Exercise-based cardiac rehabilitation improves endothelial function assessed by flow-mediated dilation but not by pulse amplitude tonometry*

Abstract

We aimed to investigate the effect of exercise on endothelium-dependent vasodilator function assessed simultaneously in the brachial artery and in the distal arterial bed by flow-mediated dilation and the pulse amplitude tonometry method, respectively, in coronary artery disease patients. The study included 146 patients with stable coronary artery disease (123 men, mean age 62 ± 9 years) who participated in the Cardiac Rehabilitation and Genetics of Exercise performance study. All patients completed a 12-week supervised cardiac rehabilitation programme (three sessions per week at an intensity of 80% of the heart rate reserve). At baseline and upon completion of the training, we measured brachial artery diameters by means of ultrasound scanning (linear array transducer of 12 MHz) and simultaneously assessed pulse amplitudes in the fingertip using a pulse amplitude tonometry device both at rest and after reactive hyperaemia induced by a 5-min forearm cuff occlusion. Peak oxygen uptake significantly increased (+22%; p < 0.0001) and flow-mediated dilation improved from 10.0% to 13.1% (+37%; p < 0.0001), whereas the reactive hyperaemia index of the pulse amplitude tonometry method remained unchanged (p = 0.47) following exercise-based cardiac rehabilitation. However, the basal digital pulse amplitude (+58%; p < 0.001) increased as a result of training, as did the digital pulse amplitude after reactive hyperaemia (+22%; p < 0.05). Exercise-based cardiac rehabilitation is associated with an improvement in endothelial function, as can be measured by flow-mediated dilation but not by the reactive hyperaemia index of the pulse amplitude tonometry method.

Aerobic interval training and continuous training equally improve aerobic exercise capacity in patients with coronary artery disease: The SAINTEX-CAD study

“…Previous studies have shown that FMD improves after exercise-based cardiac rehabilitation in CAD patients [27][28][29]. In accordance to our results, Currie et al [30] found similar improvements after AIT and MCT, while Wisløff et al [14] and Tjonna et al [31] found larger increases after AIT compared to MCT.…”

Impact of Aerobic Exercise Training on Endothelial Function in Acute Coronary Syndrome

“…Afterwards, the FMD had significantly increased and the endothelial function had improved for the CR group, as previously reported. This study is meaningful as it shows that FMD test with less than six weeks of aerobic exercise can enhance endothelial function, while previous studies verified endothelial function improvement with longer than twelve [18] or eight weeks of aerobic exercise [19]. …”

“…Cornelissen et al [18] reported that FMD test was done for patients with coronary artery disease, who had undergone a 12-week aerobic exercise to find that the aerobic exercise group showed a significant FMD increase and endothelial function improvement before and after exercise, compared to the control group. In this study, patients with coronary artery disease underwent six-week aerobic exercise.…”

Endothelial Activation Microparticles and Inflammation Status Improve with Exercise Training in African Americans

“…Cornelissen et al demonstrated a significant increase in FMD% following 12 weeks of aerobic exercise in stable CAD patients [12]. Similarly, Luk et al conducted research to determine the effect of 8 weeks of AEXT on FMD in patients with stable CAD and demonstrated significant improvements in FMD [13].…”