Abstract 17925: Physical Exercise Reduces Angiopoietin-like 2 Circulating Levels Only in CAD Patients With Endothelial Dysfunction
Introduction: Angiopoietin-like 2 (angptl2) is a circulating pro-inflammatory and pro-oxidative protein that induces endothelial dysfunction in mice. Plasma angptl2 levels are increased in diabetic or atherosclerotic patients, while a lifestyle intervention has been shown to decrease angptl2 expression in overweight, but otherwise healthy men. Whether angptl2 levels are sensitive to exercise in CAD patients is unknown.
Hypothesis: Exercise training reduces angptl2 levels in patients with CAD and endothelial dysfunction.
Methods: Stable and optimally treated CAD patients (n=31, 60±2 y/o, 7 females) were enrolled in a 3-month exercise-based prevention program at the Montreal Heart Institute. Blood samples were collected before and at the end of the study to measure plasma levels of angptl2 (ELISA) and of hs-CRP. Endothelial function was assessed by measuring the ratio of the slope of the nuclear tracer Myoview activity-time in the right to the left arm. A ratio lower than 3.55 is indicative of endothelial dysfunction. Data are mean±SEM.
Results: Exercise training was associated with a 11% increase in maximal cardiopulmonary capacity (VO2max; p=0.003). Endothelial function was not affected by exercise (from 3.41±0.25 to 3.58±0.26; p=0.455), but plasma levels of angptl2 were significantly decreased by 32% (from 3.4±0.7 to 2.3±0.4 ng/ml; p=0.020), while hs-CRP levels were unaffected (from 2.2±0.5 to 1.5±0.2 mg/l; p=0.155). Levels of angptl2 (but not of hs-CRP) were negatively correlated with VO2max (p=0.0471, r=0.257): the lower angptl2, the fitter the patient. In addition, levels of angptl2 (but not of hs-CRP) were negatively correlated with endothelial function (p=0.0217, r=0.304): the lower angptl2, the better the endothelial function. Importantly, exercise training was associated with a reduction in angptl2 levels (from 4.3±1.2 to 2.5±0.6 ng/ml; p=0.011, n=18) only among individuals with endothelial dysfunction at baseline, but not in patients with normal endothelial function (from 2.2±0.4 to 1.7±0.4 ng/ml; p=0.350, n=11).
Conclusions: In CAD patients with endothelial dysfunction, angptl2 levels are sensitive to exercise training. Low levels of angptl2 may reflect good cardiopulmonary fitness and endothelial function.
Author Disclosures: C. Yu: None. D. Hayami: None. M. Gayda: None. J. Larouche: None. G. Lapierre: None. C. Henri: None. J. Lambert: None. M. Juneau: None. J. Lalonge: None. N. Thorin-Trescases: None. A. Arsenault: None. E. Thorin: None. A. Nigam: None.
- © 2014 by American Heart Association, Inc.