The effect of structured exercise training on endothelial function in patients with coronary artery disease

Du Preez, Tammerin Lee

Abstract

Background: Endothelial function and arterial stiffness have shown to be predictive of cardiovascular risk.

Aim: The study sought to investigate the effect of a current 8-week exercise based cardiac rehabilitation (CR) programme in the UK on endothelial function. Blood-borne biomarkers known to affect endothelial function including intracellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and C-Reactive Protein (CRP) were measured and correlated with measures of pulse wave velocity (PWV), a surrogate marker of arterial stiffness.

Methods: Patients were randomised to either the intervention (exercise training) or control group (patients who were eligible but refused to participate in the CR programme) following a cardiac event 4-6 weeks prior to the start of CR. All patients were on optimal pharmacological therapy. The intervention consisted of 8 weeks x 2 sessions per week (a total of 16 supervised training sessions equivalent to Phase III) at 40-60% of heart rate reserve (HRR), starting with 10 min of exercise training and progressing to 30 min depending on individual progress in week 8. Baseline and 8-week measurements of PWV and blood-borne biomarkers of endothelial function including ICAM-1, VCAM-1 and CRP were measured.

Results: 28 patients (mean age 62 ± 8 years; 86% male) were recruited (n=20 intervention; n=8 controls). There was a significant difference in the prevalence of Type 2 diabetes between the intervention and the control groups (P=0.004) at baseline. After 8 weeks, no statistically significant changes were found between groups for all measures of pulse wave velocity including cf-PWV, ba-PWV and aortic PWV (all P>0.05). Likewise, no changes were found between groups for blood-borne biomarkers including C- reactive protein, ICAM-1 and VCAM-1 (all P>0.05). There were no significant associations between PWV measures and blood biomarkers after 8 weeks. Weak associations were found between ba-PWV and ICAM-1 (r = -0.090, P=0.706), ba-PWV and VCAM-1 (r =0.304, P=0.192), and ba-PWV and CRP (r =0.317, P=0.174). In addition, there were no significant differences in cardiorespiratory fitness changes as a result of CR between groups (P=0.891).

Conclusions: A short-term CR programme consisting of 16 supervised training sessions does not improve markers of adhesion, inflammation or arterial stiffness in patients with cardiovascular disease. Further investigation is required to determine the appropriate training volume to induce favourable adaptations in endothelial function.

Citation

Du Preez, T. L. (2015). The effect of structured exercise training on endothelial function in patients with coronary artery disease. (Thesis). University of Hull. Retrieved from https://hull-repository.worktribe.com/output/4218497

• Thesis Type: Thesis
• Deposit Date: Sep 2, 2016
• Publicly Available Date: Feb 23, 2023
• Keywords: Sports sciences
• Public URL: https://hull-repository.worktribe.com/output/4218497
• Additional Information: Department of Sport, Health and Exercise Science, The University of Hull
• Award Date: Sep 1, 2015