Predictors of Left Ventricular Remodeling in Patients With Acute Myocardial Infarction Participating in Cardiac Rehabilitation-Brain Natriuretic Peptide and Anterior Infarction-

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  • Brain Natriuretic Peptide and Anterior Infarction

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Background This study was designed to determine the factors influencing the development of left ventricular (LV) remodeling in patients participating in a comprehensive cardiac rehabilitation (CR) program after acute myocardial infarction (AMI), with special reference to exercise intensity and frequency. Methods and Results A total of 72 patients with AMI participated in CR consisting of exercise training of moderate intensity (heart rate reserve 40-60%) and education for 12 weeks. Plasma concentration of brain natriuretic peptide (BNP) was measured at the beginning and the end of CR. Echocardiography was performed before and 1 year after CR. An increase in LV end-diastolic dimension (delta-LVDd) from baseline was used as an index of remodeling. Delta-LVDd was significantly greater in patients with an anterior AMI than with other infarct locations (p<0.05) and correlated significantly with baseline BNP concentration (p<0.05). Delta-LVDd >5 mm occurred exclusively in patients with baseline BNP >150 pg/ml. Variables representing the intensity and frequency of exercise training did not correlate with delta-LVDd. Conclusion In patients with AMI participating in CR, those having both anterior infarction and baseline BNP concentration >150 pg/ml are at high risk for subsequent LV remodeling, whereas neither exercise intensity nor participation frequency in CR appears to be associated with LV remodeling. (Circ J 2004; 68: 214 - 219)<br>

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  • Circulation Journal

    Circulation Journal 68 (3), 214-219, 2004

    一般社団法人 日本循環器学会

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