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To the Editor: Recently, Giannuzzi et al1 eloquently described the beneficial effect of long-term exercise training on left ventricular remodeling in postinfarction patients. An earlier report from Coats et al2 demonstrated that training can improve autonomic function (mainly in terms of RR variability and norepinephrine spillover) in patients with chronic heart failure but failed to show significant changes in resting catecholamine levels after a short-term exercise program.In an attempt to explain their findings, Giannuzzi et al used a series of reports describing the reduction of catecholamine levels by exercise training in subjects with normal left ventricular function3 4 and speculated that this effect exists in patients with left ventricular dysfunction as well. However, …

Attenuation of Unfavorable Sympathetic Hyperactivity Induced by Long-Term Physical Training in Postinfarction Patients: Fact or Speculation?