Document Type : Review Article

Authors

1 Ph.D. Student of Sport Physiology, University of Mazandaran

2 Professor of Sport Physiology, University of Mazandaran

3 Assistant Professor of Biostatistics, Tehran University of Medical Sciences

Abstract

The aim of this peper was meta-analysis of studies on the effectiveness of different exercise training on vascular endothelial function. To assessment studies in the field of vascular endothelial function search was done in databases; PubMed, scienceDirect, Scopus, Web of science, SID, Magiran and google Scholar with specified keywords among articles that were published in the years 1986 to 2016 both in Persian and English. After initial screening, full text search and critical appraisal, studies which pass the inclusion criteria were analyzed. Among imported article, 14 study which included 17 trials with meta-analysis inclusion criteria were analyzed. The results of the meta-analysis of studies showed that exercise can improve flow mediated dilation in healthy subjects (SMD=0.75, 95% CI 0.49–1.00, P=0.001) and patients with coronary artery disease (SMD=0.47, 95% CI 0.29–0.65, P=0.001). Although the effect size obtained for various exercise training are different, but considering the low number of studies, we cannot make an absolute statement about the superiority of one method of training. The exercise can be effective in improving endothelial function, although still high-quality research studies with sufficient sample size is needed.

Keywords

Main Subjects

  1. World Health Organization. Cardiovascular diseases (CVDs). Fact sheet no. 317. Genova: World Health Organization. 2015.
  2. Hatami Z. Prevalence of coronary artery disease risk factors in Iran: A population based survey. Cardiovascular Disorder. 2007; 7: 32.
  3. Davignon J, Ganz P. Role of endothelial dysfunction in atherosclerosis. Circulation. 2004; 109(23 suppl 1): 27-32.
  4. Verma S, Anderson T J. Fundamentals of endothelial function for the clinical cardiologist. Circulation. 2002; 105(5): 546-9.
  5. Brevetti G, Silvestro A, Schiano V, Chiariello M. Endothelial dysfunction and cardiovascular risk prediction in peripheral arterial disease: Additive value of flow-mediated dilation to ankle-brachial pressure index. Circulation. 2003; 108(17): 2093-8.
  6. Huang A L, Silver A E, Shvenke E, Schopfer D W, Jahangir E, Titas M A, et al. Predictive value of reactive hyperemia for cardiovascular events in patients with peripheral arterial disease undergoing vascular surgery. Arterioscler Thromb Vasc Biol. 2007; 27(10): 2113-9.
  7. Modena M G, Bonetti L, Coppi F, Bursi F, Rossi R. Prognostic role of reversible endothelial dysfunction in hypertensive postmenopausal women. J Am Coll Cardiol. 2002; 40(3): 505-10.
  8. Charakida M, Masi S, Luscher T F, Kastelein J J, Deanfield J E. Assessment of atherosclerosis: The role of flow-mediated dilatation. Eur Heart J. 2010; 31(23): 2854-61.
  9. Pierce G L, Eskurza I, Walker A E, Fay T N, Seals D R. Sex-specific effects of habitual aerobic exercise on brachial artery flow-mediated dilation in middle-aged and older adults. Clinical Science (London, England; 1979). 2011; 120(1): 13-23.
  10. Corretti M C, Anderson T J, Benjamin E J, Celermajer D, Charbonneau F, Creager M A, et al. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: A report of the International Brachial Artery Reactivity Task Force. J Am Coll Cardiol. 2002; 39(2): 257-65.
  11. Farahati S A H S R, Bijeh N, Mahjoob O. The effect of aerobic exercising on plasma nitric oxide level and vessel endothelium function in postmenopausal women. Razi Journal of Medical Sciences. 2014; 20(115): 78-88. (In Persian).
  12. Green D J, Jones H, Thijssen D, Cable N T, Atkinson G. Flow-mediated dilation and cardiovascular event prediction: Does nitric oxide matter? Hypertension (Dallas, Tex; 1979). 2011; 57(3): 363-9.
  13. Di Francescomarino S, Sciartilli A, Di Valerio V, Di Baldassarre A, Gallina S. The effect of physical exercise on endothelial function. Sports Medicine (Auckland, NZ). 2009; 39(10): 797-812.
  14. Green D J, Walsh J H, Maiorana A, Burke V, Taylor R R, O'Driscoll J G. Comparison of resistance and conduit vessel nitric oxide-mediated vascular function in vivo: Effects of exercise training. Journal of Applied Physiology (Bethesda, Md; 1985). 2004; 97(2): 749-55 (discussion 8).
  15. Miyachi M. Effects of resistance training on arterial stiffness: A meta-analysis. Br J Sports Med. 2013; 47(6): 393-6.
  16. Okamoto T, Masuhara M, Ikuta K. Combined aerobic and resistance training and vascular function: Effect of aerobic exercise before and after resistance training. Journal of Applied Physiology (Bethesda, Md; 1985). 2007; 103(5): 1655-61.
  17. Montero D, Roberts C K, Vinet A. Effect of aerobic exercise training on arterial stiffness in obese populations: A systematic review and meta-analysis. Sports Medicine (Auckland, NZ). 2014; 44(6): 833-43.
  18. Birk G K, Dawson E A, Batterham A M, Atkinson G, Cable T, Thijssen D H, et al. Effects of exercise intensity on flow mediated dilation in healthy humans. Int J Sports Med. 2013; 34(5): 409-14.
  19. Currie K D, McKelvie R S, Macdonald M J. Flow-mediated dilation is acutely improved after high-intensity interval exercise. Med Sci Sports Exerc. 2012; 44(11): 2057-64.
  20. Clarkson P, Montgomery H E, Mullen M J, Donald A E, Powe A J, Bull T, et al. Exercise training enhances endothelial function in young men. Journal of the American College of Cardiology. 1999; 33(5): 1379-85.
  21. Lippincott M F, Desai A, Zalos G, Carlow A, De Jesus J, Blum A, et al. Predictors of endothelial function in employees with sedentary occupations in a worksite exercise program. The American Journal of Cardiology. 2008; 102(7): 820-4.
  22. Casey D P, Pierce G L, Howe K S, Mering M C, Braith R W. Effect of resistance training on arterial wave reflection and brachial artery reactivity in normotensive postmenopausal women. Eur J Appl Physiol. 2007; 100(4): 403-8.
  23. Okamoto T, Masuhara M, Ikuta K. Effects of muscle contraction timing during resistance training on vascular function. Journal of Human Hypertension. 2009; 23(7): 470-8.
  24. Rakobowchuk M, McGowan C L, de Groot P C, Hartman J W, Phillips S M, MacDonald M J. Endothelial function of young healthy males following whole body resistance training. Journal of Applied Physiology. 2005; 98(6): 2185-90.
  25. Ashor A W, Lara J, Siervo M, Celis-Morales C, Oggioni C, Jakovljevic D G, et al. Exercise modalities and endothelial function: A systematic review and dose-response meta-analysis of randomized controlled trials. Sports Medicine. 2015; 45(2): 279-96.
  26. Higgins J, Green S. Cochrane handbook for systematic reviews of interventions version 5.1. The Cochrane Collaboration. 2011. http://www.cochranehandbook.org.
  27. Liberati A, Altman D G, Tetzlaff J, Mulrow C, Gøtzsche P C, Ioannidis J P A, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration. BMJ. 2009; 339: 5-27.
  28. Downs S H B N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998; 52(6): 377-384.
  29. Vona M, Codeluppi G M, Iannino T, Ferrari E, Bogousslavsky J, von Segesser L K. Effects of different types of exercise training followed by detraining on endothelium-dependent dilation in patients with recent myocardial infarction. Circulation. 2009; 11(9); 1601-8.
  30. Okamoto T, Masuhara M, Ikuta K. Effects of low-intensity resistance training with slow lifting and lowering on vascular function. J Hum Hypertens. 2008; 22(7): 509-11.
  31. Okamoto T, Masuhara M, Ikuta K. Effect of low-intensity resistance training on arterial function. European Journal of Applied Physiology. 2011; 111(5): 743-8.
  32. Akazawa N, Choi Y, Miyaki A, Tanabe Y, Sugawara J, Ajisaka R, et al. Curcumin ingestion and exercise training improve vascular endothelial function in postmenopausal women. Nutrition Research. 2012; 32(10): 795-9.
  33. Edwards D G, Schofield R S, Lennon S L, Pierce G L, Nichols W W, Braith R W. Effect of exercise training on endothelial function in men with coronary artery disease. The American Journal of Cardiology. 2004; 93(5): 617-20.
  34. Blumenthal J A, Sherwood A, Babyak M A, Watkins L L, Waugh R, Georgiades A, et al. Effects of exercise and stress management training on markers of cardiovascular risk in patients with ischemic heart disease: A randomized controlled trial. Jama. 2005; 293(13): 1626-34.
  35. Sixt S, Rastan A, Desch S, Sonnabend M, Schmidt A, Schuler G, et al. Exercise training but not rosiglitazone improves endothelial function in prediabetic patients with coronary disease. European Journal of Cardiovascular Prevention and Rehabilitation: Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology. 2008; 15(4): 473-8.
  36. Munk P S, Staal E M, Butt N, Isaksen K, Larsen A I. High-intensity interval training may reduce in-stent restenosis following percutaneous coronary intervention with stent implantation A randomized controlled trial evaluating the relationship to endothelial function and inflammation. Am Heart J. 2009; 158(5): 734-41.
  37. Desch S, Sonnabend M, Niebauer J, Sixt S, Sareban M, Eitel I, et al. Effects of physical exercise versus rosiglitazone on endothelial function in coronary artery disease patients with prediabetes. Diabetes, Obesity & Metabolism. 2010; 12(9): 82.
  38. Luk T H, Dai Y L, Siu C W, Yiu Kh, Chan H T, Lee S W, et al. Effect of exercise training on vascular endothelial function in patients with stable coronary artery disease: A randomized controlled trial. Eur J Prev Cardiol. 2012; 19(4): 830-9.
  39. Casey D P B D, Braith R W. Systemic plasma levels of nitrate/ nitrite reflect brachial flow mediated dilation responses in young men and women. Clin Exp Pharmacol Physiol. 2007; 34: 1291-3.
  40. Duncker D J, Bache R J. Regulation of coronary blood flow during exercise. Physiol Rev. 2008; 88(3): 1009-86.
  41. Higashi Y Y M. Exercise and endothelial function: Role of endothelium-derived nitric oxide and oxidative stress in healthy subjects and hypertensive patients. Pharmacol Ther. 2004; 102: 87-96.
  42. Xu Q. Role of heat shock proteins in atherosclerosis. Arterioscler Thromb Vasc Biol. 2002; 22: 1547-59.
  43. Belardinelli R, Lacalaprice F, Faccenda E, Purcaro A, Perna G. Effects of short-term moderate exercise training on sexual function in male patients with chronic stable heart failure. Int J Cardiol. 2005; 101(1): 83-90.
  44. Ribeiro F, Ribeiro I P, Alves A J, do Ceu Monteiro M, Oliveira N L, Oliveira J, et al. Effects of exercise training on endothelial progenitor cells in cardiovascular disease: A systematic review. Am J Phys Med Rehabil. 2013; 92(11): 1020-30.