Physical Training in the Management of Coronary Artery Disease

The effects of 4 to 6 weeks' physical conditioning on the cardiovascular and respiratory response to exercise were studied in nine patients with coronary artery disease. Clinical improvement and increased physical working capacity were observed in all patients. The average cardiac output during exercise was unchanged. The stroke volume increased and the myocardial work, assessed by the tension-time index, decreased during exercise at a given work load. It is suggested that at submaximal work loads a reduction of the blood flow to the working muscles occurs after training. Such change might be fundamental for the altered circulatory regulation by allowing a reduced general sympathetic vasoconstriction during exercise. It is concluded that the hemodynamic changes form a rational physiologic basis for the use of physical training in the management of patients with coronary artery disease.