RT Journal Article
SR Electronic
T1 Effect of cardiac rehabilitation on angiogenic cytokines in postinfarction patients
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1012
OP 1018
DO 10.1136/hrt.2008.153510
VO 95
IS 12
A1 Lee, B-C
A1 Hsu, H-C
A1 Tseng, W-Y I
A1 Su, M-Y M
A1 Chen, S-Y
A1 Wu, Y-W
A1 Chien, K-L
A1 Chen, M-F
YR 2009
UL http://heart.bmj.com/content/95/12/1012.abstract
AB 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 non-training 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 enrolment and at 3 months after randomisation.Results: At baseline, when compared with 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 non-training group, MBF and cytokines were unchanged.Conclusion: Cardiac rehabilitation improves stress MBF in postinfarction patients, with an inverse decrease in circulating angiogenic cytokines.