A randomised trial comparing the effect of exercise training and weight loss on microvascular function in coronary artery disease

Rasmus Huan Olsen; Lene Rørholm Pedersen; Anders Jürs; Martin Snoer; Steen B Haugaard; Eva Prescott

doi:10.1016/j.ijcard.2015.03.118

A randomised trial comparing the effect of exercise training and weight loss on microvascular function in coronary artery disease

Rasmus Huan Olsen, Lene Rørholm Pedersen, Anders Jürs, Martin Snoer, Steen B Haugaard, Eva Prescott

Institut for Klinisk Medicin

21 Citationer (Scopus)

Abstract

BACKGROUND: Coronary microvascular function is associated with outcome and is reduced in coronary artery disease (CAD) and obesity. We compared the effect of aerobic interval training (AIT) and weight loss on coronary flow reserve (CFR) and peripheral vascular function in revascularised obese CAD patients.

METHODS AND RESULTS: Seventy non-diabetic patients (BMI 28-40 kg × m(-2), age 45-75 years) were randomised to 12 weeks' AIT (three weekly sessions lasting 38 min with ≈ 16 min at 85-90% of VO2peak) or low energy diet (LED, 800-1000 kcal/day). Per protocol adherence was defined by training-attendance ≥ 60% and weight loss ≥ 5%, respectively. CFR was assessed by Doppler echocardiography of the LAD. Peripheral vascular function was assessed by arterial tonometry as reactive hyperaemia index (RHI) and augmentation index. Most participants had impaired CFR with a mean CFR of 2.38 (SD 0.59). Twenty-six AIT and 24 LED participants completed the study per protocol with valid CFR measurements. AIT resulted in a 10.4% improvement in VO2peak and LED in a 10.6% weight loss (between group differences both P<0.001). CFR increased by 0.26 (95%CI 0.04;0.48) after AIT and by 0.39 (95%CI 0.13;0.65) after LED without significant between-group difference (-0.13 (95%CI -0.45;0.20)). RHI and augmentation index remained unchanged after both interventions (P>0.50). Intention-to-treat analyses showed similar results.

CONCLUSIONS: 12 weeks' AIT and LED increased CFR by comparable magnitude; thus both interventions might impact prognosis of CAD through improvement of coronary microvascular function.

CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01724567.

Originalsprog	Engelsk
Tidsskrift	International Journal of Cardiology
Vol/bind	185
Sider (fra-til)	229-35
Antal sider	7
ISSN	0167-5273
DOI	https://doi.org/10.1016/j.ijcard.2015.03.118
Status	Udgivet - 15 apr. 2015

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10.1016/j.ijcard.2015.03.118

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@article{9a22575ce570437281e3ab39a38c90c3,

title = "A randomised trial comparing the effect of exercise training and weight loss on microvascular function in coronary artery disease",

abstract = "BACKGROUND: Coronary microvascular function is associated with outcome and is reduced in coronary artery disease (CAD) and obesity. We compared the effect of aerobic interval training (AIT) and weight loss on coronary flow reserve (CFR) and peripheral vascular function in revascularised obese CAD patients.METHODS AND RESULTS: Seventy non-diabetic patients (BMI 28-40 kg × m(-2), age 45-75 years) were randomised to 12 weeks' AIT (three weekly sessions lasting 38 min with ≈ 16 min at 85-90% of VO2peak) or low energy diet (LED, 800-1000 kcal/day). Per protocol adherence was defined by training-attendance ≥ 60% and weight loss ≥ 5%, respectively. CFR was assessed by Doppler echocardiography of the LAD. Peripheral vascular function was assessed by arterial tonometry as reactive hyperaemia index (RHI) and augmentation index. Most participants had impaired CFR with a mean CFR of 2.38 (SD 0.59). Twenty-six AIT and 24 LED participants completed the study per protocol with valid CFR measurements. AIT resulted in a 10.4% improvement in VO2peak and LED in a 10.6% weight loss (between group differences both P<0.001). CFR increased by 0.26 (95%CI 0.04;0.48) after AIT and by 0.39 (95%CI 0.13;0.65) after LED without significant between-group difference (-0.13 (95%CI -0.45;0.20)). RHI and augmentation index remained unchanged after both interventions (P>0.50). Intention-to-treat analyses showed similar results.CONCLUSIONS: 12 weeks' AIT and LED increased CFR by comparable magnitude; thus both interventions might impact prognosis of CAD through improvement of coronary microvascular function.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01724567.",

keywords = "Aged, Body Mass Index, Coronary Artery Disease, Coronary Circulation, Echocardiography, Doppler, Exercise, Exercise Therapy, Female, Follow-Up Studies, Humans, Male, Microcirculation, Middle Aged, Obesity, Prognosis, Regional Blood Flow, Time Factors, Weight Loss",

author = "Olsen, {Rasmus Huan} and Pedersen, {Lene R{\o}rholm} and Anders J{\"u}rs and Martin Snoer and Haugaard, {Steen B} and Eva Prescott",

year = "2015",

month = apr,

day = "15",

doi = "10.1016/j.ijcard.2015.03.118",

language = "English",

volume = "185",

pages = "229--35",

journal = "International Journal of Cardiology",

issn = "0167-5273",

publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - A randomised trial comparing the effect of exercise training and weight loss on microvascular function in coronary artery disease

AU - Olsen, Rasmus Huan

AU - Pedersen, Lene Rørholm

AU - Jürs, Anders

AU - Snoer, Martin

AU - Haugaard, Steen B

AU - Prescott, Eva

PY - 2015/4/15

Y1 - 2015/4/15

N2 - BACKGROUND: Coronary microvascular function is associated with outcome and is reduced in coronary artery disease (CAD) and obesity. We compared the effect of aerobic interval training (AIT) and weight loss on coronary flow reserve (CFR) and peripheral vascular function in revascularised obese CAD patients.METHODS AND RESULTS: Seventy non-diabetic patients (BMI 28-40 kg × m(-2), age 45-75 years) were randomised to 12 weeks' AIT (three weekly sessions lasting 38 min with ≈ 16 min at 85-90% of VO2peak) or low energy diet (LED, 800-1000 kcal/day). Per protocol adherence was defined by training-attendance ≥ 60% and weight loss ≥ 5%, respectively. CFR was assessed by Doppler echocardiography of the LAD. Peripheral vascular function was assessed by arterial tonometry as reactive hyperaemia index (RHI) and augmentation index. Most participants had impaired CFR with a mean CFR of 2.38 (SD 0.59). Twenty-six AIT and 24 LED participants completed the study per protocol with valid CFR measurements. AIT resulted in a 10.4% improvement in VO2peak and LED in a 10.6% weight loss (between group differences both P<0.001). CFR increased by 0.26 (95%CI 0.04;0.48) after AIT and by 0.39 (95%CI 0.13;0.65) after LED without significant between-group difference (-0.13 (95%CI -0.45;0.20)). RHI and augmentation index remained unchanged after both interventions (P>0.50). Intention-to-treat analyses showed similar results.CONCLUSIONS: 12 weeks' AIT and LED increased CFR by comparable magnitude; thus both interventions might impact prognosis of CAD through improvement of coronary microvascular function.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01724567.

AB - BACKGROUND: Coronary microvascular function is associated with outcome and is reduced in coronary artery disease (CAD) and obesity. We compared the effect of aerobic interval training (AIT) and weight loss on coronary flow reserve (CFR) and peripheral vascular function in revascularised obese CAD patients.METHODS AND RESULTS: Seventy non-diabetic patients (BMI 28-40 kg × m(-2), age 45-75 years) were randomised to 12 weeks' AIT (three weekly sessions lasting 38 min with ≈ 16 min at 85-90% of VO2peak) or low energy diet (LED, 800-1000 kcal/day). Per protocol adherence was defined by training-attendance ≥ 60% and weight loss ≥ 5%, respectively. CFR was assessed by Doppler echocardiography of the LAD. Peripheral vascular function was assessed by arterial tonometry as reactive hyperaemia index (RHI) and augmentation index. Most participants had impaired CFR with a mean CFR of 2.38 (SD 0.59). Twenty-six AIT and 24 LED participants completed the study per protocol with valid CFR measurements. AIT resulted in a 10.4% improvement in VO2peak and LED in a 10.6% weight loss (between group differences both P<0.001). CFR increased by 0.26 (95%CI 0.04;0.48) after AIT and by 0.39 (95%CI 0.13;0.65) after LED without significant between-group difference (-0.13 (95%CI -0.45;0.20)). RHI and augmentation index remained unchanged after both interventions (P>0.50). Intention-to-treat analyses showed similar results.CONCLUSIONS: 12 weeks' AIT and LED increased CFR by comparable magnitude; thus both interventions might impact prognosis of CAD through improvement of coronary microvascular function.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01724567.

KW - Aged

KW - Body Mass Index

KW - Coronary Artery Disease

KW - Coronary Circulation

KW - Echocardiography, Doppler

KW - Exercise

KW - Exercise Therapy

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Microcirculation

KW - Middle Aged

KW - Obesity

KW - Prognosis

KW - Regional Blood Flow

KW - Time Factors

KW - Weight Loss

U2 - 10.1016/j.ijcard.2015.03.118

DO - 10.1016/j.ijcard.2015.03.118

M3 - Journal article

C2 - 25802037

SN - 0167-5273

VL - 185

SP - 229

EP - 235

JO - International Journal of Cardiology

JF - International Journal of Cardiology

ER -

A randomised trial comparing the effect of exercise training and weight loss on microvascular function in coronary artery disease

Abstract

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