Manresa-Rocamora Agustín, Ribeiro Fernando, Casanova-Lizón Antonio, Flatt Andrew A, Sarabia José Manuel, Moya-Ramón Manuel
Sports Research Centre, Department of Sport Sciences, Miguel Hernández University of Elche, 03202 Elche, Spain.
Institute for Health and Biomedical Research (ISABIAL Foundation), Miguel Hernandez University, 03550 Alicante, Spain.
Int J Sports Med. 2022 Oct;43(11):905-920. doi: 10.1055/a-1717-1798. Epub 2022 Apr 25.
Exercise-based cardiac rehabilitation may be an effective non-pharmacological intervention for improving endothelial function in coronary artery disease patients. Therefore, this systematic review with meta-analysis aimed to (a) estimate the training-induced effect on endothelial and vascular smooth muscle function, assessed by flow-mediated dilation and nitroglycerin-mediated dilation, respectively, in coronary artery disease patients; and to (b) study the influence of potential trial-level variables (i. e. study and intervention characteristics) on the training-induced effect on endothelial and vascular smooth muscle function. Electronic searches were performed in Pubmed, Scopus, and Embase up to February 2021. Random-effects models of standardised mean change were estimated. Heterogeneity analyses were performed by using the test and index. Our results showed that exercise-based cardiac rehabilitation significantly enhanced flow-mediated dilation (1.04 [95% confidence interval=0.76 to 1.31]) but did not significantly change nitroglycerin-mediated dilation (0.05 [95% confidence interval=-0.03 to 0.13]). Heterogeneity testing reached statistical significance (.001) with high inconsistency for flow-mediated dilation ( 92%). Nevertheless, none of the analysed variables influenced the training-induced effect on flow-mediated dilation. Exercise-based cardiac rehabilitation seems to be an effective therapeutic strategy for improving endothelial-dependent dilation in coronary artery disease patients, which may aid in the prevention of cardiovascular events.
基于运动的心脏康复可能是改善冠心病患者内皮功能的一种有效的非药物干预措施。因此，这项系统评价及荟萃分析旨在：（a）评估训练对冠心病患者内皮和血管平滑肌功能的影响，分别通过血流介导的血管舒张和硝酸甘油介导的血管舒张进行评估；（b）研究潜在的试验水平变量（即研究和干预特征）对训练诱导的内皮和血管平滑肌功能影响的作用。截至2021年2月，在PubMed、Scopus和Embase中进行了电子检索。估计了标准化平均变化的随机效应模型。使用Q检验和I²指数进行异质性分析。我们的结果表明，基于运动的心脏康复显著增强了血流介导的血管舒张（1.04 [95%置信区间=0.76至1.31]），但硝酸甘油介导的血管舒张没有显著变化（0.05 [95%置信区间=-0.03至0.13]）。血流介导的血管舒张异质性检验达到统计学显著性（P=0.001），不一致性较高（I²=92%）。然而，分析的变量均未影响训练对血流介导的血管舒张的作用。基于运动的心脏康复似乎是改善冠心病患者内皮依赖性血管舒张的一种有效治疗策略，这可能有助于预防心血管事件。
