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Effect of Cardiac Rehabilitation on Angiogenic Cytokines in Postinfarction Patients
  1. Bai-Chin Lee (lebai{at}ntuh.gov.tw)
  1. National Taiwan University Hospital, Taiwan
    1. Hsiu-Ching Hsu (hhching{at}ntuh.gov.tw)
    1. National Taiwan University Hospital, Taiwan
      1. Wen-Yih Isaac Tseng (wytseng{at}ntu.edu.tw)
      1. National Taiwan University Hospital, Taiwan
        1. Mao-Yuan Marine Su (marine{at}ntuh.gov.tw)
        1. National Taiwan University Hospital, Taiwan
          1. Ssu-Yuan Chen (ssuyuan{at}ntu.edu.tw)
          1. National Taiwan University Hospital, Taiwan
            1. Yen-Wen Wu (ywwu{at}ntuh.gov.tw)
            1. National Taiwan University Hospital, Taiwan
              1. Kuo-Liong Chien (klchien{at}ntu.edu.tw)
              1. National Taiwan University Hospital, Taiwan
                1. Ming-Fong Chen (mfchen{at}ntu.edu.tw)
                1. National Taiwan University Hospital, Taiwan

                  Abstract

                  Objective: To determine whether cardiac rehabilitation influences plasma levels of angiogenic cytokines and their correlation with myocardial blood flow (MBF).

                  Design: Randomised controlled study.

                  Setting: Tertiary cardiac centre.

                  Patients: 39 postinfarction patients randomised to either a 3-month training group (n=20) or a nontraining group (n=19), and 19 normal controls.

                  Interventions: Cardiac rehabilitation.

                  Main outcome measures: MBF by cardiac magnetic resonance imaging, and plasma levels of stem cell factor (SCF), stromal-derived factor-1 (SDF-1), and vascular endothelial growth factor (VEGF) measured at enrollment and at 3 months after randomisation.

                  Results: At baseline, when compared to the healthy subjects, postinfarction patients had a lower MBF in the infarcted myocardium during dipyridamole-induced stress (1.65(0.58) vs 2.77(0.78) ml/min/g, p<0.001) but higher plasma levels of VEGF (3.65(0.75) vs 2.77(0.59) pg/ml, p<0.001 expressed as the natural logarithm) and SDF-1 (2113(345) vs 1869(309) pg/ml, p=0.009). Only SDF-1 was inversely associated with stress MBF in both remote (r= -0.39, p=0.03) and infarcted myocardium (r= -0.62, p<0.001). After 3 months, the training group¡¯s stress MBF had increased by 33% in the remote (p<0.001) and 28% in infarcted myocardium (p=0.02), while VEGF decreased by 9% (p=0.01) and SDF-1 decreased by 11% (p=0.02). The change in SDF-1 was inversely correlated with the change in stress MBF in both remote (r= -0.40, p=0.01) and infarcted myocardium (r= -0.50, p=0.001). In the nontraining group, MBF and cytokines were unchanged.

                  Conclusion: Cardiac rehabilitation improves stress MBF in postinfarction patients, with an inverse decrease in circulating angiogenic cytokines.

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