Effect Of Exercise Rehabilitation On Angiogenesis And Endothelial Function In Patients With Stable Coronary Heart Disease

Objective:To observe the level changes of nitric oxide(NO),endothelin-1(ET-1),vascular endothelial growth factor(VEGF),and basic fibroblast growth factor(bFGF)in patients with stable coronary heart disease(SCAD)before and after exercise rehabilitation,and understand the effects of exercise rehabilitation on angiogenesis and vascular endothelial function in patients with stable coronary heart disease.Methods:85 outpatients and inpatients were included from January 2016 to July 2018 in our hospital.According to the inclusion criteria,they were divided into control group(group A),including 16 cases,risk factor group(group B),including 17 cases,and stable coronary heart disease group,including 52 cases.In light of the situation of rehabilitation exercise,the stable coronary heart disease group were further divided into non-rehabilitation exercise group(group C),including 15 cases,sub-rehabilitation exercise group(group D),including 18 cases,and rehabilitation exercise group(group E),including 19 cases.Then we collected general information of all subjects,including age,gender,smoking history,blood pressure,body mass index(BMI),etc.Blood biochemical indicators of all subjects were measured,including fasting blood glucose,total cholesterol(TC),triglycerides(TG),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),and uric acid(UA),etc.And at the time of enrollment and after 6 months,all subjects were tested for NO,ET-1,VEGF,and bFGF.The data were analyzed by statistics.To observe the changes of NO,ET-1,VEGF,bFGF levels in and between groups before and after exercise to understand the effects of exercise rehabilitation on angiogenesis and vascular endothelial function in patients with stable coronary heart disease.Results:1.Comparison of basic data:the smoking proportion,systolic blood pressure,diastolic blood pressure,fasting blood glucose and LDL of the control group were less than the other four groups(P<0.05).There were no significant differences in the remaining basic data(P>0.05).2.Comparison of NO,ET-1,VEGF and bFGF at the time of enrollment among 5 groups:(1).Compared with group A,NO decreased while ET-1 increased in group BCDE(P<0.05),there were no significant differences in VEGF and bFGF(P>0.05);(2)Compared with group B,NO decreased while ET-1 increased in CDE group(P<0.05),there were no significant differences in VEGF and bFGF(P>0.05).(3).Comparison among group CDE,there were no significant differences in NO,ET-1,VEGF and bFGF(P>0.05).3.Comparison of NO,ET-1,VEGF and bFGF after 6 months among 5 groups:(1)Compared with group A,NO decreased while ET-1 increased in group BCD(P<0.05),there were no significant differences in VEGF and bFGF(P>0.05).The level of VEGF and bFGF increased in groupE(P<0.05),while there were no significant differences in NO and ET-1(P>0.05).(2)Compared with group B,NO decreased while ET-1 increased in group CD(P<0.05),there were no significant differences in VEGF and bFGF(P>0.05).In group E,NO,VEGF and bFGFincreased while ET-1 decreased(P<0.05).(3).Compared with group C,there were no significant differences in NO,ET-1,VEGF and bFGF between group D(P>0.05).ET-1 decreased(P<0.05)while VEGF and bFGF increased between group E(P<0.05).(4).Compared with group D,NO,VEGF and bFGF increased while ET-1 decreased between group E(P<0.05).4.The T test of NO,ET-1,VEGF and bFGF in each group before and after exercise for 6 months:(1).After exercise for 6 months,NO increased,ET-1 decreased,VEGF and bFGF increased(P<0.05).(2).There were no significant changes in NO,ET-1,VEGF and bFGF before and after exercise among group ABCD(P>0.05).Conclusions:1.Compared with the control group,NO in the risk factor group decreased while ET-1 increased,so coronary heart disease risk factors may cause endothelial dysfunction.2.Compared with the control group,NO in stable coronary heart disease group decreased while ET-lincreased,so patients with stable coronary heart disease may have vascular endothelial dysfunction.3.Com pared with the non-rehabilitation group,there were no significant differences in NO and ET-1 in the sub-rehabilitation exercise group,and before and after exercise,there were no significant differences in NO and ET-1 in the sub-rehabilitation exercise group.So less rigorous rehabilitation exercise could not improve the vascular endothelial function.4.Compared with the non-rehabilitation exercise group,there were no significant differences in VEGF and bFGF in the sub-rehabilitation exercise group,and there were no significant differences in VEGF and bFGF before and after exercise in the sub-rehabilitation exercise group.So less rigorous rehabilitation exercise could not promote angiogenesis.5.Compared with the non-rehabilitation exercise group and the sub-rehabilitation exercise group,NO increased while ET-1 decreased in the rehabilitation exercise group,and after exercise,NO increase while ET-1 decline in the rehabilitation group.So strict rehabilitation exercise in light of exercise prescription can improve vascular endothelial function in patients with coronary heart disease.6.Compared with the non-rehabilitation exercise group and the sub-rehabilitation exercise group,VEGF and bFGF were increased in the rehabilitation exercise group.After exercise,VEGF and bFGF increased in the rehabilitation group,so if exercise was strictly performed,it Could improve angiogenesis in patients with coronary heart disease.