Article

The purpose of this study was to determine whether different initiation
of exercise training (ET) produces different effect sizes for left ventricular
(LV) remodeling and cardiopulmonary rehabilitation in patients with LV
dysfunction after myocardial infarction (MI). METHOD:
Trials evaluating ET
outcomes identified by searches in OVID MEDLINE, EMBASE, PubMed and WEB OF
SCIENCE were used. Meta-analysis was conducted with the use of the software STATA
11.0. The results were expressed as the standardized mean difference (SMD), with
corresponding 95% CI and p value. RESULTS: The largest changes in LV remodeling
and cardiopulmonary capacity rehabilitation were obtained when programs began the
acute phase after MI. With the healing of MI, the beneficial effects of ET on LV
ejection fraction (LVEF), LV end-systolic diameter (LVDs) and peak VO2 were
gradually weakened even worse. The incidence of major adverse cardiac events was
not significantly increased in acute phase post-MI. Sensitivity analyses show
that ET still had significant effect in reducing LVDs and increasing peak VO2,
while ET no longer had statistical effect in increasing LVEF but showed favorable
trends when the same research institution's works were excluded. CONCLUSIONS: ET
has favorable effects on LV remodeling and cardiopulmonary rehabilitation in LV
dysfunction post-MI patients. The greatest benefits are obtained when ET starts
at the acute phase following MI. IMPLICATIONS FOR REHABILITATION: Early exercise
training is safe and feasible in acute and healing phase after myocardial
infarction. Early exercise training could attenuate LV remodeling and improve
cardiopulmonary capacity in patients with myocardial infarction after hospital
discharge (around one week post-MI). Exercise training has favorable effects on
LV remodeling and cardiopulmonary capacity rehabilitation. Exercise training
should be treated to have the same roles with drugs in secondary prevention of
myocardial infarction.

Langue : ANGLAIS