title: Exercise training restores the endothelial response to vascular growth factors in patients with stable coronary artery disease.
abstract: OBJECTIVE
  Exercise training partially corrects endothelial dysfunction in patients with coronary artery disease (CAD). Growth factors like vascular endothelial growth factor (VEGF) as well as erythropoietin (EPO) are known to modulate the bioavailability of nitric oxide and, thereby, contribute to the maintenance of a normal vascular tone. The aim of the present study was to determine the impact of 4 weeks of exercise training on circulating growth factors and to elucidate their involvement in the training-induced changes in vasomotion in patients with CAD.
  
  
  RESULTS
  A total of 39 patients were enrolled (training group: n = 20; control group: n = 19). At start of study and after 4 weeks, average peak flow velocity (APV) of the left internal mammary artery (LIMA) in response to acetylcholine was measured invasively in the treatment and control groups. Serum concentrations of VEGF and EPO were determined by enzyme-linked immunosorbent assay. After exercise training, LIMA APV in response to acetylcholine was increased by 93% (from 69 ± 17% at start of study to 133 ± 16% at 4 weeks, p < 0.01 vs. start of study and control). At start of study, there was no association between any of the vascular growth factors and endothelial function. However, after exercise training a close correlation was apparent between the acetylcholine-induced change in APV and EPO (r = 0.69, p < 0.01) and VEGF (r = 0.76, p < 0.01) serum concentrations. In the control group, these correlations were not evident and there was no change in endothelial function either.
  
  
  CONCLUSIONS
  Exercise training improves agonist-mediated endothelium-dependent vasodilatation in CAD, partially through a restoration of the endothelial response to EPO and VEGF.
authors: Heart Center, Department of Cardiology, University of Leipzig, Struempellstrasse 39, Leipzig, Germany.
authors: Ephraim B
authors: EB
authors: Beck
authors: Sandra
authors: S
authors: Erbs
authors: Sven
authors: S
authors: Möbius-Winkler
authors: Volker
authors: V
authors: Adams
authors: Felix J
authors: FJ
authors: Woitek
authors: Thomas
authors: T
authors: Walther
authors: R
authors: R
authors: Hambrecht
authors: Friedrich-Wilhelm
authors: FW
authors: Mohr
authors: Michael
authors: M
authors: Stumvoll
authors: Matthias
authors: M
authors: Blüher
authors: Gerhard
authors: G
authors: Schuler
authors: Axel
authors: A
authors: Linke
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001783:Blood Flow Velocity; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D004730:Endothelium, Vascular / Q000187:drug effects / Q000378:metabolism* / Q000503:physiopathology; D004797:Enzyme-Linked Immunosorbent Assay; D004921:Erythropoietin / Q000097:blood*; D005081:Exercise Therapy; D005260:Female; D005858:Germany; D006801:Humans; D016014:Linear Models; D008297:Male; D008323:Mammary Arteries / Q000187:drug effects / Q000378:metabolism* / Q000503:physiopathology; D008875:Middle Aged; D012039:Regional Blood Flow; D013997:Time Factors; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*; D014664:Vasodilation / Q000187:drug effects; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: C554270:EPO protein, human; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D014665:Vasodilator Agents; D004921:Erythropoietin