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Articles in PresS, published online ahead of print February 14, 2002
Am J Physiol Heart Circ Physiol, 10.1152/ajpheart.00977.2001
Submitted on November 12, 2001
Accepted on February 7, 2002
1 Cardiology, Swiss Cardiovascular Center Bern, Bern, Switzerland
* To whom correspondence should be addressed. E-mail: christian.seiler.cardio{at}insel.ch.
Background: The purpose of this study in healthy young male volunteers without cardiovascular disease or risk factors was to quantify the changes in coronary artery size and function in response to regular physical endurance exercise. Methods: In 8 healthy male volunteers (cardiologists; age 36±5 years), bicycle spiroergometry, Doppler echocardiography, and quantitative coronary angiography with intracoronary Doppler measurements before and after completion of a physical endurance exercise program of >5 months duration were performed. Right and left coronary angiography was first done without medication. Flow-induced (hyperemic) endothelium-dependent left coronary artery vasodilatation was determined using intracoronary adenosine. Endothelium-independent vasodilatation of the left coronary artery was assessed using nitroglycerin. Coronary flow velocity reserve was determined by intracoronary Doppler measurement using adenosine. Results: After the exercise program, maximum oxygen uptake increased from 46±6 to 54±5ml/min/kg (p=0.04), maximum ergometric workload changed from 3.8±0.3 to 4.4±0.3Watt/kg (p=0.001), and left ventricular mass index increased from 82±18 to 108±29g/m2 (p=0.001). The right, left main and left anterior descending coronary artery cross-sectional area increased significantly in repsonse to exercise. Before versus at the end of the exercise program, flow-induced left anterior descending coronary artery cross-sectional area was 10.1±3.5mm2 and 11.0±3.9mm2, respectively (p=0.03), nitroglycerin-induced left coronary calibercalibres increased significantly, and coronary flow velocity reserve changed from 3.8±0.8 to 4.5±0.7 (p=0.001). Left coronary artery calibercalibre correlated significantly with ventricular mass and maximum oxygen uptake, and coronary flow velocity reserve was significantly associated with maximum workload. Conclusions: Regular physical endurance exercise in young men without cardiovascular disease or risk factors results in an adaptive increase of epicardial coronary artery size, in improved vasodilatation and in enhanced hyperemic microcirculatory reserve.
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