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Aerobic interval exercise training in the afternoon reduces attacks of coronary spastic angina in conjunction with improvement in endothelial function, oxidative stress, and inflammation

Morikawa, Yoshinobua,b; Mizuno, Yujia; Harada, Eisakua; Katoh, Daisukea,c; Kashiwagi, Yusukea,c; Morita, Sumioa; Yoshimura, Michihiroc; Uemura, Shirod; Saito, Yoshihikod; Yasue, Hirofumia

doi: 10.1097/MCA.0b013e32835cbef5
Pathophysiology and Natural History

Background: Coronary spasm plays an important role in the pathogenesis of ischemic heart disease. Endothelial function is impaired in patients with coronary spasm. Exercise training has been shown to improve endothelial function.

Objective: We examined the effects of aerobic interval exercise training (AIT) on attacks in conjunction with endothelial function in patients with coronary spastic angina.

Participants and methods: The study participants were 26 patients with rest angina (19 men and 7 women, mean age 61.7±11.7 years) in whom coronary spasm was documented and no severe organic lesions were found. The numbers of attacks and of individuals with attacks were examined in conjunction with endothelial function, oxidative stress, inflammation, and insulin resistance before and after 3 successive days of AIT.

Results: The number of attacks/patient and the ratio of patients with attacks/5 days decreased [from 2 (1, 7) to 0 (0, 2), P<0.001, and from 23/26 (88.5%) to 10/26 (38.5%), P<0.001] in conjunction with the improvement in endothelial function assessed by improved flow-mediated dilatation (4.8±2.7 vs. 6.9±2.8%, P<0.001), plasma levels of diacron-reactive oxygen metabolites (363±58 vs. 349±61 U.CARR, P=0.001), interleukin-6[1.63 (1.33, 2.22) vs. 1.39 (1.09, 2.02) pg/ml, P=0.012], high-sensitivity C-reactive protein [0.087 (0.041, 0.136) vs. 0.063 (0.028, 0.085) mg/dl, P=0.028], and homeostasis model assessment-insulin resistance [1.79 (1.41, 2.39) vs. 1.54 (1.17, 1.79) mg/dl µU/ml, P=0.005] after AIT.

Conclusion: AIT in the afternoon suppressed the attacks in conjunction with improvement in endothelial function, oxidative stress, inflammation, and insulin resistance in patients with coronary spastic angina.

aDivision of Cardiovascular Medicine, Kumamoto Kinoh Hospital, Kumamoto Aging Research Institute, Kumamoto City, Japan

bDivision of Cardiovascular Medicine, Nara City Hospital, Nara City

cDepartment of Internal Medicine, Division of Cardiology, The Jikei University School of Medicine, Tokyo

dFirst Department of Medicine, Nara Medical University, Kashiwara City, Japan

Correspondence to Hirofumi Yasue, MD, Division of Cardiovascular Medicine, Kumamoto Kinoh Hospital, Kumamoto Aging Research Institute, 6-8-1, Yamamuro, Kita-ku, Kumamoto City 860-8518, Japan Tel: +81 96 345 8111; fax: +81 96 341 5700; e-mail: yasue@juryo.or.jp

Received September 29, 2012

Accepted November 12, 2012

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins