1
|
Chen W, Ni J, Qiao Z, Wu Y, Lu L, Zheng J, Chen R, Lu X. Comparison of the Clinical Outcomes of Two Physiological Ischemic Training Methods in Patients with Coronary Heart Disease. Open Med (Wars) 2019; 14:224-233. [PMID: 30847399 PMCID: PMC6401491 DOI: 10.1515/med-2019-0016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 11/29/2018] [Indexed: 11/24/2022] Open
Abstract
The aim of the present study was to verify the effectiveness of physiological ischemic training (PIT) in patients with coronary heart disease (CHD) and compare differences in clinical outcomes between isometric exercise training (IET) and cuff inflation training (CIT). Fifty-five CHD patients were randomized into three groups: IET group (n=19), CIT group (n=18), and no-exercise group (n=18). PIT was practiced in the IET and CIT groups. Changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded. The cardiac structure and function were evaluated and vascular endothelial growth factor (VEGF) measured. SBP and DBP decreased significantly in both PIT groups after 3-month training (P<0.01). Cardiac function and structure were significantly improved in both PIT groups after 3-month training (P<0.01). Cardiac structure and function in the IET group were both superior to those in the CIT group by the end of training (P<0.01). The VEGF level in both PIT groups increased significantly after 3-month training (P<0.01). PIT was safe and feasible when performed in CHD patients. An appropriate period of PIT helped improve blood pressure and the cardiac structure and function, with the outcome more positive in the IET group.
Collapse
Affiliation(s)
- Weihai Chen
- Department of Cardiology, The First People's Hospital of Wujiang District, Suzhou, Jiangsu 215200 China
| | - Jun Ni
- Department of Rehabilitation, Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, China
| | - Zhenguo Qiao
- Department of Gastroenterology, The First People's Hospital of Wujiang District, 169 Gongyuan Road, Suzhou, Jiangsu 215200, China
| | - Yanming Wu
- Department of Cardiology, The First People's Hospital of Wujiang District, Suzhou, Jiangsu 215200 China
| | - Lijuan Lu
- Department of Gynecology and Obstetrics, Suzhou Hospital of Traditional Chinese Medicine, Suzhou, Jiangsu 215003, China
| | - Ju Zheng
- Department of Cardiology, The First People's Hospital of Wujiang District, Suzhou, Jiangsu 215200 China
| | - Rongrong Chen
- Department of Geriatric, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu 215002, China
| | - Xiao Lu
- Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| |
Collapse
|
2
|
Gao M, Lu X, Chen W, Xiao GH, Zhang Y, Yu R, Li J. Randomized clinical trial of physiological ischemic training for patients with coronary heart disease complicated with heart failure: Safety of training, VEGF of peripheral blood and quality of life. Exp Ther Med 2018; 16:260-264. [PMID: 29896247 PMCID: PMC5995091 DOI: 10.3892/etm.2018.6175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 04/16/2018] [Indexed: 12/28/2022] Open
Abstract
Effects of a 12-week physiological ischemic training (PIT) programme on safety of training and quality of life (QOL) in patients with coronary heart disease (CHD) complicated with heart failure were evaluated. A total of 30 patients with CHD complicated with heart failure were randomized to either an intervention group (n=15) or to controls (n=15) after baseline testing. A 12-week, 5 times a week, maximum subjective force group PIT was conducted. Safety of the training was measured with ECG and heart rate and blood pressure, QOL was measured using the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and vascular endothelial growth factor (VEGF) was measured with peripheral blood. VEGF and MLHFQ were improved in the intervention group. The finding of the study shows PIT is safe to patients with CHD complicated with heart failure by improving VEGF of peripheral blood and QOL.
Collapse
Affiliation(s)
- Min Gao
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, P.R. China.,Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China.,Department of Rehabilitation Medicine, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, P.R. China.,Department of Cardiopulmonary Rehabilitation, Xuzhou Rehabilitation Hospital, Xuzhou, Jiangsu 221003, P.R. China
| | - Xiao Lu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Wei Chen
- Department of Rehabilitation Medicine, Xuzhou Central Hospital, Xuzhou, Jiangsu 221009, P.R. China.,Department of Cardiopulmonary Rehabilitation, Xuzhou Rehabilitation Hospital, Xuzhou, Jiangsu 221003, P.R. China
| | - Gui-Hong Xiao
- Department of Cardiopulmonary Rehabilitation, Xuzhou Rehabilitation Hospital, Xuzhou, Jiangsu 221003, P.R. China
| | - Yijin Zhang
- Department of Cardiopulmonary Rehabilitation, Xuzhou Rehabilitation Hospital, Xuzhou, Jiangsu 221003, P.R. China
| | - Rongbin Yu
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, P.R. China
| | - Jianan Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| |
Collapse
|
3
|
Wang Y, Zhang L, Jia L, Liu J, Liu K, Feng Q, Wang Q. Calcitonin gene-related peptide in aerobic exercise induces collateral circulation development in rat ischemia myocardium. Biomed Pharmacother 2016; 82:561-7. [PMID: 27470397 DOI: 10.1016/j.biopha.2016.05.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 05/22/2016] [Accepted: 05/23/2016] [Indexed: 12/29/2022] Open
Abstract
PURPOSE Aerobic exercise may offer favorable effects for coronary perfusion in the myocardial ischemia area, although the underlying molecular mechanisms remain unclear. This study was designed to investigate the effect of aerobic exercise on the collateral circulation in the ischemia myocardium and to evaluate calcitonin gene-related peptide (CGRP) changes during this process. METHODS AND RESULTS Wistar rats were randomly divided into 3 groups of 7 rats each: a sham operated group (Sham), a myocardial ischemia-only group (MI) and a MI plus aerobic exercise group (MI+AE). The rat myocardial ischemia model was established by injecting isoprenaline (2mg/kg, i.p.). The aerobic exercise training consisted of swimming (40min/d, 5d/wk) for 4 weeks. At the end-points, after echocardiographic analysis was performed, blood and ischemia myocardium samples were collected and analyzed by ELISA to quantify the CGRP protein. The dorsal root ganglia were isolated and analyzed by reverse transcription polymerase chain reaction (RT-PCR) to examine the CGRP mRNA expression, and ischemia myocardium capillary density was evaluated by immunohistochemistry. Our data showed that the capillary density in the left ventricle and heart function were significantly decreased with decreased CGRP production in the MI rats, which were reversed by aerobic exercise in the MI+AE rats. CONCLUSION These results indicate that aerobic exercise may alleviate myocardial ischemia through collateral circulation development with increased CGRP production. CGRP may play an important role in developing the collateral circulation.
Collapse
Affiliation(s)
- YuanHui Wang
- Department of Rehabilitation Medicine, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong, China; Clinical Medical School, Jining Medical University, Jining 272013, Shandong, China
| | - Lei Zhang
- Clinical Medical School, Jining Medical University, Jining 272013, Shandong, China
| | - Li Jia
- Clinical Medical School, Jining Medical University, Jining 272013, Shandong, China
| | - Jing Liu
- Clinical Medical School, Jining Medical University, Jining 272013, Shandong, China
| | - Kun Liu
- Clinical Medical School, Jining Medical University, Jining 272013, Shandong, China
| | - QiZhen Feng
- Clinical Medical School, Jining Medical University, Jining 272013, Shandong, China
| | - Qiang Wang
- Department of Rehabilitation Medicine, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong, China.
| |
Collapse
|
4
|
Ni J, Lu H, Lu X, Jiang M, Peng Q, Ren C, Xiang J, Mei C, Li J. The evolving concept of physiological ischemia training vs. ischemia preconditioning. J Biomed Res 2015; 29:445-50. [PMID: 26664354 PMCID: PMC4662205 DOI: 10.7555/jbr.29.20140142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 01/24/2015] [Accepted: 05/22/2015] [Indexed: 01/08/2023] Open
Abstract
Ischemic heart diseases are the leading cause of death with increasing numbers of patients worldwide. Despite advances in revascularization techniques, angiogenic therapies remain highly attractive. Physiological ischemia training, which is first proposed in our laboratory, refers to reversible ischemia training of normal skeletal muscles by using a tourniquet or isometric contraction to cause physiologic ischemia for about 4 weeks for the sake of triggering molecular and cellular mechanisms to promote angiogenesis and formation of collateral vessels and protect remote ischemia areas. Physiological ischemia training therapy augments angiogenesis in the ischemic myocardium by inducing differential expression of proteins involved in energy metabolism, cell migration, protein folding, and generation. It upregulates the expressions of vascular endothelial growth factor, and induces angiogenesis, protects the myocardium when infarction occurs by increasing circulating endothelial progenitor cells and enhancing their migration, which is in accordance with physical training in heart disease rehabilitation. These findings may lead to a new approach of therapeutic angiogenesis for patients with ischemic heart diseases. On the basis of the promising results in animal studies, studies were also conducted in patients with coronary artery disease without any adverse effect in vivo, indicating that physiological ischemia training therapy is a safe, effective and non-invasive angiogenic approach for cardiovascular rehabilitation. Preconditioning is considered to be the most protective intervention against myocardial ischemia-reperfusion injury to date. Physiological ischemia training is different from preconditioning. This review summarizes the preclinical and clinical data of physiological ischemia training and its difference from preconditioning.
Collapse
Affiliation(s)
- Jun Ni
- Department of Rehabilitation Medicine, the Affiliated Hospital of Nantong University , Nantong, Jiangsu 226000 , China
| | - Hongjian Lu
- The Second People's Hospital , Nantong, Jiangsu 226002 , China
| | - Xiao Lu
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Minghui Jiang
- Department of Cardiology, the Affiliated Hospital of Nantong University , Nantong, Jiangsu 226000 , China
| | - Qingyun Peng
- Department of Cardiology, the Affiliated Hospital of Nantong University , Nantong, Jiangsu 226000 , China
| | - Caili Ren
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Jie Xiang
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| | - Chengyao Mei
- Department of Rehabilitation Medicine, the Affiliated Hospital of Nantong University , Nantong, Jiangsu 226000 , China
| | - Jianan Li
- Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanjing Medical University , Nanjing, Jiangsu 210029 , China
| |
Collapse
|
5
|
Physical ischaemia induced by isometric exercise facilitated collateral development in the remote ischaemic myocardium of humans. Clin Sci (Lond) 2014; 127:581-8. [PMID: 24888429 DOI: 10.1042/cs20130618] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Isometric-handgrip-exercise-induced local ischaemia in the normal limb facilitated collateral recruitment in acutely occluded vessels in patients with coronary artery disease. Ischaemic-handgrip-exercise-induced physical ischaemic training for 3 months facilitated myocardial collateral growth.
Collapse
|
6
|
Li C, Qiu Q, Wang Y, Li P, Xiao C, Wang H, Lin Y, Wang W. Time course label-free quantitative analysis of cardiac muscles of rats after myocardial infarction. MOLECULAR BIOSYSTEMS 2014; 10:505-13. [PMID: 24382414 DOI: 10.1039/c3mb70422j] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Heart failure is a worldwide cause of mortality and morbidity and is the ultimate ending of a variety of complex diseases. This reflects our incomplete understanding of its underlying molecular mechanisms and furthermore increases the complexity of the disease. To better understand the molecular mechanisms of heart failure, we investigated dynamic proteomic differences between the heart tissue of myocardial infarction rats and the rats in the sham group at days 4, 14, 28, 45 after operation. Using a label-free quantitative proteomic approach based on nanoscale ultra-performance liquid chromatography-ESI-MS(E), 133 proteins were identified at the four time points in 8 groups. 13 non-redundant proteins changed dynamically after acute myocardial infarction (AMI) in rat left ventricular (LV) tissue, including cytoskeletal proteins, metabolic enzymes, oxidative stress related proteins and ion channel proteins. The network analysis showed that the differential protein might play an important role in lipid metabolism and hypertrophic cardiomyopathy. The dynamic changes in the expression of beta-actin, alpha B-crystallin (CryAB), heat shock protein 8(HSP8), desmin and l-lactate dehydrogenase B (LDHB) were tested by the western-blot assay, and the results were consistent with the label-free quantitative proteomic results. Correlative analysis indicates that the CryAB and desmin have a better linear relation with heart function (ejection fraction) than cardiac troponin T (cTNT). Our results provide the first experimental evidence of the proteins that are differentially expressed following myocardial infarction, using time-course label-free quantitative proteomics in vivo without ischemia-reperfusion injury or myocardial ischemia. These differential functional proteins (especially CryAB and desmin) have different patterns during the myocardial infarction, which may partially account for the underlying mechanisms involved in cardiac rehabilitation.
Collapse
Affiliation(s)
- Chun Li
- Modern Research Center for Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | | | | | | | | | | | | | | |
Collapse
|
7
|
Viganò A, Vasso M, Caretti A, Bravatà V, Terraneo L, Fania C, Capitanio D, Samaja M, Gelfi C. Protein modulation in mouse heart under acute and chronic hypoxia. Proteomics 2011; 11:4202-17. [PMID: 21948614 DOI: 10.1002/pmic.201000804] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 07/08/2011] [Accepted: 08/08/2011] [Indexed: 11/10/2022]
Abstract
Exploring cellular mechanisms underlying beneficial and detrimental responses to hypoxia represents the object of the present study. Signaling molecules controlling adaptation to hypoxia (HIF-1α), energy balance (AMPK), mitochondrial biogenesis (PGC-1α), autophagic/apoptotic processes regulation and proteomic dysregulation were assessed. Responses to acute hypoxia (AH) and chronic hypoxia (CH) in mouse heart proteome were detected by 2-D DIGE, mass spectrometry and antigen-antibody reactions. Both in AH and CH, the results indicated a deregulation of proteins related to sarcomere stabilization and muscle contraction. Neither in AH nor in CH the HIF-1α stabilization was observed. In AH, the metabolic adaptation to lack of oxygen was controlled by AMPK activation and sustained by an up-regulation of adenosylhomocysteinase and acetyl-CoA synthetase. AH was characterized by the mitophagic protein Bnip 3 increment. PGC-1α, a master regulator of mitochondrial biogenesis, was down-regulated. CH was characterized by the up-regulation of enzymes involved in antioxidant defense, in aldehyde bio-product detoxification and in misfolded protein degradation. In addition, a general down-regulation of enzymes controlling anaerobic metabolism was observed. After 10 days of hypoxia, cardioprotective molecules were substantially decreased whereas pro-apoptotic molecules increased accompained by down-regulation of specific target proteins.
Collapse
Affiliation(s)
- Agnese Viganò
- Dipartimento di Scienze e Tecnologie Biomediche, Università degli Studi di Milano, Segrate (MI), Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Gao J, Shen M, Guo X, Li X, Li J. Proteomic Mechanism of Myocardial Angiogenesis Augmented by Remote Ischemic Training of Skeletal Muscle in Rabbit. Cardiovasc Ther 2010; 29:199-210. [DOI: 10.1111/j.1755-5922.2009.00097.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
|
9
|
Reed R, Potter B, Smith E, Jadhav R, Villalta P, Jo H, Rocic P. Redox-sensitive Akt and Src regulate coronary collateral growth in metabolic syndrome. Am J Physiol Heart Circ Physiol 2009; 296:H1811-21. [PMID: 19376806 DOI: 10.1152/ajpheart.00920.2008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
We have recently shown that the inability of repetitive ischemia (RI) to activate p38 MAPK (p38) and Akt in metabolic syndrome [JCR:LA-cp (JCR)] rats was associated with impaired coronary collateral growth (CCG). Furthermore, Akt and p38 activation correlated with optimal O(2)(-). levels and were altered in JCR rats, and redox-sensitive p38 activation was required for CCG. Here, we determined whether the activation of Src, a possible upstream regulator, was altered in JCR rats and whether redox-dependent Src and Akt activation were required for CCG. CCG was assessed by myocardial blood flow (microspheres) and kinase activation was assessed by Western blot analysis in the normal zone and collateral-dependent zone (CZ). RI induced Src activation (approximately 3-fold) in healthy [Wistar-Kyoto (WKY)] animals but not in JCR animals. Akt inhibition decreased (approximately 50%), and Src inhibition blocked RI-induced CCG in WKY rats. Src inhibition decreased p38 and Akt activation. Myocardial oxidative stress (O(2)(-). and oxidized/reduced thiols) was measured quantitatively (X-band electron paramagnetic resonance). An antioxidant, apocynin, reduced RI-induced oxidative stress in JCR rats to levels induced by RI in WKY rats versus the reduction in WKY rats to very low levels. This resulted in a significant restoration of p38 (approximately 80%), Akt (approximately 65%), and Src (approximately 90%) activation in JCR rats but decreased the activation in WKY rats (p38: approximately 45%, Akt: approximately 65%, and Src: approximately 100%), correlating with reduced CZ flow in WKY rats (approximately 70%), but significantly restored CZ flow in JCR rats (approximately 75%). We conclude that 1) Akt and Src are required for CCG, 2) Src is a redox-sensitive upstream regulator of RI-induced p38 and Akt activation, and 3) optimal oxidative stress levels are required for RI-induced p38, Akt, and Src activation and CCG.
Collapse
Affiliation(s)
- Ryan Reed
- Department of Biochemistry, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | | | | | | | | | | | | |
Collapse
|