Exercise and Vascular Modulation

Among the hundreds, if not thousands, of posters presented at the 59^th Annual Scientific Sessions of the American College of Cardiology were three that stood out under the Exercise and Vascular Modulation heading.

Atrial Fibrillation Is Not Associated with Increased Progression of Coronary Atherosclerosis: Insights from Intravascular Ultrasound Atherosclerosis Trials

Researchers: Bayturan O, Tuzcu E, Shao M, et al.

Purpose: Because concomitant “presence of coronary artery disease (CAD) and atrial fibrillation (AF) portends higher risk of cardiovascular events,” and atherosclerosis and AF are “both associated with heightened systemic inflammatory activity,” Bauturan, et al. sought to determine if the presence of AF is associated with increased progression of coronary atherosclerosis in patients with CAD.”

Results: No greater atheroma progression and less plaque burden were seen upon follow-up in study participants with AF, supporting the role of established antiatherosclerotic therapies in those with concomitant AF and CAD. The research teams also found AF to be related to greater likelihood of expansive remodeling.

The Impact of Early Compared to Late Morning Hours on Brachial Endothelial Function and Long-Term Cardiovascular Events in Healthy Subjects with no Apparent Coronary Heart Disease Presentation

Researchers: Shechter M, Hirsh L, Koren-Morag N, et al.

Purpose: “To find out,” Shechter explains, “the impact of early morning hours on brachial flow-mediated dilation and long-term cardiovascular outcome” because cardiovascular events (CVE) “have a peak incidence in the early morning hours.”

Results: Shechter states that in “healthy subjects with no apparent [coronary heart disease], [flow-mediated dilation] demonstrates a diurnal variation with a relatively lower FMD during early morning vs. late-day hours, suggesting a potential mechanism for higher CVE during early morning hours. Furthermore, brachial artery median FMD independently predicts long-term adverse CVE in addition to the traditional CHD risk factor assessment in healthy subjects with no apparent heart disease.”

Effect of Candesartan with Pioglitazone on Coronary Endothelial Function and Vascular Inflammation in Porcine Coronary Arteries Implanted with Sirolimus-eluting Stents

Researchers: Dohi T, Miyauchi K, Tsuruta R, et al.

Purpose: Because late “stent thrombosis is a major clinical problem related to endothelial dysfunction and inflammation after sirolimus-eluting stents (SES) implantation,” notes Dohi, “and therapeutic strategies to overcome these disorders are unclear,” Dohi and colleagues sought to “demonstrate that candesartan and pioglitazone protect against endothelial dysfunction and vascular inflammation following sirolimus-eluting stent implantation.”

Results: “Candesartan protected against vascular inflammation and restored endothelial dysfunction after SES implantation and pioglitazone added further beneficial effects,” explains Dohi, adding that administering these agents prior to SES implantation might be successful as vascular protection.”