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PubMed2005

Expression of phospholemman and its association with Na+-K+-ATPase in skeletal muscle: effects of aging and exercise training.

Phospholemman (PLM) is a recently identified accessory protein of the Na(+)-K(+)-ATPase (NKA), with a high level of expression in skeletal muscle. The objectives of this study are to characterize the PLM in skeletal muscle and to test the hypothesis that, as an accessory protein of NKA, expression of PLM and its association with the alpha-subunits of NKA is regulated during aging and with exercise training. PLM was characterized in skeletal muscle of 6- and 16-mo-old sedentary middle-aged rats (Ms), and the effects of aging and exercise training were studied in Ms, 29-mo-old sedentary senescent, and 29-mo-old treadmill-exercised senescent rats. Expression of PLM was muscle-type dependent, and immunofluorescence study showed that PLM distributed predominantly on the sarcolemmal membrane of the muscle fibers. Anti-PLM antibody reduced activity of NKA, and thus PLM appears to be required for NKA to express its full activity in skeletal muscle. Expression of PLM was not altered with aging but increased after exercise training. Coimmunoprecipitation studies demonstrated that PLM associates with both the alpha(1)- and alpha(2)-subunit isoforms of NKA. Compared with Ms rats, levels of PLM-associated alpha(1)-subunit increased in 29-mo-old sedentary senescent rats, and treadmill exercise has a tendency to partially reverse it. There was no significant change in PLM-associated alpha(2)-subunit with age, and exercise training has a tendency to increase that level. It is concluded that, in skeletal muscle, PLM appears to be a protein integral to the NKA complex and that PLM has the potential to modulate NKA in an isoform-specific and muscle type-dependent manner in aging and after exercise training.

Aging↗

PubMed1992

Exercise training and body composition in childhood.

The influence of exercise training on body composition changes in children is examined in terms of muscle, bone, and fat development. Because of the inexact body composition methodologies in general use and an over-reliance on the two-components system--fat and fat-free body--the extent of changes especially for muscle and bone with exercise training has not been well quantified. With the recent development of new methodologies these limitations may be overcome. The relationship of body composition to health related fitness is also explored with an emphasis on establishing fitness standards for body fatness and the need for research on the etiology of lower back pain and osteoporosis.

Body Composition↗

PubMed1992

Reduction in LBNP tolerance following prolonged endurance exercise training.

Eight young men underwent an 8-month endurance exercise training program. Prior to and following the training program, the subjects' maximal oxygen uptake (VO2max), total blood volume (TBV) and plasma volume (PV), tolerance to lower body negative pressure (LBNP) assessed by the cumulative stress index (CSI) to presyncope, and their hemodynamic responses to 0 to -45 torr LBNP was determined. Hemodynamic measures included rebreathe carbon dioxide cardiac output (Qc), heart rate (HR), directly measured arterial blood pressures (ABP), and strain gauge determination of forearm blood flow (FBF) and leg volume changes (delta LgV). Calculated values of stroke volume (SV), forearm, vascular resistance (FVR), and peripheral vascular resistance (PVR) were made. Following training, each subject had an increased VO2max (mean = +27.4%, P < 0.001), TBV (mean = +15.8%, P < 0.02), and PV (mean = +16.5%, P < 0.02) and each subject had a decreased tolerance to LBNP (mean CSI = -24%, P < 0.001). Stepwise linear regression identified that the major factors to significantly predict the decreased CSI pre- to post-training were a reduced response of PVR to LBNP from -15 to -45 torr (Model R2 = 0.853), the delta TBV (model R2 = 0.981), and the greater post-training reduction in SBP to LBNP of 0 to -45 torr (model R2 = 1.0). These data suggest that physiologic adaptations associated with the increased VO2max and TBV resulting from a prolonged endurance exercise training program can alter the reflex control of vasomotion and cardiac output during LBNP and reduce the LBNP tolerance.

Adult↗

PubMed1993

Glycemia and exercise training alter glucose transport and GLUT4 in the Zucker rat.

The purpose of this study was to determine the effects of chronic hyperglycemia and/or exercise training on the muscle concentration of the insulin-responsive glucose transporter protein, GLUT4, and on maximally insulin-stimulated hindlimb muscle glucose transport. Five-wk-old lean and obese Zucker rats were randomly assigned to sham-operated control (CTL) or 90% pancreatectomized (PX) groups. Obese-PX animals were further randomized into sedentary or exercise trained groups (15-wk treadmill running for 2 h.d-1, 5 d.wk-1, 15% grade, at 15-18 m.min-1). Muscle GLUT4 protein content and maximally insulin-stimulated glucose transport were determined in gastrocnemius, plantaris, and soleus muscles. At 20 wk, lean-PX displayed mild fasting hyperglycemia but normal insulin levels. Obese-PX rats had insulin levels similar to lean-CTL rats but had severe hyperglycemia. Hyperglycemia in lean-PX was associated with a 28% decrease in maximal glucose transport and a 65% decrease in muscle GLUT4 (P < 0.05) compared with lean-CTL. In obese-PX, maximal glucose transport was not affected, but muscle GLUT4 was reduced by 62% (P < 0.05) compared to obese-CTL. Exercise training obese-PX reduced hyperglycemia, increased maximal glucose transport by 45%, and increased muscle GLUT4 by > 2-fold (P < 0.05) compared with obese-CTL. Thus, hyperglycemia associated with PX may be an important factor in the reduction of muscle GLUT4 levels in lean and obese rats. The reduced GLUT4 was accompanied by reduced maximal glucose transport in lean but not obese rats. Exercise training reduced hyperglycemia, normalized glucose transport, and increased muscle GLUT4 in obese-PX.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗

PubMed1995

Lack of effect of exercise training on dehydroepiandrosterone-sulfate.

Although functions of dehydroepiandrosterone (DHEA) and its sulfate ester are unknown, investigators have found an inverse relation between DHEA-sulfate levels and coronary artery disease, suggesting its importance as an inverse coronary risk factor. In previous studies, where behavioral therapy was used to try to reduce stress and social isolation, DHEA levels increased--although other confounding factors, including enhanced physical activity, also were affected. To determine the influence of physical activity alone on plasma DHEA-sulfate levels in patients with coronary artery disease, the authors studied the effects of exercise training by measuring plasma DHEA-sulfate levels and other parameters in 96 patients at baseline and after 12 weeks of cardiac rehabilitation and exercise training. They confirmed that DHEA-sulfate levels decreased with age (r = 0.41; P < 0.0001) and that DHEA-sulfate levels correlated with body mass index (r = 0.32; P < 0.001), but not with other baseline risk factors. Exercise training during cardiac rehabilitation resulted in a 43% increase in exercise capacity (P < 0.0001) and was associated with improvement in other cardiac risk factors; however, there were no significant changes in plasma DHEA-sulfate levels (106 +/- 77 micrograms/dL versus 102 +/- 76 micrograms/dL). Although behavior therapy in combination with exercise training was shown to lead to concomitant increases in DHEA-sulfate and physical activity, exercise training alone has no significant impact on DHEA-sulfate, thereby strengthening the suggested role of behavioral changes in modifying this hormone.

Aged↗

PubMedDate not supplied

Safety and efficacy of exercise training in a patient awaiting heart transplantation while on positive intravenous inotropic support.

The safety and efficacy of exercise training in patients with congestive heart failure (CHF) is well established; however, the impact that exercise has on the subgroup of CHF patients awaiting heart transplant while on intravenous positive inotropic support remains largely unreported. This case study describes the safety and efficacy of exercise training in a patient awaiting heart transplant while on intravenous milrinone. Over a 1.2-year period, 246 exercise sessions were conducted with a total of 180.15 hours of aerobic exercise. During that time, the patient experienced only one hypotensive episode during exercise and had no other adverse events. The patient demonstrated a 38% increase in aerobic exercise time and a 34% increase in sustainable exercise workload. Research is needed to demonstrate the positive impact of exercise training on this subgroup of CHF patients.

Aged↗

PubMed1985

Exercise training during chronic beta blockade in cardiovascular disease.

To determine whether cardioselective and nonselective beta-blocking agents impair exercise training effects in patients with cardiovascular disease, 50 subjects were evaluated. All were in a 3-times-weekly medically supervised outpatient exercise program for 3 months or longer. Treadmill exercise tests were done initially and at 3-month intervals. Eight patients were receiving atenolol, 23 propranolol, 3 timolol, 6 metoprolol, and 8 nadolol and 1 patient receiving timolol changed to atenolol and 1 receiving nadolol changed to propranolol. Treadmill test duration increased significantly (p less than 0.05), from 7.5 +/- 2.5 to 9.9 +/- 2.3 minutes, with exercise training. In 35 of the 50 subjects heart rate at rest decreased significantly (p less than 0.05) from 67.5 +/- 11.7 to 60.4 +/- 10.5 beats/min. The other 15 subjects were excluded from heart rate analysis because beta blockade was begun 1 to 2 weeks after the initial exercise test. It is concluded that exercise training effects (increase in exercise test duration and decrease in resting heart rate) can be achieved in patients with cardiovascular disease in the presence of both cardioselective and nonselective beta-blocking agents.

Adrenergic beta-Antagonists↗

PubMed1997

Altered basal and adenosine-mediated protein flux from coronary arterioles isolated from exercise-trained pigs.

Solute flux per unit surface area and concentration gradient, (J(S)/SdeltaC), was quantified in arterioles isolated from hearts of sedentary (SED) and exercise-trained (EX) female Yucatan Miniature Swine. Apparent permeability (P(S)) was assessed from measures of J(S)/SdeltaC for two proteins, alpha-lactalbumin (alpha-lact) and porcine serum albumin (PSA), under basal conditions and following 5 min suffusion with 10(-5) M adenosine (ADO). Both proteins were labelled with the fluorescent dye tetramethyl rhodamine isothiocyanate. Basal P(S) to alpha-lact differed with exercise training ((P(S)alpha-lact)SED = 5.2+/-1.8 (median+/-median absolute deviation (MAD), n = 9 pigs) versus (P(S)alpha-lact)EX = 7.4+/-1.1 x 10(-7) cm s(-1), n = 9, P < 0.05). For the larger protein PSA, basal P(S) did not change with training (P(S)PSA)SED = 50+/-1.6, N = 11 vs. (P(S)PSA)EX = 4.1+/-1.2 x 10(-7) cm s(-1), N = 11). Suffusion of the arterioles (33+/-4 microm diameter, n = 18 vessels) from SED hearts (n = 14) with 10(-5) M ADO decreased P(S)alpha-lact 15+/-8% relative to control and was without effect on P(S)PSA. By contrast, in arterioles (39+/-4 microm diameter, n = 22 vessels) from EX hearts (n = 14), ADO increased P(S)alpha-lact and P(S)PSA by 32 and 65% respectively, indicating that receptor-mediated changes in permeability were also sensitive to exercise training. These data demonstrate that, for coronary arterioles, permeability to macromolecules adapts to exercise training. The adaptive mechanisms may involve more than one structural component of the vessel wall as the changes in permeability were size-dependent.

Adenosine↗

PubMed2005

Effects of exercise training on contractile function in myocardial trabeculae after ischemia-reperfusion.

Potential protective effects of aerobic exercise training on the myocardium, before an ischemic event, are not completely understood. The purpose of the study was to investigate the effects of exercise training on contractile function after ischemia-reperfusion (Langendorff preparation with 15-min global ischemia/30-min reperfusion). Trabeculae were isolated from the left ventricles of both sedentary control and 10- to 12-wk treadmill exercise-trained rats. The maximal normalized isometric force (force/cross-sectional area; Po/CSA) and shortening velocity (Vo) in isolated, skinned ventricular trabeculae were measured using the slack test. Ischemia-reperfusion induced significant contractile dysfunction in hearts from both sedentary and trained animals; left ventricular developed pressure (LVDP) and maximal rates of pressure development and relaxation (+/-dP/dtmax) decreased, whereas end-diastolic pressure (EDP) increased. However, this dysfunction (as expressed as percent change from the last 5 min before ischemia) was attenuated in trained myocardium [LVDP: sedentary -60.8 +/- 6.4% (32.0 +/- 5.5 mmHg) vs. trained -15.6 +/- 8.6% (64.9 +/- 6.6 mmHg); +dP/dtmax: sedentary -54.1 +/- 4.7% (1,058.7 +/- 124.2 mmHg/s) vs. trained -16.7 +/- 8.4% (1,931.9 +/- 188.3 mmHg/s); -dP/dtmax: sedentary -44.4 +/- 2.5% (-829.3 +/- 52.0 mmHg/s) vs. trained -17.9 +/- 7.2% (-1,341.3 +/- 142.8 mmHg/s); EDP: sedentary 539.5 +/- 147.6%; (41.3 +/- 6.0 mmHg) vs. trained 71.6 +/- 30.6%; 11.4 +/- 1.2 mmHg]. There was an average 26% increase in Po/CSA in trained trabeculae compared with sedentary controls, and this increase was not affected by ischemia-reperfusion. Ischemia-reperfusion reduced Vo by 39% in both control and trained trabeculae. The relative amount of the beta-isoform of myosin heavy chain (MHC-beta) was twofold greater in trained trabeculae as well as in the ventricular free walls. Despite a possible increase in the economy in the trained heart, presumed from a greater amount of MHC-beta, ischemia-reperfusion reduced Vo, to a similar extent in both control and trained animals. Nevertheless, the trained myocardium appears to have a greater maximum force-generating ability that may, at least partially, compensate for reduced contractile function induced by a brief period of ischemia.

Adaptation, Physiological↗

PubMed1998

The effects of exercise training on muscle atrophy in haemodialysis patients.

BACKGROUND: Patients with end-stage renal disease on haemodialysis (HD) have limited work capacity. Many structural and functional alterations in skeletal muscles contribute to this disability. METHODS: To evaluate the effects of exercise training on uraemic myopathy, seven HD patients (mean age 44.1+/-17.2 years) were studied. Open muscle biopsies were taken from their vastus lateralis muscle before and after a 6-month exercise rehabilitation programme and examined by routine light- and transmission electron-microscopy. Histochemical stainings of frozen sections were performed and morphometric analysis was also applied to estimate the proportion of each fibre type and the muscle fibre area. Spiroergometric and neurophysiological testing and peak extension forces of the lower limbs were measured before and after exercise training. RESULTS: All patients showed impaired exercise capacity, which was associated with marked muscular atrophy (mean area 2548+/-463 microm2) and reduction in muscle strength and nerve conduction velocity. All types of fibres were atrophied, but type II were more affected. The ultrastructural study showed severe degenerative changes in skeletal muscle fibres, mitochondria, and capillaries. Exercise training had an impressive effect on muscular atrophy; in particular the proportion of type II fibres increased by 51% and mean muscle fibre area by 29%. Favourable changes were also seen on the structure and number of capillaries and mitochondria. These results were confirmed by a 48% increase in VO2 peak and a 29% in exercise time, as well as an improvement in the peak muscle strength of the lower limbs and in nerve conduction velocity. CONCLUSIONS: Skeletal muscle atrophy in HD patients contribute to their poor exercise tolerance. The application of an exercise training rehabilitation programme improved muscle atrophy markedly, and therefore had beneficial effects in overall work performance.

Adult↗

PubMed1982

Catecholamines and triiodothyronine variations and the calorigenic response to norepinephrine in cold-adapted and exercise-trained rats.

A comparison was made of the thermogenic response to norepinephrine (NE) in cold-adapted (2 h per day at -15 degrees C for 5 weeks) and in exercise-trained rats (2 h swimming per day for 5 weeks). The oxygen consumption and the plasma catecholamine elevation were comparable for both conditions. Similarly plasma corticosterone determinations indicated comparable elevations in acute stress exposure and reduced responses in both exercise-trained and cold-adapted rats. The marked increase in colonic temperature which was observed in cold-adapted animals injected with NE (30 micrograms/100 g s.c.) was not found in exercise-trained rats. Similarly the brown adipose tissue was double in size in the cold-adapted rats but remained unchanged with exercise training. An important elevation of triiodothyronine (T3) was found in cold-exposed rats, either adapted or not. However, exercise was found to decrease plasma T3 in trained and nontrained rats. The results indicate that swimming for 2 h and exposure to cold (-15 degrees C) for 2 h produced comparable elevation of plasma corticosterone and catecholamine, and of oxygen consumption. However, only the cold-adapted animals develop a NE-induced thermogenesis. It is suggested that thyroid hormones are necessary as permissive factor, in stress-induced thermogenesis.

Acclimatization↗

PubMed1989

Regional blood flow of exercise-trained younger and older cold-exposed rats.

O2 consumption (thermogenesis) and regional blood flows (measured using radioactively labeled microspheres) were evaluated in younger (12 mo) and older (24 mo) sedentary and exercised male Fischer 344 (F-344) rats. These variables were measured at rest and during exposure to 6 degrees C. Exercise-trained rats were run on a motor-driven treadmill 5 days/wk, 1 h/day, at 20 m/min for 6 mo. Resting rates of O2 consumption did not differ with age or exercise training. However, thermogenesis during cold exposure was significantly greater in the older exercised rats than in the other three groups. This difference did not reflect a greater contribution from brown fat as indicated by the fact that total blood flow to the brown fat depots during cold exposure was not greater in the older exercised vs. the other rat groups. Neither exercise training nor age had a significant effect on specific resting blood flow (expressed as ml.min-1.g tissue mass-1) to most of the organs measured, including heart, kidney, brown fat, white fat, and skeletal muscle. The notable exception to this was in the spleen of the older sedentary animals where flow was diminished compared with that in the older exercised animals. We conclude that aging, between 12 and 24 mo of age, and/or exercise training have only a minor effect on regional blood flow of F-344 rats during rest or cold exposure and that the enhanced thermogenesis seen in cold-exposed older exercised vs. sedentary F-344 rats cannot be explained by a greater contribution from brown fat.

Aging↗

PubMed1991

Exercise training, serum lipids, and lipoprotein particles: is there a change threshold?

The role of lipoprotein manipulation in the treatment of atherosclerosis is well established. Improvement in lipoprotein cholesterol concentrations and subclass distribution through exercise training is often advised prior to pharmacologic intervention. As with other therapeutic interventions, dose must be stipulated to the patient. The dose of exercise training required to induce beneficial lipoprotein changes is unclear. This issue is further complicated by the potential effect of exercise training on lipoprotein subclass distribution (LDL I, LDL II, LDL III, LDL IV, HDL2a, HDL2b, HDL3a, HDL3b, HDL3c), enzymes, apoproteins, and transfer proteins and by the changes in diet and body composition that often accompany exercise training. These changes may be responsible for all or part of the lipoprotein change attributed to exercise. From available data, it appears that a threshold of approximately 15 miles.wk(-1) of jogging may be required to induce beneficial change.

Arteriosclerosis↗

PubMed1988

Regional capillary and myocyte distribution in normal and exercise trained male and female rat hearts.

Adult Sprague-Dawley male and female rats were exercise trained for five months by either treadmill running or swimming. Significant differences in left ventricular regional capillary density and myocyte cross-sectional area were found. In control rats the epicardial regions had greater capillary density than endocardial regions. Endocardial myocyte cross-sectional areas were greater than those of epicardial myocytes in both sexes. Male rats had larger endocardial myocytes and larger hearts than females. After exercise training, myocyte size increased in the epicardial region but not in the endocardial region, while capillary density increased significantly only in the endocardial region. Similar changes were seen in both male and female rats with comparable degrees of exercise induced hypertrophy. These data suggest that exercise training "normalizes" the distribution of capillaries in the myocardium. Capillary density increased only in the regions where myocyte cross-sectional area did not increase. Further, the effects of exercise on male and female rat hearts is not different when the degree of exercise induced hypertrophy is similar.

Animals↗

PubMed1986

Energy balance in exercise-trained rats acclimated at two environmental temperatures.

The present study was carried out to investigate the effects of exercise training on energy balance in male rats acclimated at two different environmental temperatures. Sedimentary and exercised rats were housed and trained at either 24 or 4 degrees C, with the training program consisting of running on a motor-driven treadmill within their respective environments. After 45 days, energy, protein, and fat contents of rats were determined together with the energy content of food and feces. The results show that metabolizable energy intake was reduced by 10% in exercise-trained groups. Substantial differences in energy gains were observed between sedentary and trained rats; sedentary rats showed almost three times more energy gain than trained rats. Carcass analysis revealed the energy gain differences to be mainly due to varied amounts of fat deposition. Energy expenditure (kJ) excluding the cost of exercise training was corrected for metabolic body size (BW 0.75), which in turn showed no significant differences between trained rats and their respective sedentary controls. The present results suggested that exercise training in rats leads to neither increase nor decrease in energy expenditure through components additional to physical activity. The present results also indicated that brown adipose tissue thermogenesis, as assessed through mitochondrial guanosine 5'-diphosphate binding, was not significantly modified by exercise training, regardless of the temperature at which the rats were housed and trained.

Acclimatization↗

PubMed1998

Effects of low-impact, moderate-intensity exercise training with and without wrist weights on functional capacities and mood states in older adults.

This study examined the effects of low-impact, moderate-intensity exercise training with and without wrist weights (0.68 kg.wrist-1) on functional capacities and mood states in older adults (age 68.6 +/- 5.6, mean +/- SD). Twenty-three senior citizens residing in the community were randomly assigned to wrist weight (WW; n = 12) and no-wrist weight (NW; n = 11) exercise groups while 11 matched subjects served as non-exercise controls (NE). Exercise training was performed for 10 weeks, 3 days/week, for 60 min/session and consisted of low-impact aerobic dance (50-70% of maximal heart rate) combined with exercises to promote muscular fitness, flexibility, and balance. Before and after the intervention, each participant's aerobic fitness, muscular strength, flexibility, static and dynamic balance, skinfold thickness, and psychological mood states were assessed under standardized testing conditions. Exercise training resulted in significant improvements in peak oxygen uptake, lower extremity muscle strength, and psychological vigor (p < 0.05) but did not affect other fitness components (p > 0.05). There were no differences between the WW and NW exercise groups for any of the same variables studied (p > 0.05). No significant pre- to post-test changes were found for the NE control group (p > 0.05). It is concluded that 10 weeks of low-impact, moderate-intensity exercise training of the type that can be considered well-rounded in nature provides a sufficient stimulus to augment aerobic fitness, beneficially affects leg strength, and increases feelings of vigor in older adults. The present observations indicate that the use of light wrist weights has no beneficial or adverse effects on the measured training outcomes.

Activities of Daily Living↗

PubMedDate not supplied

Effect of an aerobic exercise training program on resting metabolic rate in chronically beta-adrenergic blocked hypertensive patients.

PURPOSE: There is substantial evidence that the use of beta-adrenergic receptor blockers (beta-blockers) is associated with a reduction in resting metabolic rate (RMR) and that a weight gain usually occurs in the first few months of treatment. The purpose of this study was to determine if RMR of overweight and sedentary subjects consuming beta-blockers can be increased following an aerobic exercise training program. METHODS: Twenty-four subjects participated in the study; 11 (6 women, 5 men) were treated with beta-blockers for hypertension and 13 (9 women, 4 men) were nonmedicated (control group). Body composition, RMR, and peak oxygen uptake (VO2peak) were assessed for all subjects before and after a 12-week aerobic exercise training program. Weekly exercise energy expenditure equaled 83.68 kJ (20 kcal) per kg of body weight while exercise intensity was maintained between 60% and 70% of the VO2 reserve. RESULTS: Body composition, RMR, and VO2peak did not differ among groups at the beginning of the study. Body weight (-1.4 kg for beta-blockers, P < .05; -2.5 kg for control, P < .05) and VO2peak (+2.2 mL x kg(-1) x min(-1) for beta-blockers, P < .05; +4.1 mL x kg(-1) x min(-1) for control, P < .001) were significantly improved in both groups, whereas RMR (-272 kJ x day(-1) for beta-blockers, NS; +573 kJ x day(-1) for control, P < .05) was increased only in the control group after the aerobic exercise training program. CONCLUSIONS: These results suggest that beta-blockers limit the increase in RMR normally observed following an aerobic exercise training program. Consequently, obtaining a negative energy balance in an attempt to lose weight may be more difficult.

Adrenergic beta-Antagonists↗

PubMedDate not supplied

Moderate-high intensity exercise training after myocardial infarction: effect on left ventricular remodeling.

BACKGROUND: Regular exercise increases exercise capacity and physical fitness, but questions remain about the effects of exercise on left ventricle (LV) remodeling after myocardial infarction. This study investigated the effects of moderate to high intensity exercise training on LV remodeling after a first myocardial infarction. METHODS: An exercise group of 68 patients in cardiac rehabilitation after a first myocardial infarction had an initial echocardiogram and exercise stress test. Thirty patients completed the 12 weeks of training and had echocardiograms suitable for quantitative analysis. Follow-up echocardiograms and exercise tests were performed. A carefully matched control group of 30 patients with echocardiograms at fixed intervals after myocardial infarction and no formal exercise training were also studied. LV size was expressed as the endocardial surface area-to-body surface area (ESAi), whereas infarct size was characterized by the percent abnormal wall motion (%AWM) by echocardiography using an endocardial surface area mapping technique. Indices of LV shape (sphericity) were also assessed. RESULTS: In the exercise group, no significant changes were seen in ESAi (57.95 +/- 13.1 vs 57.80 +/- 12.04 cm2/m2) or in %AWM (19.33 +/- 15.27 vs 20.11 +/- 15.95) from the initial to the final echo. The indices of sphericity were also unchanged. None of these parameters changed in the control group. Within each group was found heterogeneity in LV remodeling. Multivariate regression analysis revealed initial ESAi and initial %AWM to predict change in ESAi over time. CONCLUSIONS: In this study of patients with predominately small infarcts, exercise training did not adversely affect LV remodeling after myocardial infarction. Remodeling is heterogeneous and appears related to infarct and LV size.

Aged↗