Cardiovascular Protection Variables Based on Exercise Intensity in Stable Coronary Heart Disease Patients After Coronary Stenting: A Comparative Study

Vasc Health Risk Manag. 2020 Jul 6:16:257-270. doi: 10.2147/VHRM.S259190. eCollection 2020.

Abstract

Purpose: Our study aimed at determining and comparing the mechanism of cardiovascular protection variables in moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) in patients with stable coronary heart disease (CHD) after coronary stenting.

Participants and methods: This experimental study used the same subject and cross-over design, involving eleven stable CHD patients after coronary stenting. These were randomly divided into two groups; MICT for 29 minutes at 50-60% heart rate reserve and HIIT with 4x4 minute intervals at 60-80% heart rate reserve, each followed by three minutes of active recovery at 40-50% heart rate reserve. These were conducted three times a week for two weeks. The participants' levels of adrenaline, noradrenaline, endothelial nitric oxide synthase (eNOS), extracellular superoxide dismutase (EC-SOD) activity assayed, and flow-mediated dilatation (FMD) were examined before and after treatments were completed.

Results: The HIIT significantly increased the levels of noradrenaline and eNOS compared with MICT (p<0.05). Also, HIIT was better in maintaining EC-SOD activity and FMD compared with MICT (p<0.05). Through the noradrenalin pathway, HIIT had a direct and significant effect on eNOS and FMD (p<0.05) but MICT, through the noradrenaline pathways, had a direct and significant effect on eNOS (p<0.05), and through the EC-SOD activity pathways had a direct and significant effect on FMD (p<0.05). MICT reduced EC-SOD activity and also decreased the FMD value.

Conclusion: HIIT is superior to MICT in increasing cardiovascular protection by increasing the concentrations of noradrenalin and eNOS, maintaining EC-SOD activity, and FMD in stable CHD patients after coronary stenting.

Keywords: FMD; SOD; catecholamine; coronary heart disease; eNOS; high-intensity interval training.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Biomarkers / blood
  • Coronary Disease / blood
  • Coronary Disease / diagnostic imaging
  • Coronary Disease / physiopathology
  • Coronary Disease / therapy*
  • Cross-Over Studies
  • Epinephrine / blood
  • Exercise Tolerance
  • Female
  • High-Intensity Interval Training*
  • Humans
  • Indonesia
  • Male
  • Middle Aged
  • Nitric Oxide Synthase Type III / blood
  • Norepinephrine / blood
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / instrumentation*
  • Stents*
  • Superoxide Dismutase / blood
  • Time Factors
  • Treatment Outcome

Substances

  • Biomarkers
  • NOS3 protein, human
  • Nitric Oxide Synthase Type III
  • SOD3 protein, human
  • Superoxide Dismutase
  • Norepinephrine
  • Epinephrine