Skip to main content

Advertisement

SpringerLink
Log in

Cardiac Rehabilitation with Targeted Intensity Improves Cardiopulmonary Functions Accompanying with Reduced Copeptin Level in Patients with Coronary Artery Disease

  • Original Article
  • Published:
Journal of Cardiovascular Translational Research Aims and scope Submit manuscript

Abstract

Cardiac rehabilitation (CR) plays an important role in cardiovascular disease prevention. Understanding the key component of CR such as training intensity and biomarkers reflecting cardiopulmonary functions may help to better target the rehabilitation program. Thirty-four consecutive patients with coronary artery disease after percutaneous coronary intervention participated in the CR program. The difference between intervention group and control group was mainly the training intensity. Cardiopulmonary exercise testing (CPET) and blood biomarker measurements were performed before and after CR. The results demonstrated that it was safe and feasible to perform CR, while sufficient training intensity was required to significantly ameliorate CPET parameters. Among numerous biomarkers tested, vasopressin surrogate marker copeptin (CPP) improved significantly after CR. Moreover, improved CPP was correlated with exercise intensity and peak oxygen uptake, two most important indicators of cardiopulmonary exercise capacities. Therefore, CR may have a novel role in maintaining plasma osmolality and cardiovascular homeostasis.

Cardiac rehabilitation training improves cardiopulmonary exercise parameters El and PVO2 which are correlated with reduced CPP level. CPP, copeptin; El, exercise intensity; POV2, peak oxygen uptake.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Abbreviations

BMI:

Body mass index

CAD:

Coronary artery disease

CPET:

Cardiopulmonary exercise testing

CPP:

Copeptin

CR:

Cardiac rehabilitation

EI:

Exercise intensity

ELISA:

Enzyme-linked immunosorbent assay

HRR:

Heart rate reserve

IFN-γ:

Interferon gamma

IL:

Interleukin

MET:

Metabolic equivalent of task

MHR:

Maximum heart rate

O2 pulse:

Oxygen pulse

PCI:

Percutaneous coronary intervention

PTX3:

Pentraxin 3

PVO2 :

Peak oxygen uptake

RDBP:

Resting diastolic blood pressure

RHR:

Resting heart rate

RSBP:

Resting systolic blood pressure

TNF-α:

Tumor necrosis factor alpha

VAT:

Ventilatory anaerobic threshold

VE/CO2 :

Ventilation/carbon dioxide output ratio

VEGF:

Vascular endothelial growth factor

WC:

Waist circumference

References

  1. Naghavi, M., Wang, H., Lozano, R., et al. (2015). Global, regional, and national age sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet, 385, 117–171.

    Article  Google Scholar 

  2. Liu, S., Li, Y., Zeng, X., Wang, H., Yin, P., Wang, L., et al. (2019). Burden of cardiovascular diseases in China, 1990-2016: findings from the 2016 Global Burden of Disease Study. JAMA Cardiology, 4(4), 342–352.

    Article  Google Scholar 

  3. Chen, W. W., Gao, R. L., Liu, L. S., Zhu, M. L., Wang, W., Wang, Y. J., et al. (2017). China cardiovascular diseases report 2015: a summary. Journal of Geriatric Cardiology, 14, 1–10.

    PubMed  Google Scholar 

  4. Wu, Y., Benjamin, E. J., & Macmahon, S. (2016). Prevention and control of cardiovascular disease in the rapidly changing economy of China. Circulation, 133, 2545.

    Article  Google Scholar 

  5. Batacan Jr., R. B., Duncan, M. J., Dalbo, V. J., Buitrago, G. L., & Fenning, A. S. (2018). Effect of different intensities of physical activity on cardiometabolic markers and vascular and cardiac function in adult rats fed with a high-fat high-carbohydrate diet. Journal of Sport and Health Science, 7(1), 109–119.

    Article  Google Scholar 

  6. van Halewijn, G., Deckers, J., Tay, H. Y., van Domburg, R., Kotseva, K., & Wood, D. (2017). Lessons from contemporary trials of cardiovascular prevention and rehabilitation: a systematic review and meta-analysis. International Journal of Cardiology, 232, 294–303.

    Article  Google Scholar 

  7. Shepherd, C. W., & While, A. E. (2012). Cardiac rehabilitation and quality of life: a systematic review. International Journal of Nursing Studies, 49(6), 755–771.

    Article  Google Scholar 

  8. Keteyian, S. J., Brawner, C. A., Savage, P. D., Ehrman, J. K., Schairer, J., Divine, G., Aldred, H., Ophaug, K., & Ades, P. A. (2008). Peak aerobic capacity predicts prognosis in patients with coronary heart disease. American Heart Journal, 156(2), 292–300.

    Article  Google Scholar 

  9. Solbraa, A. K., Anderssen, S. A., Holme, I. M., et al. (2018). The built environment correlates of objectively measured physical activity in Norwegian adults: a cross-sectional study. Journal of Sport and Health Science, 7(1), 19–26.

    Article  Google Scholar 

  10. Wisløff, U., Støylen, A., Loennechen, J. P., Bruvold, M., Rognmo, Ø., Haram, P. M., et al. (2007). Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study. Circulation, 115(24), 3086–3094.

    Article  Google Scholar 

  11. Elliott, A. D., Rajopadhyaya, K., Bentley, D. J., Beltrame, J. F., & Aromataris, E. C. (2015). Interval training versus continuous exercise in patients with coronary artery disease: a meta-analysis. Heart, Lung & Circulation, 24, 149–157.

    Article  Google Scholar 

  12. Strimbu, K., & Tavel, J. (2010). What are biomarkers? Current Opinion in HIV and AIDS, 5(6), 463–466.

    Article  Google Scholar 

  13. Min, X., Lu, M., Tu, S., et al. (2017). Serum cytokine profile in relation to the severity of coronary artery disease. BioMed Research International, 2017, 4013685.

    PubMed  PubMed Central  Google Scholar 

  14. Bolignano, D., Cabassi, A., Fiaccadori, E., et al. (2014). Copeptin (CTproAVP), a new tool for understanding the role of vasopressin in pathophysiology. Clinical Chemistry and Laboratory Medicine, 52(10), 1447–1456.

    Article  CAS  Google Scholar 

  15. Choi, H. J., Kim, M. C., Sim, D. S., Hong, Y. J., Kim, J. H., Jeong, M. H., et al. (2018). Serum copeptin levels predict clinical outcomes after successful percutaneous coronary intervention in patients with acute myocardial infarction. Annals of Laboratory Medicine, 38, 538–544.

    Article  CAS  Google Scholar 

  16. Rolph, M. S., Zimmer, S., Bottazzi, B., Garlanda, C., Mantovani, A., & Hansson, G. K. (2002). Production of the long pentraxin PTX3 in advanced atherosclerotic plaques. Arteriosclerosis, Thrombosis, and Vascular Biology, 22(5), 10–14.

    Article  Google Scholar 

  17. Ristagno, G., Fumagalli, F., Bottazzi, B., et al. (2019). Pentraxin 3 in cardiovascular disease. Frontiers in Immunology, 10, 823.

    Article  CAS  Google Scholar 

  18. Felmeden, D. C., Spencer, C. G., Belgore, F. M., et al. (2003). Endothelial damage and angiogenesis in hypertensive patients: relationship to cardiovascular risk factors and risk factor management. American Journal of Hypertension, 16(1), 11–20.

    Article  CAS  Google Scholar 

  19. Cao, R. Y., Zheng, H., Mi, Q., Li, Q., Yuan, W., Ding, Y., et al. (2018). Aerobic exercise-based cardiac rehabilitation in Chinese patients with coronary heart disease: study protocol for a pilot randomized controlled trial. Trials, 19, 363.

    Article  Google Scholar 

  20. Gensini, G. G. (1983). A more meaningful scoring system for determining the severity of coronary heart disease. American Journal of Cardiology, 51, 606.

    Article  CAS  Google Scholar 

  21. Andrikoula, M., & McDowell, I. F. W. (2008). The contribution of ApoB and ApoA1 measurements to cardiovascular risk assessment. Diabetes, Obesity & Metabolism, 10, 271–278.

    Article  CAS  Google Scholar 

  22. Koch, B., Schaper, C., Ittermann, T., Spielhagen, T., Dorr, M., Volzke, H., et al. (2009). Reference values for cardiopulmonary exercise testing in healthy volunteers: the SHIP study. The European Respiratory Journal, 33, 389–397.

    Article  CAS  Google Scholar 

  23. Tan, S. J. J., Allen, J. C., & Tan, S. Y. (2017). Determination of ideal target exercise heart rate for cardiac patients suitable for rehabilitation. Clinical Cardiology, 40, 1008–1012.

    Article  Google Scholar 

  24. Sperling, M. P. R., Simoes, R. P., Caruso, F. C. R., et al. (2016). Is heart rate variability a feasible method to determine anaerobic threshold in progressive resistance exercise in coronary artery disease? Brazilian Journal of Physical Theraphy, 20, 289–297.

    Article  Google Scholar 

  25. Jette, M., Sidney, K., & Blumchen, G. (1990). Metabolic equivalents (METS) in exercise testing, exercise prescription, and evaluation of functional capacity. Clinical Cardiology, 13, 555–565.

    Article  CAS  Google Scholar 

  26. Thomas, R. J., King, M., Lui, K., et al. (2010). AACVPR/ACCF/AHA 2010 update: performance measures on cardiac rehabilitation for referral to cardiac rehabilitation/secondary prevention services endorsed by the American College of Chest Physicians, the American College of Sports Medicine, the American Physical Therapy Association, the Canadian Association of Cardiac Rehabilitation, the Clinical Exercise Physiology Association, the European Association for Cardiovascular Prevention and Rehabilitation, the Inter-American Heart Foundation, the National Association of Clinical Nurse Specialists, the Preventive Cardiovascular Nurses Association, and the Society of Thoracic Surgeons. Journal of the American College of Cardiology, 56, 1159–1167.

    Article  Google Scholar 

  27. Piepoli, M. F., Corrà, U., Adamopoulos, S., et al. (2014). Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery: a policy statement from the cardiac rehabilitation section of the European Association for Cardiovascular Prevention & Rehabilitation. Endorsed by the Committee for Practice Guidelines of the European Society of Cardiology. European Journal of Preventive Cardiology, 21, 664–681.

    Article  Google Scholar 

  28. Albouaini, K., Egred, M., Alahmar, A., & Wright, D. J. (2007). Cardiopulmonary exercise testing and its application. Heart, 93(10), 1285–1292.

    CAS  PubMed  PubMed Central  Google Scholar 

  29. Dyrstad, S. M., Edvardsen, E., Hansen, B. H., & Anderssen, S. A. (2019). Waist circumference thresholds and cardiorespiratory fitness. Journal of Sport and Health Science, 8(1), 17–22.

    Article  Google Scholar 

  30. Conraads, V. M., Pattyn, N., Maeyer, C. D., et al. (2015). Aerobic interval training and continuous training equally improve aerobic exercise capacity in patients with coronary artery disease: the SAINTEX-CAD study. International Journal of Cardiology, 179, 203–210.

    Article  Google Scholar 

  31. Amedro P, Gavotto A, Guillaumont S, et al. (2017). Cardiopulmonary fitness in children with congenital heart diseases versus healthy children. Heart, 0:1–11.

  32. Goldhammer, E., Tanchilevitch, A., Maor, I., et al. (2005). Exercise training modulates cytokines activity in coronary heart disease patients. International Journal of Cardiology, 100(1), 93–99.

    Article  Google Scholar 

  33. Kim, Y. J., Shin, Y. O., Bae, J. S., et al. (2008). Beneficial effects of cardiac rehabilitation and exercise after percutaneous coronary intervention on hsCRP and inflammatory cytokines in CAD patients. Pflügers Archiv, 455(6), 1081–1088.

    Article  CAS  Google Scholar 

  34. Windsor, M. T., Bailey, T. G., Perissiou, M., et al. (2018). Cytokine responses to acute exercise in healthy older adults: the effect of cardiorespiratory fitness. Frontiers in Physiology, 9, 203.

    Article  Google Scholar 

  35. Sandor, B., Nagy, A., Toth, A., et al. (2014). Effects of moderate aerobic exercise training on hemorheological and laboratory parameters in ischemic heart disease patients. PLoS One, 9(10), e110751.

    Article  Google Scholar 

  36. Ferratini, M., Ripamonti, V., Masson, S., et al. (2012). Pentraxin-3 predicts functional recovery and 1-year major adverse cardiovascular events after rehabilitation of cardiac surgery patients. Journal of Cardiopulmonary Rehabilitation and Prevention, 32(1), 17–24.

    Article  Google Scholar 

  37. Lee, B. C., Hsu, H. C., Tseng, W. Y., et al. (2009). Effect of cardiac rehabilitation on angiogenic cytokines in postinfarction patients. Heart, 95(12), 1012–1018.

    Article  CAS  Google Scholar 

  38. Tu, W. J., Ma, G. Z., Ni, Y., et al. (2017). Copeptin and NT-proBNP for prediction of all-cause and cardiovascular death in ischemic stroke. Neurology, 88(20), 1899–1905.

    Article  CAS  Google Scholar 

Download references

Acknowledgments

The authors would like to express their gratitude to Dr. Qun Zhao from Shanghai Xuhui Central Hospital for his help with statistical analysis, Drs. Lingling Jiang and Wanqun Sun from Shanghai Xuhui Central Hospital, and Wenqin Gu from Shanghai Xuhui Fengling Community Healthcare Service Center for their generous contributions to the revision.

Funding

This work was supported by National Natural Science Foundation of China (grant number 81672260 for RYC); Shanghai Municipal Health Commission (grant numbers ZK2018A11 for HZ, ZK2018A10 and 201640194 for JY); and a hospital internal grant for JY.

Author information

Author notes

  1. Richard Yang Cao and Hongchao Zheng contributed equally to this work.

Authors and Affiliations

  1. Cardiac Rehabilitation Program, Shanghai Xuhui Central Hospital/Zhongshan-Xuhui Hospital, Fudan University/Shanghai Clinical Research Center, Chinese Academy of Sciences, 966 Middle Huaihai Road, Shanghai, 200031, China

    Richard Yang Cao, Hongchao Zheng, Yueyou Ding, Lifang Zhao, Hao Li, Qing Li, Wenchao Yuan & Jian Yang

  2. The First Rehabilitation Hospital of Shanghai, 349 Hangzhou Road, Shanghai, 200090, China

    Yi Hong

  3. Department of Cardiology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, 725 South Wanping Road, Shanghai, 200032, China

    Yuntao Zheng

  4. Department of Sport Rehabilitation, Shanghai University of Sport, 650 Qingyuanhuan Road, Shanghai, 200438, China

    Shanshan Liu & Lezheng Wang

Authors
  1. Richard Yang Cao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hongchao Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yi Hong
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yuntao Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yueyou Ding
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lifang Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hao Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Qing Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Wenchao Yuan
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Shanshan Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Lezheng Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Jian Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Richard Yang Cao or Jian Yang.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Human Subjects/Informed Consent Statement

Ethical approval was acquired from the Ethics Committee of Shanghai Xuhui Central Hospital (approval no. 2016-10) and registered on Chinese Clinical Trial Registry (ChiCTR-IPR-17010556). All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the World Medical Association (Declaration of Helsinki of 1975). Informed consent was obtained from each patient in the study.

Additional information

Editor-in-Chief Enrique Lara-Pezzi oversaw the review of this article

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cao, R.Y., Zheng, H., Hong, Y. et al. Cardiac Rehabilitation with Targeted Intensity Improves Cardiopulmonary Functions Accompanying with Reduced Copeptin Level in Patients with Coronary Artery Disease. J. of Cardiovasc. Trans. Res. 14, 317–326 (2021). https://doi.org/10.1007/s12265-020-10055-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12265-020-10055-y

Keywords

Search

Navigation