Abstract
Endothelial dysfunction is an early abnormality in the process of atherosclerosis and cardiovascular disease and has been associated with worse clinical outcome. Cardiac rehabilitation (CR) has been reported to be helpful to reduce cardiovascular events in various types of cardiac disease, but the mechanisms of its beneficial effects remain only partially known. In this article, we review the studies that assessed the effect of CR on endothelial function in patients with various cardiac conditions. Available data show that CR significantly improves impaired endothelial function in these patients, which may contribute to the beneficial effects of CR on clinical outcome.
Highlights
Cardiac rehabilitation (CR) is a program of physical and respiratory exercises, handled by an interdisciplinary team, aimed to improve cardiovascular function and physical capacity mainly after an acute cardiac event or intervention
CR programs have been reported to decrease morbidity and improve quality of life in these patients; they have been suggested to improve survival. These beneficial effects are likely mainly achieved through a tighter control of cardiovascular risk factors (CVRFs) as well as adherence to optimal medical therapy, which prevent the progression of atherosclerosis and reduce complications of atherosclerotic lesions [1,2,3,4,5]
CR programs mainly focus on exercise training, but they involve a careful implementation of integrative measures, including appropriate treatment of CVRFs, optimization of medical therapy, psychosocial interventions and patients’ education [1,2,3,4,5,6,7,8,9]
Summary
Cardiac rehabilitation (CR) is a program of physical and respiratory exercises, handled by an interdisciplinary team, aimed to improve cardiovascular function and physical capacity mainly after an acute cardiac event or intervention. CR programs have been reported to decrease morbidity and improve quality of life in these patients; they have been suggested to improve survival. These beneficial effects are likely mainly achieved through a tighter control of cardiovascular risk factors (CVRFs) as well as adherence to optimal medical therapy, which prevent the progression of atherosclerosis and reduce complications of atherosclerotic lesions [1,2,3,4,5]. An impairment of endothelial function is considered a major cause of susceptibility to vascular complications and an improvement in endothelial function may constitute a major mechanism through which CR may improve vascular function and, clinical outcome. We will precede the review of the available data on the effects of CR on endothelial function by a comment on the function of the normal endothelium and the implications of its dysfunction and by a short review of the main methods applied to assess endothelial function in clinical studies
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