Abstract 17072: Marked Increases of Large HDL Particles Induced by Exercise-based Cardiac Rehabilitation Are Strongly Associated With Improved Cardiopulmonary Fitness in Patients With Acute Coronary Syndrome
Background: Exercised-based cardiac rehabilitation (CR) can increase HDL-cholesterol (HDL-C). However it remains unclear how elevated HDL-C and changes of HDL subfractions are correlated with the improvement of exercise tolerance in acute coronary syndrome (ACS) patients participated with CR.
Methods: Concentrations of cholesterol and apolipoproteins (Apo) in HDL subfractions separated by heparin-Mn precipitation method were measured at the onset of ACS and at the end of the 6-month CR program in 51 patients (45 men and 6 women) aged of 64.3 ± 11.8 years. All patients received successful percutaneous coronary intervention on admission, and then started to take statins.
Results: Serum levels of HDL-C and ApoA1, and concentrations of cholesterol and apoA1 in large HDL fraction (HDL2) were significantly increased by CR (42.7 mg/dl ± 14.1 mg/dl to 47.4 mg/dl ± 14.2 mg/dl, 128.8 mg/dl ± 23.4 mg/dl to 139.2 mg/dl ± 26.0 mg/dl, 25.3 mg/dl ± 12.4 mg/dl to 30.3 mg/dl ± 13.6 mg/dl, 67.8 mg/dl ± 20.3 mg/dl to 79.4 mg/dl ± 24.5 mg/dl, respectively), while cholesterol and apoA1 in small HDL fraction (HDL3) were not changed. Moreover HDL2-C / HDL-C ratio, and HDL2-ApoA1 / ApoA1 ratio were significantly increased by CR. In addition, Spearman’s rank correlation coefficient analysis revealed that only % increases of HDL2-C were significantly associated with % increases of peak oxygen consumption (VO2) (r = 0.439, p = 0.007), while neither HDL-C nor HDL3-C were associated with them.
Conclusion: CR can markedly increase the number of HDL2 particles, which is significantly associated with the improvement of cardiopulmonary fitness. CR is very useful therapy for the reverse cholesterol transport, and the prevention of atheroscrerosis.
- © 2013 by American Heart Association, Inc.