased significantly in Groups 2 and 3. However, the ejection fraction at 6 min of heavy-intensity exercise increased significantly only in Group 3. The maximal work rate attained during incremental exercise testing increased significantly in Groups 2 and 3. This parameter did not significantly change in the control group.
Effects of physical training on maximal exercise capacity were noted in both exercise training groups. However, improvement in cardiac function (such as stroke volume), both at rest and during exercise, was noted only in the high-intensity training group. Our results suggest that relatively high-intensity training may improve exercise capacity and cardiac function of patients with prior myocardial infarction.
本研究的目的是确定适当的耐力运动训练是否能改善既往心肌梗死患者的心脏功能。
29例既往心肌梗死患者被分为三组（第1组：对照组，第2组：低强度训练组，第3组：高强度训练组）。低强度和高强度训练根据每位患者的气体交换阈值确定。第2组和第3组的患者在家中安全地进行15分钟的体育锻炼，每天两次，每周5天，共2个月。在该训练之前和之后，每位患者进行两次恒定工作率测试（中等强度和高强度）以及一次症状限制递增运动测试。
所有三组在2个月后静息心率和运动时心率均显著降低。仅第3组在2个月后静息时的每搏输出量显著增加。第2组和第3组在高强度运动6分钟后的每搏输出量显著增加。然而，仅第3组在高强度运动6分钟时的射血分数显著增加。递增运动测试期间达到的最大工作率在第2组和第3组中显著增加。该参数在对照组中无显著变化。
两个运动训练组均观察到体育锻炼对最大运动能力的影响。然而，仅在高强度训练组中观察到静息和运动时心脏功能（如每搏输出量）的改善。我们的结果表明，相对高强度的训练可能改善既往心肌梗死患者的运动能力和心脏功能。
