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Comparaison de deux modalités d'entrainement à l'effort sur la fonction régionale gauche myocardique après un infarctus du myocarde évaluée par échographie 2D strain - STRAICT - résultats intermédiaires d'une étude bicentrique randomisée contrôlée
Mémoire de Master / Thèse d'exercice

Comparaison de deux modalités d'entrainement à l'effort sur la fonction régionale gauche myocardique après un infarctus du myocarde évaluée par échographie 2D strain - STRAICT - résultats intermédiaires d'une étude bicentrique randomisée contrôlée

Cédric Mazeau
Masters , Université de Montpellier
07/12/2021

Résumé

Longitudinal global strain Acute myocardial infarction Moderate continuous training Rééducation cardio-vasculaire Strain global longitudinal Réentrainement intermittent Réentrainement continu Infarctus du myocarde Cardiac Rehabilitation High-Intensity Interval Training
Background: exercise-based cardiac rehabilitation (CR) is an effective strategy to reduce all-cause and cardiovascular mortality following acute myocardial infarction (AMI). However, the best training plan to improve longitudinal global strain and functional capacities remains controversial.Objective: to compare the effect of interval training (IT) and moderate continuous training (MCT) on the improvement of the global longitudinal strain (GLS) in AMI patients.Methods: the STRAICT study is a bicentric, prospective, randomized, simple blinded trial. AMI patients with LVEF >45% were eligible and included within the 6 weeks following AMI. They were randomized between an IT or MCT plan during an 8-week CR program. Cardiopulmonary exercise test and transthoracic echocardiography 2D strain were performed at baseline and after training plan. All echocardiographies were reviewed by an independent operator, blinded to the group. The primary outcome was the GLS. Secondary outcomes were others echocardiographic parameters, aerobic exercise test and quality of life questionnaires.Results: from January 2020 to May 2021, 43 patients were included, 35 patients (16 in MCT group and 19 in IT group) were analyzed. Patients were aged of 57 years on average and had an LVEF of 62.77% on average. There was no significant difference between the variation of GLS and the training plan after CR: -18.34% to -19.52% in MCT group and -17.40% to -18.29% in IT group, p=0.70). There was no significant difference between the aerobic exercise test parameters and the training group, particularly regarding to the VO2peak (20.28 to 24.17 mL/Kg/min in MCT group, 19.92 to 22.21 mL/Kg/min in IT group, p=0.15).Conclusion: there was no significant difference to the improvement of the GLS according to the type of CR program performed by patients.

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