Influence of Dynamic Training on Hemodynamic, Neurohormonal Responses to Static Exercise and on Inflammatory Markers in Patients After Coronary Artery Bypass Grafting

Abstract

Little is known about the influence of dynamic training on the hemodynamic and neurohormonal responses to static exercise and on inflammatory markers in optimally treated post-coronary artery bypass grafting (CABG) patients. One hundred and twenty male patients, aged 55±6 years, 3 months after receiving CABG, were randomized to either 6 weeks of aerobic training on a cycloergometer, 3 times a week, at a 70-80% of the maximum tolerated heart rate (HR) (training group, n=60) or to a control group (n=60). At baseline and at the end of the study, all patients underwent: (1) a cardiopulmonary test; (2) handgrip at 30% of maximal voluntary contraction for 3min in a sitting position during in which HR, blood pressure (BP), stroke volume (SV, by impedance cardiography), cardiac output (CO) and total peripheral resistance (TPR) were monitored; and (3) plasma level assessment of catecholamines, nitric oxide and inflammatory markers. During the final tests, handgrip-induced increases in HR, BP, and TPR (14% vs 27%, P<0.01) were lower, whereas SV and CO were higher (by 13% and 15%, respectively, P<0.05) in trained patients compared with controls. Moreover, a higher increase in nitric oxide level (46% vs 14%, P<0.01) and a lower increase in noradrenaline (11% vs 20%, P<0.05) were observed in trained patients compared with controls. Accordingly, training caused significant improvement in peak oxygen uptake per kilogram body weight (peak VO(2)) and inflammatory markers. Short-term dynamic training caused significant improvement of hemodynamic and neurohormonal responses to handgrip, cardiovascular fitness and inflammatory state.