Coronary Collateral Growth Induced by Physical Exercise

Autor: Thomas Hilberg, Susanne Brunner, Karsten Lenk, Madlen Uhlemann, Volker Adams, Marcus Sandri, Meinhard Mende, Sven Möbius-Winkler, Sandra Erbs, Norman Mangner, Ulrike Mueller, Martin Grunze, Gerhard Schuler, Jennifer Adam, Axel Linke
Rok vydání: 2016
Předmět:
Adult
Male
Cardiac Catheterization
medicine.medical_specialty
Central Venous Pressure
medicine.medical_treatment
Collateral Circulation
Coronary Disease
Physical exercise
Fractional flow reserve
030204 cardiovascular system & hematology
Coronary artery disease
03 medical and health sciences
Oxygen Consumption
0302 clinical medicine
Physiology (medical)
Internal medicine
Embolism
Air
Humans
Medicine
Arterial Pressure
Angina
Unstable
Prospective Studies
030212 general & internal medicine
Prospective cohort study
Aorta
Aged
Cardiac catheterization
Exercise Tolerance
Intention-to-treat analysis
business.industry
Femoral Vein
Middle Aged
Collateral circulation
medicine.disease
Coronary Vessels
Exercise Therapy
Fractional Flow Reserve
Myocardial
Blood pressure
Exercise Test
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Zdroj: Circulation. 133:1438-1448
ISSN: 1524-4539
0009-7322
DOI: 10.1161/circulationaha.115.016442
Popis: Background— A well-developed coronary collateral circulation provides a potential source of blood supply in coronary artery disease. However, the prognostic importance and functional relevance of coronary collaterals is controversial with the association between exercise training and collateral growth still unclear. Methods and Results— This prospective, open-label study randomly assigned 60 patients with significant coronary artery disease (fractional flow reserve ≤0.75) to high-intensity exercise (group A, 20 patients) or moderate-intensity exercise (group B, 20 patients) for 4 weeks or to a control group (group C, 20 patients). The primary end point was the change of the coronary collateral flow index (CFI) after 4 weeks. Analysis was based on the intention to treat. After 4 weeks, baseline CFI increased significantly by 39.4% in group A (from 0.142±0.07 at beginning to 0.198±0.09 at 4 weeks) in comparison with 41.3% in group B (from 0.143±0.06 to 0.202±0.09), whereas CFI in the control group remained unchanged (0.7%, from 0.149±0.09 to 0.150±0.08). High-intensity exercise did not lead to a greater CFI than moderate-intensity training. After 4 weeks, exercise capacity, V o 2 peak and ischemic threshold increased significantly in group A and group B in comparison with group C with no difference between group A and group B. Conclusions— A significant improvement in CFI was demonstrated in response to moderate- and high-intensity exercise performed for 10 hours per week. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT01209637.
Databáze: OpenAIRE
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