title: Exercise training improves diastolic perfusion time in patients with coronary artery disease.
abstract: Exercise training elicits an improvement in work capacity and in left-ventricular function in patients with coronary artery disease. An improvement in myocardial oxygen supply accounts for these effects. The aim of this study was to test the hypothesis that exercise training could favorably influence diastolic perfusion time, a major determinant of subendocardial perfusion. Twenty-two male patients with coronary artery disease were randomized to a training or control group. At the study entry and after one year, all patients underwent an exercise stress test. After one year, rest heart rate was lower and diastolic perfusion time was higher in the training group but not in the control group. At peak of exercise, diastolic perfusion time increased and ST-segment depression decreased significantly in the training group but not in the control group. A significant relation was found between the R-R interval and the diastolic perfusion time either before or after training, with a difference in the intercepts of two regressions. Training shifted updown-line regression, effecting a higher value of diastolic perfusion time for a given value of heart rate. Thus, training increases diastolic perfusion time, independently from the effect on heart rate. This mechanism may contribute to the improvement of myocardial perfusion.
authors.affiliation: Division of Cardiology, A. Cardarelli Hospital, Naples, Italy. g.cinquegrana@iol.it
authors.forename: Giorgio
authors.initials: G
authors.lastname: Cinquegrana
authors.forename: Letizia
authors.initials: L
authors.lastname: Spinelli
authors.forename: Luigi
authors.initials: L
authors.lastname: D'Aniello
authors.forename: Massimo
authors.initials: M
authors.lastname: Landi
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: D'Aniello
authors.forename: Pasquale
authors.initials: P
authors.lastname: Meccariello
mesh_terms: D001783:Blood Flow Velocity; D003327:Coronary Disease / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D003971:Diastole / Q000502:physiology*; D004562:Electrocardiography; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D006334:Heart Function Tests; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index