Adherence to lifestyle modifications after a cardiac rehabilitation program and endothelial progenitor cells

Francesca Cesari; Rossella Marcucci; Anna Maria Gori; Costanza Burgisser; Sara Francini; Anna Teresa Roberts; Francesco Sofi; Gian Franco Gensini; Rosanna Abbate; Francesco Fattirolli

doi:10.1160/TH13-10-0869

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2014; 112(01): 196-204
DOI: 10.1160/TH13-10-0869

Cardiovascular Biology and Cell Signalling

Schattauer GmbH

Adherence to lifestyle modifications after a cardiac rehabilitation program and endothelial progenitor cells

A six-month follow-up study

Authors

Francesca Cesari

¹Department of Clinical and Experimental Medicine, Thrombosis Centre, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Rossella Marcucci

¹Department of Clinical and Experimental Medicine, Thrombosis Centre, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Anna Maria Gori

¹Department of Clinical and Experimental Medicine, Thrombosis Centre, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

²Fondazione Don Carlo Gnocchi Italia, Florence, Italy
Costanza Burgisser

³Geriatric Cardiology and Medicine, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Sara Francini

⁴Cardiac Rehabilitation Unit, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Anna Teresa Roberts

³Geriatric Cardiology and Medicine, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Francesco Sofi

¹Department of Clinical and Experimental Medicine, Thrombosis Centre, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

²Fondazione Don Carlo Gnocchi Italia, Florence, Italy
Gian Franco Gensini

¹Department of Clinical and Experimental Medicine, Thrombosis Centre, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

²Fondazione Don Carlo Gnocchi Italia, Florence, Italy
Rosanna Abbate

¹Department of Clinical and Experimental Medicine, Thrombosis Centre, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
Francesco Fattirolli

⁴Cardiac Rehabilitation Unit, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

Abstract

Summary

An increase of endothelial progenitor cells (EPCs) among acute myo-cardial infarction (AMI) patients participating in a cardiac rehabilitation (CR) program has been reported, but no data on the impact of adherence to lifestyle recommendations provided during a CR program on EPCs are available. It was our aim to investigate the effect of adherence to lifestyle recommendations on EPCs, inflammatory and functional parameters after six months of a CR program in AMI patients. In 110 AMI patients (90 male/20 female; mean age 57.9 ± 9.4 years) EPCs, high sensitivity C-reactive protein (hsCRP), N-terminal pro-brain natriuretic peptide (NT-ProBNP) levels, and cardiopulmonary testings were determined at the end of the CR (T1) and at a six-month follow-up (T2). At T2 we administered a questionnaire assessing dietary habits and physical activity. At T2, we observed a decrease of EPCs (p<0.05), of hsCRP (p=0.009) and of NT-ProBNP (p<0.0001). Patient population was divided into three categories by Healthy Lifestyle (HL) score (none/low, moderate and high adherence to lifestyle recommendations). We observed a significant association between adherence to lifestyle recommendations, increase in EPCs and exercise capacity between T1 and T2 (Δ EPCs p for trend <0.05; ΔWatt max p for trend=0.004). In a multivariate logistic regression analyses, being in the highest tertile of HL score affected the likelihood of an increase of EPC levels at T2 [OR (95% confidence interval): 3.36 (1.0–10.72) p=0.04]. In conclusion, adherence to lifestyle recommendations provided during a CR program positively influences EPC levels and exercise capacity.

Keywords

Lifestyle modifications - endothelial progenitor cells - cardiac rehabilitation - healthy lifestyle score

Full Text

References

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