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Previous Volume 342:454-460 February 17, 2000 Number 7 Next

	Full Text PDF Editorial by Vita, J. A. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Studies of the cardioprotective effects of exercise training in patients with coronary artery disease have yielded contradictory results. Exercise training has been associated with improvement in myocardial perfusion even in patients who have progression of coronary atherosclerosis. We therefore conducted a prospective study of the effect of exercise training on endothelial function in patients with coronary artery disease.

Methods We randomly assigned 19 patients with coronary endothelial dysfunction, indicated by abnormal acetylcholine-induced vasoconstriction, to an exercise-training group (10 patients) or a control group (9 patients). To reduce confounding, patients with coronary risk factors that could be influenced by exercise training (such as diabetes, hypertension, hypercholesterolemia, and smoking) were excluded. In an initial study and after four weeks, the changes in vascular diameter in response to the intracoronary infusion of increasing doses of acetylcholine (0.072, 0.72, and 7.2 µg per minute) were assessed. The mean peak flow velocity was measured by Doppler velocimetry, and the diameter of epicardial coronary vessels was measured by quantitative coronary angiography.

Results In the initial study, the two groups had similar vasoconstrictive responses to acetylcholine. After four weeks of exercise training, coronary-artery constriction in response to acetylcholine at a dose of 7.2 µg per minute was reduced by 54 percent (from a mean [±SE] decrease in the luminal diameter of 0.41±0.05 mm in the initial study to a decrease of 0.19±0.07 mm at four weeks; P<0.05 for the comparison with the change in the control group). In the exercise-training group, the increases in mean peak flow velocity in response to 0.072, 0.72, and 7.2 µg of acetylcholine per minute were 12±7, 36±11, and 78±16 percent, respectively, in the initial study. After four weeks of exercise, the increases in response to acetylcholine were 27±7, 73±19, and 142±28 percent (P< 0.01 for the comparison with the control group). Coronary blood-flow reserve (the ratio of the mean peak flow velocity after adenosine infusion to the resting velocity) increased by 29 percent after four weeks of exercise (from 2.8±0.2 in the initial study to 3.6±0.2 after four weeks; P<0.01 for the comparison with the control group).

Conclusions Exercise training improves endothelium-dependent vasodilatation both in epicardial coronary vessels and in resistance vessels in patients with coronary artery disease.

Source Information

From the University of Leipzig Heart Center, Department of Medicine and Cardiology, Leipzig, Germany.

Address reprint requests to Dr. Hambrecht at the Herzzentrum, Universität Leipzig, Russenstr. 19, 04289 Leipzig, Germany, or at hamr{at}server3.medizin.uni-leipzig.de.

Full Text of this Article

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Exercise and Coronary Endothelial Function
Georgiou D., Belardinelli R., Hambrecht R., Gielen S., Schuler G.
Extract | Full Text  
N Engl J Med 2000; 343:147-148, Jul 13, 2000. Correspondence

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• Watts, K., Beye, P., Siafarikas, A., Davis, E. A., Jones, T. W., O'Driscoll, G., Green, D. J. (2004). Exercise training normalizes vascular dysfunction and improves central adiposity in obese adolescents. J Am Coll Cardiol 43: 1823-1827 [Abstract] [Full Text]  
• Batty, G D., Lee, I-M. (2004). Physical activity and coronary heart disease. BMJ 328: 1089-1090 [Full Text]  
• Gordon, N. F., Gulanick, M., Costa, F., Fletcher, G., Franklin, B. A., Roth, E. J., Shephard, T. (2004). Physical Activity and Exercise Recommendations for Stroke Survivors: An American Heart Association Scientific Statement From the Council on Clinical Cardiology, Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention; the Council on Cardiovascular Nursing; the Council on Nutrition, Physical Activity, and Metabolism; and the Stroke Council. Stroke 35: 1230-1240 [Full Text]  
• Gielen, S., Hambrecht, R. (2004). The Childhood Obesity Epidemic: Impact on Endothelial Function. Circulation 109: 1911-1913 [Full Text]  
• Gordon, N. F., Gulanick, M., Costa, F., Fletcher, G., Franklin, B. A., Roth, E. J., Shephard, T. (2004). Physical Activity and Exercise Recommendations for Stroke Survivors: An American Heart Association Scientific Statement From the Council on Clinical Cardiology, Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention; the Council on Cardiovascular Nursing; the Council on Nutrition, Physical Activity, and Metabolism; and the Stroke Council. Circulation 109: 2031-2041 [Full Text]  
• Woo, K. S., Chook, P., Yu, C. W., Sung, R. Y.T., Qiao, M., Leung, S. S.F., Lam, C. W.K., Metreweli, C., Celermajer, D. S. (2004). Effects of Diet and Exercise on Obesity-Related Vascular Dysfunction in Children. Circulation 109: 1981-1986 [Abstract] [Full Text]  
• Hambrecht, R., Walther, C., Mobius-Winkler, S., Gielen, S., Linke, A., Conradi, K., Erbs, S., Kluge, R., Kendziorra, K., Sabri, O., Sick, P., Schuler, G. (2004). Percutaneous Coronary Angioplasty Compared With Exercise Training in Patients With Stable Coronary Artery Disease: A Randomized Trial. Circulation 109: 1371-1378 [Abstract] [Full Text]  
• Woodman, C. R., Turk, J. R., Rush, J. W. E., Laughlin, M. H. (2004). Exercise attenuates the effects of hypercholesterolemia on endothelium-dependent relaxation in coronary arteries from adult female pigs. J. Appl. Physiol. 96: 1105-1113 [Abstract] [Full Text]  
• Thompson, M. A., Henderson, K. K., Woodman, C. R., Turk, J. R., Rush, J. W. E., Price, E., Laughlin, M. H. (2004). Exercise preserves endothelium-dependent relaxation in coronary arteries of hypercholesterolemic male pigs. J. Appl. Physiol. 96: 1114-1126 [Abstract] [Full Text]  
• Benjamin, E. J., Larson, M. G., Keyes, M. J., Mitchell, G. F., Vasan, R. S., Keaney, J. F. Jr, Lehman, B. T., Fan, S., Osypiuk, E., Vita, J. A. (2004). Clinical Correlates and Heritability of Flow-Mediated Dilation in the Community: The Framingham Heart Study. Circulation 109: 613-619 [Abstract] [Full Text]  
• Fogarty, J. A., Muller-Delp, J. M., Delp, M. D., Mattox, M. L., Laughlin, M. H., Parker, J. L. (2004). Exercise Training Enhances Vasodilation Responses to Vascular Endothelial Growth Factor in Porcine Coronary Arterioles Exposed to Chronic Coronary Occlusion. Circulation 109: 664-670 [Abstract] [Full Text]  
• Fonseca, V., Desouza, C., Asnani, S., Jialal, I. (2004). Nontraditional Risk Factors for Cardiovascular Disease in Diabetes. Endocr. Rev. 25: 153-175 [Abstract] [Full Text]  
• Rossi, G. P., Maiolino, G. (2004). Letter to the Editor: T-786C and G894T Variants of the Endothelial Nitric Oxide Synthase Gene and Training-Induced Correction of Endothelial Dysfunction in Coronary Artery Disease Patient. Arterioscler. Thromb. Vasc. Bio. 24: e11-11 [Full Text]