Article

Endurance exercise training induces cardio-protective effects, but
athletes are not exempted from a myocardial infarction. Evidence from animal
studies suggests that exercise training attenuates pathological left ventricular
remodelling following myocardial infarction. We tested the hypothesis that
lifelong exercise training is related to attenuated pathological left ventricular
remodelling after myocardial infarction as evidenced by better left ventricular
systolic function in veteran athletes compared to sedentary peers. Design This
was a cross-sectional study. Methods Sixty-five males (60 +/- 6 years) were
included and allocated to four groups based on lifelong exercise training
volumes: (a) athletes ( n = 18), (b) post-myocardial infarction athletes
(athletes + myocardial infarction, n = 20), (c) sedentary controls ( n = 13), and
(d) post-myocardial infarction controls (sedentary controls + myocardial
infarction, n = 14). Athletes were lifelong (>/=20 years) highly physically
active (>/=30 metabolic equivalent of task (MET)-h/week), whereas sedentary
controls did not meet the exercise guidelines (<10 MET-h/week) for the past 20
years. left ventricular systolic function, diastolic function and wall strain
were measured using echocardiography. Results Cardiac enzyme markers
(creatine-kinase, creatinine, aspartate transaminase and lactate dehydrogenase)
following myocardial infarction and infarct location did not differ between
athletes + myocardial infarction and sedentary controls + myocardial infarction.
Left ventricular ejection fraction was significantly higher in athletes (61% +/-
4), athletes + myocardial infarction (58% +/- 4) and sedentary controls (57% +/-
6) compared to sedentary controls + myocardial infarction (51% +/- 7; p < 0.01).
Left ventricular circumferential strain was superior in athletes (-19% (-21% to
-17%), athletes + myocardial infarction (-16% (-20% to -12%)), and sedentary
controls (-15% (-18% to -14%) compared to sedentary controls + myocardial
infarction (-13% (-15% to -8%), p < 0.01). Diastolic function parameters did not
differ across groups. Conclusion These findings suggest that lifelong exercise
training may preserve left ventricular systolic function and possibly attenuates
or minimises the deleterious effects of pathological post-myocardial infarction
left ventricular remodelling in veteran athletes.

Langue : ANGLAIS