Cardiovascular Protection Variables Based on Exercise Intensity in Stable Coronary Heart Disease Patients After Coronary Stenting: A Comparative Study

Abstract

Purpose

Our study aimed at determining and comparing the mechanism of cardiovascular protection variables in moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) in patients with stable coronary heart disease (CHD) after coronary stenting.

Participants and Methods

This experimental study used the same subject and cross-over design, involving eleven stable CHD patients after coronary stenting. These were randomly divided into two groups; MICT for 29 minutes at 50–60% heart rate reserve and HIIT with 4x4 minute intervals at 60–80% heart rate reserve, each followed by three minutes of active recovery at 40–50% heart rate reserve. These were conducted three times a week for two weeks. The participants’ levels of adrenaline, noradrenaline, endothelial nitric oxide synthase (eNOS), extracellular superoxide dismutase (EC-SOD) activity assayed, and flow-mediated dilatation (FMD) were examined before and after treatments were completed.

Results

The HIIT significantly increased the levels of noradrenaline and eNOS compared with MICT (p<0.05). Also, HIIT was better in maintaining EC-SOD activity and FMD compared with MICT (p<0.05). Through the noradrenalin pathway, HIIT had a direct and significant effect on eNOS and FMD (p<0.05) but MICT, through the noradrenaline pathways, had a direct and significant effect on eNOS (p<0.05), and through the EC-SOD activity pathways had a direct and significant effect on FMD (p<0.05). MICT reduced EC-SOD activity and also decreased the FMD value.

Conclusion

HIIT is superior to MICT in increasing cardiovascular protection by increasing the concentrations of noradrenalin and eNOS, maintaining EC-SOD activity, and FMD in stable CHD patients after coronary stenting.

Keywords:

• coronary heart disease
• high-intensity interval training
• catecholamine
• eNOS
• SOD
• FMD

Acknowledgments

The authors are grateful to all nurses, staff, and trainers of the Cardiovascular Prevention and Rehabilitation Unit, Vascular Unit, and the Molecular Laboratory and Stem Cell Facility of the National Cardiovascular Center Harapan Kita, Jakarta, for making this project a success.

Disclosure

The authors report no conflicts of interest in this work.