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PubMed2004

The beneficial effect of regular endurance exercise training on blood pressure and quality of life in patients with hypertension.

Regular aerobic exercise can reduce blood pressure and is recommended as part of the lifestyle modification to reduce high blood pressure and cardiovascular risk. Hypertension itself, or/and pharmacological treatment for hypertension is associated with adverse effects on some aspects of quality of life. This study was performed to evaluate the effects of regular endurance exercise training on quality of life and blood pressure. Patients with mild to moderate hypertension (systolic blood pressure 140-180 or diastolic blood pressure 90-110 mm Hg) were randomized to a moderate-intensity aerobic exercise group training for 3 sessions/week over 10 weeks or to a non-exercising control group. Health-related quality of life was assessed with the Short Form 36-item Health Survey (SF-36) at baseline and after 6 and 10 weeks. In the 102 subjects (47 male, mean age 47 years) who completed the study, reductions in blood pressure in the exercise group at 10 weeks (-13.1/-6.3 mm Hg) were significant (P < 0.001) compared to baseline and to the control group (-1.5/+6.0 mm Hg). Unlike the control group, the exercise group showed an increase in exercise capacity from 8.2 +/- 1.6 to 10.8 +/- 2.2 METS (P < 0.01) and showed higher scores on 7 out of 8 subscales (P < 0.05) of the SF-36. Improvement in bodily pain and general health sub-scores correlated with reduction in systolic blood pressure. Regular endurance training improves both blood pressure and quality of life in hypertensive patients and should be encouraged more widely.

Adult↗
PubMed1989

Exercise training after experimental myocardial infarction increases the ventricular fibrillation threshold before and after the onset of reinfarction in the isolated rat heart.

Previous work has shown that exercise training increases the ventricular fibrillation threshold of the isolated perfused rat heart. The aim of our study was to determine whether exercise training that begins after myocardial infarction can similarly increase the ventricular fibrillation threshold. Rats that had suffered an experimental myocardial infarction were subject to a running training program. Thereafter, the ventricular fibrillation threshold was measured before and after the onset of acute reinfarction induced by a second coronary artery ligation. Ventricular fibrillation thresholds were significantly elevated in trained rats during normoxia (13.7 +/- 2.2 vs. 4.7 +/- 0.8 mA, p less than 0.01) and during acute ischemia (6.8 +/- 1.6 vs. 3.0 +/- 0.7 mA, p less than 0.02). The myocardial cyclic AMP level was lower in the nonischemic zone of the trained hearts (0.21 +/- 0.01 vs. 0.28 +/- 0.01 nmol/g, p less than 0.05), which also had lower cyclic AMP levels after epinephrine challenge (0.50 +/- 0.05 vs. 0.73 +/- 0.09 nmol/g, p less than 0.01; 1.41 +/- 0.11 vs. 1.85 +/- 0.09 nmol/g, p less than 0.02 after epinephrine 10(-7) M and 5 x 10(-6) M injection, trained vs. untrained). Both propranolol 10(-6) M and epinephrine 5 x 10(-7) M attenuated the difference in ventricular fibrillation thresholds before and after second coronary artery ligation and eliminated any difference in cyclic AMP content of both the nonischemic and ischemic myocardial tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2002

Resting thyroid and leptin hormone changes in women following intense, prolonged exercise training.

This study examined whether free (f) triidothyronine (T3), f thyroxine (T4), thyroid stimulating hormone (TSH), and leptin concentrations at rest changed in response to 20 weeks of exercise-training. Two groups of women were recruited for participation in the study, collegiate athletes ( n=17) and sedentary controls (n=4). Exercise training consisted of daily athletic activity such as rowing, running, and weight lifting. Subjects were initially grouped into rowers and controls. However, earlier suggested criteria were further used to categorize hormone changes (percentages) in the subjects into (+) responders (increases), (-) responders (decreases), or non-responders (no changes). The fT3 results of the rowers revealed two distinct categories of responses, (-) responder (all decreases; n=10) and non-responder (no change; n=7) rowers. In the responders fT3 concentration decreased (P<0.05) from baseline (BL) during an intense training period [(mean SEM) at 5 weeks by -28.2 (6.2)% and at 10 weeks by -24.9 (7.9)%], then returned towards BL levels (20 weeks compared to BL, P>0.05). Similar changes (P<0.05), at comparable times, were noted for leptin and TSH concentrations in the (-) responder rowers. The non-responder rowers and control subjects displayed no significant (P>0.05) hormone changes over the 20 weeks. The hormone changes observed in the (-) responder rowers were not significantly (P>0.05) correlated with changes in body composition or hydration status during the study. The mechanism for the hormone changes in the (-) responder rowers is unclear. We speculate the decrease in concentrations of TSH and fT3 could be attributable to a lower hypothalamic-pituitary signaling action, and this is related to the decreased leptin concentrations, and could represent a possible means of energy conservation in these exercising women.

Adult↗
PubMed2002

Exercise training improves vascular endothelial function in patients with type 1 diabetes.

OBJECTIVE-Impaired endothelial function of resistance and conduit arteries can be detected in patients with type 1 diabetes. We studied whether a persistent improvement of endothelial function can be achieved by regular physical training. RESEARCH DESIGN AND METHODS-The study included 26 patients with type 1 diabetes of 20 +/- 10 years' duration and no overt angiopathy; 18 patients (42 +/- 10 years old) participated in a bicycle exercise training program, and 8 patients with type 1 diabetes (33 +/- 11 years old) served as control subjects. Vascular function of conduit arteries was assessed by flow-mediated and endothelium-independent dilation of the brachial artery and of resistance vessels by the response of ocular fundus pulsation amplitudes to intravenous N(G)-monomethyl-L-arginine (L-NMMA) at baseline, after 2 and 4 months of training, and 8 months after cessation of regular exercise. RESULTS-Training increased peak oxygen uptake (VO(2max)) by 13% after 2 months and by 27% after 4 months (P = 0.04). Flow-mediated dilation (FMD) of the brachial artery increased from 6.5 +/- 1.1 to 9.8 +/- 1.1% (P = 0.04) by training. L-NMMA administration decreased fundus pulsation amplitude (FPA) by 9.1 +/- 0.9% before training and by 13.4 +/- 1.5% after 4 months of training (P = 0.02). VO(2max), FMD, and FPA were unchanged in the control group. Vascular effects from training were abrogated 8 months after cessation of exercise. CONCLUSIONS-Our study demonstrates that aerobic exercise training can improve endothelial function in different vascular beds in patients with long-standing type 1 diabetes, who are at considerable risk for diabetic angiopathy. However, the beneficial effect on vascular function is not maintained in the absence of exercise.

Adult↗
PubMed1999

Effect of aging on response to exercise training in humans: skeletal muscle GLUT-4 and insulin sensitivity.

The purpose of this study was to compare the effects of short-term exercise training on insulin-responsive glucose transporter (GLUT-4) concentration and insulin sensitivity in young and older individuals. Young and older women [22.4 +/- 0.8 (SE) yr, n = 9; and 60.9 +/- 1. 0 yr, n = 10] and men (20.9 +/- 0.9, n = 9; 56.5 +/- 1.9 yr, n = 8), respectively, were studied before and after 7 consecutive days of exercise training (1 h/day, approximately 75% maximal oxygen uptake). The older groups had more adipose tissue, increased central adiposity, and a lower maximal oxygen uptake. Despite these differences, increases in whole body insulin action (insulin sensitivity index, determined with an intravenous glucose tolerance test and minimal-model analysis) with training were similar regardless of age, in both the women and men (mean increase of 2.2 +/- 0.3-fold). This was accompanied by similar relative increases in muscle (vastus lateralis) GLUT-4 protein concentration, irrespective of age (mean increase of 3.1 +/- 0.7-fold). Body mass did not change with training in any of the groups. These data suggest that older human skeletal muscle retains the ability to rapidly increase muscle GLUT-4 and improve insulin action with endurance training.

Adolescent↗
PubMed1994

Effects of difference in amount of exercise training on prevention of diabetes mellitus in the Otsuka-Long-Evans-Tokushima fatty rats, a model of spontaneous non-insulin-dependent diabetes mellitus.

Exercise training every day has been shown to be effective in preventing the development of non-insulin-dependent diabetes mellitus (NIDDM) in a model rat (Otsuka Long Evans Tokushima Fatty (OLETF)). For determination of whether less vigorous exercise training also has a protective effect against the development of NIDDM in this model, seven male OLETF rats each were assigned to training every other day, every 3 days and every 7 days from 6 to 30 weeks of age. At 30 weeks of age, rats trained every other day, 3 days, 7 days and sedentary rats weighed averages of 547, 548, 603 and 695 g and had abdominal fat deposits of 28, 24, 32 and 72 g, respectively. The mean meterages of running of rats trained every other day, 3 days and 7 days over the whole experimental period were 9630, 5166 and 1685 m/week, respectively. At 30 weeks of age, the cumulative incidence of NIDDM in sedentary rats was 85.7% (6/7), while none of the trained rats became diabetic except for one of rats trained every 7 days. The glucose infusion rate (GIR), an index of insulin sensitivity, in the group trained every 7 days, 60.6 +/- 5.0 mumol.kg-1.min-1, was significantly greater than that in the sedentary group, 21.7 +/- 1.7 mumol.kg-1.min-1. Morphological studies on the pancreas of rats trained every other day and every 3 days showed minimal changes of islets, whereas sections of islets from rats trained every 7 days appeared enlarged and fibrotic, though significantly less so than the islets of sedentary rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

Effects of diurnal variability and exercise training on properties of large arteries.

OBJECTIVE: To examine the diurnal variability in arterial distensibility and compliance and to study the effects of exercise training on these large artery properties. DESIGN: Vessel wall properties of the elastic common carotid and muscular brachial arteries were measured non-invasively with a vessel wall movement detector system in 12 healthy volunteers. Properties of the common carotid, the femoral and the brachial arteries were studied in 15 sedentary males in comparison with 15 male cyclists. RESULTS: Diurnal changes in the carotid and brachial arteries were similar. Blood pressure decreased at night while arterial diameter increased. Distensibility decreased and compliance was preserved at night. The vessel wall properties of the carotid artery did not differ between the sedentary males and the cyclists, but the femoral and brachial arteries were more elastic in the cyclists. The diameter of the femoral artery was larger in the cyclists. CONCLUSIONS: We found a diurnal pattern in changes in diameter and distensibility of elastic and muscular large arteries. Compliance, the buffering capacity of larger arteries, was preserved at night. The supplying femoral artery was larger and more distensible in cyclists. Exercise training did not affect the elastic carotid artery, but improved vessel wall properties of the brachial, and maybe also of other, muscular large arteries.

Adult↗
PubMed2002

Exercise training attenuates coronary smooth muscle phenotypic modulation and nuclear Ca2+ signaling.

Physical inactivity is an independent risk factor for coronary heart disease, yet the mechanism(s) of exercise-related cardioprotection remains unknown. We tested the hypothesis that coronary smooth muscle after exercise training would have decreased mitogen-induced phenotypic modulation and enhanced regulation of nuclear Ca(2+). Yucatan swine were endurance exercise trained (EX) on a treadmill for 16-20 wk. EX reduced endothelin-1-induced DNA content by 40% compared with sedentary (SED) swine (P < 0.01). EX decreased single cell peak endothelin-1-induced cytosolic Ca(2+) responses compared with SED by 16% and peak nuclear Ca(2+) responses by 33% (P < 0.05), as determined by confocal microscopy. On the basis of these results, we hypothesized that sarco(endo)plasmic reticulum Ca(2+)-ATPase (SERCA) and intracellular Ca(2+) stores in native smooth muscle are spatially localized to dissociate cytosolic Ca(2+) and nuclear Ca(2+). Subcellular localization of SERCA in living and fixed cells revealed a distribution of SERCA near the sarcolemma and on the nuclear envelope. These results show that EX enhances nuclear Ca(2+) regulation, possibly via SERCA, which may be one mechanism by which coronary smooth muscle cells from EX are less responsive to mitogen-induced phenotypic modulation.

Animals↗
PubMed1992

Exercise training improves fat distribution patterns in 60- to 70-year-old men and women.

Changes in body composition and fat distribution in response to endurance exercise training were compared in 47 men and 46 women, aged 60 to 70 yr. Body composition was assessed by hydrodensitometry and fat distribution was evaluated with skinfold thickness and circumference measures. The 9- to 12-mo exercise program consisted primarily of walking and/or jogging for 46 +/- 5 min.d-1, 4.0 +/- 0.6 d.wk-1, at 80 +/- 5% of maximal heart rate. Although men lost more weight during the exercise program than women (men, -3.4 +/- 4.4 kg; women, -1.6 +/- 3.8 kg), relative changes were not significantly different, averaging -3.7 +/- 4.1% and -2.7 +/- 2.9% of body weight in men and women, respectively. The changes in body weight reflected fat loss, as fat-free mass did not change. The reductions in skinfold thickness and circumferences were similar in men and women, and in both groups the largest absolute and relative changes occurred in the truncal area, indicating a preferential loss of fat from the central regions of the body. The results of this study indicate that endurance exercise training can favorably modify the abdominal fat distribution profile that is typical of older men and women in the United States and thus, perhaps, reduce the risk of the diseases associated with abdominal obesity.

Abdomen↗
PubMed2006

Effects of different modes of exercise training on glucose control and risk factors for complications in type 2 diabetic patients: a meta-analysis.

OBJECTIVE: We sought to meta-analyze the effects of different modes of exercise training on measures of glucose control and other risk factors for complications of diabetes. RESEARCH DESIGN AND METHODS: The 27 qualifying studies were controlled trials providing, for each measure, 4-18 estimates for the effect of aerobic training, 2-7 for resistance training, and 1-5 for combined training, with 1,003 type 2 diabetic patients (age 55 +/- 7 years [mean +/- between-study SD]) over 5-104 weeks. The meta-analytic mixed model included main-effect covariates to control for between-study differences in disease severity, sex, total training time, training intensity, and dietary cointervention (13 studies). To interpret magnitudes, effects were standardized after meta-analysis using composite baseline between-subject SD. RESULTS: Differences among the effects of aerobic, resistance, and combined training on HbA(1c) (A1C) were trivial; for training lasting >/=12 weeks, the overall effect was a small beneficial reduction (A1C 0.8 +/- 0.3% [mean +/- 90% confidence limit]). There were generally small to moderate benefits for other measures of glucose control. For other risk factors, there were either small benefits or effects were trivial or unclear, although combined training was generally superior to aerobic and resistance training. Effects of covariates were generally trivial or unclear, but there were small additional benefits of exercise on glucose control with increased disease severity. CONCLUSIONS: All forms of exercise training produce small benefits in the main measure of glucose control: A1C. The effects are similar to those of dietary, drug, and insulin treatments. The clinical importance of combining these treatments needs further research.

Blood Glucose↗
PubMed2005

Evidence of QTLs on chromosomes 13q and 14q for triglycerides before and after 20 weeks of exercise training: the HERITAGE Family Study.

Fasting triglyceride (TG) levels in total plasma and in lipoprotein subfractions were assessed both at baseline and after a 20-week exercise training intervention in 99 White and 101 Black families. A genome-wide multipoint variance component linkage analysis was performed separately by race, using 509 markers. The strongest evidence of linkage was for the TG subfractions of low-density lipoprotein (LDL-TG) and high-density lipoprotein (HDL-TG) rather than for overall levels of TG. For baseline levels, the maximum LOD score was 3.8 on 13q12-q14 with HDL-TG in Whites. Additional linkage evidence was found on 14q31 (LOD=3.2) and 10p14 (LOD=2.9) for baseline LDL-TG in Whites. Suggestive linkage signal at baseline in Whites was detected for HDL-TG (LOD=2.6) on 12q24 and for LDL-TG on 19p13. For training response in Whites, suggestive signal (LOD=2.2) was observed on 13q12-q14 with LDL-TG and for HDL-TG on 10q23. For Blacks, weak signals (LODs<2.0) were found either for baseline and responses to training, perhaps due to small sample sizes that reduced the power of the linkage analysis. These results represent the first report of linkage for the lipoprotein subfractions and for the lipid and lipoprotein responses to exercise training. It is interesting that the strongest signals were found for the LDL-TG and HDL-TG subfractions, given their particular relationships with the atherogenic lipid profile including dense LDL and HDL particles.

Adolescent↗
PubMed2003

Adjunctive effects of exercise training in heart failure patients receiving maximum pharmacologic therapy.

The purpose of this pilot study was to test the adjunctive effects of a 12-week exercise training intervention vs. standard pharmacologic therapy on quality of life, functional status, and mood in heart failure patients. A randomized, two-group repeated measures design was used to test outcomes at baseline and 12 weeks in 23 subjects (ejection fraction <or=40%, standard pharmacologic therapy [diuretics, angiotensin-converting enzyme inhibitors, b blockers, and digoxin] and no change in medical therapy for 30 days). The exercise group had significantly higher adjusted means on the role physical, role emotional, and mental functioning subscales of the Medical Outcomes Study 36-item Short-Form Health Survey compared with the control group. Confusion/bewilderment (Profile of Mood States subscale) adjusted mean scores were significantly lower for the exercise group, indicating better mood compared with the control group. Exercise training provided adjunctive benefit in terms of role and mental functioning for these heart failure patients.

Aged↗
PubMed1999

Randomized, controlled trial of long-term moderate exercise training in chronic heart failure: effects on functional capacity, quality of life, and clinical outcome.

BACKGROUND: It is still a matter of debate whether exercise training (ET) is a beneficial treatment in chronic heart failure (CHF). METHODS AND RESULTS: To determine whether long-term moderate ET improves functional capacity and quality of life in patients with CHF and whether these effects translate into a favorable outcome, 110 patients with stable CHF were initially recruited, and 99 (59+/-14 years of age; 88 men and 11 women) were randomized into 2 groups. One group (group T, n=50) underwent ET at 60% of peak &f1;O2, initially 3 times a week for 8 weeks, then twice a week for 1 year. Another group (group NT, n=49) did not exercise. At baseline and at months 2 and 14, all patients underwent a cardiopulmonary exercise test, while 74 patients (37 in group T and 37 in group NT) with ischemic heart disease underwent myocardial scintigraphy. Quality of life was assessed by questionnaire. Ninety-four patients completed the protocol (48 in group T and 46 in group NT). Changes were observed only in patients in group T. Both peak &f1;O2 and thallium activity score improved at 2 months (18% and 24%, respectively; P<0. 001 for both) and did not change further after 1 year. Quality of life also improved and paralleled peak VO2. Exercise training was associated both with lower mortality (n=9 versus n=20 for those with training versus those without; relative risk (RR)=0.37; 95% CI, 0.17 to 0.84; P=0.01) and hospital readmission for heart failure (5 versus 14; RR=0.29; 95% CI, 0.11 to 0.88; P=0.02). Independent predictors of events were ventilatory threshold at baseline (beta-coefficient=0.378) and posttraining thallium activity score (beta-coefficient -0.165). CONCLUSIONS: Long-term moderate ET determines a sustained improvement in functional capacity and quality of life in patients with CHF. This benefit seems to translate into a favorable outcome.

Aged↗
PubMed2000

Transient enhancement of GLUT-4 levels in rat epitrochlearis muscle after exercise training.

The purpose of the present study was to examine the effect of detraining on the glucose transport system after short-term swim training (5 days), long-term swim training (5 wk), and treadmill run training (5 wk). Skeletal muscles were isolated from female Wistar rats at 24 or 48 h posttraining. SST produces a 48% increase in GLUT-4 mRNA, a 30% increase in GLUT-4 protein, and a 60% increase in insulin-stimulated glucose transport activity at 24 h posttraining but not at 48 h posttraining. Similar to SST, long-term swim training produces a 60% increase in GLUT-4 mRNA and a 30% increase in GLUT-4 protein content at 24 h posttraining but not at 48 h posttraining. Finally, treadmill run training produces a transient 35% increase in GLUT-4 protein content that is completely reversed at 48 h after the last bout of exercise. These results demonstrate that the increase in GLUT-4 mRNA and GLUT-4 protein occurs during the first week of exercise training and is rapidly lost after training cessation. We believe that the transient enhancement in GLUT-4 protein after exercise training is due to a short GLUT-4 half-life, a process that is primarily regulated by pretranslational mechanisms.

Animals↗
PubMed1989

Effect of swim exercise training on human muscle fiber function.

This study examined the effect of a typical collegiate swim-training program and an intensified 10-day training period on the peak tension (Po), negative log molar Ca2+ concentration (pCa)-force, and maximal shortening speed (Vmax) of the slow-twitch type I and fast-twitch type II fibers of the deltoid muscle. Over a 10-wk period, the swimmers averaged 4,266 +/- 264 m/day swimming intermittent bouts of front crawl, kicking, or pulling. The training program induced an almost twofold increase in the mitochondrial marker enzyme citrate synthase. Po of the single fibers was not altered by either the training or 10-day intensive training programs, and no significant differences were observed in the Po (kg/cm2) of type I compared with the type II fibers. The type II fiber diameters were significantly larger than the type I fibers (94 +/- 4 vs. 80 +/- 2 microns), and although fiber diameters were unaffected by the training, the 10-day intensive training significantly reduced the type II fiber diameter. The type I fibers from the trained swimmers showed pCa-force curves shifted to the right such that higher free Ca2+ levels were required to elicit a given percent of Po (for values less than 0.5 Po). The activation threshold (pCa) for the onset of tension and the pCa required to elicit one-half maximal tension were not altered by the training in either fiber type. Fiber Vmax (measured by the slack test) was fivefold higher in type II compared with type I fibers (4.85 +/- 0.50 vs. 0.86 +/- 0.04 fiber lengths/s). The exercise-training program significantly increased and decreased the Vmax of the slow and fast fibers, respectively. The 10 days of intensified training produced a further significant decrease in the Vmax of the type II fibers. After a period of detraining, the Vmax of both fiber types returned to the control level. The force-velocity relation was not significantly altered in either fiber type by the swim training; however, the intensified training significantly depressed the velocity of the type II fiber at all loads studied. The Vmax changes with exercise training are likely explained by an exercise-induced expression of fast myosin in slow fibers and slow myosin in fast fibers.

Adult↗
PubMed1994

Lipoprotein response to exercise training and a low-fat diet in older subjects with glucose intolerance.

The purpose of this study was to determine the effect of aerobic exercise training (Ex), a low-fat diet (LF, 19% fat), or combined interventions (LF-Ex) on lipoprotein cholesterol (LDL, HDL, and VLDL) and triglyceride (TG) concentrations in glucose-intolerant subjects while their weight was maintained. Baseline dietary fat and carbohydrate composition, body composition, body mass index, age, and lipoprotein cholesterol were not different among groups. Aerobic capacity increased in both exercise groups (P < 0.01) and remained unchanged in the LF group. Body composition was unaltered and change in body weight (kg) was small: Ex, -0.8 +/- 0.4, (P < 0.05); LF, +0.4 +/- 0.4; (NS); LF-Ex, -1.4 +/- 0.4 (P < 0.01). Exercise alone did not significantly affect lipoprotein cholesterol or TG concentrations. In LF and LF-Ex, respectively, decreases (P < 0.02) in total cholesterol (-0.66 +/- 0.24 and -0.42 +/- 0.21 mmol/L), HDL (-0.14 +/- 0.07 and -0.26 +/- 0.04), and LDL (-0.60 +/- 0.25 and -0.23 +/- 0.13) were seen after 12 wk, whereas VLDL and TG remained unchanged. Our data indicate that beneficial effects of exercise training on lipid indexes are not observed in subjects with impaired glucose tolerance on either an average US diet or a low-fat diet if substantial changes in weight or body composition do not occur.

Aged↗
PubMed1997

Attenuation of unfavorable remodeling by exercise training in postinfarction patients with left ventricular dysfunction: results of the Exercise in Left Ventricular Dysfunction (ELVD) trial.

BACKGROUND: Exercise is currently recommended for patients after myocardial infarction; however, the effects of regular exercise on the remodeling process remain to be defined. The aim of this multicenter, randomized study was to investigate whether a long-term physical training program influences left ventricular size and function in postinfarction patients with systolic dysfunction. METHODS AND RESULTS: Consecutive patients with <40% ejection fraction after a first Q-wave myocardial infarction were randomly assigned to a 6-month exercise training program (n=39) or control group (n=38). After 6 months, a significant increase in work capacity was observed only in the training group (from 4.462+/-1.095 to 5.752+/-1.749 kilopond-meters [Kp-m], P<.01), not in the control group (from 4.375+/-1.143 to 4.388+/-1.199 Kp-m), whereas left ventricular volumes had increased in the control group (end-diastolic volume, from 94+/-26 to 99+/-27 mL/m2, P<.01; end-systolic volume, from 62+/-20 to 67+/-23 mL/m2, P<.01) but not in the training group (end-diastolic volume, from 93+/-28 to 92+/-28 mL/m2, P=NS; end-systolic volume, from 61+/-22 to 57+/-23 mL/m2, P=NS). Conversely, ejection fraction had improved in the training group (from 34+/-5% to 38+/-8%, P<.01) but not in the control group (from 34+/-5% to 33+/-7%, P=NS). CONCLUSIONS: In postinfarction patients with systolic dysfunction, long-term exercise training may attenuate the unfavorable remodeling response and even improve ventricular function over time.

Adult↗