The changes of oxidative stress and endothelial function biomarkers after 6 weeks of aerobic physical training in patients with stable ischemic coronary disease

Background/Aim. Exercise-based cardiac rehabilitation improves endothelial function, reduces cardiac mortality and anginal symptoms in patients with established cardiovascular disease. We evaluated the changes of oxidative stress and endothelial function biomarkers after 6 weeks of aerobic physical training in patients with stable ischemic coronary disease (IHD) participating in a cardiovascular rehabilitation exercise program. Methods. Thirty-five patients with stable IHD engaged in cardiovascular rehabilitation program with the regular aerobic physical activity during 6 weeks were consecutively included together with 37 control, age and sex-matched, IHD patients with a sedentary lifestyle. Clinical data about anthropometric and cardiovascular parameters and laboratory data: serum cell adhesion molecules intracellular (sICAM-1) and vascular (sVCAM-1), reactive carbonyl derivatives (RCD), lipid peroxidation products malondialdehyde (MDA) and nitric oxide (NO) concentration were determined at the beginning and after 6 weeks of aerobic training (45 minutes of continuous exercise up to 80% of maximal heart rate, 3 times a week). Results. The baseline characteristics of examined groups were similar according to age, gender, and cardiovascular risk profiles. The regular aerobic physical activity induced significant reduction of body mass index, blood pressure, heart rate, triglycerides, RCD (1.27 ± 0.48 μmol/g proteins vs. 1.04 ± 0.22 μmol/g proteins), sVCAM-1 [100.4, interquartile range (IQR)(78.4–118.3) ng/mL vs. 80.0 IQR(68.5–97.2 ng/mL)] and increasing of NO (64.72 ± 16.06 nmol/mg proteins vs. 74.38 ± 18.57 nmol/mg proteins) and HDL cholesterol (p < 0.05), which was not seen in sedentary control RCD (1.16 ± 0.25 interquartile range vs. 1.12 ± 0.14 interquartile range), sVCAM-1 [92.2 IQR (73.6–106.8 ng/mL) vs. 91.3 IQR (73.0–105.3 ng/mL) and NO (68.5 ± 17.9 nmol/mg vs. 65.7 ± 19.6). The values of sICAM-1 were lower in exercise training group baseline without significant changes during observation [80.74 IQR (54.92–97.3) vs. 80.36 IQR (68.1–95.3)] compared to the control [86.35 IQR(57.32– 95.8) vs. 84.65 IQR(55.67–93.8. In the exercise training group, values of sVCAM-1 and RCD were significantly lower and NO higher at the end of the study compared to those in the sedentary control. Conclusion. Regular physical activity induced reduction of oxidatively modified proteins and vascular cells adhesion molecules alongside with increased NO bioavailability and favorable changes in HDL cholesterol and triglycerides.