Strong Leg Muscles and a Heart Attack

Frailty in the elderly is a high-priority consideration with cardiovascular (CV) medicine.1,2 Muscle weakness is strongly associated with reduced exercise capacity and physical disability.3 Quadriceps isometric strength (QIS) is a strong predictor of exercise capacity in patients with coronary artery disease (CAD).  

After a heart attack, known as a myocardial infarction, the heart goes through a process in which fibrous tissue accumulates, causing an enlargement of the heart. Evidence suggests that exercise-based cardiac rehabilitation can alter the course of the remodeling in a way that improves heart function.

A study was performed to test predictive value of quadriceps strength in older patients for cardiovascular disease (CVD). The study included 1,314 patients, age 65+, with CVD. The primary finding of the study was that a higher level of QIS is associated with lower risks of all-cause and CV mortality in patients with CVD. This suggests that strength training should be recommended for patients who have experienced a heart attack to prevent heart failure.


  1. Ekerstad N., Swahn E., Janzon M., et al. Frailty is independently associated with 1-year mortality for elderly patients with non-ST-segment elevation myocardial infarction. Eur J Prev Cardiol. 2014; 21: 1216-1224
  2. Afilalo J., Alexander K.P., Mack M.J., et al. Frailty assessment in the cardiovascular care of older adults. J Am Coll Cardiol. 2014; 63: 747-762
  3. Kamiya K., Mezzani A., Hotta K., et al. Quadriceps isometric strength as a predictor of exercise capacity in coronary artery disease patients. Eur J Prev Cardiol. 2014; 21: 1285-1291
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