title: Effect of exercise on upper and lower extremity endothelial function in patients with coronary artery disease.
abstract: Aerobic exercise training improves endothelial vasomotor function in the coronary circulation of patients with coronary artery disease (CAD), an effect that has been attributed to local repetitive increases in shear stress on the endothelium. To study the effects of exercise on endothelial function in the peripheral circulation, we used vascular ultrasound to examine flow-mediated dilation and nitroglycerin-mediated dilation in the brachial and posterior tibial arteries of 58 subjects with CAD. Studies were performed at baseline and after 10 weeks in 40 subjects (aged 59 +/- 10 years) who participated in a supervised cardiac rehabilitation program that predominantly involved moderate intensity leg exercise (three 30-minute sessions/week), and 18 matched patients who did not exercise and maintained a sedentary lifestyle. Exercise was associated with a 29% increase in functional capacity (7.3 +/- 2.2 vs 9.4 +/- 2.7 METs, p <0.001), and significant improvement in endothelium-dependent, flow-mediated dilation in a conduit artery of the leg, but not the arm. Nitroglycerin-mediated dilation in the upper arm and lower extremity was unaffected. These findings suggest that exercise improves endothelial function in peripheral conduit arteries of patients with CAD and that the beneficial effect may be more marked in the vascular beds of the exercised limbs.
authors.affiliation: Evans Department of Medicine, Cardiology Section, and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Noyan
authors.initials: N
authors.lastname: Gokce
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Vita
authors.forename: David S
authors.initials: DS
authors.lastname: Bader
authors.forename: Debra L
authors.initials: DL
authors.lastname: Sherman
authors.forename: Liza M
authors.initials: LM
authors.lastname: Hunter
authors.forename: Monika
authors.initials: M
authors.lastname: Holbrook
authors.forename: Carol
authors.initials: C
authors.lastname: O'Malley
authors.forename: John F
authors.initials: JF
authors.lastname: Keaney
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Balady
mesh_terms: D001132:Arm / Q000098:blood supply*; D001916:Brachial Artery / Q000187:drug effects / Q000503:physiopathology; D003324:Coronary Artery Disease / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology*; D015444:Exercise; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000494:pharmacology; D010807:Physical Endurance; D016909:Tibial Arteries / Q000187:drug effects / Q000503:physiopathology
chemical_list: D005996:Nitroglycerin