Effects of physical exercise on inflammatory parameters and risk for repeated acute coronary syndrome in patients with ischemic heart disease

Background/Aim. Inflammation is an important factor in the pathogenesis of atherosclerosis, and several markers of inflammation have been associated with an increased risk of cardiovascular events. Physical activity may lower the risk for coronary heart disease (CHD) by mitigating inflammation. The aim of this study was to investigate the effects of aerobic physical exercise on systemic inflammatory response in patients with stable coronary disease participating in a cardiovascular rehabilitation exercise program. Methods. Male (n = 29) and female (n = 23) patients with stable coronary heart disease were enrolled in this study. All the patients were divided into two groups: the group with regular aerobic physical training during cardiovascular rehabilitation program phase II for 3 weeks in our rehabilitation center and 3 weeks after that in their home setting, and sedentary lifestyle group. There were no significant differences in gender distribution among the analyzed groups. Student's t-test showed no significant differences in average age, waist circumference (OS) and waist/hip ratio (WHR). Results. The degree of obesity was measured by BMI and there was a significant improvement in BMI in the patients who undertook 6-week physical training compared to the controls (p < 0.05). Physical training during 6-week appeared not to have any effects on leukocite count and ICAM-1 levels compared to controls. Exercise induced reduction in plasma CRP levels by 23.72% (p < 0.001) and reduction in plasma VCAM-1 levels by 10.23%, (p < 0.05). Conclusion. Moderate aerobic exercise resulted in a significant reduction of inflammatory state by decreasing CRP and VCAM-1 levels with significant obesity reduction but without visceral obesity reduction. The obtained results indicate that regular physical activity is clinically desirable in primary and secondary prevention of coronary heart diseases.

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The effects of exercise capacity and sedentary lifestyle on haemostasis among middle-aged women with coronary heart disease

Thrombosis and Haemostasis ◽

10.1160/th07-10-0650 ◽

2008 ◽

Vol 100 (05) ◽

pp. 899-904 ◽

Cited By ~ 4

Author(s):

Imre Janszky ◽

Margita Eriksson-Berg ◽

Faris Al-Khalili ◽

Karin Schenck-Gustafsson ◽

Edit Nagy

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Exercise Capacity ◽

Coronary Event ◽

Factor Vii ◽

Middle Aged ◽

Blood Profile ◽

Coronary Syndrome ◽

Increased Risk ◽

Haemostatic Factors

SummaryPrevious studies have established a link/relationship between haemostatic factors and increased risk of cardiovascular disease. In addition, physical conditioning is associated with lower coronary heart disease risk. The purpose of this study was to assess the association between physical exercise and haemostatic factors among middle-aged women surviving an acute coronary event. The Stockholm Female Coronary Risk Study included 292 women aged < 65 years, resident in the greater Stockholm area, who were hospitalized for an acute coronary syndrome. Extensive clinical screening including exercise testing, and blood tests were performed 3–6 months after the coronary event. Self-reported physical activity was assessed by a WHO questionnaire. Patients on warfarin treatment were excluded from our analyses. Haemostatic factors were generally higher among physically inactive patients when compared to physically active women in our univariate models. Exercise capacity had a statistically significant relationship with factor VII antigen (p=0.039) and vWFag (p=0.038) even in our multiadjusted analyses. Physical inactivity and poor physical fitness are associated with a potentially prothrombotic blood profile in middle aged women with coronary heart disease.

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The impact of behavioral counseling on stage of change in fat intake, physical activity, and cigarette smoking in adults at increased risk of coronary heart disease

American Journal of Public Health ◽

10.2105/ajph.91.2.265 ◽

2001 ◽

Vol 91 (2) ◽

pp. 265-269 ◽

Cited By ~ 121

Keyword(s):

Physical Activity ◽

Coronary Heart Disease ◽

Heart Disease ◽

Cigarette Smoking ◽

Stage Of Change ◽

Fat Intake ◽

Behavioral Counseling ◽

Increased Risk ◽

The Impact

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The importance of stratifying ischemic risk by using the Duke score in women with ischemic heart disease and hypothyroidism before inclusion in cardiovascular rehabilitation programs

Balneo and PRM Research Journal ◽

10.12680/balneo.2021.444 ◽

2021 ◽

Vol 12 (3) ◽

pp. 248-254

Author(s):

Diana Andrada GURZĂU ◽

Bogdan CALOIAN ◽

Horaţiu COMŞA ◽

Adela SITAR-TĂUT ◽

Dumitru ZDRENGHEA ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

High Risk ◽

Ischemic Heart Disease ◽

Thyroid Function ◽

Ischemic Heart ◽

Exercise Stress ◽

Rehabilitation Programs ◽

Cardiovascular Rehabilitation ◽

Increased Risk

Introduction: The relationship between abnormal thyroid function and coronary heart disease has been known for a long time, and particularly, hypothyroidism is associated with an increased risk of cardiovascular disease. The aim of this study was to evaluate the ischemic risk by using the Duke score in women with ischemic heart disease and associated hypothyroidism before inclusion in cardiovascular rehabilitation program. Materials and methods: We included in the study 150 female patients admitted to the Cardiology Department of the Clinical Rehabilitation Hospital Cluj-Napoca. All the patients included had ischemic heart disease and performed an exercise stress testing to evaluate the effort capacity and also to stratify the ischemic risk by calculating the Duke Score. After dosing the thyroid stimulating hormone (TSH) we divided the patients in two groups: with hypothyroidism and a control group. Results: Patients with hypothyroidism were more frequently hypertensive, (98% vs 87%, p-0.035), and they had diabetes mellitus in a higher proportion (51% vs 22%, p-0.005). HDL cholesterol was significantly decreased in the group of patients with hypothyroidism: 40.36±10.39mg/dl vs 44.85±10.29mg/dl (p-0.01). Regarding the ischemic risk assessed by the Duke score, the statistically significant differences between the two groups were registered only for the category of high-risk patients, 5.55% vs 18% (p-0.048). Also, the TSH value was higher in the group with high-risk Duke score, 4.21±3.73µIU/ml, compared to the moderate-risk score group, 1.95±1.12µIU/ml(p-0.05). Conclusion: In women with ischemic heart disease, assessing thyroid function can be useful to identify patients at high risk of ischemia. Patients with hypothyroidism tend to have a higher prevalence of cardiovascular risk factors, a higher ischemic risk objectified by the Duke score and more commonly multivascular coronary lesions. For these patients, the inclusion in cardiovascular rehabilitation programs is essential, but it is very important that the programs to be customized for each patient. Keywords: coronary heart disease in women, exercise ECG, Duke score, ischemic risk, hypothyroidism, cardiovascular rehabilitation programs

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Lipoprotein-associated Phospholipase A2 and Coronary Heart Disease

Current Pharmaceutical Design ◽

10.2174/1381612824666180111110550 ◽

2018 ◽

Vol 24 (3) ◽

pp. 291-296 ◽

Cited By ~ 5

Author(s):

Areti Sofogianni ◽

Stelina Alkagiet ◽

Konstantinos Tziomalos

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Phospholipase A2 ◽

Therapeutic Target ◽

Association Studies ◽

Genetic Association Studies ◽

Markers Of Inflammation ◽

Chd Risk ◽

Increased Risk

In the last decades, the role of inflammation in the pathogenesis of atherosclerosis has been the topic of intense research. Several markers of inflammation have shown predictive value for first and recurrent coronary events in patients without and with established Coronary Heart Disease (CHD). Among these markers, lipoprotein- associated phospholipase A2 (Lp-PLA2) has recently received considerable attention. In the present review, the potential role of Lp-PLA2 as a marker of CHD risk and as a therapeutic target is discussed. Elevated Lp- PLA2 mass and activity appears to be associated with increased risk for CHD, both in the general population and in patients with established CHD. However, it is unclear whether the measurement of Lp-PLA2 improves risk discrimination when incorporated in models that include traditional cardiovascular risk factors. Moreover, the lack of effect on CHD events of darapladib, a potent, selective Lp-PLA2 inhibitor, in two large, randomized, placebo-controlled trials and the mostly negative findings of genetic association studies suggest that Lp-PLA2 is unlikely to represent a causal factor in atherogenesis. Therefore, it is doubtful whether Lp-PLA2 will constitute a therapeutic target for the prevention of CHD.

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Physical Activity and Markers of Inflammation and Thrombosis Related to Coronary Heart Disease

Preventive Cardiology ◽

10.1111/j.1520-037x.2004.03539.x ◽

2004 ◽

Vol 7 (4) ◽

pp. 190-194 ◽

Cited By ~ 10

Author(s):

Demosthenes B. Panagiotakos ◽

Peter Kokkinos ◽

Yannis Manios ◽

Christos Pitsavos

Keyword(s):

Physical Activity ◽

Coronary Heart Disease ◽

Heart Disease ◽

Markers Of Inflammation

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Depression and coronary heart disease. Clinical characteristics, pathogenetic links and treatment issues

Die Psychiatrie ◽

10.1055/s-0038-1671718 ◽

2012 ◽

Vol 09 (03) ◽

pp. 165-173

Author(s):

A. M. Monteleone ◽

L. Steardo ◽

M. Maj ◽

P. Monteleone

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Recurrent Depression ◽

Cardiac Events ◽

Randomized Controlled Clinical Trials ◽

Coronary Syndrome ◽

Cardiovascular Prognosis ◽

Increased Risk ◽

Endothelial Dysfunctions ◽

Robust Evidence

SummaryIt is widely accepted that depression increases the risk of coronary heart disease (CHD) in healthy people while, in individuals with an existing heart disease, depression is a predictor of recurrent cardiac events and death. It seems that new-onset depression after an acute coronary syndrome (ACS) and not recurrent depression may worsen the cardiovascular outcome, and it has been suggested, although not conclusively proved, that depressive somatic symptoms, could be more cardiotoxic than depressive cognitive symptoms. Both psychosocial (low social support, less adherence to treatment recommendations, physical inactivity) and biological mechanisms (autonomic nervous system dysregulation, platelet and endothelial dysfunctions, inflammation, and neuroendocrine abnormalities) have been hypothesized to explain the link between depression and the increased risk of CHD or adverse cardiovascular prognosis. Randomized controlled clinical trials seem to suggest that depression in CHD patients is poor responsive to both pharmacological and psychotherapeutic treatments. Nevertheless, these trials provide also a robust evidence that CHD depressed patients non responder to antidepressant treatments are at greater risk of adverse cardiac event than patients with successfully treated depression. Therefore, it is advisable that psychiatrists, cardiologists and general practitioners coordinate their efforts in managing depression in CHD patients.

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Physical Training effectiveness and Tolerance in Patients after Myocardial Infraction, Depending on the Initial Physical activity Tolerance

Journal of restorative medicine and rehabilitation ◽

10.38025/2078-1962-2021-20-3-104-112 ◽

2021 ◽

Vol 20 (3) ◽

pp. 104-112

Author(s):

Yulia V. Chistyakova ◽

Irina E. Mishina ◽

Yuri V. Dovgalyuk ◽

Irina V. Mitryaeva ◽

Anna A. Zolotareva ◽

...

Keyword(s):

Physical Activity ◽

Myocardial Infarction ◽

Coronary Heart Disease ◽

Heart Disease ◽

Cardiac Rehabilitation ◽

Physical Training ◽

Exercise Tolerance ◽

Walk Test ◽

6 Minute Walk Test ◽

Minute Walk

Aim. To investigate exercise tolerance in patients undergoing acute coronary syndrome with outcome in myocardial infarction, dependingon physical activity tolerance. Material and methods. We studied 80 patients aged from 40 to 75 years old who were admitted from primary vascular centers for athree-week rehabilitation course to the department of medical rehabilitation for patients with somatic diseases of the clinic of the IvanovoState Medical University of the Ministry of Health of Russia, of which 61 were men (76,3%) and 19 women (23,7%). In accordancewith the aim of the study, a 6-minute walk test was performed in all patients before and after the completion of the rehabilitationcourse. Based on the test results, physical exercise tolerance was assessed and the functional class (FC) of coronary heart disease (CHD) was determined. The patients with I class coronary heart disease (CHD) in the number of 20 patients (25%) made up the 1st group, 21patients (26,3%) with II class – the 2nd group, 21 patients (26,3%) with III class – the 3rd group, and 18 patients (22,5%) with IV class– the 4th group. Results. Every third patient who was admitted to a 3-week cardiac rehabilitation course had short-term adverse reactionson loading during physical training on simulators. Most cases of inadequate reactions were noted in patients with III and IV IHDclass III (according to the 6-minute walk test) having, according to the International Classification of Functioning, Disability and Health(ICF), moderate and pronounced reduction of exercise tolerance function. Patients often had tachycardic and hypertensive reactionsin the porcess of prysical training on stimulators and some patients (more often those with the pronounced decrease in exercise tolerancefunction) had hypotensive reaction which is the most unfavorable type of response to the load. In the vast majority of patientswith I and II CHF with no impairment or mild decrease in exercise tolerance according to ICF, an adequate response of hemodynamicparameters to exercise was determined. Adverse reactions were observed only in every fifth-seventh patient and were manifested onlyin the form of tachycardic and hypertensive reactions to exercise. The study analyzed the effectiveness of rehabilitation measures inthe groups of patients with different levels of tolerance to physical activity. It was found out that all the patients with myocardial infarction,regardless of the initial level, had increased exercise tolerance after cardiac rehabilitation. Conclusion. The 6-minute walk test is insufficiently informative for patients with markedly reduced tolerance to physical activity. The«gold standard» of qualitative and quantitative assessment of reactions and interaction between cardiovascular and respiratory systems,as well as metabolic response of the body during physical activity for these patients is the spiroergometric study.

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