Ninety-nine patients with documented myocardial infarction (MI) were randomly assigned either to a training group (n = 53) or to a control group (n = 46) at an average of 6.5 weeks after their MI. The training group was further divided into an anterior-wall infarct group (AWI) or a inferior-wall infarct group (IWI). During a four-week program, the training group underwent two daily 30-minute physical training sessions consisting of calisthenics, cycling, and walking/jogging. Ejection fraction (EF) at rest and during exercise was measured by radionuclide ventriculography. The results indicate that a four-week training program significantly improved the physical working capacity of the training group, but had no apparent effect on their resting EF values. However, there was a significant improvement in their submaximal exercise EF when it was adjusted for the resting value (deltaEF). There were no significant changes in the rate-pressure product in either the training group or the control group. When patients were classified on the basis of the location of their infarct, AWI patients showed significantly lower resting and exercise EF values than did IWI patients prior to the training program. Patients with IWI who trained, improved significantly after the training program. Both AWI and IWI patients showed improvements in EF during exercise when this variable was adjusted for resting values; there were no statistically significant between-group differences in improvement.
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