title: The impact of physical training on endothelial function in myocardial infarction survivors: pilot study.
abstract: BACKGROUND
  Endothelial dysfunction (ED) may indirectly influence the outcome of patients with coronary artery disease.
  
  
  OBJECTIVE
  To assess the influence of cardiac rehabilitation (CR) on endothelial function in patients after ST-segment elevation myocardial infarction (STEMI).
  
  
  METHODS
  Twenty-nine patients scheduled for CR were included in the study. CR began at least four weeks after STEMI and consisted of 12 or 24 training sessions. Endothelial function assessment was performed before and after CR, using reactive hyperaemia peripheral arterial tonometry.
  
  
  RESULTS
  Before the CR, ED was diagnosed in 16 of 29 (55.2%) patients. A total of 25 patients had two assessments of endothelial function: before and after CR. In univariate analysis the factors of negative response of endothelial function to CR were: higher baseline hyperaemia index (lnRHI) (odds ratio [OR] for positive response to CR 0.01; 95% confidence interval [CI] 0.00-0.33; p = 0.01) and higher peak serum troponin I level during index hospitalisation (OR 0.97; 95% CI 0.94-1.00; p = 0.04). The independent, negative predictor of response to CR was lnRHI (OR 0.01; 95% CI 0.01-0.16; p = 0.03). Patients training for 24 sessions (n = 16) had similar lnRHI changes to those of patients training for 12 sessions (n = 9); [0.16 (-0.06)-0.30 vs. 0.10 (0.05-0.15); p = 0.44, respectively].
  
  
  CONCLUSIONS
  ED is a frequent abnormality in STEMI survivors. Despite the lack of statistically significant improvement of endothelial function after CR in the analysed group of patients, some factors can influence the efficacy of this type of physical activity. The best effect of CR on endothelial function was observed in patients with baseline ED.
authors.forename: Michał
authors.initials: M
authors.lastname: Peller
authors.affiliation: I Katedra i Klinika Kardiologii Warszawski Uniwersytet Medyczny. pawel@balsam.com.pl.
authors.forename: Paweł
authors.initials: P
authors.lastname: Balsam
authors.forename: Renata
authors.initials: R
authors.lastname: Główczyńska
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Ossoliński
authors.forename: Anna
authors.initials: A
authors.lastname: Gilarowska
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Kołtowski
authors.forename: Marcin
authors.initials: M
authors.lastname: Grabowski
authors.forename: Krzysztof J
authors.initials: KJ
authors.lastname: Filipiak
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Opolski
mesh_terms: D000072038:Cardiac Rehabilitation; D004727:Endothelium / Q000503:physiopathology; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000534:rehabilitation*; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: cardiac rehabilitation; endothelial dysfunction; myocardial infarction