Improvement in arterial stiffness following cardiac rehabilitation.
BACKGROUND
Exercise has been shown to beneficially alter arterial stiffness in selected clinical settings. However, the effects of a standardized exercise protocol--"cardiac rehabilitation (CR)"--on measures of arterial stiffness in patients with established coronary heart disease (CHD) has not been well studied.


METHODS
Using applanation tonometry, we studied arterial vascular properties in 26 men and 22 women (mean age 60.5 ± 10.8 years) with established CHD over a 20 week CR program. All patients continued to receive their anti-anginal and vasoactive medications. In addition to standard hemodynamics we estimated central aortic pressure, central arterial pulsatility, augmentation index and arterial pulse wave velocity (PWV).


RESULTS
After 20 weeks of CR, there were no significant changes in resting heart rate or peripheral blood pressure. In 33 patients with at least two follow-up visits, central aortic systolic pressure was consistently lower than peripheral arterial blood pressure and decreased over the CR program time (baseline, 109 ± 16 mmHg; final, 105 ± 14 mmHg. p=0.01). Both carotid-radial (n=12) and carotid-femoral (n=21) - derived PWV decreased over the CR program (carotid-radial: baseline, 7.3 ± 1.2m/s; final, 6.6 ± 1.2m/s, p=0.028. carotid-femoral: baseline, 7.2 ± 1.4m/s; final, 6.5 ± 1.3m/s, p=0.02).


CONCLUSIONS
In this group of patients with established CHD, arterial PWV was noted to significantly decrease over a 20 week CR program. This change occurred in the absence of detectable changes in peripheral blood pressure or heart rate. Decreases in PWV may serve as a sensitive indicator of improved arterial stiffness in patients with atherosclerotic arterial disease notwithstanding ongoing medical therapy.
Division of Cardiology, Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM 87131, United States. wlaskey@salud.unm.edu.
Warren
W
Laskey
Saadi
S
Siddiqi
Cheri
C
Wells
Richard
R
Lueker
D000368:Aged; D015331:Cohort Studies; D003327:Coronary Disease / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D003331:Coronary Vessels / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D059289:Vascular Stiffness / Q000502:physiology*