title: High frequency home-based exercise decreases levels of vascular endothelial growth factor in patients with stable angina pectoris.
abstract: BACKGROUND
  In coronary artery disease (CAD), circulating angiogenic factors have been seen to increase, possibly as a response to ischaemia. Regular physical activity (PA) is recommended for prevention and treatment of CAD, but more research is needed to optimise PA regimes. We investigated the effect of home-based high frequency exercise (HFE) on angiogenic cytokines and cardiac markers in patients with stable CAD.
  
  
  METHODS
  This was a randomised case-control study
  
  
  METHODS
  Sixty-two patients, with stable CAD, were randomised to HFE (n = 33), (aerobic exercise 70% of max, 30 min, five times/week and resistance exercise three times/week), performed at home, or usual lifestyle (control, n = 29). After eight weeks, percutaneous coronary intervention (PCI) was performed in both groups, and the HFE group continued another six months of exercise. Serum vascular endothelial growth factor (VEGF) and stromal derived factor-1 (SDF-1), plasma N-terminal-brain natriuretic peptide (NT-proBNP), high-sensitive troponin T (TnT) and copeptin were analysed.
  
  
  RESULTS
  Data are presented as median (25(th), 75(th) percentile) of relative changes (%) from baseline. Values of p are given for the difference between the HFE and controls. HFE decreased circulating VEGF levels, before PCI (-5% (-15%, -2%)), while VEGF levels increased in the control group (5% (-3%, 20%) p = 0.004). A significant difference in VEGF remained at three months post-PCI (HFE (-1%(-12%, 5%), control (7% (0%, 14%), p = 0.04), but not at six months after PCI. SDF-1, NT-proBNP, TnT and copeptin levels did not differ significantly. In addition, VEGF levels were positively correlated to NT pro-BNP.
  
  
  CONCLUSIONS
  Home-based HFE decreased circulating VEGF in patients with stable CAD, suggesting a reduced ischaemic burden. HFE does not increase markers of cardiac dysfunction, suggesting that it is a safe therapeutic intervention in these patients.
authors.affiliation: Department of Molecular and Clinical Medicine/Cardiology, University of Gothenburg, Sweden smita.dutta-roy@vgregion.se.
authors.forename: Smita
authors.initials: S
authors.lastname: DuttaRoy
authors.affiliation: Department of Molecular and Clinical Medicine/Cardiology, University of Gothenburg, Sweden.
authors.forename: Jonas
authors.initials: J
authors.lastname: Nilsson
authors.affiliation: Department of Clinical Chemistry, University of Gothenburg, Sweden.
authors.forename: Ola
authors.initials: O
authors.lastname: Hammarsten
authors.affiliation: Institute of Neuroscience and Physiology/Physiotherapy, University of Gothenburg, Sweden Department of Physiotherapy and Occupational Therapy, Sahlgrenska University Hospital/Sahlgrenska, Gothenburg, Sweden.
authors.forename: Åsa
authors.initials: Å
authors.lastname: Cider
authors.affiliation: Department of Molecular and Clinical Medicine/Cardiology, University of Gothenburg, Sweden Department of Physiotherapy and Occupational Therapy, Sahlgrenska University Hospital/Sahlgrenska, Gothenburg, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Bäck
authors.affiliation: Centre for Applied Biostatisics, Occupational and Environmental Medicine, University of Gothenburg, Sweden.
authors.forename: Thomas
authors.initials: T
authors.lastname: Karlsson
authors.affiliation: Department of Molecular and Clinical Medicine/Cardiology, University of Gothenburg, Sweden.
authors.forename: Bertil
authors.initials: B
authors.lastname: Wennerblom
authors.affiliation: Swedish School of Sport and Health Sciences, Sweden Karolinska University Hospital, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Borjesson
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000097:blood / Q000628:therapy*; D043925:Angiogenesis Inducing Agents / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D054377:Chemokine CXCL12 / Q000097:blood; D015444:Exercise / Q000502:physiology*; D005260:Female; D006020:Glycopeptides / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D020107:Troponin T / 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; D006020:Glycopeptides; D010446:Peptide Fragments; D020107:Troponin T; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C048197:copeptins; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Angiogenesis; coronary artery disease; exercise; stromal derived factor-1; vascular endothelial growth factor