Study Design and Population
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 Sao Paulo Medical School (InCor/HCFMUSP), who agreed to participate in the study, were randomized to 2 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 1 month after AMI and were submitted to a 2D-STE echocardiogram and cardiopulmonary exercising testing (CPX). After this, participants randomized to the TRAINING group were included in a weekly supervised physical training program, twice a week, for 4 months, at the Rehabilitation Lab, while individuals randomized to the CONTROL group received usual recommendations for physical activity at home. Time 2 : at the end of the fourth month (5th month after the AMI event), all patients repeated 2D-STE echo and CPX. This design is provided in the Supplementary Data I.
Inclusion criteria were: age over 18; hospitalization for spontaneous AMI with or without ST-segment elevation, established according to the 3rd Universal Definition of AMI26; clinically and hemodynamically stable; left ventricular ejection fraction (LVEF) ≥ 0.45 and Killip classes I or II. The exclusion criteria were: any condition that contraindicated physical activity; regular physical activity practitioners prior to the event; LV systolic dysfunction (LVEF < 45%); Killip classes III or IV; irregular heart rhythm; cardiac pacemaker; chronic kidney disease characterized by creatinine clearance < 30 ml/min/m2; limited echocardiographic window for analysis.
The present protocol was in accordance with the recommendations contained in the Declaration of Helsinki and was approved by the institutional Scientific and Ethics committees. All the patients signed the informed consent form before inclusion in this protocol.