[Rehabilitative intervention after a myocardial infarct]

The purpose of the present review was to determine whether exercise training improves cardiac function in patients with prior myocardial infarction. Home exercise programs for patients with myocardial infarction effectively improve their ability to exercise as well as quality of life. A computer-based, automated, telemetry system comprising central and peripheral computers and telephone line was developed. Myocardial infarction patients were evaluated for peak oxygen uptake and anaerobic threshold. Some studies have in fact suggested that using echocardiography, exercise training in patients with reduced left ventricular function after a myocardial infarction leads to further myocardial damage, including wall thinning, infarct and expansion. A more recent analysis by these investigators suggested that training actually has a beneficial effect on the remodeling process. Many factors appear to influence the extent of the remodeling process, including attenuation by Ace inhibition therapy, extent and site of the infarction, hypertension and continued ischemia. Some results suggest early physical training may be safe and improve the autonomic nerve balance and exercise tolerance in patients with acute myocardial infarction.