title: Effect of exercise-based cardiac rehabilitation on arterial stiffness and inflammatory and endothelial dysfunction biomarkers: a randomized controlled trial of myocardial infarction patients.
abstract: BACKGROUND
  Arterial stiffness have shown an independent predictive value for cardiovascular and all-cause mortality.
  
  
  OBJECTIVE
  This study sought to evaluate the effects of an 8-week exercise-based cardiac rehabilitation program (ECR) on arterial stiffness, and on inflammatory and endothelial dysfunction biomarkers. Additionally, it was assessed two potential confounding variables, daily physical activity and dietary intake.
  
  
  METHODS
  In this parallel-group trial, 96 patients (56 ± 10 years) were randomized to either the exercise group (EG) or control group (CG) 4 weeks after suffering acute myocardial infarction (MI). ECR consisted of 8 weeks of aerobic exercise at 70-85% of maximal heart rate during 3 sessions weekly, plus usual care. CG participants received only usual care. Baseline and final assessments included arterial stiffness through carotid-femoral pulse wave velocity (cf-PWV), inflammatory and endothelial dysfunction biomarkers, daily physical activity, and dietary intake. (ClinicalTrials.gov: NCT01432639).
  
  
  RESULTS
  After 8 weeks, no significant changes were found between groups in cf-PWV, inflammatory and endothelial dysfunction biomarkers, daily physical activity, or dietary intake. Excluding those patients (n = 7) who did not attend, at least 80% of the exercise sessions provided similar results, excepting a significant reduction in cf-PWV in the EG compared to the CG.
  
  
  CONCLUSIONS
  A short-term ECR does not seem to reduce arterial stiffness and inflammatory and endothelial dysfunction biomarkers of post-MI patients under optimized medication. Nevertheless, the decrease of cf-PWV observed in the EG, when considering only those patients who attended at least 80% of exercise sessions, warrants further investigation.
authors.affiliation: Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200.450 Porto, Portugal. Electronic address: nloedfisica@gmail.com.
authors.forename: Nórton Luís
authors.initials: NL
authors.lastname: Oliveira
authors.affiliation: School of Health Sciences, University of Aveiro, Agras do Crasto, Campus Universitário de Santiago, 3810.193 Aveiro, Portugal. Electronic address: fernando.ribeiro@ua.pt.
authors.forename: Fernando
authors.initials: F
authors.lastname: Ribeiro
authors.affiliation: Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200.450 Porto, Portugal. Electronic address: gugonsilva@gmail.com.
authors.forename: Gustavo
authors.initials: G
authors.lastname: Silva
authors.affiliation: Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200.450 Porto, Portugal; Higher Institute of Educational Sciences, Rua Dr. Luís Gonzaga F. Moreira, 4610.177 Felgueiras, Portugal. Electronic address: aljo.alves@gmail.com.
authors.forename: Alberto Jorge
authors.initials: AJ
authors.lastname: Alves
authors.affiliation: Department of Clinical Pathology, S. João Hospital, Alameda Prof. Hernâni Monteiro, 4200.319 Porto, Portugal. Electronic address: nunosilva.box@gmail.com.
authors.forename: Nuno
authors.initials: N
authors.lastname: Silva
authors.affiliation: Department of Clinical Pathology, S. João Hospital, Alameda Prof. Hernâni Monteiro, 4200.319 Porto, Portugal. Electronic address: jtguimar@med.up.pt.
authors.forename: João Tiago
authors.initials: JT
authors.lastname: Guimarães
authors.affiliation: Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, Vila Nova de Gaia, 4434.502 Espinho, Portugal. Electronic address: mteix@chvng.min-saude.pt.
authors.forename: Madalena
authors.initials: M
authors.lastname: Teixeira
authors.affiliation: Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200.450 Porto, Portugal. Electronic address: joliveira@fade.up.pt.
authors.forename: José
authors.initials: J
authors.lastname: Oliveira
mesh_terms: D000368:Aged; D000886:Anthropometry; D004032:Diet; D004730:Endothelium, Vascular / Q000503:physiopathology*; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006331:Heart Diseases / Q000534:rehabilitation*; D006439:Hemodynamics; D006801:Humans; D007249:Inflammation / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D011174:Portugal; D013997:Time Factors; D059289:Vascular Stiffness
keywords: Cardiovascular disease; Chronic exercise; Inflammation; Pulse wave velocity; Secondary prevention