Physical activity should be a central part of coronary artery disease treatment

Erik Madssen. Foto: Andrea Hegdahl Tiltnes, NTNU

Atherosclerosis is a chronic inflammatory condition and the cause of angina pectoris and acute myocardial infarction, which represent the most common causes of death in the western world. Physical inactivity is an independent risk factor for atherosclerosis, and patients that are physically active have an improved prognosis compared to inactive patients. Although the clinical relationship between physical activity and cardiac health seems obvious, the pathophysiological mechanisms are still largely unknown.

Erik Madssen, M.D. and scientist at CERG, has in his PhD investigated whether physical exercise in patients with coronary artery disease induces beneficial effects in coronary atherosclerosis. The primary endpoint of the study was reduction of necrotic core, which is a marker of plaque instability, and future risk of plaque rupture and acute coronary syndrome. Madssen and co-workers included 36 patients with angina pectoris or acute myocardial infarction and used intravascular ultrasound to assess the coronary artery wall before and after a 12 week exercise period. Patients were randomized to aerobic interval training or moderate continuous training.

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The main finding of the study was a moderate reduction in necrotic core and total plaque burden at follow-up. There was no difference between patients exercising with high or moderate intensity. The reduction in necrotic core was larger in patients with angina pectoris than in patients who had suffered from an acute myocardial infarction. These findings have been published in American Journal of Cardiology and Medicine & Science in Sports & Exercise, and support the hypothesis that physical exercise has the ability to induced beneficial effects in coronary atherosclerosis. Thus, the scientific basis for recommending physical activity as a central part of coronary artery disease treatment is strengthened.

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About CERG

The Cardiac Exercise Research Group (CERG) at the Norwegian University of Science and Technology (NTNU) seeks to identify the key mechanisms underlying the beneficial effects of physical on cardiac health in the context of disease prevention and treatment. Named the K.G. Jebsen Center for Exercise in Medicine under Professor Ulrik Wisløff's leadership in 2011, CERG uses both top-down and bottom-up approaches to combat lifestyle-related disease.

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