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. 1980 Mar;43(3):262–269. doi: 10.1136/hrt.43.3.262

Effects of physical training on myocardial ischaemia in patients with coronary artery disease.

J A Raffo, I Y Luksic, C T Kappagoda, D A Mary, W Whitaker, R J Linden
PMCID: PMC482274  PMID: 7437173

Abstract

The effects of a simple physical training programme were investigated in a prospective and randomised trial in patients with stable angina pectoris using a modified exercise test. Twenty-four patients with ischaemic heart disease and an ischaemic response to conventional exercise electrocardiography were randomised into two groups: 12 patients took part in a training programme and 12 patients were allocated to a control group (no training). Exercise testing was performed sequentially at entry to the study and six months afterwards. At both studies we determined the heart rate at the same level of ischaemic ST segment depression (HR/ST threshold), the duration of the test, and relation of heart rate to the exercise load. The HR/ST threshold increased only in patients who underwent the exercise programme, suggesting indirectly that training resulted in the ability to do more work and attain a higher degree of myocardial oxygen consumption at the same level of myocardial ischaemia. In addition, training led to an increase in the duration of the test and to a reduction in heart rate at any level of submaximal exercise load. It is concluded that physical training in anginal patients results in an enhancement of myocardial oxygen availability.

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Selected References

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  1. Ari E. B., Kellermann J. J., Lapitod C., Drory Y., Fisman E., Hayat M. Effect of prolonged intensive training on cardiorespiratory response in patients with angina pectoris. Br Heart J. 1978 Oct;40(10):1143–1148. doi: 10.1136/hrt.40.10.1143. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. BRUCE R. A., BLACKMON J. R., JONES J. W., STRAIT G. EXERCISING TESTING IN ADULT NORMAL SUBJECTS AND CARDIAC PATIENTS. Pediatrics. 1963 Oct;32:SUPPL–756. [PubMed] [Google Scholar]
  3. Barry A. J., Daly J. W., Pruett E. D., Steinmetz J. R., Birkhead N. C., Rodahl K. Effects of physical training in patients who have had myocardial infarction. Am J Cardiol. 1966 Jan;17(1):1–8. doi: 10.1016/0002-9149(66)90254-2. [DOI] [PubMed] [Google Scholar]
  4. Bersohn M. M., Scheuer J. Effects of physical training on end-diastolic volume and myocardial performance of isolated rat hearts. Circ Res. 1977 May;40(5):510–516. doi: 10.1161/01.res.40.5.510. [DOI] [PubMed] [Google Scholar]
  5. Bhan A. K., Scheuer J. Effects of physical training on cardiac myosin ATPase activity. Am J Physiol. 1975 Apr;228(4):1178–1182. doi: 10.1152/ajplegacy.1975.228.4.1178. [DOI] [PubMed] [Google Scholar]
  6. Carey R. A., Tipton C. M., Lund D. R. Influence of training on myocardial responses of rats subjected to conditions of ischaemia and hypoxia. Cardiovasc Res. 1976 May;10(3):359–367. doi: 10.1093/cvr/10.3.359. [DOI] [PubMed] [Google Scholar]
  7. Chatterjee K., Matloff J. M., Swan H. J., Ganz W., Kaushik V. S., Magnusson P., Henis M. M., Forrester J. S. Abnormal regional metabolism and mechanical function in patients with ischemic heart diseases: improvement after successful regional revascularization by aortocoronary bypass. Circulation. 1975 Sep;52(3):390–399. doi: 10.1161/01.cir.52.3.390. [DOI] [PubMed] [Google Scholar]
  8. Clausen J. P. Circulatory adjustments to dynamic exercise and effect of physical training in normal subjects and in patients with coronary artery disease. Prog Cardiovasc Dis. 1976 May-Jun;18(6):459–495. doi: 10.1016/0033-0620(76)90012-8. [DOI] [PubMed] [Google Scholar]
  9. Clausen J. P. Effect of physical training on cardiovascular adjustments to exercise in man. Physiol Rev. 1977 Oct;57(4):779–815. doi: 10.1152/physrev.1977.57.4.779. [DOI] [PubMed] [Google Scholar]
  10. DeMaria A. N., Neumann A., Lee G., Fowler W., Mason D. T. Alterations in ventricular mass and performance induced by exercise training in man evaluated by echocardiography. Circulation. 1978 Feb;57(2):237–244. doi: 10.1161/01.cir.57.2.237. [DOI] [PubMed] [Google Scholar]
  11. Detry J. M., Bruce R. A. Effects of physical training on exertional S-T-segment depression in coronary heart disease. Circulation. 1971 Sep;44(3):390–396. doi: 10.1161/01.cir.44.3.390. [DOI] [PubMed] [Google Scholar]
  12. ECKSTEIN R. W. Effect of exercise and coronary artery narrowing on coronary collateral circulation. Circ Res. 1957 May;5(3):230–235. doi: 10.1161/01.res.5.3.230. [DOI] [PubMed] [Google Scholar]
  13. Fortuin N. J., Weiss J. L. Exercise stress testing. Circulation. 1977 Nov;56(5):699–712. doi: 10.1161/01.cir.56.5.699. [DOI] [PubMed] [Google Scholar]
  14. Hellerstein H. K., Hornsten T. R., Goldbarg A., Burlando A. G., Friedman E. H., Hirsch E. Z., Marik S. The influence of active conditioning upon subjects with coronary artery disease: cardiorespiratory changes during training in 67 patients. Can Med Assoc J. 1967 Mar 25;96(12):758–760. [PMC free article] [PubMed] [Google Scholar]
  15. Kappagoda C. T., Linden R. J., Newell J. P. Effect of the Canadian Air Force training programme on a submaximal exercise test. Q J Exp Physiol Cogn Med Sci. 1979 Jul;64(3):185–204. doi: 10.1113/expphysiol.1979.sp002472. [DOI] [PubMed] [Google Scholar]
  16. Kavanagh T., Shephard R. J., Pandit V., Doney H. Exercise and hypnotherapy in the rehabilitation of the coronary patient. Arch Phys Med Rehabil. 1970 Oct;51(10):578–587. [PubMed] [Google Scholar]
  17. Kennedy C. C., Spiekerman R. E., Lindsay M. I., Jr, Mankin H. T., Frye R. L., McCallister B. D. One-year graduated exercise program for men with angina pectoris. Evaluation by physiologic studies and coronary arteriography. Mayo Clin Proc. 1976 Apr;51(4):231–236. [PubMed] [Google Scholar]
  18. Kitamura K., Jorgensen C. R., Gobel F. L., Taylor H. L., Wang Y. Hemodynamic correlates of myocardial oxygen consumption during upright exercise. J Appl Physiol. 1972 Apr;32(4):516–522. doi: 10.1152/jappl.1972.32.4.516. [DOI] [PubMed] [Google Scholar]
  19. Leon A. S., Bloor C. M. The effect of complete and partial deconditioning on exercise-induced cardiovascular changes in the rat. Adv Cardiol. 1976;18(0):81–92. doi: 10.1159/000399514. [DOI] [PubMed] [Google Scholar]
  20. MONROE R. G. MYOCARDIAL OXYGEN CONSUMPTION DURING VENTRICULAR CONTRACTION AND RELAXATION. Circ Res. 1964 Apr;14:294–300. doi: 10.1161/01.res.14.4.294. [DOI] [PubMed] [Google Scholar]
  21. McHenry P. L., Phillips J. F., Knoebel S. B. Correlation of computer-quantitated treadmill exercise electrocardiogram with arteriographic location of coronary artery disease. Am J Cardiol. 1972 Nov;30(7):747–752. doi: 10.1016/0002-9149(72)90149-x. [DOI] [PubMed] [Google Scholar]
  22. Nelson R. R., Gobel F. L., Jorgensen C. R., Wang K., Wang Y., Taylor H. L. Hemodynamic predictors of myocardial oxygen consumption during static and dynamic exercise. Circulation. 1974 Dec;50(6):1179–1189. doi: 10.1161/01.cir.50.6.1179. [DOI] [PubMed] [Google Scholar]
  23. Penpargkul S., Repke D. I., Katz A. M., Scheuer J. Effect of physical training on calcium transport by rat cardiac sarcoplasmic reticulum. Circ Res. 1977 Feb;40(2):134–138. doi: 10.1161/01.res.40.2.134. [DOI] [PubMed] [Google Scholar]
  24. Penpargkul S., Scheuer J. The effect of physical training upon the mechanical and metabolic performance of the rat heart. J Clin Invest. 1970 Oct;49(10):1859–1868. doi: 10.1172/JCI106404. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Physical training and intrinsic cardiac adaptations. Circulation. 1973 Apr;47(4):677–680. doi: 10.1161/01.cir.47.4.677. [DOI] [PubMed] [Google Scholar]
  26. Raffo J. A., Luksic I. Y., Kappagoda C. T., Mary D. A., Stoker J. B., Whitaker W., Linden R. J. Diagnostic value of routine exercise testing in hospital patients with angina pectoris. Br Med J. 1979 Aug 4;2(6185):295–297. doi: 10.1136/bmj.2.6185.295. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Redwood D. R., Rosing D. R., Epstein S. E. Circulatory and symptomatic effects of physical training in patients with coronary-artery disease and angina pectoris. N Engl J Med. 1972 May 4;286(18):959–965. doi: 10.1056/NEJM197205042861801. [DOI] [PubMed] [Google Scholar]
  28. SARNOFF S. J., BRAUNWALD E., WELCH G. H., Jr, CASE R. B., STAINSBY W. N., MACRUZ R. Hemodynamic determinants of oxygen consumption of the heart with special reference to the tension-time index. Am J Physiol. 1958 Jan;192(1):148–156. doi: 10.1152/ajplegacy.1957.192.1.148. [DOI] [PubMed] [Google Scholar]
  29. STEVENSON J. A., FELEKI V., RECHNITZER P., BEATON J. R. EFFECT OF EXERCISE ON CORONARY TREE SIZE IN THE RAT. Circ Res. 1964 Sep;15:265–269. doi: 10.1161/01.res.15.3.265. [DOI] [PubMed] [Google Scholar]
  30. Sim D. N., Neill W. A. Investigation of the physiological basis for increased exercise threshold for angina pectoris after physical conditioning. J Clin Invest. 1974 Sep;54(3):763–770. doi: 10.1172/JCI107814. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Smokler P. E., MacAlpin R. N., Alvaro A., Kattus A. A. Reproducibility of a multi-stage near maximal treadmill test for exercise tolerance in angina pectoris. Circulation. 1973 Aug;48(2):346–351. doi: 10.1161/01.cir.48.2.346. [DOI] [PubMed] [Google Scholar]
  32. Sonnenblick E. H., Ross J., Jr, Braunwald E. Oxygen consumption of the heart. Newer concepts of its multifactoral determination. Am J Cardiol. 1968 Sep;22(3):328–336. doi: 10.1016/0002-9149(68)90117-3. [DOI] [PubMed] [Google Scholar]
  33. Wiley J. F. Effects of 10 weeks of endurance training on left ventricular intervals. J Sports Med Phys Fitness. 1971 Jun;11(2):104–111. [PubMed] [Google Scholar]
  34. Wyatt H. L., Mitchell J. H. Influences of physical training on the heart of dogs. Circ Res. 1974 Dec;35(6):883–889. doi: 10.1161/01.res.35.6.883. [DOI] [PubMed] [Google Scholar]

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