A randomised trial comparing the effect of exercise training and weight loss on microvascular function in coronary artery disease. (15th April 2015)

• Record Type: Journal Article
• Authors: Olsen, Rasmus Huan; Pedersen, Lene Rørholm; Jürs, Anders; Snoer, Martin; Haugaard, Steen B.; Prescott, Eva
• Is Part Of: International journal of cardiology. Volume 185(2015)
• Page Start: 229
• Page End: 235
• Publication Date: 2015-04-15
• Subjects: AIT aerobic interval training -- AIx augmentation index -- AI@75 augmentation index normalised for heart rate -- BP blood pressure -- CAD coronary artery disease -- CCS Canadian Cardiovascular Society -- CFR coronary flow reserve -- CFV coronary flow velocity -- FFM fat-free mass -- FMD flow-mediated dilation -- LAD left anterior descending artery -- LED low energy diet -- LVEF left ventricular ejection fraction -- PAT peripheral arterial tonometry -- PWA pulse wave amplitude -- RHI reactive hyperaemia index -- RPP rate-pressure product; Caloric restriction -- Coronary artery disease -- Coronary flow reserve -- Coronary microvascular function -- Exercise training -- Weight loss; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2015.03.118
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Coronary microvascular function is associated with outcome and is reduced in coronary artery disease (CAD) and obesity. We compared the effect of aerobic interval training (AIT) and weight loss on coronary flow reserve (CFR) and peripheral vascular function in revascularised obese CAD patients. Methods and results: Seventy non-diabetic patients (BMI 28–40 kg×m − 2, age 45–75 years) were randomised to 12 weeks' AIT (three weekly sessions lasting 38 min with ≈ 16 min at 85–90% of VO2 peak) or low energy diet (LED, 800–1000 kcal/day). Per protocol adherence was defined by training-attendance ≥ 60% and weight loss ≥ 5%, respectively. CFR was assessed by Doppler echocardiography of the LAD. Peripheral vascular function was assessed by arterial tonometry as reactive hyperaemia index (RHI) and augmentation index. Most participants had impaired CFR with a mean CFR of 2.38 (SD 0.59). Twenty-six AIT and 24 LED participants completed the study per protocol with valid CFR measurements. AIT resulted in a 10.4% improvement in VO2 peak and LED in a 10.6% weight loss (between group differences both P < 0.001). CFR increased by 0.26 (95%CI 0.04;0.48) after AIT and by 0.39 (95%CI 0.13;0.65) after LED without significant between-group difference (− 0.13 (95%CI − 0.45;0.20)). RHI and augmentation index remained unchanged after both interventions ( P > 0.50). Intention-to-treat analyses showed similar results. Conclusions: 12 weeks' AIT and LED increased CFR by comparable magnitude; thus both interventions might impact prognosis of CAD through improvement of coronary microvascular function. Clinical Trial Registration: URL:http://www.clinicaltrials.gov . Unique identifier:NCT01724567 .