Advertisement

Planning of Comprehensive Rehabilitation on the Basis of Exercise Testing After Myocardial Infarction

  • E. Kentala
Part of the Ettore Majorana International Science Series book series (EMISS, volume 4)

Abstract

The range of physical working capacity (PWC) after myocardial infarction is wide (Fig.1) (9), and therefore, exercise testing is essential for realistic rehabilitation plans. Physical training has been one promising method of improving PWC when there is a gap between physical fitness and the demands of the work. In two controlled Finnish studies, however, intervention with physical training alone did not induce any significant improvement in return to work, or in mortality. In our feasibility study with consecutive postinfarction men (Fig.l) (9) the effect of one year’s physical activity programme was not very protracted (Fig. 2). Mortality was similar and return to work tended to be better in the reference group (Fig. 3) when the basic treatment, including exercise tests and follow-up examinations, was the same in both groups. So, psychosocial and local factors seems to be much more important in return to work than physical fitness. In similar Finnish study on physical training, results regarding return to work and mortality were the same, although there was a slight trend towards lower mortality in the training group (17).

Keywords

Sudden Death Physical Training Multivessel Disease Coronary Artery Spasm Physical Working Capacity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    The Anturane reinfarction trial research group: Sulfinpyrazone in the prevention of cardiac death after myocardial infarction N. Engl. J. Med. 298:289 (1978).CrossRefGoogle Scholar
  2. 2.
    R. J. Barnard, R. Mac Alpin, A. A. Kattus, G. D. Buckberg, Effect of training on myocardial oxygen supply/demand balance. Circ. 56:281 (1977).Google Scholar
  3. 3.
    E. Braunwald, Coronary spasm and acute myocardial infarction -new possibility for treatment and prevention. N. Engl. J. Med. 299:1301 (1978).PubMedCrossRefGoogle Scholar
  4. 4.
    M. J. Burgess, Relation of ventricular repolarization to electrocardiographic T wave-form and arrhythmia vulnerability. AM. J. Physiol. 236:H391 (1979).PubMedGoogle Scholar
  5. 5.
    R. J. Ferguson, P. Côté, P. Gauthier, M. G. Bourassa, Changes in exercise coronary sinus blood flow with training in patients with angina pectoris, Circ. 58:41 (1978).Google Scholar
  6. 6.
    L. D. Hillis, E. Braunwald, Coronary artery spasm, N. Engl. J. Med. 299:695 (1978).PubMedCrossRefGoogle Scholar
  7. 7.
    V. Kallio, H. Hämäläinen, J. Hakkila, O. Luurila, Reduction of sudden deaths after a multifactorial intervention programme in patients after acute myocardial infarction. To be published.Google Scholar
  8. 8.
    K. M. Kent, T. Cooper, The denervated heart. A model for studying autonomic control of the heart, N. Engl. J. Med. 291:1017 (1974).PubMedCrossRefGoogle Scholar
  9. 9.
    E. Kentala, Physical fitness and feasibility of physical rehabilitation after myocardial infarction in men of working age, Ann Clin. Res. 4, Suppl. 9 (1972).Google Scholar
  10. 10.
    E. Kentala, Discrimination between subsequent sudden and non-sudden death by postinfarction exercise testing. Scand. J. Rehab. Med. 8:73 (1976).Google Scholar
  11. 11.
    E. Kentala, U.K. Repo, QT-interval prolongation during somatomotor activation as predictor of sudden death after myocardial infarction, Ann Clin. Res. 11:42 (1979).PubMedGoogle Scholar
  12. 12.
    E. Kentala, U. K. Repo, Low exercise R wave amplitude after myocardial infarction predicting subsequent non-sudden death, to be published.Google Scholar
  13. 13.
    E. Kentala, S. Sarna, Sudden death and factors related to long-term prognosis following acute myocardial infarction, Scand. J, Rehab. Med. 8:27 (1976).Google Scholar
  14. 14.
    B. Letac, A. Cribbier, J. F. Desplanches, A study of left ventricular function in coronary patients before and after physical training, Circ. 56:375 (1977).Google Scholar
  15. 15.
    J. Mehta, P. Mehta, C. J. Pepine, Platelet aggregation in aortic and coronary venous blood in patients with and without coronary disease, 3. Role of tachycardia stress and propranolol, Circ. 58:881 (1978).Google Scholar
  16. 16.
    A. J. Nolewajka, W. J. Kostuk. P. A. Rechnitzer, D. A. Cunningham, Exercise and human collateralization: An angiographic and scintigroaphic assessment, Circ. 60:114 (1979).Google Scholar
  17. 17.
    I. Palatsi, Feasibility of physical training after myocardial infarction and its effect on return to work, morbidity and mortality, Acta Med. Scand. Suppl. 599, (1976).Google Scholar
  18. 18.
    D. R. Ricci, A. E. Orlick, R. P. Cipriano, D.F. Guthaner, D.C. Harrison, Altered adrenergic activity in coronary arterial spasm, Insight into mechanism based on study of coronary hemodynamics and the electrocardiogram, Am. J. Cardiol. 43:1073 (1979).PubMedCrossRefGoogle Scholar
  19. 19.
    D. A. Weiner, C. McCabe, M. D. Klein, T. J. Ryan, ST segment changes post-infarction: Predictive value for multivessel coronary disease and left ventricular aneurysm, Circ. 58:887(1978).Google Scholar
  20. 20.
    C. Wilhelmsson, A. Vedin, L. Wilhelmsen, G. Tibblin, L. Werkö: Reduction of sudden deaths after myocardial infarction by treatment with alprenolol, Lancet 2:1157 (1974).PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1980

Authors and Affiliations

  • E. Kentala
    • 1
  1. 1.Kiljava HospitalFinland

Personalised recommendations