PHYSICAL CONDITIONING AFTER ACUTE MYOCARDIAL-INFARCTION IN ELDERLY

Exercise and activity intolerance art the most frequent and debilitating symptoms in patients with moderate and severe heart failure (CHF) after acute myocardial infarction (AMI) also in elderly. Paradoxically, the severity of these symptoms correlates poorly with cardiac function such as hemodynamic measurements. These disorders have focused attention on pathophysiological changes in the periphery to explain the mechanism of impaired exercise capacity. Systemic vasoconstriction is a hallmark in CHF and due to several compensatory mechanisms such as neural, humoral and local vascular factors. Exercise training can improve the ability of the peripheral vessels to dilate and the peripheral oxygen extraction in the face of increased oxidative capacity. Studies in elderly with CHF after AMT indicate that ambulatory exercise training is effective and safe. In addition, these results can be stabilized over a period of one year in patients with pharmacological therapies (captopril and isosorbide dinitrate, ISDN) and exercise training. Up to three years, the peak VO2 and exercise capacity were increased.