Effects of Catheterization on Artery Function and Health: When Should Patients Start Exercising Following Their Coronary Intervention?

Tryfonos, A, Green, DJ and Dawson, EA (2019) Effects of Catheterization on Artery Function and Health: When Should Patients Start Exercising Following Their Coronary Intervention? Sports Medicine. ISSN 0112-1642

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Abstract

Coronary artery disease (CAD) is a leading cause of death worldwide, and percutaneous transluminal coronary angiography (PTCA) and/or percutaneous coronary intervention (PCI; angioplasty) are commonly used to diagnose and/or treat the obstructed coronaries. Exercise-based rehabilitation is recommended for all CAD patients; however, most guidelines do not specify when exercise training should commence following PTCA and/or PCI. Catheterization can result in arterial dysfunction and acute injury, and given the fact that exercise, particularly at higher intensities, is associated with elevated inflammatory and oxidative stress, endothelial dysfunction and a pro-thrombotic milieu, performing exercise post-PTCA/PCI may transiently elevate the risk of cardiac events. This review aims to summarize extant literature relating to the impacts of coronary interventions on arterial function, including the time-course of recovery and the potential deleterious and/or beneficial impacts of acute versus long-term exercise. The current literature suggests that arterial dysfunction induced by catheterization recovers 4-12 weeks following catheterization. This review proposes that a period of relative arterial vulnerability may exist and exercise during this period may contribute to elevated event susceptibility. We therefore suggest that CAD patients start an exercise training programme between 2 and 4 weeks post-PCI, recognizing that the literature suggest there is a 'grey area' for functional recovery between 2 and 12 weeks post-catheterization. The timing of exercise onset should take into consideration the individual characteristics of patients (age, severity of disease, comorbidities) and the intensity, frequency and duration of the exercise prescription.

Item Type:	Article
Additional Information:	This is a post-peer-review, pre-copyedit version of an article published in Sports Medicine. The final authenticated version is available online at: http://dx.doi.org/10.1007/s40279-019-01055-3
Uncontrolled Keywords:	1106 Human Movement and Sports Sciences, 0913 Mechanical Engineering, 1302 Curriculum and Pedagogy
Subjects:	R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions:	Sport and Exercise Sciences
Publisher:	Springer Verlag
Related URLs:	https://www.ncbi.nlm.nih.gov/pubmed/30719682
Date of acceptance:	19 January 2019
Date of first compliant Open Access:	5 February 2020
Date Deposited:	22 Feb 2019 09:39
Last Modified:	04 Sep 2021 09:42
DOI or ID number:	10.1007/s40279-019-01055-3
URI:	https://researchonline.ljmu.ac.uk/id/eprint/10198

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