Effect of Exercise Training on Left Ventricular Function in Patients Post Myocardial Infarction

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

26 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-02-28

Study Completion Date

2018-10-16

Brief Summary

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Patients who have suffered a heart attack are at risk of developing worsening heart function and heart failure. Exercise training has a beneficial effect on heart function and prevents heart failure. The aim of the current study is to investigate the effect of exercise training on heart function in patients who have suffered a heart attack.

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Detailed Description

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Patients who have suffered a myocardial infarction are at significant risk for developing heart failure and progressive left ventricular dysfunction One of the proposed mechanisms responsible for this observation is reduction in myocardial beta-adrenergic receptor density due to elevated cell membrane protein G - protein coupled receptor kinase -2 (GRK2).

It is known that exercise training preserves heart function in patients who have suffered a myocardial infarction. The mechanism for this is not clear.

The purpose of this study is to examine the effect of exercise training on myocardial function and GRK2 levels in patients who have suffered a myocardial infarction, with the hypothesis that exercise training in this population reduces GRK2 levels and preserves or improves myocardial function.

Conditions

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Myocardial Infarction Heart Failure Coronary Artery Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Exercise training

Secondary prevention and cardiac rehabilitation clinic of the Montreal Heart Institute. Subjects will undergo twice weekly exercise training with high intensity interval training for a period of 12 weeks.

Group Type EXPERIMENTAL

Secondary prevention and cardiac rehabilitation clinic

Intervention Type OTHER

Secondary prevention and cardiac rehabilitation clinic of the Montreal Heart Institute. Subjects will undergo twice weekly exercise training with high intensity interval training for a period of 12 weeks.

control

Individuals in this group are offered current ACC/AHA recommendations on physical activity in patients post-myocardial infarction.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Secondary prevention and cardiac rehabilitation clinic

Secondary prevention and cardiac rehabilitation clinic of the Montreal Heart Institute. Subjects will undergo twice weekly exercise training with high intensity interval training for a period of 12 weeks.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Acute myocardial infarction
* Complete revascularization: no residual major epicardial coronary artery coronary stenosis ≥ 70%; no residual left main coronary stenosis ≥ 40%.
* Stage A-C heart failure, New York Heart Association class I-III.
* Stable dose of medications during the 4 weeks prior to enrolment.
* Able to perform a maximal cardiopulmonary stress test.
* Capacity and willingness to provide sign informed consent.

Exclusion Criteria

* Pregnant
* Coronary artery bypass surgery: patients post coronary artery bypass graft exhibit wall motion abnormalities that may interfere with speckle tracking analysis.
* Incomplete revascularization with major epicardial coronary artery (left anterior descending, circumflex, or right coronary) stenosis ≥ 70%.
* Myocardial necrosis in the absence of significant flow limiting coronary artery stenosis or thrombosis, with the exception of documented STEMI and successful thrombolytic therapy resulting on no significant residual epicardial coronary artery stenosis.
* Significant valvular disease that is greater than moderate in severity
* History of non-ischemic cardiomyopathy (dilated, restrictive, infiltrative cardiomyopathy, hypertrophic, LV non compaction, or Takotsubo cardiomyopathy)
* Significant resting ECG abnormalities that preclude accurate speckle tracking.
* Paced rhythm.
* left bundle branch block
* Atrial arrhythmias (ex. persistent/permanent atrial fibrillation, atrial flutter).
* Frequent ventricular ectopics
* Significant ventricular arrhythmias (non-sustained ventricular tachycardia or syncope).
* New York Heart Association class IIIb - IV symptoms.
* Severe LV systolic dysfunction (Ejection fraction ≤ 30%)
* Active decompensated heart failure with orthopnea or paroxysmal nocturnal dyspnea.
* Uncontrolled resting arterial hypertension \> 180/110 mmHg.
* More than moderate systemic disease
* Chronic inflammation or infection.
* Any contraindication to exercise training or any condition limiting ability to partake in adequate exercise stress testing or training (peripheral artery disease, articular, neurologic, or psychiatric pathology)

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No