that, in addition to an improvement in functional capacity, LV volumes would be reduced and LVEF increased. The primary findings were an improvement in exercise capacity and a reduction in LV volumes in response to CR exercise training. Given the association between reduced LV volumes and improved clinical outcome,6 albeit in patients with more severe LV systolic dysfunction, these data provide additional evidence for the use of CR exercise training in post-MI patients with preserved LVEF. Reverse volumetric remodeling with CR exercise training In patients with significant LV systolic dysfunction, reductions in LV volumes are associated with improved survival.16 While data confirming this relation are primarily derived from pharmacological trials, CR exercise training has also been consistently shown to reduce cardiovascular and all-cause mortality in patients with MI.23 The mechanisms responsible for this remain to be fully elucidated, but are likely to include both structural and functional cardiac remodeling. The reduction in LV volumes observed in the current study confirm findings from a recent meta-analysis which a positive effect of exercise training on LV volumes in post-MI patients with impaired LVEF.8 Unique to the current study is evidence of reverse LV remodeling in post-MI patients with preserved LVEF (>45%). In this population, where LV volumes were within normal limits, the significance of medically mediated or exercise-induced reverse LV remodeling is yet to be fully evaluated. However, it is possible that improved prognosis as a result of reduced LV volumes may not be exclusive to those with pronounced LV systolic dysfunction, rather, it may also extend to less compromised patients. Abnormal hemodynamics following MI are a product of the
that, in addition to an improvement in functional capacity, LV volumes would be reduced and LVEF increased. The primary findings were an improvement in exercise capacity and a reduction in LV volumes in response to CR exercise training. Given the association between reduced LV volumes and improved clinical outcome,6 albeit in patients with more severe LV systolic dysfunction, these data provide additional evidence for the use of CR exercise training in post-MI patients with preserved LVEF. Reverse volumetric remodeling with CR exercise training In patients with significant LV systolic dysfunction, reductions in LV volumes are associated with improved survival.16 While data confirming this relation are primarily derived from pharmacological trials, CR exercise training has also been consistently shown to reduce cardiovascular and all-cause mortality in patients with MI.23 The mechanisms responsible for this remain to be fully elucidated, but are likely to include both structural and functional cardiac remodeling. The reduction in LV volumes observed in the current study confirm findings from a recent meta-analysis which a positive effect of exercise training on LV volumes in post-MI patients with impaired LVEF.8 Unique to the current study is evidence of reverse LV remodeling in post-MI patients with preserved LVEF (>45%). In this population, where LV volumes were within normal limits, the significance of medically mediated or exercise-induced reverse LV remodeling is yet to be fully evaluated. However, it is possible that improved prognosis as a result of reduced LV volumes may not be exclusive to those with pronounced LV systolic dysfunction, rather, it may also extend to less compromised patients. Abnormal hemodynamics following MI are a product of the