Article

We aimed to investigate the effect of exercise on endothelium-dependent
vasodilator function assessed simultaneously in the brachial artery and in the
distal arterial bed by flow-mediated dilation and the pulse amplitude tonometry
method, respectively, in coronary artery disease patients. The study included 146
patients with stable coronary artery disease (123 men, mean age 62 +/- 9 years)
who participated in the Cardiac Rehabilitation and Genetics of Exercise
performance study. All patients completed a 12-week supervised cardiac
rehabilitation programme (three sessions per week at an intensity of 80% of the
heart rate reserve). At baseline and upon completion of the training, we measured
brachial artery diameters by means of ultrasound scanning (linear array
transducer of 12 MHz) and simultaneously assessed pulse amplitudes in the
fingertip using a pulse amplitude tonometry device both at rest and after
reactive hyperaemia induced by a 5-min forearm cuff occlusion. Peak oxygen uptake
significantly increased (+22%; p < 0.0001) and flow-mediated dilation improved
from 10.0% to 13.1% (+37%; p < 0.0001), whereas the reactive hyperaemia index of
the pulse amplitude tonometry method remained unchanged (p = 0.47) following
exercise-based cardiac rehabilitation. However, the basal digital pulse amplitude
(+58%; p < 0.001) increased as a result of training, as did the digital pulse
amplitude after reactive hyperaemia (+22%; p < 0.05). Exercise-based cardiac
rehabilitation is associated with an improvement in endothelial function, as can
be measured by flow-mediated dilation but not by the reactive hyperaemia index of
the pulse amplitude tonometry method.

Langue : ANGLAIS