Effect of exercise on coronary endothelial function in patients with coronary artery disease.
Effect of exercise on coronary endothelial function in patients with coronary artery disease.
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DOI：
10.1056/nejm200002173420702
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发表时间：
2000-02-17
影响因子：
158.5
通讯作者：
Schuler, G
中科院分区：
文献类型：
--
作者：
Hambrecht, R;Wolf, A;Schuler, G
背景：关于运动训练对冠心病患者心脏保护作用的研究得出了相互矛盾的结果。运动训练与心肌灌注的改善相关，即使在冠状动脉粥样硬化进展的患者中也是如此。因此，我们进行了一项前瞻性研究的运动训练对内皮功能的影响，在患者coronary artery disease.Methods：我们随机分配19例冠状动脉内皮功能障碍，表明异常乙酰胆碱诱导的血管收缩，运动训练组（10例）或对照组（9例）。为了减少混杂因素，排除了具有可能受运动训练影响的冠状动脉危险因素（如糖尿病、高血压、高胆固醇血症和吸烟）的患者。在最初的研究中和4周后，对冠状动脉内输注增加剂量的乙酰胆碱（0.072、0.72和7.2微克/分钟）后血管直径的变化进行了评估。多普勒测速仪测量平均峰值流速，定量冠状动脉造影测量心外膜冠状血管直径。结果：在初步研究中，两组对乙酰胆碱的血管收缩反应相似。经过4周的运动训练，乙酰胆碱每分钟7.2 μ g剂量引起的冠状动脉收缩减少了54%（从最初研究的平均[+/-SE]管腔直径减少0.41+/-0.05 mm到4周时减少0.19+/-0.07 mm; P
Background: Studies of the cardioprotective effects of exercise training in patients with coronary artery disease have yielded contradictory results. Exercise training has been associated with improvement in myocardial perfusion even in patients who have progression of coronary atherosclerosis. We therefore conducted a prospective study of the effect of exercise training on endothelial function in patients with coronary artery disease.Methods: We randomly assigned 19 patients with coronary endothelial dysfunction, indicated by abnormal acetylcholine-induced vasoconstriction, to an exercise-training group (10 patients) or a control group (9 patients). To reduce confounding, patients with coronary risk factors that could be influenced by exercise training (such as diabetes, hypertension, hypercholesterolemia, and smoking) were excluded. In an initial study and after four weeks, the changes in vascular diameter in response to the intracoronary infusion of increasing doses of acetylcholine (0.072, 0.72, and 7.2 microg per minute) were assessed. The mean peak flow velocity was measured by Doppler velocimetry, and the diameter of epicardial coronary vessels was measured by quantitative coronary angiography.Results: In the initial study, the two groups had similar vasoconstrictive responses to acetylcholine. After four weeks of exercise training, coronary-artery constriction in response to acetylcholine at a dose of 7.2 microg per minute was reduced by 54 percent (from a mean [+/-SE] decrease in the luminal diameter of 0.41+/-0.05 mm in the initial study to a decrease of 0.19+/-0.07 mm at four weeks; P