title: A randomised trial comparing the effect of exercise training and weight loss on microvascular function in coronary artery disease.
abstract: BACKGROUND
  Coronary microvascular function is associated with outcome and is reduced in coronary artery disease (CAD) and obesity. We compared the effect of aerobic interval training (AIT) and weight loss on coronary flow reserve (CFR) and peripheral vascular function in revascularised obese CAD patients.
  
  
  RESULTS
  Seventy non-diabetic patients (BMI 28-40 kg × m(-2), age 45-75 years) were randomised to 12 weeks' AIT (three weekly sessions lasting 38 min with ≈ 16 min at 85-90% of VO2peak) or low energy diet (LED, 800-1000 kcal/day). Per protocol adherence was defined by training-attendance ≥ 60% and weight loss ≥ 5%, respectively. CFR was assessed by Doppler echocardiography of the LAD. Peripheral vascular function was assessed by arterial tonometry as reactive hyperaemia index (RHI) and augmentation index. Most participants had impaired CFR with a mean CFR of 2.38 (SD 0.59). Twenty-six AIT and 24 LED participants completed the study per protocol with valid CFR measurements. AIT resulted in a 10.4% improvement in VO2peak and LED in a 10.6% weight loss (between group differences both P<0.001). CFR increased by 0.26 (95%CI 0.04;0.48) after AIT and by 0.39 (95%CI 0.13;0.65) after LED without significant between-group difference (-0.13 (95%CI -0.45;0.20)). RHI and augmentation index remained unchanged after both interventions (P>0.50). Intention-to-treat analyses showed similar results.
  
  
  CONCLUSIONS
  12 weeks' AIT and LED increased CFR by comparable magnitude; thus both interventions might impact prognosis of CAD through improvement of coronary microvascular function.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT01724567.
authors: Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark. Electronic address: rasmus.huan.olsen@gmail.com.
authors: Rasmus Huan
authors: RH
authors: Olsen
authors: Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
authors: Lene Rørholm
authors: LR
authors: Pedersen
authors: Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
authors: Anders
authors: A
authors: Jürs
authors: Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
authors: Martin
authors: M
authors: Snoer
authors: Department of Internal Medicine, Amager Hospital & Clinical Research Centre, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark.
authors: Steen B
authors: SB
authors: Haugaard
authors: Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
authors: Eva
authors: E
authors: Prescott
mesh_terms: D000368:Aged; D015992:Body Mass Index; D003324:Coronary Artery Disease / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D003326:Coronary Circulation / Q000502:physiology*; D015150:Echocardiography, Doppler / Q000379:methods; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000534:rehabilitation; D011379:Prognosis; D012039:Regional Blood Flow / Q000502:physiology*; D013997:Time Factors; D015431:Weight Loss
keywords: Caloric restriction; Coronary artery disease; Coronary flow reserve; Coronary microvascular function; Exercise training; Weight loss