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Muacevic A, Adler JR. The Effects of Exercise on Coronary Collateral Circulation: A Review. Cureus 2022; 14:e32732. [PMID: 36570117 PMCID: PMC9771523 DOI: 10.7759/cureus.32732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
The effects of exercise on the cardiovascular system are multifaceted and complex. It is well-documented that exercise can reduce mortality related to cardiovascular pathology. One anatomical structure that has been implicated in this process is the coronary collateral circulation. The goal of this review is to evaluate the current literature on the effects of exercise on human coronary collateral circulation. A search for literature was conducted on the databases Science Direct and PubMed using the terms: coronary collateral, collateral, exercise, physical activity, resistance training, endurance training, and collateral artery. Research that had the primary outcome of assessing human coronary collateralization secondary to exercise was included. Research in which the effect of exercise was not the primary outcome was excluded. As a result, a total of 13 research papers on the effects of exercise on coronary collateral circulation were included. Thirteen original research papers were reviewed. The mean age range in all studies was between 48 and 64 years old. There was a predominance of male participants, with a total of 597 male patients and 108 female patients across all studies. It was found that initial research underestimated the effect of exercise on coronary collateral circulation due to a lack of sensitive assessment methods. With the introduction of sensitive measures like the collateral flow index (CFI) and Rentrop scoring, results have shown that coronary collateral function can be increased with exercise. Exercise has been shown to enhance coronary collateral function. There is limited evidence as to which type, duration, or intensity of exercise is most favourable to enhance coronary collateral function. There is also relatively little data on the effects of exercise in the female population and those over the age of 65 years. More research is required to determine the specific effects of exercise on coronary collateral circulation in various age groups, genders, co-morbidities, specific exercise modalities, durations, intensities, and the effect of pharmacotherapy.
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Exercise Training and Interventions for Coronary Artery Disease. J Cardiovasc Dev Dis 2022; 9:jcdd9050131. [PMID: 35621842 PMCID: PMC9146277 DOI: 10.3390/jcdd9050131] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/18/2022] [Accepted: 04/24/2022] [Indexed: 12/22/2022] Open
Abstract
Coronary artery disease (CAD) may be considered a main cause of mortality and the prevalence of CAD is increasing nowadays, leading to high health costs in many countries. Despite the fact of the regression of the atherosclerotic plaque, the decrease in blood viscosity and the growth of collateral vessels have been proposed as improvements that CAD patients may obtain under exercise performance. Thus, the present narrative review aimed to carry out a brief specific analysis of the results achieved when performing endurance, strength or inspiratory muscle training. Exercise attenuates certain pathophysiological processes of this disease, such as endothelial dysfunction or the vulnerability of atherosclerotic plaques, and produces improvements in functional capacity and muscle strength, among others. Within the different exercise modalities, the most important parameter to be considered seems to be the total caloric expenditure, and not so much the modality itself. As such, in cardiac rehabilitation, when prescribing exercise, we should possibly focus on the modality that obtains more adherence in patients. To conclude, it must be highlighted that total caloric expenditure is not being taken into account when comparing interventions and this relevant information should be considered in future studies.
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Saini RK, Chaudhury S, Singh N, Chadha DS, Kapoor R. Depression, anxiety, and quality of life after percuataneous coronary interventions. Ind Psychiatry J 2022; 31:6-18. [PMID: 35800859 PMCID: PMC9255611 DOI: 10.4103/ipj.ipj_126_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/25/2021] [Accepted: 08/29/2021] [Indexed: 11/04/2022] Open
Abstract
Coronary artery disease (CAD) is the leading cause of morbidity and mortality in the world. However, some fascinating advances in the field of cardiology have not only added years to people's life but life to years as well. Percutaneous coronary intervention (PCI), commonly known as coronary angioplasty is a nonsurgical procedure used to treat stenotic coronary arteries. In recent years, PCI has become the preferred modality of treatment for occluded coronary arteries. However, there has been growing interest in the quality of life (QOL) issues for those who undergo such procedures. Depression, anxiety, vital exhaustion, hostility, anger, and acute mental stress have been evaluated as risk factors for the development and progression of CAD. Further, they also have strong bearing toward recovery from an acute coronary event. The current article discusses the role of depression, anxiety, and QOL of patients undergoing PCI.
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Affiliation(s)
- Rajiv Kumar Saini
- Department of Psychiatry, Command Hospital (Eastern Command), Kolkata, West Bengal, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr D Y Patil Medical College, Hospital and Research Centre, Dr D Y Patil Vidyapeeth, Pimpri, Pune, India
| | - Navreet Singh
- Department of Cardiology, CH (WC) Chandimandir, Panchkula, India
| | - D S Chadha
- Department of Cardiology, CH (IAF), Bengaluru, Karnataka, India
| | - Rajneesh Kapoor
- Department of Interventional Cardiology, Medanta Medicity, Gurgaon, Haryana, India
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Torres Crigna A, Link B, Samec M, Giordano FA, Kubatka P, Golubnitschaja O. Endothelin-1 axes in the framework of predictive, preventive and personalised (3P) medicine. EPMA J 2021; 12:265-305. [PMID: 34367381 PMCID: PMC8334338 DOI: 10.1007/s13167-021-00248-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 06/11/2021] [Indexed: 02/07/2023]
Abstract
Endothelin-1 (ET-1) is involved in the regulation of a myriad of processes highly relevant for physical and mental well-being; female and male health; in the modulation of senses, pain, stress reactions and drug sensitivity as well as healing processes, amongst others. Shifted ET-1 homeostasis may influence and predict the development and progression of suboptimal health conditions, metabolic impairments with cascading complications, ageing and related pathologies, cardiovascular diseases, neurodegenerative pathologies, aggressive malignancies, modulating, therefore, individual outcomes of both non-communicable and infectious diseases such as COVID-19. This article provides an in-depth analysis of the involvement of ET-1 and related regulatory pathways in physiological and pathophysiological processes and estimates its capacity as a predictor of ageing and related pathologies,a sensor of lifestyle quality and progression of suboptimal health conditions to diseases for their targeted preventionand as a potent target for cost-effective treatments tailored to the person.
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Affiliation(s)
- Adriana Torres Crigna
- Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Barbara Link
- Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Marek Samec
- Clinic of Obstetrics and Gynecology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 036 01 Martin, Slovakia
| | - Frank A. Giordano
- Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Peter Kubatka
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, 036 01 Martin, Slovakia
| | - Olga Golubnitschaja
- Predictive, Preventive and Personalised (3P) Medicine, Department of Radiation Oncology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
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Abstract
Endothelial dysfunction (ED) plays a substantial role in the pathogenesis of atherosclerosis and some other vascular diseases. ED has been demonstrated in patients with hypercholesterolemia, diabetes, smoking, hypertension, and in patients with atherosclerotic disease. Besides classical risk factors, ED is affected by chronic inflammatory diseases and acute infections, particularly viral diseases. Causes of ED include oxidative stress, inflammation, and shear stress, which decrease the bioavailability of nitric oxide. Markers of ED have been sought, particularly circulating markers. Using these tests, it is possible to evaluate the response to harmful effects of risk factors and the effects of treatment on vessel wall function. Endothelial dysfunction is significantly and directly correlated with the occurrence of cardiac events and the risk of cardiac events increase as ED worsens. Because endothelial function plays a central role in atherogenesis it became a therapeutic target. Endothelial dysfunction is reversible and its improvement may be achieved by elimination of risk factors, inhibitors of endothelium-derived contracting factors (angiotensin-converting enzyme), smoking cessation, lipid-lowering drugs, diet, and physical exercise. By reversing ED, it is possible to restore vascular function.
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Affiliation(s)
- Pavel Poredos
- Department of Vascular Disease, 37663University Medical Centre Ljubljana, Slovenia.,Department of Advanced Cardiopulmonary Therapies and Transplantation, 7067The University of Texas Health Science Centre at Houston, TX, USA
| | | | - Igor Gregoric
- Department of Advanced Cardiopulmonary Therapies and Transplantation, 7067The University of Texas Health Science Centre at Houston, TX, USA
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Chen L, Tang L. Effects of interval training versus continuous training on coronary artery disease: an updated meta-analysis of randomized controlled trials. Physiother Theory Pract 2020; 37:1273-1282. [PMID: 32073332 DOI: 10.1080/09593985.2019.1706213] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Lei Chen
- Department of Physical Education, Shanghai Jiaotong University, Shanghai, China
| | - Lin Tang
- Department of Rehabilitation, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China
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Schultchen D, Reichenberger J, Mittl T, Weh TRM, Smyth JM, Blechert J, Pollatos O. Bidirectional relationship of stress and affect with physical activity and healthy eating. Br J Health Psychol 2019; 24:315-333. [PMID: 30672069 PMCID: PMC6767465 DOI: 10.1111/bjhp.12355] [Citation(s) in RCA: 116] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 12/30/2018] [Indexed: 11/30/2022]
Abstract
Objectives Physical activity and healthy eating seem to be protective against experiencing stress and negative affect as well as increase positive affect. At the same time, previous studies showed that people reduce salutogenic behaviours such as physical activity and healthy eating in the face of stress and negative affect while increasing such behaviours in the context of positive affect. Due to daily fluctuations of these behaviours, the present study examined these relationships in daily life using ecological momentary assessment (EMA). Design and methods Fifty‐one university students responded to six daily prompts during 7 days via smartphone‐based EMA. Items examined stress, emotional experience, physical activity duration, and healthy eating. Results Higher stress and negative affect, as well as lower positive affect, were related to a reduction in subsequent physical activity. Higher physical activity levels, in turn, were associated with less subsequent stress and negative affect, as well as more positive affect. No such effects for stress and affect on healthy eating or vice versa were found. Conclusions Engaging in physical activity is related to better mood and less stress/negative affect over the next several hours in daily life. Prevention efforts therefore may benefit by focusing on promoting physical activity, particularly when stress/negative affect is high to ‘break the cycle’ of inactivity, stress, and negative affect. Potential effects of healthy eating might be more subtle and characterized by interindividual differences or state effects. Statement of contribution What is already known on this subject? Physical activity can reduce stress as well as negative emotions and can enhance positive emotions. People tend to eat less healthy food during stressful times, and healthy eating can increase general health. Physical activity and healthy eating have been mostly assessed separately and through retrospective methods.
What does this study add? This is an EMA study investigating bidirectional effects of stress, emotions, and salutogenic behaviour. After physical activity, people felt less stressed/negative and more positive; feeling better and less stressed resulted in more physical activity. Healthy eating was not associated with stress or emotion level and vice versa.
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Affiliation(s)
- Dana Schultchen
- Department of Clinical and Health Psychology, Ulm University, Germany
| | - Julia Reichenberger
- Centre for Cognitive Neuroscience, University of Salzburg, Austria.,Department of Psychology, University of Salzburg, Austria
| | - Theresa Mittl
- Department of Clinical and Health Psychology, Ulm University, Germany
| | - Tabea R M Weh
- Department of Clinical and Health Psychology, Ulm University, Germany
| | - Joshua M Smyth
- Department of Biobehavioral Health and Medicine, Pennsylvania State University, State College, Pennsylvania, USA
| | - Jens Blechert
- Centre for Cognitive Neuroscience, University of Salzburg, Austria.,Department of Psychology, University of Salzburg, Austria
| | - Olga Pollatos
- Department of Clinical and Health Psychology, Ulm University, Germany
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Wienbergen H, Fach A, Meyer S, Meyer J, Stehmeier J, Backhaus T, Michel S, Krämer K, Osteresch R, Schmucker J, Haase H, Härle T, Elsässer A, Hambrecht R. Effects of an intensive long-term prevention programme after myocardial infarction - a randomized trial. Eur J Prev Cardiol 2018; 26:522-530. [PMID: 29911893 DOI: 10.1177/2047487318781109] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Long-term risk factor control after myocardial infarction (MI) is currently inadequate and there is an unmet need for effective secondary prevention programmes. DESIGN AND METHODS It was the aim of the study to compare a 12-month intensive prevention programme (IPP), coordinated by prevention assistants and including education sessions, telephone visits and telemetric risk factor control, with usual care after MI. Three hundred and ten patients were randomized to IPP vs. usual care one month after hospital discharge for MI in two German heart centres. Primary study endpoint was the IPP Prevention Score (0-15 points) quantifying global risk factor control. RESULTS Global risk factor control was strongly improved directly after MI before the beginning of the randomized study (30% increase IPP Prevention Score). During the 12-month course of the randomized trial the IPP Prevention Score was improved by a further 14.3% in the IPP group ( p < 0.001), while it decreased by 11.8% in the usual care group ( p < 0.001). IPP significantly reduced smoking, low-density lipoprotein cholesterol, systolic blood pressure and physical inactivity compared with usual care ( p < 0.05). Step counters with online documentation were used by the majority of patients (80%). Quality of life was significantly improved by IPP ( p < 0.05). The composite endpoint of adverse clinical events was slightly lower in the IPP group during 12 months (13.8% vs. 18.9%, p = 0.25). CONCLUSIONS A novel intensive prevention programme after MI, coordinated by prevention assistants and using personal teachings and telemetric strategies for 12 months, was significantly superior to usual care in providing sustainable risk factor control and better quality of life.
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Affiliation(s)
- Harm Wienbergen
- 1 Bremen Institute for Heart and Circulation Research (BIHKF) at the Klinikum Links der Weser, Germany
| | - Andreas Fach
- 1 Bremen Institute for Heart and Circulation Research (BIHKF) at the Klinikum Links der Weser, Germany
| | - Sven Meyer
- 2 Klinikum Oldenburg, Department for Cardiology, European Medical School Oldenburg-Groningen, Germany
| | - Jochen Meyer
- 3 OFFIS - Institute for Information Technology Oldenburg, Germany
| | - Janina Stehmeier
- 1 Bremen Institute for Heart and Circulation Research (BIHKF) at the Klinikum Links der Weser, Germany
| | - Tina Backhaus
- 1 Bremen Institute for Heart and Circulation Research (BIHKF) at the Klinikum Links der Weser, Germany
| | - Stephan Michel
- 1 Bremen Institute for Heart and Circulation Research (BIHKF) at the Klinikum Links der Weser, Germany
| | - Kirsten Krämer
- 1 Bremen Institute for Heart and Circulation Research (BIHKF) at the Klinikum Links der Weser, Germany
| | - Rico Osteresch
- 1 Bremen Institute for Heart and Circulation Research (BIHKF) at the Klinikum Links der Weser, Germany
| | - Johannes Schmucker
- 1 Bremen Institute for Heart and Circulation Research (BIHKF) at the Klinikum Links der Weser, Germany
| | | | - Tobias Härle
- 2 Klinikum Oldenburg, Department for Cardiology, European Medical School Oldenburg-Groningen, Germany
| | - Albrecht Elsässer
- 2 Klinikum Oldenburg, Department for Cardiology, European Medical School Oldenburg-Groningen, Germany
| | - Rainer Hambrecht
- 1 Bremen Institute for Heart and Circulation Research (BIHKF) at the Klinikum Links der Weser, Germany
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Fiogbé E, Ferreira R, Sindorf MAG, Tavares SA, de Souza KP, de Castro Cesar M, Lopes CR, Moreno MA. Water exercise in coronary artery disease patients, effects on heart rate variability, and body composition: A randomized controlled trial. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2018. [PMID: 29542251 DOI: 10.1002/pri.1713] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND PURPOSE It is important to assess the effectiveness and efficiency of water-based training programs in order to prescribe it as an alternative in cardiac rehabilitation for patients who have coronary artery disease (CAD). In these patients, autonomic dysfunction is an important physiological change strongly associated with adverse outcomes, morbidity, and mortality. Given that the beneficial effects of physical training in CAD patients have been traditionally evidenced with programs involving land-based aerobic exercises, this study aims to evaluate the effects of water aerobic exercise training (WAET) on the autonomic modulation of heart rate (HR) and body composition, in the rehabilitation of CAD patients. METHODS Twenty-six male subjects with CAD were randomly divided into a training group (n = 14), submitted to the WAET, and a control group (n = 12). The WAET consisted of 3 weekly sessions on alternate days, totalling 48 sessions. The analysis of HR variability was used to evaluate the autonomic modulation of HR, from the recording of R-R intervals for 15 min, at rest in the supine position, and the body composition was evaluated through the bioelectrical impedance analysis. RESULTS Only the training group participants had improvement in the HR variability indices; patterns without variation decreased (0V, p = .005) and an increase of patterns of two different variations (p < .001), Shannon entropy (p = .02), and normalized conditional entropy (p = .03), whereas the control group had an increase of 0V (p = .04) and a decrease of normalized conditional entropy (p = .01). All body composition variables remained unchanged. CONCLUSIONS The WAET protocol improved the cardiac autonomic modulation of patients with CAD and can be considered as exercise training strategy in cardiac rehabilitation programs.
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Affiliation(s)
- Elie Fiogbé
- Post-Graduation Program in Physical Therapy, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil.,Post-Graduation Program in Physical Therapy, Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Rafaela Ferreira
- Post-Graduation Program in Physical Therapy, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil
| | - Márcio Antônio Gonçalves Sindorf
- Post-Graduation Program in Physical Education, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil
| | - Silvia Aparecida Tavares
- Graduation Program in Physical Therapy, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil
| | - Keiti Passoni de Souza
- Graduation Program in Physical Therapy, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil
| | - Marcelo de Castro Cesar
- Post-Graduation Program in Physical Education, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil
| | - Charles Ricardo Lopes
- Post-Graduation Program in Physical Education, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil.,Faculty Adventist of Hortolândia (UNASP), Hortolândia, SP, Brazil
| | - Marlene Aparecida Moreno
- Post-Graduation Program in Physical Therapy, College of Health Sciences, Methodist University of Piracicaba (UNIMEP), Piracicaba, SP, Brazil
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Design and rationale of the HITTS randomized controlled trial: Effect of High-intensity Interval Training in de novo Heart Transplant Recipients in Scandinavia. Am Heart J 2016; 172:96-105. [PMID: 26856221 DOI: 10.1016/j.ahj.2015.10.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 10/04/2015] [Indexed: 12/11/2022]
Abstract
There is no consensus on how, when, and at what intensity exercise should be performed and organized after heart transplantation (HTx). Most rehabilitation programs are conducted in HTx centers, which might be impractical and costly. We have recently shown that high-intensity interval training (HIT) is safe, well tolerated, and efficacious in maintenance HTx recipients, but there are no studies among de novo patients, and whether HIT is feasible and superior to moderate training in HTx recipients is unclear. A total of 120 clinically stable HTx recipients older than 18 years will be recruited from 3 Scandinavian HTx centers. Participants are randomized to HIT or moderate training, shortly after surgery. All exercises are supervised in the patients' local communities. Testing at baseline and follow-up includes the following: VO2peak (primary end point), muscle strength, body composition, quality of life, myocardial performance, endothelial function, biomarkers, and progression of cardiac allograft vasculopathy. A subgroup (n = 90) will also be tested at 3-year follow-up to assess long-term effects of exercise. So far, the HIT intervention is well tolerated, without any serious adverse events. We aim to test whether decentralized HIT is feasible, safe, and superior to moderate training, and whether it will lead to significant improvement in exercise capacity and less long-term complications.
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11
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Park KH, Park WJ. Endothelial Dysfunction: Clinical Implications in Cardiovascular Disease and Therapeutic Approaches. J Korean Med Sci 2015; 30:1213-25. [PMID: 26339159 PMCID: PMC4553666 DOI: 10.3346/jkms.2015.30.9.1213] [Citation(s) in RCA: 176] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 05/29/2015] [Indexed: 12/17/2022] Open
Abstract
Atherosclerosis is a chronic progressive vascular disease. It starts early in life, has a long asymptomatic phase, and a progression accelerated by various cardiovascular risk factors. The endothelium is an active inner layer of the blood vessel. It generates many factors that regulate vascular tone, the adhesion of circulating blood cells, smooth muscle proliferation, and inflammation, which are the key mechanisms of atherosclerosis and can contribute to the development of cardiovascular events. There is growing evidence that functional impairment of the endothelium is one of the first recognizable signs of development of atherosclerosis and is present long before the occurrence of atherosclerotic cardiovascular disease. Therefore, understanding the endothelium's central role provides not only insights into pathophysiology, but also a possible clinical opportunity to detect early disease, stratify cardiovascular risk, and assess response to treatments. In the present review, we will discuss the clinical implications of endothelial function as well as the therapeutic issues for endothelial dysfunction in cardiovascular disease as primary and secondary endothelial therapy.
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Affiliation(s)
- Kyoung-Ha Park
- Cardiovascular Division, Department of Internal Medicine, Hallym University Medical Center, Anyang, Korea
| | - Woo Jung Park
- Cardiovascular Division, Department of Internal Medicine, Hallym University Medical Center, Anyang, Korea
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12
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Mehta PK, Wei J, Wenger NK. Ischemic heart disease in women: a focus on risk factors. Trends Cardiovasc Med 2015; 25:140-51. [PMID: 25453985 PMCID: PMC4336825 DOI: 10.1016/j.tcm.2014.10.005] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 10/08/2014] [Accepted: 10/09/2014] [Indexed: 02/08/2023]
Abstract
Heart disease remains a major contributor to morbidity and mortality in women in the United States and worldwide. This review highlights known and emerging risk factors for ischemic heart disease (IHD) in women. Traditional Framingham risk factors such as hypertension, hyperlipidemia, diabetes, smoking, as well as lifestyle habits such as unhealthy diet and sedentary lifestyle are all modifiable. Health care providers should be aware of emerging cardiac risk factors in women such as adverse pregnancy outcomes, systemic autoimmune disorders, obstructive sleep apnea, and radiation-induced heart disease; psychosocial factors such as mental stress, depression, anxiety, low socioeconomic status, and work and marital stress play an important role in IHD in women. Appropriate recognition and management of an array of risk factors is imperative given the growing burden of IHD and need to deliver cost-effective, quality care for women.
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Affiliation(s)
- Puja K Mehta
- Barbra Streisand Women׳s Heart Center, Cedars-Sinai Heart Institute, 127S San Vicente Boulevard, A 3212, Los Angeles, CA 90048.
| | - Janet Wei
- Barbra Streisand Women׳s Heart Center, Cedars-Sinai Heart Institute, 127S San Vicente Boulevard, A 3212, Los Angeles, CA 90048
| | - Nanette K Wenger
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA
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Sommer W, Knöfel AK, Izykowski N, Oldhafer F, Avsar M, Jonigk D, Warnecke G, Haverich A. Physical exercise reduces transplant arteriosclerosis in a mouse aorta transplantation model. J Thorac Cardiovasc Surg 2015; 149:330-7. [DOI: 10.1016/j.jtcvs.2014.10.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Revised: 10/01/2014] [Accepted: 10/05/2014] [Indexed: 12/18/2022]
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Bruning RS, Sturek M. Benefits of exercise training on coronary blood flow in coronary artery disease patients. Prog Cardiovasc Dis 2014; 57:443-53. [PMID: 25446554 DOI: 10.1016/j.pcad.2014.10.006] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Every 34 seconds an American experiences a myocardial infarction or cardiac death. Approximately 80% of these coronary artery disease (CAD)-related deaths are attributable to modifiable behaviors, such as a lack of physical exercise training (ET). Regular ET decreases CAD morbidity and mortality through systemic and cardiac-specific adaptations. ET increases myocardial oxygen demand acting as a stimulus to increase coronary blood flow and thus myocardial oxygen supply, which reduces myocardial infarction and angina. ET augments coronary blood flow through direct actions on the vasculature that improve endothelial and coronary smooth muscle function, enhancing coronary vasodilation. Additionally, ET promotes collateralization, thereby, increasing blood flow to ischemic myocardium and also treats macrovascular CAD by attenuating the progression of coronary atherosclerosis and restenosis, potentially through stabilization of atherosclerotic lesions. In summary, ET can be used as a relatively safe and inexpensive way to prevent and treat CAD.
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Affiliation(s)
- Rebecca S Bruning
- Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, IN 46202-5120
| | - Michael Sturek
- Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, IN 46202-5120.
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15
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16
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Nytrøen K, Gullestad L. Exercise after heart transplantation: An overview. World J Transplant 2013; 3:78-90. [PMID: 24392312 PMCID: PMC3879527 DOI: 10.5500/wjt.v3.i4.78] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 07/15/2013] [Accepted: 07/25/2013] [Indexed: 02/05/2023] Open
Abstract
While life expectancy is greatly improved after a heart transplant, survival is still limited, and compared to the general population, the exercise capacity and health-related quality of life of heart transplant recipients are reduced. Increased exercise capacity is associated with a better prognosis. However, although several studies have documented positive effects of exercise after heart transplantation (HTx), little is known about the type, frequency and intensity of exercise that provides the greatest health benefits. Moreover, the long-term effects of exercise on co-morbidities and survival are also unclear. Exercise restrictions apply to patients with a denervated heart, and for decades, it was believed that the transplanted heart remained denervated. This has since been largely disproved, but despite the new knowledge, the exercise restrictions have largely remained, and up-to-date guidelines on exercise prescription after HTx do not exist. High-intensity, interval based aerobic exercise has repeatedly been documented to have superior positive effects and health benefits compared to moderate exercise. This applies to both healthy subjects as well as in several patient groups, such as patients with metabolic syndrome, coronary artery disease or heart failure. However, whether the effects of this type of exercise are also applicable to heart transplant populations has not yet been fully established. The purpose of this article is to give an overview of the current knowledge about the exercise capacity and effect of exercise among heart transplant recipients and to discuss future exercise strategies.
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Abstract
Functional integrity of endothelial cells is an indicator and a prerequisite for vascular health and counteracts the development of atherosclerosis. This concept of 'endothelial therapy' was developed in the late 1990s as an approach to preserve or restore endothelial cell health given that 'the knowledge of the mechanisms involved in 'endothelial dysfunction' allows us to interfere specifically with pathogenic pathways at very early time points and to slow down the progression of disease'. In the present review, the principles underlying endothelial cell health will be discussed as well as the role of endothelial therapy as a preventive measure to reduce the prevalence of coronary artery disease or to delay disease progression in patients with chronic coronary artery disease. This article also highlights the importance of active participation, the need to reduce the number of future patients in view of the rising prevalence of childhood obesity, and the potential of endothelial therapy to improve survival, reduce disability and health costs, and to improve overall quality of life in patients at risk for or already diagnosed with coronary artery disease. The preventive and therapeutic approaches and considerations described herein can be applied by physicians, patients, parents, educators, health agencies, and political decision makers to help reducing the global cardiovascular disease burden in the decades to come.
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Affiliation(s)
- Matthias Barton
- Molecular Internal Medicine, University of Zürich, LTK Y44 G22, Winterthurerstrasse 190, 8057 Zürich, Switzerland.
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18
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Abstract
In 1913, exactly 100 years ago, Nikolai Nikolaevich Anichkov (1885-1964) and Semen Sergeevich Chalatov (1884-1951) discovered in St. Petersburg, Russia, that atherosclerosis of large arteries is critically dependent on cholesterol. The inflammatory nature of atherosclerosis was first observed and suggested by Rudolf Virchow in 1856. Today, we have orally active drugs at our disposition that not only lower cholesterol levels but also interfere with vascular inflammation and atherogenesis. The disease process is multifactorial and its development is accelerated by modifiable and given risk factors such as cigarette smoking, dyslipidemia, arterial hypertension, diabetes, obesity, physical inactivity, estrogen deficiency, chronic renal disease, genetic predisposition, and the physiological aging process, among others. The present issue of Current Opinion in Pharmacology features a collection of articles by clinicians and scientists-many of whom are world authorities in their field-on mechanisms, preventive measures, clinical complications, and treatment of coronary artery disease. This monograph provides a '2013 update' on the pathogenesis, prevention, and therapy of atherosclerosis.
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