title: Exercise capacity is associated with endothelin-1 release during emotional excitement in coronary artery disease patients.
abstract: Endothelin-1 (ET-1), a potent vasoconstrictor, IL-6, and catecholamines are increased and heart rate variability [SD of normal to normal R-R intervals (SDNN)] decreased during emotional excitement, but individual responses vary. We tested the hypothesis that exercise capacity is associated with physiological responses caused by real-life emotional excitement. We measured the plasma levels of ET-1, IL-6, catecholamines, heart rate, and SDNN in enthusiastic male ice hockey spectators (n = 51; age, 59 ± 9 years) with stable coronary artery disease (CAD) at baseline and during the Finnish National Ice Hockey League's final play-off matches. Maximal exercise capacity (METs) by bicycle exercise test and left ventricular ejection fraction (LVEF) were measured on a separate day. ET-1 response from baseline to emotional excitement correlated with maximal METs (r = -0.30; P = 0.040). In a linear stepwise regression analysis age, body mass index (BMI), METs, LVEF, basal ET-1, and subjective experience of excitement were entered the model as independent variables to explain ET-1 response. This model explained 27% of ET-1 response (P = 0.003). Maximal METs were most strongly correlated with ET-1 response (β = -0.45; partial correlation r = -0.43; P = 0.002), followed by BMI (β = -0.31; partial correlation r = -0.31; P = 0.033) and LVEF (β = -0.30; partial correlation r = -0.33; P = 0.023). Exercise capacity may protect against further cardiovascular events in CAD patients, because it is associated with reduced ET-1 release during emotional excitement.
authors.affiliation: Institute of Clinical Medicine, Department of Internal Medicine, University of Oulu, Finland; Department of Exercise and Medical Physiology, Verve Research, Verve, Oulu, Finland; and Department of Applied Sciences, London South Bank University, London, UK Mikko.Tulppo@verve.fi.
authors.forename: Mikko P
authors.initials: MP
authors.lastname: Tulppo
authors.affiliation: Institute of Clinical Medicine, Department of Internal Medicine, University of Oulu, Finland;
authors.forename: Olli-Pekka
authors.initials: OP
authors.lastname: Piira
authors.affiliation: Department of Exercise and Medical Physiology, Verve Research, Verve, Oulu, Finland; and.
authors.forename: Arto J
authors.initials: AJ
authors.lastname: Hautala
authors.affiliation: Institute of Clinical Medicine, Department of Internal Medicine, University of Oulu, Finland; Department of Exercise and Medical Physiology, Verve Research, Verve, Oulu, Finland; and.
authors.forename: Antti M
authors.initials: AM
authors.lastname: Kiviniemi
authors.affiliation: Institute of Clinical Medicine, Department of Internal Medicine, University of Oulu, Finland;
authors.forename: Johanna A
authors.initials: JA
authors.lastname: Miettinen
authors.affiliation: Institute of Clinical Medicine, Department of Internal Medicine, University of Oulu, Finland;
authors.forename: Heikki V
authors.initials: HV
authors.lastname: Huikuri
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002395:Catecholamines / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D025401:Echocardiography, Stress; D004562:Electrocardiography; D004644:Emotions; D019332:Endothelin-1 / Q000097:blood*; D005080:Exercise Test; D017079:Exercise Tolerance; D005387:Finland; D006339:Heart Rate; D006688:Hockey / Q000523:psychology*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D013997:Time Factors; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D002395:Catecholamines; D019332:Endothelin-1; C508600:IL6 protein, human; D015850:Interleukin-6
keywords: endothelin-1; exercise capacity; stress