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Exercise Training on Anginal Threshold Does Not Improve Endothelial Function in Refractory Angina Patients

Camila P Jordão1, Luciana O C Dourado2, Camila R A de Assumpção2

  • 1Unidade de Reabilitação Cardiovascular e Fisiologia do Exercício, Instituto do Coraçao (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil; Centro de Reabilitação, Hospital Israelita Albert Einstein, SP, Brazil.

The American Journal of Cardiology
|August 13, 2023
PubMed

Insights

Exercise training improves exercise tolerance in refractory angina patients but does not enhance endothelial function. This study investigated the effects of exercise on endothelial function in refractory angina.

Area of Science:

  • Cardiology
  • Exercise Physiology
  • Vascular Biology

Background:

  • Refractory angina (RA) is a severe manifestation of coronary artery disease (CAD).
  • Endothelial function (EF), assessed by flow-mediated dilation (FMD), is a key prognostic indicator in CAD.
  • The impact of exercise training on EF in RA patients remains unclear.

Purpose of the Study:

  • To determine the effects of a structured exercise training program on endothelial function in patients with refractory angina.
  • To evaluate changes in exercise capacity and cardiovascular risk markers following exercise intervention.

Main Methods:

  • A longitudinal, non-randomized study involving 38 RA patients (aged 45-75) allocated to exercise training (ET) or control (C) groups.
  • The ET group underwent 12 weeks of training including aerobic exercise at anginal threshold, resistance training, and stretching.
  • Cardiopulmonary exercise testing (CPET), FMD measurements, and laboratory analyses were performed at baseline and after 12 weeks.

Main Results:

  • The exercise training group showed significant reductions in glycated hemoglobin and systolic blood pressure compared to baseline.
  • Exercise time during CPET improved in the ET group.
  • Crucially, exercise training did not lead to significant changes in flow-mediated dilation (FMD), indicating no improvement in endothelial function.

Conclusions:

  • Exercise training at the anginal threshold effectively increases exercise tolerance and improves certain cardiovascular risk factors in RA patients.
  • However, this specific exercise regimen does not appear to improve endothelial function as measured by FMD in this population.

Keywords:
endothelial functionexercise trainingrefractory anginavascular

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