Beneficial effects of exercise training on physical performance in patients with vasospastic angina. (1st April 2021)

• Record Type: Journal Article
• Authors: Sugisawa, Jun; Matsumoto, Yasuharu; Takeuchi, Masashi; Suda, Akira; Tsuchiya, Satoshi; Ohyama, Kazuma; Nishimiya, Kensuke; Akizuki, Mina; Sato, Koichi; Ohura, Shoko; Ota, Hideki; Ikeda, Shohei; Shindo, Tomohiko; Kikuchi, Yoku; Hao, Kiyotaka; Shiroto, Takashi; Takahashi, Jun; Miyata, Satoshi; Sakata, Yasuhiko; Takase, Kei; Kohzuki, Masahiro; Shimokawa, Hiroaki
• Is Part Of: International journal of cardiology. Volume 328(2021)
• Page Start: 14
• Page End: 21
• Publication Date: 2021-04-01
• Subjects: Coronary vasospasm -- CT perfusion -- Exercise capacity -- Exercise training -- Microvascular angina; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2020.12.003
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Aims: In vasospastic angina (VSA), coronary vasomotion abnormalities could develop not only in epicardial coronary arteries but also in coronary microvessels, where calcium channel blockers (CCBs) have limited efficacy. However, efficacy of exercise training for VSA remains to be elucidated. We thus aimed to examine whether vasodilator capacity of coronary microvessels is impaired in VSA patients, and if so, whether exercise exerts beneficial effects on the top of CCBs. Methods: We performed 2 clinical protocols. In the protocol 1, we measured myocardial blood flow (MBF) using adenosine-stress dynamic computed tomography perfusion (CTP) in 38 consecutive VSA patients and 17 non-VSA controls. In the protocol 2, we conducted randomized controlled trial, where 20 VSA patients were randomly assigned to either 3-month exercise training group (Exercise group) or Non-Exercise group (n= 10 each). Results: In the protocol 1, MBF on CTP was significantly decreased in the VSA group compared with the Non-VSA group (138 ± 6 vs 166 ± 10 ml/100 g/min, P = 0.02). In the protocol 2, exercise capacity was significantly increased in the Exercise group than in the Non-Exercise group (11.5 ± 0.5 to 15.4 ± 1.8 vs 12.6 ± 0.7 to 14.0 ± 0.8 ml/min/kg, P < 0.01). MBF was also significantly improved after 3 months only in the Exercise group (Exercise group, 145 ± 12 to 172 ± 8 ml/100 g/min, P < 0.04; Non-Exercise group, 143 ± 14 to 167 ± 8 ml/100 g/min, P = 0.11), although there were no significant between-group differences. Conclusions: These results provide the first evidence that, in VSA patients, exercise training on the top of CCBs treatment may be useful to improve physical performance, although its effect on MBF may be minimal. Graphical abstract: Unlabelled Image Highlights: Adenosine-stress myocardial blood flow is reduced in vasospastic angina patients. Exercise training improves physical capability in patients with vasospastic angina. Exercise training ameliorates angina symptoms in patients with vasospastic angina. Exercise training may ameliorate myocardial blood flow with its minimal effects.