Early Kate S, Stewart Abigail, Johannsen Neil, Lavie Carl J, Thomas Jerry R, Welsch Michael
School of Kinesiology, Louisiana State University, Baton Rouge (Mss Early and Stewart and Dr Johannsen); Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, Louisiana (Drs Johannsen and Lavie); John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, Louisiana (Dr Lavie); College of Education, University of North Texas, Denton (Dr Thomas); and Institute of Sport and Physical Activity Research, University of Bedfordshire, Bedfordshire, United Kingdom (Dr Welsch).
J Cardiopulm Rehabil Prev. 2017 Mar;37(2):77-89. doi: 10.1097/HCR.0000000000000206.
Flow-mediated dilation, a barometer of cardiovascular (CV) health, is reported to increase with exercise training (ET); however, the potential moderating factors of ET are not clear to date. The purpose of this study was to determine the effect of ET assessed by brachial artery flow-mediated dilation (BAFMD).
Authors searched PubMed between January 1999 and December 2013, bibliographies, and reviews to identify studies examining ET and BAFMD. Two independent reviewers extracted quality, descriptive, exercise, and outcome data of eligible studies. Data were presented as weighted effect sizes (ESs) and 95% confidence limits.
Analysis included 66 studies reporting BAFMD data (1865 ET and 635 control subjects). Overall, ET had significant improvements in BAFMD compared with controls (P < .0001). Exercise training at higher ET intensities resulted in a greater increase in BAFMD (9.29; 95% CI, 5.09-13.47) than lower ET intensities (3.63; 95% CI, -0.56 to 7.83) or control (-0.42; 95% CI, -2.06 to 1.21). Subjects whose ET duration was ≥150 min/wk (11.33; 95% CI, 7.15-15.51) had a significant improvement in BAFMD compared with those with <150 min/wk (4.79; 95% CI, 3.08-6.51) or control (-0.30; 95% CI, -1.99 to 1.39). Age (P = .11) and baseline artery diameter (P = .31) did not modify the BAFMD response to ET.
Exercise training contributes to a significant increase in BAFMD. These results provide indirect evidence that ET alters a well-known factor associated with the primary and secondary prevention of CV diseases. Exercise training interventions, including greater intensity and duration, may optimize the increase in BAFMD.
血流介导的血管舒张是心血管（CV）健康的一项指标，据报道其会随着运动训练（ET）而增加；然而，迄今为止ET的潜在调节因素尚不清楚。本研究的目的是确定通过肱动脉血流介导的血管舒张（BAFMD）评估的ET的效果。
作者检索了1999年1月至2013年12月期间的PubMed、参考文献及综述，以确定研究ET和BAFMD的研究。两名独立评审员提取了符合条件研究的质量、描述性、运动及结果数据。数据以加权效应大小（ESs）和95%置信区间表示。
分析纳入了66项报告BAFMD数据的研究（1865名ET受试者和635名对照受试者）。总体而言，与对照组相比，ET使BAFMD有显著改善（P <.0001）。与较低ET强度（3.63；95% CI，-0.56至7.83）或对照组（-0.42；95% CI，-2.06至1.21）相比，较高ET强度的运动训练使BAFMD增加幅度更大（9.29；95% CI，5.09 - 13.47）。ET持续时间≥150分钟/周的受试者（BAFMD改善幅度为11.33；95% CI，7.15 - 15.51）与持续时间<150分钟/周的受试者（4.79；95% CI，3.08 - 6.51）或对照组（-0.30；95% CI，-1.99至1.39）相比，BAFMD有显著改善。年龄（P =.11）和基线动脉直径（P =.31）并未改变BAFMD对ET的反应。
运动训练有助于BAFMD显著增加。这些结果提供了间接证据，表明ET改变了与CV疾病一级和二级预防相关的一个知名因素。包括更大强度和持续时间的运动训练干预可能会优化BAFMD的增加幅度。
