Study design and population
CORONARY DISEASE, EVENT, RESPIRATORY COMPENSATION, AMI, HEART
This was a prospective, longitudinal, randomized and controlled study. Patients with uncomplicated AMI admitted to the Acute Coronary Disease Unit of the Heart Institute of the University of Sao Paulo Medical School (InCor/HCFMUSP), who agreed to participate in the study, were randomized to two groups (TRAINING and CONTROL), in the proportion 1:1 according to the following protocol: Time 0: still hospitalized, all patients, after due explanations, signed the informed consent for inclusion in the study. Time 1: all participants returned one month after AMI and were submitted to an echocardiogram and cardiopulmonary exercising testing (CPX). After this, participants randomized to the TRAINING group were included in a supervised physical training program, twice a week, for four months, at the Rehabilitation Lab, while individuals randomized to the CONTROL group received usual recommendations for physical activity at home. Briefly, patients were instructed to engage in aerobic exercises of low-to-moderate intensity, with a minimum duration of 30 minutes, at least three times a week in the first two months. In the third month, they were instructed to increase the intensity to a moderate level 3-5 times a week, 30 to 60 minutes. No specific monitoring was carried out. Supervised training program consisted of two 60-minute exercise sessions per week. Each exercise session consisted of 5 minutes of stretching exercises, 40 minutes of cycling on a stationary bicycle, 10 minutes of local strengthening exercises, and five minutes of cool down with stretching exercises. The exercise intensity was established by heart rate levels that corresponded to the anaerobic threshold and respiratory compensation point. Time 2: at the end of the fourth month (fifth month after the AMI event), all patients repeated the echocardiogram and CPX (Inclusion criteria were: age over 18; hospitalization for spontaneous AMI with or without ST-segment elevation, established according to the 3The present study was conducted in accordance with the Declaration of Helsinki and was approved by the institutional ethics and scientific committees. All the patients signed the informed consent form before inclusion in the study.