scholarly journals Contemporary Approaches to Prescribing Exercise in Coronary Artery Disease Patients

2016 ◽  
Vol 12 (2) ◽  
pp. 130-139 ◽  
Author(s):  
Peter H. Brubaker ◽  
James H. Ross ◽  
Kee Chan Joo
Keyword(s):  
Physical Activity ◽  
Coronary Artery Disease ◽  
Health Care ◽  
Coronary Artery ◽  
Resistance Exercise ◽  
Health Care Professionals ◽  
Health Care Cost ◽  
Stress Test ◽  
Exercise Stress ◽  
Artery Disease

Health care professionals engaged in the management of coronary artery disease (CAD) patients, both in primary and secondary prevention settings, should possess the knowledge to develop and modify both aerobic exercise as well as musculoskeletal resistance exercise training programs. The traditional exercise prescription (ExRx) for aerobic-type exercise describes the intensity, frequency, duration, and mode of exercise, as well as the rate of progression. The more contemporary ExRx focuses on the energy expenditure associated with all physical activity not just structured exercise bouts. The total “volume or dose” of physical activity is associated with important health outcomes, including the potential to prevent and potentially reverse CAD lesions. Also, emerging evidence supporting the use of high-intensity interval training in CAD patients will also be provided. Furthermore, this review will also address the issue of generating an appropriate ExRx in the absence of maximal exercise “stress” test data, a common occurrence in the primary care setting and in this era of health care cost containment. Prescribing resistance exercise for CAD patients requires careful consideration and will be discussed in this review. Finally, this review will conclude with a section that describes the special considerations and/or modifications for some common comorbidities seen in CAD patients

Hemodynamic Characteristics of Patients with Coronary Artery Disease Presenting False-Negative Exercise Stress Test

Angiology ◽  
1992 ◽  
Vol 43 (6) ◽  
pp. 506-511 ◽  
Author(s):  
Michihito Sekiya ◽  
Makoto Suzuki ◽  
Yasushi Fujiwara ◽  
Takumi Sumimoto ◽  
Mareomi Hamada ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Stress Test ◽  
False Negative ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Hemodynamic Characteristics ◽  
Artery Disease

Recent advances in the role of the adenosinergic system in coronary artery disease

2020 ◽  
Author(s):  
Franck Paganelli ◽  
Marine Gaudry ◽  
Jean Ruf ◽  
Régis Guieu
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Tissue Hypoxia ◽  
Exercise Stress ◽  
Fractional Flow ◽  
Coronary Syndrome ◽  
Flow Reserve ◽  
Artery Disease

Abstract Adenosine is an endogenous nucleoside that plays a major role in the physiology and physiopathology of the coronary artery system, mainly by activating its A2A receptors (A2AR). Adenosine is released by myocardial, endothelial, and immune cells during hypoxia, ischaemia, or inflammation, each condition being present in coronary artery disease (CAD). While activation of A2AR improves coronary blood circulation and leads to anti-inflammatory effects, down-regulation of A2AR has many deleterious effects during CAD. A decrease in the level and/or activity of A2AR leads to: (i) lack of vasodilation, which decreases blood flow, leading to a decrease in myocardial oxygenation and tissue hypoxia; (ii) an increase in the immune response, favouring inflammation; and (iii) platelet aggregation, which therefore participates, in part, in the formation of a fibrin-platelet thrombus after the rupture or erosion of the plaque, leading to the occurrence of acute coronary syndrome. Inflammation contributes to the development of atherosclerosis, leading to myocardial ischaemia, which in turn leads to tissue hypoxia. Therefore, a vicious circle is created that maintains and aggravates CAD. In some cases, studying the adenosinergic profile can help assess the severity of CAD. In fact, inducible ischaemia in CAD patients, as assessed by exercise stress test or fractional flow reserve, is associated with the presence of a reserve of A2AR called spare receptors. The purpose of this review is to present emerging experimental evidence supporting the existence of this adaptive adenosinergic response to ischaemia or inflammation in CAD. We believe that we have achieved a breakthrough in the understanding and modelling of spare A2AR, based upon a new concept allowing for a new and non-invasive CAD management.

Prognostic Value of Exercise Stress Test and Dobutamine Stress Echo in Patients with Known Coronary Artery Disease

2009 ◽  
Vol 26 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Francesca Innocenti ◽  
Francesca Caldi ◽  
Irene Tassinari ◽  
Chiara Agresti ◽  
Costanza Burgisser ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Prognostic Value ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Dobutamine Stress ◽  
Exercise Stress ◽  
Stress Echo ◽  
Artery Disease

scholarly journals Patients with Coronary Artery Disease Have Lower Levels of Antibody to Heat-Stressed Fibroblast Derived Proteins, versus Normal Subjects

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Azin Aghamajidi ◽  
Hesam Babaei Khameneh ◽  
Narges Amirjamshidi ◽  
Seyed Farzad Jalali ◽  
Haleh Akhavan-Niaki ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Stress Test ◽  
Cellular Stress ◽  
Normal Subjects ◽  
Cardiac Cells ◽  
Cellular Stress Response ◽  
Exercise Stress ◽  
Clinical Approach ◽  
Artery Disease

Cellular stress response plays an important role in the pathophysiology of coronary artery disease (CAD). Inhibition of cellular stress may provide a novel clinical approach regarding the diagnosis and treatment of CAD. Fibroblasts constitute 60-70% of cardiac cells and have a crucial role in cardiovascular function. Hence, the aim of this study was to show a potential therapeutic application of proteins derived from heat-stressed fibroblast in CAD patients. Fibroblasts were isolated from the foreskin and cultured under heat stress conditions. Surprisingly, 1.06% of the cells exhibited a necrotic death pattern. Furthermore, heat-stressed fibroblasts produced higher level of total proteins than control cells. In SDS-PAGE analysis, a 70 kDa protein band was observed in stressed cell culture supernatants which appeared as two acidic spots with close pI in the two-dimensional electrophoresis. To evaluate the immunogenic properties of fibroblast-derived heat shock proteins (HSPs), the serum immunoglobulin-G (IgG) was measured by ELISA in 50 CAD patients and 50 normal subjects who had been diagnosed through angiography. Interestingly, the level of anti-HSP antibody was significantly higher in non-CAD individuals in comparison with the patient’s group ( p < 0.05 ). The odds ratio for CAD was 5.06 ( 95 % CI = 2.15 ‐ 11.91 ) in cut-off value of 30 AU/mL of anti-HSP antibody. Moreover, ROC analysis showed that anti-HSP antibodies had a specificity of 74% and a sensitivity of 64%, which is almost equal to 66% sensitivity of exercise stress test (EST) as a CAD diagnostic method. These data revealed that fibroblast-derived HSPs are suitable for the diagnosis and management of CAD through antibody production.

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