Abstract 1054: Exercise Training Improves Endothelial Function and Regenerative Capacity in Pre-diabetic, Adipose Patients With Coronary Heart Disease
Certain fat-tissue-derived adipokines are thought to contribute to endothelial dysfunction, which is a predictor of future cardiovascular events. Aim of study was to elucidate the association between obesity and endothelial function in pre-diabetic patients with CHD and to investigate effects of physical exercise training (ET) in these patients.
Methods: 39 patients with CHD (age <75 years), obesity (BMI>26kg/m2) and impaired glucose tolerance were randomized to 4 weeks of ET (in-hospital basis, 4 times a day for 30 min on bicycle and rowing ergometer) or sedentary lifestyle (C). At begin and after 4 weeks peripheral endothelial function was measured by EndoPAT2000 (ITAMAR Inc., Israel). Invasive measurement of coronary vasomotion in response to acetylcholine (endothelium-dependent vasodilation) and adenosine (microcirculatory function) was determined as peak flow velocity using a Doppler wire. The number of circulating CD 34+ stem cells and CD34/KDR+ endothelial progenitor cells (EPC) was quantified by FACS and the functional properties of EPC were assessed using migration and matrigel assay.
Results: ET was associated with a reduction in body weight by −1.7±0.3kg, in BMI by −0.6±0.1kg/m2, in waist circumference by −2.8±0.4cm and a normalization of glucose tolerance (2h glucose tolerance test level at begin 9.0±0.3mmol/l; at 4 weeks 6.7±0.4mmol/l, p<0.05 vs. C). ET induced an increase in peripheral endothelial function by +24±5%, an improvement of acetylcholine-mediated coronary vasomotion by +106±33% and of microcirculatory function by +100±23% (p<0.05 vs. C). ET increased the number of CD34+ stem cells by +50±18% and the amount of CD34/KDR+ EPC by +218±53% (p<0.05 vs. C). Migratory capacity of EPC was augmented by +303±45% (p<0.05 vs. C) and their ability to integrate into endothelial networks increased by +74±16% after ET (p<0.05 vs. C).
Conclusion: In obese patients with CHD and impaired glucose tolerance, ET leads to a reduction in body weight and a normalization of glucose tolerance. This is associated with an improvement of peripheral and coronary endothelial function, partially as a result of an augmented regenerative capacity. The ongoing analysis will link these findings with adipokine expression levels in fat tissue.