Left ventricular remodelling in patients with moderate systolic dysfunction after myocardial infarction: favourable effects of exercise training and predictive role of N-terminal pro-brain natriuretic peptide

  1. Francesco Giallauriaa⇓
  2. Plinio Cirillob
  3. Rosa Luccia
  4. Mario Pacileob
  5. Anna De Lorenzoa
  6. Mariantonietta D’Agostinoa
  7. Sabino Moschellaa
  8. Marianna Psaroudakia
  9. Domenico Del Fornoa
  10. Francesco Orioc
  11. Dino Franco Vitaled
  12. Massimo Chiariellob
  13. Carlo Vigoritoa
  1. a Cardiac Rehabilitation Unit
  2. b Division of Cardiology, Department of Clinical Medicine, Cardiovascular and Immunological Sciences
  3. c Department of Molecular and Clinical Endocrinology and Oncology, University of Naples ‘Federico II’, Naples
  4. d Fondazione Salvatore Maugeri IRCSS, Telese Terme (BN), Italy
  1. Correspondence to Francesco Giallauria, MD, Cardiac Rehabilitation Unit, Department of Clinical Medicine, Cardiovascular and Immunological Sciences, University of Naples ‘Federico II’, Naples, Italy Tel: +390817462639; fax: +390817462639; e-mail: giallauria@libero.it

Abstract

Aims To investigate the effects of exercise training (ET) on left ventricular (LV) volumes, cardiopulmonary functional capacity and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in postinfarction patients with moderate LV dysfunction.

Methods Sixty-one postinfarction patients were randomized into two groups: group T [n = 30, LV ejection fraction (EF) 41.6 ± 11.3%, mean ± SD] entered a 6-month ET programme, whereas group C (n = 31, EF 42.0 ± 7.6%, P=NS) did not. NT-proBNP assay, Doppler-echocardiography and cardiopulmonary exercise test were performed upon enrolment and at sixth months.

Results At sixth months, trained patients showed an improvement in workload (+26%, P<0.001), Vo2peak (+31%, P<0.001), LV end-diastolic volume index (LVEDVI; −9%, P<0.001), a reduction in NT-proBNP (−71%, P<0.001) and a significant correlation between changes in NT-proBNP and in LVEDVI (r=0.858, P<0.001). Baseline NT-proBNP correlated with changes in LVEDVI in both trained (r=0.673, P<0.001) and untrained (r=0.623, P<0.001) patients. Group C showed unfavourable LVEDVI dilation (+8%, P<0.001; T vs. C group, P<0.001) and a smaller reduction in NT-proBNP (−40%, P<0.001; T vs. C group, P<0.001).

Conclusions Six month ET induced a favourable LV remodelling and a marked fall in NT-proBNP that could predict LV remodelling in postinfarction patients with moderate LV dysfunction.

 

  • Received March 21, 2007.
  • Accepted July 12, 2007.

 

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