Oncotarget

Clinical Research Papers:

Randomized clinical trial studying effects of a personalized supervised lifestyle intervention program on cardiovascular status in physically inactive healthy volunteers

Helena U Westergren _, Li-Ming Gan, Marianne Månsson and Sara Svedlund

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Oncotarget. 2018; 9:9498-9511. https://doi.org/10.18632/oncotarget.23958

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Abstract

Helena U Westergren1,2, Li-Ming Gan1,3, Marianne Månsson3,4 and Sara Svedlund1,5

1Department of Molecular and Clinical Medicine, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden

2Cardiovascular and Metabolic Diseases, Department of Personalized HealthCare and Biomarkers, AstraZeneca R and D Gothenburg, Mölndal, Sweden

3Cardiovascular and Metabolic Diseases, Innovative Medicines and Early Development, Department of Early Clinical Development, AstraZeneca R and D Gothenburg, Mölndal, Sweden

4Department of Urology, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

5The Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden

Correspondence to:

Sara Svedlund, email: [email protected]

Keywords: coronary flow reserve; physical exercise; microvascular dysfunction; ultrasound

Received: July 19, 2017     Accepted: December 10, 2017     Published: January 03, 2018

ABSTRACT

Background: The impact of personalized exercise training and a healthy dietary lifestyle in healthy volunteers on coronary flow reserve and cardiovascular function remains to be investigated in a controlled study setting.

Purpose: To examine the effects of a Mediterranean-inspired diet combined with regular physical exercise (standard) and a personalized supervised exercise program (DAPS) on coronary flow reserve and cardiovascular function.

Results: The number of males were 10 (59%) and 9 (47%) and mean age was 54 ± 12 and 55 ± 5 years in standard versus DAPS group, respectively. Primary outcomes were in addition to improved body composition and aerobic capacity, increased TDE-CFR (5.0%, CI:1.62,8.64, p = 0.005) and left ventricle ejection fraction (LVEF) during hyperemia (10.2%, CI:1.62,19.4, p = 0.022) in DAPS adjusted for the control period. Also, plasma fibrinogen decreased (-12.1%, CI:-22.0,–0.92, p = 0.035) in the DAPS group. Secondary outcomes, after adjusting DAPS intervention effects for the standard-training period, TDE-CFR and hyperemic LVEF remained significantly improved.

Materials and Methods: This randomized, controlled clinical trial (URL: http://www.clinicaltrials.gov NCT02713724) included 36 healthy volunteers who underwent exercise ECG before randomization to standard or DAPS groups. Standard-group was given gym-membership with limited instructions and general dietary advice. DAPS-group received personalized supervised exercise programs and more detailed dietary advice with regular contact with a personal trainer. Effects were evaluated after 3 months. All participants underwent coronary flow reserve by transthoracic ultrasound (TDE-CFR), blood marker analysis and examinations of vascular function. Standard-group was evaluated pre-control, post-control (=pre-intervention) and post-intervention. DAPS-group was examined at pre-intervention and post-intervention.

Conclusions: A personalized supervised training- and diet program improves cardiovascular status in healthy subjects with a physically inactive lifestyle and may be a promising approach for cardiovascular prevention in the general population.


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