Effect of exercise-based cardiac rehabilitation on non-culprit mild coronary plaques in the culprit coronary artery of patients with acute coronary syndrome

Abstract

Approximately, 70 % of acute myocardial infarctions are known to develop from mild atherosclerotic lesions. Therefore, it is important to evaluate mild coronary plaques to prevent acute coronary syndrome (ACS). The aim of the present study was to investigate the effects of exercise-based cardiac rehabilitation (CR) on mild coronary atherosclerosis in non-culprit lesions in patients with ACS. Forty-one men with ACS who underwent emergency percutaneous coronary interventions and completed a 6-month follow-up were divided into CR and non-CR groups. Quantitative coronary angiography (QCA) was performed using the automatic edge detection program. The target lesion was a mild stenotic segment (10-50 % stenosis) at the distal site of the culprit lesion, and the segment to be analyzed was determined at a segment length ranging from 10 to 15 mm. The plaque area was significantly decreased in the CR group after 6 months, but was significantly increased in the non-CR group (P < 0.05). The low-density lipoprotein (LDL) cholesterol, LDL/high-density lipoprotein (HDL) ratio and high-sensitivity C-reactive protein (Hs-CRP) levels were significantly reduced in both groups (P < 0.01). Peak VO2 in the CR group was significantly increased (P < 0.01). Changes in the plaque area correlated with those in Hs-CRP in both groups, while that association with those in HDL-C was observed in only CR group. Stepwise regression analysis revealed the decrease in Hs-CRP as an independent predictor of plaque area regression in the CR group. CR prevented the progression of mild coronary atherosclerosis in patients with ACS.

Internet-based training of coronary artery patients: the Heart Cycle Trial

“…Cardiac rehabilitation (CR) aims at restoring exercise performance [1] in patients after a cardiac event like myocardial infarction (MI) [1], peripheral arterial disease [2,3] or heart failure (HF). [3][4][5][6][7] CR uses multifactorial intervention, including aggressive risk factor modification [8][9][10][11]7].…”

The influence of cardiac rehabilitation on heart rate variability indices in men with type 2 diabetes and coronary artery disease

“…There was also a significant improvement of exercise capacity after CR in both examined groups. Previously published studies have shown that CR programs based on regular physical activity improve exercise capacity and ability to perform physical exercise in patients with CAD, [21][22][23]32 and also in CAD patients with type-2 diabetes. 24 The analysis of HRV indices have shown that after 8 weeks of CR SDNN and pNN50% in time domain and TP and HF component in frequency domain were significantly higher than before CR in the CAD patients without diabetes.…”

Preliminary Pilot Study of Combined Effects of Physical Activity and Achievement of LDL-Cholesterol Target on Coronary Plaque Volume Changes in Patients with Acute Coronary Syndrome

“…Inflammatory markers-such as C-reactive protein level, interleukin-6 level, and proinflammatory cytokine-are major factors that influence the development of ACS [20,21]. Kurose et al reported a decrease in high sensitive C-reactive protein as an independent predictor of coronary plaque regression in ASC patients who participated in CR [22]. We reported that CR for 6 months ameliorated not only metabolic parameters, but also the exercise capacity, muscle strength, and inflammatory state in metabolic syndrome patients after CABG [23].…”