RT Journal Article SR Electronic T1 Exercise Training in Chronic Heart Failure: Beneficial Effects on Cardiac 11C-Hydroxyephedrine PET, Autonomic Nervous Control, and Ventricular Repolarization JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 773 OP 779 VO 43 IS 6 A1 Mikko Pietilä A1 Kimmo Malminiemi A1 Risto Vesalainen A1 Tuomas Jartti A1 Mika Teräs A1 Kjell Någren A1 Pertti Lehikoinen A1 Liisa-Maria Voipio-Pulkki YR 2002 UL http://jnm.snmjournals.org/content/43/6/773.abstract AB Abnormalities of autonomic nervous function are associated with a poor prognosis of patients with chronic heart failure (CHF). We studied the effects of a 6-mo exercise training program on Q–T interval dispersion, heart rate and blood pressure variability, baroreflex sensitivity, myocardial blood flow (MBF), and presynaptic sympathetic innervation in 13 patients with New York Heart Association class II–III heart failure. Methods: MBF was measured with the H215O and C15O technique. Cardiac presynaptic innervation was studied by 11C-hydroxyephedrine (HED) retention assessed with PET. Heart rate and blood pressure variability and baroreflex sensitivity were tested with the phenylephrine method. All studies were performed before and after a 6-mo exercise training program. The exercise capacity was determined by spiroergometry, and Q–T dispersion was measured from a standard 12-lead electrocardiogram. Results: Q–T dispersion was reduced after the training period (mean ± SEM, from 52 ± 5 to 36 ± 5 ms [P = 0.01]). Global 11C-HED retention improved from 0.228 ± 0.099 to 0.263 ± 0.066 s−1 (P < 0.05). Global MBF was not affected by training, but MBF increased in areas of low initial perfusion in patients with coronary artery disease (from 0.382 ± 0.062 to 0.562 ± 0.083 mL/g/min [P < 0.005]). The high-frequency spectrum and total R-R interval variability increased (from 4.53 ± 0.30 to 5.02 ± 0.36 ms2 [P < 0.05] and from 3.60 ± 0.34 to 4.31 ± 0.37 ms2 [P < 0.005], respectively). Both changes correlated significantly with the observed change in 11C-HED retention. There was a significant reduction of total and a near-significant reduction of low-frequency (LF) systolic blood-pressure (SBP) variability (from 4.89 ± 1.03 to 3.18 ± 0.48 [P < 0.05] and from 2.79 ± 0.38 to 1.76 ± 0.24 [P = 0.059], respectively). The decrease in LF SBP variability correlated inversely with the enhancement of 11C-HED retention (r = −0.66; P < 0.05). Baroreflex sensitivity increased from 5.83 ± 0.82 to 10.15 ± 1.66 ms/mm Hg (P < 0.05). Conclusion: Exercise training induces beneficial changes in functional and imaging measures of cardiovascular autonomic nervous control. These observations point to a training-induced shift toward normalization of the compensatory autonomic nervous imbalance in CHF.