Note: CABG = coronary artery bypass graft surgery; CHD = coronary heart disease; ECG = electrocardiographic; MI = myocardial infarction; PTCA = percutaneous transluminal coronary angioplasty.

remaining two trials that did not demonstrate benefit did not specify the frequency of exercise training; 14,49 one used daily home exercise in addition to group exercise once per week.161

Twenty of the 46 randomized controlled trials included a small proportion of women, between 6 and 28 percent. No trial reported exercise tolerance outcome by gender.

Nonrandomized Controlled Trials

Twenty-two of the 25 nonrandomized controlled trials reported statistically significant improvements in measures of submaximal exercise tolerance and/or maximal exercise tolerance following exercise training. The beneficial physiologic adaptations to exercise training included a reduction in anginal symptoms at exercise testing:28,162,163 decreases in heart rate, rate-pressure product, or both, at submaximal workloads; 164-166 augmented physical work capacity, expressed as kilograms per minute (kg/min) or watts; 19,22,29,163,166–169 increased measured or estimated aerobic capacity (VO2max) or exercise test duration;20,21,26,63,79, 164,170,172-174 and increased muscular strength and/or endurance.71,72 Improvement in measures of exercise tolerance were reported in seven of the nine nonrandomized controlled trials that involved patients after myocardial infarction, in five of six that involved patients after CABG, in all 10 trials that involved patients with varied presentations of coronary disease, and in each of the trials in patients after PTCA and after cardiac transplantation. Comparable improvements in measures of exercise tolerance were reported in patients following myocardial infarction and in coronary-prone patients. 163