Effects of 12 Months of Intense Exercise Training on Ischemic ST‐segment Depression in Patients with Coronary Artery Disease

This study was undertaken to determine whether adaptation to 12 months of intense endurance exercise training could alter the relationship between the product of heart rate and systolic blood pressure (double product) and the extent of ischemic ST-segment depression during exercise in patients with coronary artery disease. True (i.e., not symptom-limited) maximum oxygen uptake capacity increased from 25.5 ± 4.2 ml/kg/min (mean ± SD) to 35.3 ± 4.4 ml/kg/min with training. The maximum degree of ST-segment depression during exercise averaged 0.20 + 0.04 mV before and 0.16 0.08 mV after training despite a 20% increase in maximum double product. The double product at which ST depression (0.1 mV) first appeared was 22% greater after training. The extent of ST-segment displacement at the same double product was less after training. These findings suggest that training, if sufficiently intense and prolonged, can result in a reduction in myocardial ischemia at the same or a higher double product.

[1]  A. DeMaria,et al.  Alterations in Ventricular Mass and Performance Induced by Exercise Training in Man Evaluated by Echocardiography , 1978, Circulation.

[2]  M. Bourassa,et al.  Changes in Exercise Coronary Sinus Blood Flow with Training in Patients with Angina Pectoris , 1978, Circulation.

[3]  YANG WANG,et al.  The Rate-Pressure Product as an Index of Myocardial Oxygen Consumption during Exercise in Patients with Angina Pectoris , 1978, Circulation.

[4]  J. Holloszy,et al.  Linear increase in aerobic power induced by a strenuous program of endurance exercise. , 1977, Journal of applied physiology: respiratory, environmental and exercise physiology.

[5]  J. Clausen,et al.  Circulatory adjustments to dynamic exercise and effect of physical training in normal subjects and in patients with coronary artery disease. , 1976, Progress in cardiovascular diseases.

[6]  C. Tipton,et al.  Cardiovascular adaptations to physical training. , 1977, Annual review of physiology.

[7]  Y. Wang,et al.  Hemodynamic correlates of myocardial oxygen consumption during upright exercise. , 1972, Journal of applied physiology.

[8]  A. DeMaria,et al.  Systematic correlation of cardiac chamber size and ventricular performance determined with echocardiography and alterations in heart rate in normal persons. , 1979, The American journal of cardiology.

[9]  H. Hellerstein.  Exercise therapy in coronary disease. , 1968, Bulletin of the New York Academy of Medicine.

[10]  E. Varnauskas,et al.  Coronary circulation during heavy exercise in control subjects and patients with coronary heart disease. , 2009, Acta medica Scandinavica.

[11]  J. Mitchell,et al.  Exercise training in the treatment of coronary heart disease. , 1975, Advances in internal medicine.

[12]  E. Braunwald,et al.  Effects of catecholamines, exercise, and nitroglycerin on the normal and ischemic myocardium in conscious dogs. , 1974, The Journal of clinical investigation.

[13]  M. Fishbein,et al.  Exercise-Induced Reduction in Myocardial Infarct Size after Coronary Artery Occlusion in the Rat , 1978, Circulation.

[14]  W. Winder,et al.  Time course of sympathoadrenal adaptation to endurance exercise training in man. , 1978, Journal of applied physiology: respiratory, environmental and exercise physiology.

[15]  D. N. Sim,et al.  Investigation of the physiological basis for increased exercise threshold for angina pectoris after physical conditioning. , 1974, The Journal of clinical investigation.

[16]  R. Bruce,et al.  Exercise stress testing in evaluation of patients with ischemic heart disease. , 1969, Progress in cardiovascular diseases.

[17]  W. H. Heaton,et al.  Beneficial Effect of Physical Training on Blood Flow to Myocardium Perfused by Chronic Collaterals in the Exercising Dog , 1978, Circulation.

[18]  D. Harrison,et al.  The effect of propranolol on exercise-induced ischemic S-T segment depression. , 1969, The American journal of cardiology.

[19]  J. Ross,et al.  Regional Myocardial Dysfunction and Hemodynamic Abnormalities during Strenuous Exercise in Dogs with Limited Coronary Flow , 1978, Circulation research.

[20]  R. Bruce,et al.  Differences in cardiac function with prolonged physical training for cardiac rehabilitation. , 1977, The American journal of cardiology.

[21]  A. Ehsani,et al.  Rapid changes in left ventricular dimensions and mass in response to physical conditioning and deconditioning. , 1978, The American journal of cardiology.

[22]  D. Cunningham,et al.  Exercise and Human Collateralization: An Angiographic and Scintigraphic Assessment , 1979, Circulation.

[23]  J. Mitchell,et al.  Influences of physical conditioning and deconditioning on coronary vasculature of dogs. , 1978, Journal of applied physiology: respiratory, environmental and exercise physiology.

[24]  S. Epstein,et al.  Circulatory and symptomatic effects of physical training in patients with coronary-artery disease and angina pectoris. , 1972, The New England journal of medicine.

[25]  R. Bruce,et al.  Increased Arteriovenous Oxygen Difference After Physical Training in Coronary Heart Disease , 1971, Circulation.