Long-term effects of physical training on coronary patients with impaired ventricular function.

Eighteen patients with coronary heart disease and an ejection fraction of 0.40 or less were entered into an individualized exercise training program. Maximal symptom-limited exercise stress test and cardiac catheterization studies were performed initially and 12--42 months (average 18.5 months) after exercise training. At the time of the follow-up study, the mean functional aerobic impairment (FAI) improved from 32.1 to 23.4% (p less than or equal to 0.01); resting and submaximal heart rates were significantly lower (p less than 0.01 and 0.05, respectively). There was no significant change in the pulmonary artery or left ventricular end-diastolic pressure, cardiac index, stroke index, left ventricular end-diastolic volume or ejection fraction. Exercise training, therefore, can be beneficial even for patients with impaired ventricular function. Increase in physical work capacity was not correlated with improvement of ventricular function; on the other hand, exercise training did not cause deterioration of ventricular function.