Rationale of exercise therapy in patients with angina pectoris with normal and impaired ventricular function

The implementation of comprehensive coronary care (CCC), including multiple measures involving physical, psychologic, and pharmacologic procedures, together with a new concept of pharmacologic and surgical revascularization, have caused a remarkable improvement in the treatment of coronary patients with angina pectoris. The role of physical training per se is one measure of CCC and one must observe the fact that a single factor cannot be expected to influence a multifactorial disease. The irrefutable evidence that shows that physical training has an effect on longevity is lacking. On the other hand, a number of important physiologic and psychologic benefits have been found to be accompanying a prolonged physical training program in coronary patients suffering from angina pectoris before or after coronary artery bypass graft (CABG). The effect of training is an improvement of cardiocirculatory performance for given work tasks. This includes a decrease of heart rate, systolic blood pressure, the rate-pressure product, an increase of stroke volume, overall physical work performance, oxygen pulse, and in some instances, the rise of the angina pectoris threshold heart rate and threshold rate-pressure product in patients with angina pectoris.