title: Effect of exercise training on myocardial blood flow in patients with stable coronary artery disease.
abstract: BACKGROUND
  The mechanisms by which exercise training benefits patients with coronary artery disease (CAD) are unclear but may include improved myocardial circulation. The aim of this study was to investigate the effect of exercise training on myocardial blood flow (MBF) and coronary flow reserve (CFR) in patients with stable CAD.
  
  
  METHODS
  Twelve patients with documented CAD and ischemic ST-segment depression during exercise testing were randomized to exercise training (n = 7) or sedentary life style (control; n = 5) and underwent rubidium-82 positron emission tomography pre- and postintervention. Global left ventricle MBF and regional MBF in 17 left ventricular segments were calculated. Segments with <75% uptake (2 SD below normal) on stress uptake images were defined as abnormal.
  
  
  RESULTS
  Exercise training increased global CFR by 20.8% +/- 27.9% versus control (10.5 +/- 24.1%, P = .0001). In normal segments (exercise training: n = 91; control: n = 46), exercise training did not change resting MBF (-14.1% +/- 16.3% vs -8.8% +/- 15.6%) and hyperemic MBF (-1.93% +/- 19.1% vs 2.86% +/- 20.5%, P = NS) and increased in CFR compared to control (17.0% +/- 25.5% vs 11.3% +/- 23.5%, P = .01). In abnormal segments, the change in resting MBF was not significantly different (-12.6% +/- 18.5% exercise [28 segments] vs -2.9% +/- 18.0% control [39 segments], P = NS). A significant increase was seen in hyperemic MBF with exercise (12.5% +/- 22.1% vs 2.6% +/- 16.3%, P = .02) and CFR (32.8% +/- 32.3% vs 9.5% +/- 24.8%, P = .001).
  
  
  CONCLUSIONS
  Exercise training increased CFR in normal and diseased segments, and increased hyperemic flow in diseased segments. These data provide preliminary evidence in support of a favorable effect of exercise training on blood flow to ischemic myocardium.
authors.affiliation: Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Yoshinaga
authors.forename: Rob S B
authors.initials: RS
authors.lastname: Beanlands
authors.forename: Robert A
authors.initials: RA
authors.lastname: Dekemp
authors.forename: Mireille
authors.initials: M
authors.lastname: Lortie
authors.forename: Jason
authors.initials: J
authors.lastname: Morin
authors.forename: May
authors.initials: M
authors.lastname: Aung
authors.forename: Robert
authors.initials: R
authors.lastname: McKelvie
authors.forename: Richard F
authors.initials: RF
authors.lastname: Davies
mesh_terms: D003324:Coronary Artery Disease / Q000503:physiopathology*; D003326:Coronary Circulation; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged