Document Detail

Home-based versus hospital-based exercise programs in patients with coronary artery disease: effects on coronary vasomotion.
MedLine Citation:
PMID:  12514675     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: In a randomized study, we recently documented that a vigorous, hospital-based exercise training (ET) program improves coronary endothelial function in coronary artery disease. The aim of this consecutive study was to assess whether a home-based exercise program with reduced average training duration can sustain previously achieved effects on coronary endothelial function. METHODS: Nineteen patients with coronary endothelial dysfunction documented by acetylcholine-induced vasoconstriction were randomly assigned to a training group (n = 10) or a control group (n = 9). After 4 weeks of inhospital training (60 min of bicycle ergometry per day), all training patients were enrolled in a 5-month home-based program of 20 minutes' ergometry training per day and 1 group training session per week. At baseline, after 4 weeks and 6 months, endothelium-mediated vasodilation was assessed by quantitative coronary angiography after intracoronary infusions of acetylcholine. Average peak velocity (APV) was measured with a Doppler wire. Coronary blood flow (CBF) was calculated by multiplying vascular cross-sectional area and APV. RESULTS: CBF increased in response to 7.2 microg/min acetylcholine, from 27% +/- 11% at the beginning of the study to 110% +/- 24% after 4 weeks (P <.01 vs control group). After 6 months, the increase in CBF was lower versus inhospital training (67% +/- 18%, P <.05 vs 4 weeks). Changes in APV between 1 and 6 months correlated with daily training durations (r = 0.65, P =.03). CONCLUSIONS: Home-based ET sustained part of the effects of hospital-based ET on endothelium-dependent vasodilation in coronary artery disease. However, acetylcholine-induced increases in CBF were lower after home-based ET, suggesting a relation between daily training duration and improvement of coronary vasomotion.
Stephan Gielen; Sandra Erbs; Axel Linke; Sven Möbius-Winkler; Gerhard Schuler; Rainer Hambrecht
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  145     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2003-01-06     Completed Date:  2003-03-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E3     Citation Subset:  AIM; IM    
Department of Internal Medicine/Cardiology, University of Leipzig, Heart Center, Leipzig, Germany.
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MeSH Terms
Blood Flow Velocity
Coronary Circulation*
Coronary Disease / drug therapy,  physiopathology*,  rehabilitation*
Endothelium, Vascular / physiopathology*
Exercise Test
Exercise Therapy*
Follow-Up Studies
Home Nursing
Middle Aged
Patient Compliance

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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