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THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
Rivista di Medicina Nucleare e Imaging Molecolare
A Journal on Nuclear Medicine and Molecular Imaging
Affiliated to the and to the International Research Group of Immunoscintigraphy
Indexed/Abstracted in: Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index (SciSearch), Scopus
Impact Factor 2,413
The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2017 Mar 16
Copyright © 2017 EDIZIONI MINERVA MEDICA
Physical training improves myocardial perfusion but not left ventricular function response to exercise in patients with microvascular angina
Eduardo E. CARVALHO, Júlio C. CRESCÊNCIO, Giovani L. SANTI, Luciano F. OLIVEIRA, Pedro V. SCHWARTZMANN, Lourenço GALLO Jr., José A. MARIN-NETO, Marcus V. SIMÕES ✉
Medical School of Ribeirão Preto, University of São Paulo, Internal Medicine Department, São Paulo, Brazil
BACKGROUND: Patients with primary microvascular angina (PMA) commonly exhibit abnormal left ventricular function (LVF) during exercise, potentially owing to myocardial ischemia. Herein, we investigated n PMA patients the effect of the reduction of myocardial perfusion disorders, by using aerobic physical training, upon LVF response to exercise.
METHODS: Overall, 15 patients (mean age, 53.7±8.9 years) with PMA and 15 healthy controls (mean age, 51.0±9.4 years) were studied. All subjects were subjected to baseline resting and exercise ventriculography, myocardial perfusion scintigraphy (MPS), and cardiopulmonary testing. PMA group members then participated in a 4-month physical training program and were reevaluated via the same methods applied at baseline.
RESULTS: Baseline left ventricular ejection fraction (LVEF) determinations by ventriculography were similar for both groups (PMA, 67.7±10.2%; controls, 66.5±5.4%; p=0.67). However, a significant rise in LVEF seen in control subjects during exercise (75.3±6.2%; p=0.0001) did not materialize during peak exercise in patients with PMA (67.7±10.2%; p=0.47). Of the 12 patients in the PMA group who completed the training program, 10 showed a significant reduction in reversible perfusion defects during MPS. Nevertheless, LVEF at rest (63.5±8.7%) and at peak exercise (67.3±15.9%) did not differ significantly (p=0.30) in this subset.
CONCLUSIONS: In patients with PMA, reduced left ventricular inotropic reserve observed during exercise did not normalize after improving myocardial perfusion through aerobic physical training.
KEY WORDS: Primary microvascular angina - Ventricular systolic dysfunction - Reversible perfusion defect - Physical training