Comparison of endothelium-dependent and -independent vasomotor response after abluminal biodegradable polymer biolimus-eluting stent and persistent polymer everolimus-eluting stent implantation (COMPARE-IT)

Puricel, Serban; Kallinikou, Zacharenia; Espinola, Jaqueline; Arroyo, Diego; Goy, Jean‐Jácques; Stauffer, Jean‐Christophe; Baeriswyl, Gérard; Smits, Pieter C.; Cook, Stéphane; Togni, Mario

doi:10.1016/j.ijcard.2015.09.085

Cited by 18 publications

(10 citation statements)

References 32 publications

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“…Our observation that RA dilation in response to exercise was not impaired 1 wk postcatheterization contrasts with some previous studies in animals, which have reported a paradoxical vasoconstriction in response to exercise following endothelial denudation (4,30). In addition, two studies in patients performing supine bicycle exercise during a follow-up PTCA reported an exercise-induced constriction in the treated vessels, at 6 mo post-PCI with first generation (38) and at 16 mo with second generation drug-eluting stents (31). However, this impairment may indicate the presence of long-term complications of stenting, such as in-stent restenosis (29), rather than the effects of catheterization-induced damage per se.…”

Section: Discussioncontrasting

confidence: 99%

Exercise-induced vasodilation is not impaired following radial artery catheterization in coronary artery disease patients

Tryfonos

Cocks

Mills

et al. 2020

Journal of Applied Physiology

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Diagnosis and treatment for coronary artery disease (CAD) often involves angiography and/or percutaneous coronary intervention. However, the radial artery catheterization required during both procedures may result in acute artery dysfunction/damage. While exercise-based rehabilitation is recommended for CAD patients following catheterization, it is not known if there is a period when exercise may be detrimental due to catheter-induced damage. Animal studies have demonstrated exercise-induced paradoxical vasoconstriction postcatheterization. This study aimed to examine arterial responses to acute exercise following catheterization. Thirty-three CAD patients (65.8 ± 7.3 yr, 31.5 ± 6.3 kg/m2, 82% men) undergoing transradial catheterization were assessed before and 1 wk postcatheterization. Radial artery (RA) diameter and shear rate were assessed during handgrip exercise (HE), in both the catheterized (CATH) and control (CON) arms. Endothelial function was also assessed via simultaneous bilateral radial flow-mediated dilation (FMD) at both time points. We found that the increase in RA diameter and shear stress in response to HE ( P < 0.0001) was maintained postcatheterization in both the CATH and CON arms, whereas FMD following catheterization was impaired in the CATH [6.5 ± 3.3 to 4.7 ± 3.5% ( P = 0.005)] but not in the CON [6.2 ± 2.6 to 6.4 ± 3.5% ( P = 0.797)] limb. While endothelial dysfunction, assessed by FMD, was apparent 1 wk postcatheterization, the ability of the RA to dilate in response to exercise was not impaired. The impact of catheterization and consequent endothelial denudation on vascular dys/function in humans may therefore be stimulus specific, and a highly level of redundancy appears to exist that preserves exercise-mediated vasodilator responses. NEW & NOTEWORTHY Despite depressed flow-mediated endothelium-dependent dilation following catheterization-induced damage, radial artery responses to handgrip exercise were preserved. This suggests that arterial responses to catheterization may be stimulus specific and that redundant mechanisms may compensate for vasodilator impairment during exercise. This has implications for exercise-based rehabilitation after catheterization.

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Section: Discussioncontrasting

confidence: 99%

Exercise-induced vasodilation is not impaired following radial artery catheterization in coronary artery disease patients

Tryfonos

Cocks

Mills

et al. 2020

Journal of Applied Physiology

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“…A resposta vasomotora relaciona-se à capacidade do coração em manter a homeostase do tônus vascular, assegurando que o fluxo sanguíneo corresponda à demanda dos músculos esqueléticos e de outros órgãos, seja em repouso e/ou durante o exercício (Puricel et al, 2016;Sandoo, Zanten, Metsios, Carroll, & Kitas et al, 2010). A resposta vasomotora é regulada pela interação de dois mecanismos centrais de controle: a) o controle autonômico do drive neural simpático (controle central ou global) (Sandoo et al, 2010;Thijssen et al, 2014) e b) a capacidade das células endoteliais de responder ao estresse mecânico pela liberação de fatores vasoativos, como óxido nítrico (NO) e acetilcolina (controle periférico) (Pyke & Tschakovsky, 2005;Widlansky, Gokce, Keaney, & Vita, 2003;Wilson, Lee, & Mccarron, 2016).…”

Section: Resultsunclassified

Treinamento Muscular Inspiratório Como Recurso Para a Proteção Do Indivíduo Com Insuficiência Cardíaca

Andrade

Alves²,

Costa

et al. 2020

Psicodebate

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Esse trabalho teve como objetivo realizar uma revisão da literatura narrativa sobre as características da patologia (IC) e como o treino muscular inspiratório protege o indivíduo portador de insuficiência cardíaca. A literatura aponta que o TMI demonstrou efeitos benéficos em pessoas com IC, como melhora do VO2máx e bom desempenho em testes funcionais. Todavia, não há um consenso sobre qual a melhor carga se treinar, o melhor tempo de treinamento e a frequência do mesmo; e os reais benefícios na capacidade funcional de indivíduos com IC. Estudos mostraram que com o treinamento muscular inspiratório há melhora da capacidade funcional e da qualidade de vida dos indivíduos portadores de IC pertencentes a classes funcionais mais avançadas e com terapêutica não medicamentosa escassa, melhorando assim a capacidade funcional e a qualidade de vida de indivíduos com insuficiência cardíaca de maior gravidade, favorecendo condições de bem-estar.

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“…More recently, studies in patients performing supine bicycle exercise during coronary catheterization reported an exercise-induced paradoxical vasoconstriction in coronary-treated artery, at 6 months post-PCI with 1 st generation [228], and at 16 months with 2 nd generation DES [229], with normal vasodilation in the non-catheterized vessel [229]. VSMC-induced dilation was abolished in the stented area, whereas vasodilation was still apparent proximally and distally to the stent [229]. Coronary vasoconstriction during exercise, 6-months post-PCI, has been implicated in chest-pain with the absence of significant stenosis in a recent case report [135].…”

Section: What Are the Vascular Effects Of Acute Exercise After Ptca/pci?mentioning

confidence: 99%

Effects of Catheterization on Artery Function and Health: When Should Patients Start Exercising Following Their Coronary Intervention?

2019

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Coronary artery disease (CAD) is a leading cause of death worldwide, and percutaneous transluminal coronary angiography (PTCA) and/or percutaneous coronary intervention (PCI; angioplasty) are commonly used to diagnose and/or treat the obstructed coronaries. Exercise-based rehabilitation is recommended for all CAD patients; however, most guidelines do not specify when exercise training should commence following PTCA and/or PCI. Catheterization can result in arterial dysfunction and acute injury, and given that fact that exercise, particularly at higher intensities, is associated with elevated inflammatory and oxidative stress, endothelial dysfunction and a pro-thrombotic milieu, performing exercise post-PTCA/PCI may transiently elevate the risk of cardiac events. This review aims to summarize extant literature relating to the impacts of coronary interventions on arterial function, including the time-course of recovery and the potential deleterious and/or beneficial impacts of acute versus long-term exercise. The current literature suggests that arterial dysfunction induced by catheterization recovers 4-12 weeks following catheterization. This review proposes that a period of relative arterial vulnerability may exist and exercise during this period may contribute to elevated event susceptibility. We therefore suggest that CAD patients start an exercise-training program between 2 and 4 weeks post-PCI, recognizing that the literature suggest there is a "grey area" for functional recovery between 2-12 weeks post catheterization. The timing of exercise onset should take into consideration the individual characteristics of patients (age, severity of disease, comorbidities) and the intensity, frequency and duration of the exercise prescription.

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Comparison of endothelium-dependent and -independent vasomotor response after abluminal biodegradable polymer biolimus-eluting stent and persistent polymer everolimus-eluting stent implantation (COMPARE-IT)

Cited by 18 publications

References 32 publications

Exercise-induced vasodilation is not impaired following radial artery catheterization in coronary artery disease patients

Exercise-induced vasodilation is not impaired following radial artery catheterization in coronary artery disease patients

Treinamento Muscular Inspiratório Como Recurso Para a Proteção Do Indivíduo Com Insuficiência Cardíaca

Effects of Catheterization on Artery Function and Health: When Should Patients Start Exercising Following Their Coronary Intervention?

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