Abstract 16830: Effects of Exercise Training on Coronary Endothelial Function 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 cardiovasvular events. The aim of our study was to elucidate the association between obesity and endothelial function in pre-diabetic patients with coronary heart disease (CHD) and to investigate the influence of exercise training (ET) in these patients.
Methods: 62 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 a bicycle and rowing ergometer) or sedentary lifestyle (C). At begin and after 4 weeks changes in vascular diameter in response to intracoronary infusion of acetylcholine (7.2 μg/ minute), adenosine 2.4 mg/ minute and nitroglycerin (200 μg as an intracoronary bolus) was assessed by quantitative coronary angiography. Intracoronary average peak blood flow velocity (APV) was measured by Doppler velocimetry. Coronary blood flow (CBF) [ml/ minute] and coronary flow reserve (CFR) [x-fold increase in APV after adenosine infusion compared to saline] were calculated. The number of circulating CD 34+ stem cells and CD34/KDR+ endothelial progenitor cells (EPC) were quantified by FACS.
Results: Exercise training was associated with a reduction in BMI by -0.6±0.1 kg/m2 (p<0.05 vs. C). Four weeks of ET reduced pathological vasoconstriction in response to acetylcholine by 75% and increased APV by 59%, resulting in an increase in CBF by 177% (p<0.05 vs. C). CFR in response to adenosine increased by 32% (begin 1.9±0.2; 4 weeks 2.5±0.2) (p<0.01 vs. C) after ET wehereas endothelium-independent vasodilatation remained unchanged. ET increased the number of CD34+ stem cells by 30% and the amount of CD34/KDR+ EPC by 72% (p<0.05 vs. C). All above mentioned parameters remained virtually unchanged in the control group.
Conclusion: In obese patients with CHD having an impaired glucose tolerance, ET leads to a reduction in body weight and improves endothelium-dependend vasodilation both in epicardial coronary vessels and resistance vessels. This might be partially a result of an augmented number of circulating stem and progenitor cells.
- © 2010 by American Heart Association, Inc.