Effect of Physical Training on the Magnitude of Left Ventricular Ischaemic Dysfunction inPatients with Chronic Ischaemic Heart Disease

Overview

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) participatedin 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 exerciseunit including the warming up and relaxation stage lasted 50 minutes and was repeated threetimes per week. Before and after the rehabilitation programme in all patients spiroergometry wasperformed as well as exercise pulsed tissue Doppler echocardiography to evaluate regional systolic and diastolic left ventricular function in the ischaemic area, localized beforehand by theSPECT. The following parameters were evaluated by echocardiograpphy: the peak velocity ofmotion in the ischaemic area in systole (Si), the peak velocity of motion in the ischaemic area inearly diastole (Ei) ad in atrial contraction (Ai), and the ratio Ei/Ai was calculated. With theexception 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 theexercising 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

Key words:
Physical training - Myocardial ischaemia - Doppler tisue echocardiography