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1.
Arch. cardiol. Méx ; Arch. cardiol. Méx;83(3): 167-173, jul.-sept. 2013. tab
Artigo em Espanhol | LILACS | ID: lil-703011

RESUMO

Objetivo: Determinar los efectos del entrenamiento físico prolongado sobre la función y remodelación del ventrículo izquierdo después del infarto miocárdico. Métodos: Fueron estudiados 90 pacientes con un primer infarto miocárdico agudo, de localización anterior; todos recibieron el tratamiento médico convencional. Se realizaron pruebas de esfuerzo máximas, ecocardiogramas y ventriculografías isotópicas en reposo y esfuerzo a los 2, 6 y 12 meses de evolución; el seguimiento clínico medio fue de 36.3 ± 17 meses. A todos se les incorporó a un programa de rehabilitación cardíaca con entrenamiento físico moderado o intenso, durante un año como mínimo. Un 41.1% tuvieron una disfunción severa del ventrículo izquierdo. Resultados: Todos los parámetros ergométricos que expresaron capacidad funcional incrementaron significativamente en la evaluación del sexto mes (p < 0.0005), permaneciendo invariables al año. Se comprobó una disminución significativa (p < 0.01) de isquemia miocárdica al esfuerzo a los 6 meses. Las variables que midieron tamaño y función del ventrículo izquierdo no se modificaron evolutivamente. La mortalidad total de la serie fue un 13.3%, de causa cardiovascular un 8.9% y la morbilidad un 16.7%. Conclusiones: El entrenamiento físico prolongado no mostró efectos deletéreos sobre la función y remodelación del ventrículo izquierdo y se obtuvieron efectos funcionales y clínicos beneficiosos en estos pacientes infartados rehabilitados.


Objective: To assess the effects of long-term exercise training on the function and remodeling of the left ventricle after myocardial infarction. Methods: We studied 90 patients with a first acute anterior-wall myocardial infarction, all received conventional medical treatment. Symptom-limited maximal exercise stress tests, echocardiograms and effort-rest isotopic ventriculographies at 2, 6 and 12 months after myocardial infarction were performed; the follow-up time averaged 36.3 ± 17 months. All patients joined a cardiac rehabilitation program with moderate or intense exercise training lasting at least a year. Of all patients, 41.1% suffered severe left ventricle dysfunction. Results: Ergometric parameters that expressed functional capacity increased significantly (P< .0005) at the sixth month evaluation and remained unchanged after a year. There was significant decrease (P< .01) of exercise myocardial ischemia at 6 months. The variables that measured size and function of left ventricle did not change during evolution. Morbidity amounted to 16.7% and total mortality of the series was 13.3%, with 8.9% of cardiovascular cause. Conclusions: Long-term exercise training showed no deleterious effects on left ventricle function or remodeling and beneficial functional and clinical effects were obtained in these rehabilitated postinfarction patients.


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto Miocárdico de Parede Anterior/fisiopatologia , Infarto Miocárdico de Parede Anterior/reabilitação , Terapia por Exercício , Função Ventricular Esquerda/fisiologia , Remodelação Ventricular/fisiologia , Estudos Prospectivos , Fatores de Tempo
2.
Arch Cardiol Mex ; 83(3): 167-73, 2013.
Artigo em Espanhol | MEDLINE | ID: mdl-23906745

RESUMO

OBJECTIVE: To assess the effects of long-term exercise training on the function and remodeling of the left ventricle after myocardial infarction. METHODS: We studied 90 patients with a first acute anterior-wall myocardial infarction, all received conventional medical treatment. Symptom-limited maximal exercise stress tests, echocardiograms and effort-rest isotopic ventriculographies at 2, 6 and 12 months after myocardial infarction were performed; the follow-up time averaged 36.3±17 months. All patients joined a cardiac rehabilitation program with moderate or intense exercise training lasting at least a year. Of all patients, 41.1% suffered severe left ventricle dysfunction. RESULTS: Ergometric parameters that expressed functional capacity increased significantly (P<.0005) at the sixth month evaluation and remained unchanged after a year. There was significant decrease (P<.01) of exercise myocardial ischemia at 6 months. The variables that measured size and function of left ventricle did not change during evolution. Morbidity amounted to 16.7% and total mortality of the series was 13.3%, with 8.9% of cardiovascular cause. CONCLUSIONS: Long-term exercise training showed no deleterious effects on left ventricle function or remodeling and beneficial functional and clinical effects were obtained in these rehabilitated postinfarction patients.


Assuntos
Infarto Miocárdico de Parede Anterior/fisiopatologia , Infarto Miocárdico de Parede Anterior/reabilitação , Terapia por Exercício , Função Ventricular Esquerda/fisiologia , Remodelação Ventricular/fisiologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Tempo
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