Stretching Exercises Enhance Vascular Endothelial Function and Improve Peripheral Circulation in Patients With Acute Myocardial Infarction

Abstract

SummaryThe purpose of this study was to clarify the acute effects of a single session of stretching exercises on vascular endothelial function and peripheral circulation in patients with acute myocardial infarction. This study evaluated 32 patients (mean age, 66 ± 9 years) who received phase I cardiac rehabilitation after acute myocardial infarction. Five types of stretching exercises were performed on the floor: wrist dorsiflexion, close-legged trunk flexion, open-legged trunk flexion, open-legged lateral trunk bending, and cross-legged trunk flexion. Each exercise entailed a 30-second stretching followed by a 30-second relaxation, and was repeated twice. Low-and high-frequency components (LF and HF) of heart rate variability (LF, 0.04-0.15 Hz; HF, 0.15-0.40 Hz) were analyzed, and HF and LF/HF were used as indices of parasympathetic and sympathetic nervous activities, respectively. Reactive hyperemia peripheral arterial tonometry (RH-PAT) index was measured and used as a parameter for vascular endothelial function. Transcutaneous oxygen pressure (tcPO 2 ) on the right foot and chest was also measured, and the Foot-tcPO 2 /Chest-tcPO 2 ratio was used as a parameter for peripheral circulation. The HF, RH-PAT index, and Foot-tcPO 2 /Chest-tcPO 2 ratio were significantly higher after the exercises than before (P < 0.05, P < 0.01, and P < 0.05, respectively). There was no significant difference in the LF/HF ratio measured before and after stretching exercises. These findings demonstrate that stretching exercises improve vascular endothelial function and peripheral circulation in patients with acute myocardial infarction. (Int Heart J 2013; 54: 59-63)

Effects of Phase II Comprehensive Cardiac Rehabilitation on Coronary Plaque Volume After Acute Coronary Syndrome

“…[19][20][21] Exercise improves endothelium-dependent vasodilation through enhancing endothelial nitric oxide synthase and reducing reactive oxygen species in patients with CAD. 22) Furthermore, moderate exercise increases the numbers of circulating endothelial progenitor cells (EPC), reduces EPC apoptosis, and enhances angiogenesis in response to improved endothelial function in patients with CAD.…”

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“…Another possible mechanism is an improved endothelial-mediate vasodilation. A recent study showed that a 15 min SE acutely improved NO-mediated vasodilation (Hotta et al, 2013). Nevertheless, it is possible that SE via releasing of NO and decrease in sympathetic nervous activity contributed to PEH and fall in RPP.…”

“…BP may decrease below pre-exercise baseline levels after different muscular work, this response is known as post-exercise hypotension (PEH) (Halliwill et al, 2013). This phenomenon could be clinically significance, because it tend to maintain BP of hypertensive subjects transiently at lower levels during different times of the day, especially when BP is at its highest level ( Given the role of SE in the production of NO (Hotta et al, 2013), this model of physical activity may lead to PEH. It has been shown that stretched muscle fibers activate mechanoreceptors, which elicit cardiovascular regulation through parasympathetic inhibition and sympathetic activation (Drew et al, 2008).…”

Endothelial Function for Cardiovascular Disease Prevention and Management

“…Multivariate analysis demonstrated that RHI ≤ the median is an independent predictor of coronary atherosclerosis lesions in the CPU patients underwent coronary fective indicator of disease management, including cardiac rehabilitation. In regard to stretching exercises, RH-PAT index was significantly higher immediately after the exercise than before, which was accompanied by increasing of high-frequency components (HF, 0.15-0.40 Hz) of heart rate variability as an indicator of parasympathetic nervous activities, and transcutaneous Oxygen Pressure (tcPO 2 ) on the right Foot and Chest ratio (Foot-tcPO 2 /Chest-tcPO 2 ) [50]. Cardiac rehabilitation with 4-week stretching exercises induced a significant increase in the RH-PAT index and significant decreases in serum levels of von Willebland Factor (vWF), Malondialdehyde-modified Low-Density Lipoprotein cholesterol (MDA-LDL), reactive oxygen species, and fibrinogen concentrations [51].…”