Attenuated Progression of Coronary Artery Disease After 6 Years of Multifactorial Risk Intervention

Niebauer, Josef; Hambrecht, Rainer; Velich, Tamás; Hauer, Klaus; Marburger, Christian; Kälberer, Barbara; Weiss, Claus; Hodenberg, Eberhard von; Schlierf, G.; Schuler, Gerhard; Zimmermann, Rainer; Kübler, W.

doi:10.1161/01.cir.96.8.2534

Cited by 318 publications

(183 citation statements)

References 42 publications

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“…Comprehensive multifactorial rehabilitation and prevention programs have been shown to slow or partially reduce the progression of coronary atherosclerosis (3,4). Meta-analyses of studies performed in the 1970s and 1980s revealed a significant reduction in total and cardiac mortality following participation in CR (5,6).…”

Section: Efficacy Of Crmentioning

confidence: 99%

Universal access: But when? Treating the right patient at the right time: Access to cardiac rehabilitation

Dafoe

Arthur

Stokes

et al. 2006

Canadian Journal of Cardiology

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Section: Efficacy Of Crmentioning

confidence: 99%

Universal access: But when? Treating the right patient at the right time: Access to cardiac rehabilitation

Dafoe

Arthur

Stokes

et al. 2006

Canadian Journal of Cardiology

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“…The impact of exercise on cardiac therapeutic and preventive outcomes including reduced rates of cardiac events, morbidity, and mortality is well established (Gielen & Hambrecht, 2001;Jassen & Jolliffe, 2006;Leon et al, 2005). Research not only indicates exercise has the ability to prevent, slow progression, and reverse risk indicators among populations with CAD Hambrecht et al, 1993;Niebauer et al, 1997), but might also have a protective effect, mitigating the impact of other existing risk factors (Blair et al, 1996). While this is encouraging given exercise behavior is modifiable, it is also problematic given the complexity of initiating and maintaining exercise behavior change (Roitman & LaFontaine, 2001).…”

Section: Introductionmentioning

confidence: 99%

A Prospective Examination of Patterns and Correlates of Exercise Maintenance in Coronary Artery Disease Patients

et al. 2007

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This longitudinal study examined exercise behavior patterns (i.e., maintainers, irregular, and inactive) in cardiac patients, and investigate the sociodemographic, clinical, psychosocial, and environmental correlates of exercise patterns. 661 cardiac in-patients from 3 hospitals consented to participate (75% response rate) and were re-assessed 9 and 18 (81% retention) months postdischarge. Exercise patterns were assessed via the Health-Promoting Lifestyle Profile II subscale using a median split. Of 417 participants (mean age 63.1 ± 10.2) with complete data, 42.2% were classified as Exercise Maintainers, 21.3% as Irregular Exercisers, and 26.1% as Inactive. Multinomial logistic regression revealed that Exercise Maintainers were more likely to be male, have exercised prior to their diagnosis, attend cardiac rehabilitation, perceive fewer exercise barriers, and were less likely to be current-smokers, past-smokers, or attribute the cause of their disease to their own behavior. Patients more likely to maintain exercise have positive perceptions and utilize cardiac rehabilitation.

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“…[1][2][3][4][5] Recently, it has become apparent that there are also vascular adaptations to exercise training. 6 -9 A particularly interesting adaptation is an increase in expression of the endothelial nitric oxide synthase (eNOS) gene in both coronary conductance and resistance vessels.…”

mentioning

confidence: 99%

Dysfunctional Regulation of Endothelial Nitric Oxide Synthase (eNOS) Expression in Response to Exercise in Mice Lacking One eNOS Gene

et al. 2001

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Background —Previous data suggest that 1 endothelial NO synthase (eNOS) gene is sufficient to allow normal expression and function of eNOS under basal conditions. We hypothesized that this might not hold true for conditions known to increase eNOS gene expression, such as exercise. Methods and Results —Male mice heterozygous for a disruption of the eNOS gene (eNOS +/ − ) and normal C56Bl/6J mice (eNOS +/+ ), 3 to 4 months of age, underwent exercise training for 3 weeks. Nontrained mice were exposed to the exercise environment (noise and vibration of the treadmill) without exercise for an identical period. In eNOS +/+ mice (n=7), exercise increased aortic eNOS protein expression by 3.4±0.4-fold ( P <0.002). This was associated with a greater vascular cGMP accumulation on stimulation with acetylcholine ( P <0.05). Furthermore, exercise training increased eNOS mRNA (1.78±0.4-fold) and protein (1.76±0.17-fold) in left ventricular tissue, as determined by competitive reverse transcription–polymerase chain reaction and Western analysis ( P <0.05 for both). In striking contrast, exercise had no effect on aortic eNOS expression and cGMP accumulation in eNOS +/ − mice ( P >0.05). Thus, although eNOS expression appears to be normal in eNOS +/ − mice under basal conditions, these mice are unable to increase eNOS expression during exercise. Conclusions —These findings show that regulation of eNOS expression during exercise requires the presence of both alleles of the gene and may have implications for conditions in which polymorphisms of eNOS are present in only 1 allele in humans. These individuals may have a normal vascular reactivity under basal conditions but may be unable to adapt their vascular reactivity in response to exercise training.

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Attenuated Progression of Coronary Artery Disease After 6 Years of Multifactorial Risk Intervention

Cited by 318 publications

References 42 publications

Universal access: But when? Treating the right patient at the right time: Access to cardiac rehabilitation

Universal access: But when? Treating the right patient at the right time: Access to cardiac rehabilitation

A Prospective Examination of Patterns and Correlates of Exercise Maintenance in Coronary Artery Disease Patients

Dysfunctional Regulation of Endothelial Nitric Oxide Synthase (eNOS) Expression in Response to Exercise in Mice Lacking One eNOS Gene

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