Cellular effects of exercise in heart disease

The endothelium is a thin layer of cells that line the interior surface of blood vessels.

Endothelial dysfunction often leads to atherosclerosis (hardening of the arteries) in patients with diabetes, high blood pressure, and other chronic conditions.

Is it possible that exercise might improve the function of the endothelium and benefit patients with heart disease?

Researchers from the University of Lausanne, in Switzerland studied the effects of different kinds of exercise on endothelial function.

First, the details.

• Endothelial function was evaluated before, after 4 weeks of exercise training, and after 1 month of detraining by measuring flow-mediated dilation and von Willebrand factor levels at baseline and after training.
  • Flow-mediated dilation measures endothelium-dependent relaxation of an artery due to increased blood flow.
  • von Willebrand factor is a protein that attaches platelets to a damaged blood vessel.
• 209 patients were randomly assigned to a treatment group.
  • Aerobic exercise
  • Resistance training
  • Resistance plus aerobic training
  • No training

And, the results.

• There was no difference in endothelial function among the 4 groups at the start of the study.
• After exercise training, flow-mediated dilation increased significantly in each exercise group.
  • Those in the no exercise group were also significantly better than at the start of the study, but significantly less than the exercise groups.
• After exercise training, von Willebrand factor significantly decreased with any exercise/
  • There was no change in the no exercise group.
• Benefits were lost when training ended.

The bottom line?
The authors concluded, “These data imply that good, long-term adherence to training programs is necessary to maintain vascular benefits on endothelial dysfunction. This aspect is probably particularly important in patients with coronary artery disease in whom the correction of endothelial anomalies could help to slow the progression of atherosclerosis.”

To maintain the benefits, you have to stick with it.

3/21/09 19:19 JR