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Amelioration of ischemic cardiomyopathy in patients using physiological ischemic training

Verbesserung der ischämischen Kardiomyopathie bei Patienten durch physiologisches ischämisches Training

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Abstract

Background

This study aimed to observe the effect and potential mechanism of physiological ischemic training (PIT) in patients with ischemic cardiomyopathy.

Methods

A total of 165 patients with ischemic cardiomyopathy were randomly selected by the convenience sampling method and were divided into the control and experimental groups. The control group received conventional drug treatment, while the experimental group received additional PIT. All patients were followed up for 6 months and renin–angiotensin–aldosterone system (RAS) activity parameters and myocardial remodeling indicators were recorded.

Results

After the 6‑month intervention, cardiac function indicators in the two groups were significantly improved compared with before intervention (all P < 0.01), but the experimental group showed significantly more improvement compared with the control group (all P < 0.01). Similarly, RAS activity parameters and myocardial remodeling indicators of the two groups were significantly reduced after intervention compared with before intervention (all P < 0.01). However, the experimental group showed significantly lower myocardial remodeling indicators than the control group (all P < 0.01). Vascular endothelial growth factor (VEGF) and nitric oxide (NO) concentrations in peripheral blood in the experimental group were significantly increased after intervention compared with before intervention (both P < 0.01).

Conclusions

PIT can be applied in patients with ischemic cardiomyopathy on the basis of the original standardized drug treatment. PIT ameliorates cardiac blood flow reserve by increasing VEGF and NO concentrations in the peripheral blood, as well as by inhibiting the RAS system and myocardial remodeling. This ultimately improves the patient’s cardiac function to a greater extent.

Zusammenfassung

Hintergrund

Ziel dieser Studie war es, die Wirkung und den potenziellen Mechanismus des physiologischen ischämischen Trainings (PIT) bei Patienten mit ischämischer Kardiomyopathie zu beobachten.

Methoden

Insgesamt 165 Patienten mit ischämischer Kardiomyopathie wurden nach dem willkürlichen Stichprobenverfahren nach dem Zufallsprinzip ausgewählt und in die Kontroll- und die Versuchsgruppe aufgeteilt. Die Kontrollgruppe erhielt eine konventionelle medikamentöse Behandlung, während die Versuchsgruppe zusätzlich ein PIT erhielt. Alle Patienten wurden 6 Monate lang nachbeobachtet, und es wurden Aktivitätsparameter des Renin-Angiotensin-Aldosteron-Systems (RAS) sowie Indikatoren des myokardialen Remodelings erfasst.

Ergebnisse

Nach der 6‑monatigen Intervention waren die Herzfunktionsindikatoren in beiden Gruppen im Vergleich zu vor der Intervention signifikant besser (alle p<0,01), aber die Versuchsgruppe zeigte eine signifikant stärkere Verbesserung im Vergleich zur Kontrollgruppe (alle p<0,01). Ebenso waren die RAS-Aktivitätsparameter und die myokardialen Remodeling-Indikatoren der beiden Gruppen nach der Intervention im Vergleich zu vorher signifikant reduziert (alle p<0,01). Die Versuchsgruppe zeigte jedoch signifikant niedrigere myokardiale Remodeling-Indikatoren als die Kontrollgruppe (alle p<0,01). Die Konzentrationen des vaskulären endothelialen Wachstumsfaktors (VEGF) und von Stickstoffmonoxid (NO) im peripheren Blut waren in der Versuchsgruppe nach der Intervention im Vergleich zur vorher signifikant erhöht (beide p<0,01).

Schlussfolgerung

Die PIT kann bei Patienten mit ischämischer Kardiomyopathie auf der Grundlage der ursprünglichen standardisierten medikamentösen Behandlung angewendet werden. Die PIT verbessert die kardiale Durchblutungsreserve durch Erhöhung der VEGF- und NO-Konzentrationen im peripheren Blut sowie durch Hemmung des RAS-Systems und des myokardialen Remodelings. Dies verbessert letztendlich die Herzfunktion des Patienten in höherem Maße.

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Acknowledgements

We thank Ellen Knapp, PhD, from Liwen Bianji, Edanz Group China (www.liwenbianji.cn/ac), for editing the English text of a draft of this manuscript.

Funding

This study was supported by the Science and Technology Development Program of Suzhou Ninth People’s Hospital (YUAN201823).

Author information

Authors and Affiliations

  1. Department of Cardiology, Suzhou Ninth People’s Hospital, Affiliated Wujiang Hospital of Nantong University, Ludang Road, 2666, Suzhou, China

    Weihai Chen, Jun Shen, Hua You, Fulong Ye, Ju Zheng & Yanming Wu

  2. Department of Geriatric Medicine, Suzhou Municipal Hospital, Suzhou Cancer Medical Center, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China

    Rongrong Chen

  3. Department of Gynecology and Obstetrics, Suzhou Hospital of Traditional Chinese Medicine, Suzhou, China

    Lijuan Lu

  4. Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China

    Xiao Lu

  5. Department of Rehabilitation, Affiliated Hospital of Nantong University, Nantong, China

    Jun Ni

  6. Department of Gastroenterology, Suzhou Ninth People’s Hospital, Affiliated Wujiang Hospital of Nantong University, 2666 Ludang Road, 215200, Suzhou, China

    Zhenguo Qiao

Authors
  1. Weihai Chen
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  2. Jun Shen
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  3. Rongrong Chen
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  4. Hua You
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  6. Ju Zheng
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  7. Lijuan Lu
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  8. Xiao Lu
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  9. Jun Ni
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  10. Yanming Wu
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  11. Zhenguo Qiao
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Corresponding authors

Correspondence to Yanming Wu or Zhenguo Qiao.

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Conflict of interest

W. Chen, J. Shen, R. Chen, H. You, F. Ye, J. Zheng, L. Lu, X. Lu, J. Ni, Y. Wu and Z. Qiao declare that they have no competing interests.

All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Additional information

Weihai Chen, Jun Shen and Rongrong Chen contributed equally to this work.

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Chen, W., Shen, J., Chen, R. et al. Amelioration of ischemic cardiomyopathy in patients using physiological ischemic training. Herz 46 (Suppl 2), 173–179 (2021). https://doi.org/10.1007/s00059-020-04975-3

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  • DOI: https://doi.org/10.1007/s00059-020-04975-3

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