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Study protocol: a randomised controlled trial investigating the effect of exercise training on peripheral blood gene expression in patients with stable angina

DOI: 10.1186/1471-2458-10-620

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Abstract:

Sixty patients with stable angina will be recruited and randomised 1:1 to exercise training or conventional care. Patients randomised to exercise training will attend an exercise physiology laboratory up to three times weekly for supervised aerobic interval training sessions of one hour in total duration. Patients will undergo assessments of angina, anxiety, depression, and peripheral blood gene expression at baseline, after six and twelve weeks of training, and twelve weeks after formal exercise training ceases.This study will provide comprehensive data on the effect of exercise training on peripheral blood gene expression in patients with angina. By correlating this with improvement in angina status we will identify candidate peripheral blood transcriptional markers predictive of improvements in angina level in response to exercise training.Clinicaltrials.gov identifier: NCT01147952Regular exercise protects against cardiovascular disease [1] and has beneficial effects on coronary perfusion and ventricular function in patients with established coronary artery disease [2]. However, the exact mechanism whereby exercise training exerts these effects is unclear. Meta-analyses have concluded that exercise based cardiac rehabilitation reduces cardiac mortality in patients with coronary artery disease (prior myocardial infarction, angina, bypass grafting or angioplasty) by 26%-31% [3,4]. Although exercise favourably influences serum lipids and blood pressure, the biological pathway whereby it protects against cardiovascular death remains unclear, though there is substantial evidence that exercise improves myocardial oxygenation. Exercise-induced improvement in myocardial perfusion has been demonstrated in a number of studies [2,5] suggesting exercise training increases absolute myocardial blood flow, rather than by altering myocardial efficiency. Exercise training has also been shown to improve coronary artery endothelial function (even after only 4 weeks training) [6].So

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