title: Effect of cardiac rehabilitation on angiogenic cytokines in postinfarction patients.
abstract: OBJECTIVE
  To determine whether cardiac rehabilitation influences plasma levels of angiogenic cytokines and their correlation with myocardial blood flow (MBF).
  
  
  METHODS
  Randomised controlled study.
  
  
  METHODS
  Tertiary cardiac centre.
  
  
  METHODS
  39 postinfarction patients randomised to either a 3-month training group (n = 20) or a non-training group (n = 19), and 19 normal controls.
  
  
  METHODS
  Cardiac rehabilitation.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Cardiac rehabilitation improves stress MBF in postinfarction patients, with an inverse decrease in circulating angiogenic cytokines.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: B-C
authors.initials: BC
authors.lastname: Lee
authors.forename: H-C
authors.initials: HC
authors.lastname: Hsu
authors.forename: W-Y I
authors.initials: WY
authors.lastname: Tseng
authors.forename: M-Y M
authors.initials: MY
authors.lastname: Su
authors.forename: S-Y
authors.initials: SY
authors.lastname: Chen
authors.forename: Y-W
authors.initials: YW
authors.lastname: Wu
authors.forename: K-L
authors.initials: KL
authors.lastname: Chien
authors.forename: M-F
authors.initials: MF
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D043925:Angiogenesis Inducing Agents / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D054377:Chemokine CXCL12 / Q000097:blood; D003326:Coronary Circulation / Q000502:physiology; D016207:Cytokines / Q000097:blood*; D005080:Exercise Test / Q000379:methods; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000534:rehabilitation*; D018919:Neovascularization, Physiologic / Q000502:physiology; D019089:Stem Cell Factor / Q000097:blood; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
chemical_list: D043925:Angiogenesis Inducing Agents; D015415:Biomarkers; C515255:CXCL12 protein, human; D054377:Chemokine CXCL12; D016207:Cytokines; D019089:Stem Cell Factor; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A