title: Coronary Collateral Growth Induced by Physical Exercise: Results of the Impact of Intensive Exercise Training on Coronary Collateral Circulation in Patients With Stable Coronary Artery Disease (EXCITE) Trial.
abstract: BACKGROUND
  A well-developed coronary collateral circulation provides a potential source of blood supply in coronary artery disease. However, the prognostic importance and functional relevance of coronary collaterals is controversial with the association between exercise training and collateral growth still unclear.
  
  
  RESULTS
  This prospective, open-label study randomly assigned 60 patients with significant coronary artery disease (fractional flow reserve ≤0.75) to high-intensity exercise (group A, 20 patients) or moderate-intensity exercise (group B, 20 patients) for 4 weeks or to a control group (group C, 20 patients). The primary end point was the change of the coronary collateral flow index (CFI) after 4 weeks. Analysis was based on the intention to treat. After 4 weeks, baseline CFI increased significantly by 39.4% in group A (from 0.142±0.07 at beginning to 0.198±0.09 at 4 weeks) in comparison with 41.3% in group B (from 0.143±0.06 to 0.202±0.09), whereas CFI in the control group remained unchanged (0.7%, from 0.149±0.09 to 0.150±0.08). High-intensity exercise did not lead to a greater CFI than moderate-intensity training. After 4 weeks, exercise capacity, Vo2 peak and ischemic threshold increased significantly in group A and group B in comparison with group C with no difference between group A and group B.
  
  
  CONCLUSIONS
  A significant improvement in CFI was demonstrated in response to moderate- and high-intensity exercise performed for 10 hours per week.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT01209637.
authors.affiliation: From University of Leipzig, Heart Centre, Department of Internal Medicine/Cardiology, Germany (A.M.-W., M.U., V.A., M.S., S.E., K.L., N.M., U.M., J.A., A.P.L., G.S.); Asklepios Clinic Weißenfels, Germany (S.M.-W., K.L.); MediClin Dünenwald Klinik Trassenheide, Germany (M.G., S.B.); Department of Sports Medicine, University Wuppertal, Germany (T.H.); and Coordination Centre for Clinical Trials, University of Leipzig, Germany (M.M.).
authors.forename: Sven
authors.initials: S
authors.lastname: Möbius-Winkler
authors.affiliation: From University of Leipzig, Heart Centre, Department of Internal Medicine/Cardiology, Germany (A.M.-W., M.U., V.A., M.S., S.E., K.L., N.M., U.M., J.A., A.P.L., G.S.); Asklepios Clinic Weißenfels, Germany (S.M.-W., K.L.); MediClin Dünenwald Klinik Trassenheide, Germany (M.G., S.B.); Department of Sports Medicine, University Wuppertal, Germany (T.H.); and Coordination Centre for Clinical Trials, University of Leipzig, Germany (M.M.). MadlenUhlemann@msn.com.
authors.forename: Madlen
authors.initials: M
authors.lastname: Uhlemann
authors.affiliation: From University of Leipzig, Heart Centre, Department of Internal Medicine/Cardiology, Germany (A.M.-W., M.U., V.A., M.S., S.E., K.L., N.M., U.M., J.A., A.P.L., G.S.); Asklepios Clinic Weißenfels, Germany (S.M.-W., K.L.); MediClin Dünenwald Klinik Trassenheide, Germany (M.G., S.B.); Department of Sports Medicine, University Wuppertal, Germany (T.H.); and Coordination Centre for Clinical Trials, University of Leipzig, Germany (M.M.).
authors.forename: Volker
authors.initials: V
authors.lastname: Adams
authors.affiliation: From University of Leipzig, Heart Centre, Department of Internal Medicine/Cardiology, Germany (A.M.-W., M.U., V.A., M.S., S.E., K.L., N.M., U.M., J.A., A.P.L., G.S.); Asklepios Clinic Weißenfels, Germany (S.M.-W., K.L.); MediClin Dünenwald Klinik Trassenheide, Germany (M.G., S.B.); Department of Sports Medicine, University Wuppertal, Germany (T.H.); and Coordination Centre for Clinical Trials, University of Leipzig, Germany (M.M.).
authors.forename: Marcus
authors.initials: M
authors.lastname: Sandri
authors.affiliation: From University of Leipzig, Heart Centre, Department of Internal Medicine/Cardiology, Germany (A.M.-W., M.U., V.A., M.S., S.E., K.L., N.M., U.M., J.A., A.P.L., G.S.); Asklepios Clinic Weißenfels, Germany (S.M.-W., K.L.); MediClin Dünenwald Klinik Trassenheide, Germany (M.G., S.B.); Department of Sports Medicine, University Wuppertal, Germany (T.H.); and Coordination Centre for Clinical Trials, University of Leipzig, Germany (M.M.).
authors.forename: Sandra
authors.initials: S
authors.lastname: Erbs
authors.affiliation: From University of Leipzig, Heart Centre, Department of Internal Medicine/Cardiology, Germany (A.M.-W., M.U., V.A., M.S., S.E., K.L., N.M., U.M., J.A., A.P.L., G.S.); Asklepios Clinic Weißenfels, Germany (S.M.-W., K.L.); MediClin Dünenwald Klinik Trassenheide, Germany (M.G., S.B.); Department of Sports Medicine, University Wuppertal, Germany (T.H.); and Coordination Centre for Clinical Trials, University of Leipzig, Germany (M.M.).
authors.forename: Karsten
authors.initials: K
authors.lastname: Lenk
authors.affiliation: From University of Leipzig, Heart Centre, Department of Internal Medicine/Cardiology, Germany (A.M.-W., M.U., V.A., M.S., S.E., K.L., N.M., U.M., J.A., A.P.L., G.S.); Asklepios Clinic Weißenfels, Germany (S.M.-W., K.L.); MediClin Dünenwald Klinik Trassenheide, Germany (M.G., S.B.); Department of Sports Medicine, University Wuppertal, Germany (T.H.); and Coordination Centre for Clinical Trials, University of Leipzig, Germany (M.M.).
authors.forename: Norman
authors.initials: N
authors.lastname: Mangner
authors.affiliation: From University of Leipzig, Heart Centre, Department of Internal Medicine/Cardiology, Germany (A.M.-W., M.U., V.A., M.S., S.E., K.L., N.M., U.M., J.A., A.P.L., G.S.); Asklepios Clinic Weißenfels, Germany (S.M.-W., K.L.); MediClin Dünenwald Klinik Trassenheide, Germany (M.G., S.B.); Department of Sports Medicine, University Wuppertal, Germany (T.H.); and Coordination Centre for Clinical Trials, University of Leipzig, Germany (M.M.).
authors.forename: Ulrike
authors.initials: U
authors.lastname: Mueller
authors.affiliation: From University of Leipzig, Heart Centre, Department of Internal Medicine/Cardiology, Germany (A.M.-W., M.U., V.A., M.S., S.E., K.L., N.M., U.M., J.A., A.P.L., G.S.); Asklepios Clinic Weißenfels, Germany (S.M.-W., K.L.); MediClin Dünenwald Klinik Trassenheide, Germany (M.G., S.B.); Department of Sports Medicine, University Wuppertal, Germany (T.H.); and Coordination Centre for Clinical Trials, University of Leipzig, Germany (M.M.).
authors.forename: Jennifer
authors.initials: J
authors.lastname: Adam
authors.affiliation: From University of Leipzig, Heart Centre, Department of Internal Medicine/Cardiology, Germany (A.M.-W., M.U., V.A., M.S., S.E., K.L., N.M., U.M., J.A., A.P.L., G.S.); Asklepios Clinic Weißenfels, Germany (S.M.-W., K.L.); MediClin Dünenwald Klinik Trassenheide, Germany (M.G., S.B.); Department of Sports Medicine, University Wuppertal, Germany (T.H.); and Coordination Centre for Clinical Trials, University of Leipzig, Germany (M.M.).
authors.forename: Martin
authors.initials: M
authors.lastname: Grunze
authors.affiliation: From University of Leipzig, Heart Centre, Department of Internal Medicine/Cardiology, Germany (A.M.-W., M.U., V.A., M.S., S.E., K.L., N.M., U.M., J.A., A.P.L., G.S.); Asklepios Clinic Weißenfels, Germany (S.M.-W., K.L.); MediClin Dünenwald Klinik Trassenheide, Germany (M.G., S.B.); Department of Sports Medicine, University Wuppertal, Germany (T.H.); and Coordination Centre for Clinical Trials, University of Leipzig, Germany (M.M.).
authors.forename: Susanne
authors.initials: S
authors.lastname: Brunner
authors.affiliation: From University of Leipzig, Heart Centre, Department of Internal Medicine/Cardiology, Germany (A.M.-W., M.U., V.A., M.S., S.E., K.L., N.M., U.M., J.A., A.P.L., G.S.); Asklepios Clinic Weißenfels, Germany (S.M.-W., K.L.); MediClin Dünenwald Klinik Trassenheide, Germany (M.G., S.B.); Department of Sports Medicine, University Wuppertal, Germany (T.H.); and Coordination Centre for Clinical Trials, University of Leipzig, Germany (M.M.).
authors.forename: Thomas
authors.initials: T
authors.lastname: Hilberg
authors.affiliation: From University of Leipzig, Heart Centre, Department of Internal Medicine/Cardiology, Germany (A.M.-W., M.U., V.A., M.S., S.E., K.L., N.M., U.M., J.A., A.P.L., G.S.); Asklepios Clinic Weißenfels, Germany (S.M.-W., K.L.); MediClin Dünenwald Klinik Trassenheide, Germany (M.G., S.B.); Department of Sports Medicine, University Wuppertal, Germany (T.H.); and Coordination Centre for Clinical Trials, University of Leipzig, Germany (M.M.).
authors.forename: Meinhard
authors.initials: M
authors.lastname: Mende
authors.affiliation: From University of Leipzig, Heart Centre, Department of Internal Medicine/Cardiology, Germany (A.M.-W., M.U., V.A., M.S., S.E., K.L., N.M., U.M., J.A., A.P.L., G.S.); Asklepios Clinic Weißenfels, Germany (S.M.-W., K.L.); MediClin Dünenwald Klinik Trassenheide, Germany (M.G., S.B.); Department of Sports Medicine, University Wuppertal, Germany (T.H.); and Coordination Centre for Clinical Trials, University of Leipzig, Germany (M.M.).
authors.forename: Axel P
authors.initials: AP
authors.lastname: Linke
authors.affiliation: From University of Leipzig, Heart Centre, Department of Internal Medicine/Cardiology, Germany (A.M.-W., M.U., V.A., M.S., S.E., K.L., N.M., U.M., J.A., A.P.L., G.S.); Asklepios Clinic Weißenfels, Germany (S.M.-W., K.L.); MediClin Dünenwald Klinik Trassenheide, Germany (M.G., S.B.); Department of Sports Medicine, University Wuppertal, Germany (T.H.); and Coordination Centre for Clinical Trials, University of Leipzig, Germany (M.M.).
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schuler
mesh_terms: D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000209:etiology / Q000628:therapy; D001011:Aorta / Q000503:physiopathology; D062186:Arterial Pressure; D006328:Cardiac Catheterization / Q000009:adverse effects; D002496:Central Venous Pressure; D003097:Collateral Circulation / Q000502:physiology*; D003327:Coronary Disease / Q000503:physiopathology / Q000628:therapy*; D003331:Coronary Vessels / Q000503:physiopathology*; D004618:Embolism, Air / Q000209:etiology; D005080:Exercise Test; D005081:Exercise Therapy / Q000009:adverse effects / Q000379:methods; D017079:Exercise Tolerance; D005260:Female; D005268:Femoral Vein / Q000503:physiopathology; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011446:Prospective Studies
keywords: angiogenesis; collateral circulation; coronary artery disease; exercise; exercise movement techniques