Abstract:Patients with metabolic syndrome (MS) are at potential risk for cardiovascular disease and have received increasing public and medical attention. Studies have shown that regular physical exercise can effectively regulate metabolic indicators such as blood pressure, blood sugar and blood lipids, and play a positive role in reducing the risk of cardiovascular disease and improving the prognosis of patients. Exercise intensity has been identified as the most important aspect in reducing the risk of cardiovascular death and all-cause mortality in exercise intervention. Therefore, the design of exercise prescription which is both scientific and satisfying individual differences has become the focus of research. Most of the current clinical studies are based on the percentage of exercise intensity as the basis for the formulation of standardized exercise prescription for MS patients, while the studies on the individualized threshold of exercise intensity based on cardiopulmonary exercise test (CPET) are still few. CPET has shown that individualized exercise prescription can effectively reduce body composition index, blood pressure and blood glucose, improve cardiorespiratory function, exercise endurance and quality of life in MS patients. This paper reviewed the development of individualized exercise programs with different intensification according to threshold indexes in CPET, analyzed the intervention effects and possible mechanisms for MS patients and subgroups, and provided certain reference for the formulation and implementation of personalized exercise prescriptions for MS patients, and also provided references for in-depth research on individualized exercise intervention for MS.

Abstract:The incidence rate and mortality of cardiovascular disease are increasing. Myocardial ischemia and myocardial infarction are the main causes. Cardiopulmonary endurance reflects the fitness of cardiopulmonary function and the tolerance to maximum exercise intensity. Cardiopulmonary endurance is one of the five vital signs of human body, which can be used to evaluate the risk of cardiovascular disease. Cardiopulmonary exercise test (CPET), as a new objective noninvasive detection technology of cardiopulmonary integration, can predict the potential pathophysiological changes of patients earlier. The data interpretation of CPET is relatively complex and not widely used, so it has great potential in clinical application. At present, CPET application fields include disease diagnosis, condition and prognosis risk assessment, exercise prescription formulation and so on. It is in line with the mainstream of cardiac rehabilitation to evaluate and diagnose the early risk of cardiovascular disease with CPET.

Abstract:Aim To explore the effects of cardiac exercise rehabilitation on cardiopulmonary function and quality of life in patients with coronary heart disease after percutaneous coronary intervention(PCI). Methods 110 patients with coronary heart disease who were diagnosed and had undergone PCI were randomly divided into the rehabilitation group and the control group, according to the order of treatment and personal wishes, 55 cases in each group. General data of patients, cardiopulmonary exercise test after 6 months of exercise, cardiac ultrasound related indicators and Seattle angina scale (SAQ) were collected, and statistical analysis was performed to assess the effects of cardiac exercise rehabilitation on cardiopulmonary function and quality of life in patients with coronary heart disease after PCI. Results After 6 months exercise rehabilitation treatment, the anaerobic threshold(AT), maximal oxygen uptake(VO2 max), oxygen pulse(O2 pulse), maximal exercise time, left ventricular ejection fraction(LVEF) and SAQ score in the rehabilitation group were significantly higher than before intervention and control group (P<0.05). Conclusions Cardiac exercise rehabilitation therapy can improve cardiopulmonary function, exercise endurance and quality of life in patients with coronary heart disease after percutaneous coronary intervention. It is an important part of secondary prevention in patients with coronary artery disease after percutaneous coronary intervention.

Abstract:Aim To evaluate the diagnostic value of ST segment depression limited to the recovery phase of exercise stress testing for coronary artery disease. Methods 168 patients from July 2008 to December 2012 were selected for the study. They received both exercise stress testing and selective coronary angiography. According to the results of exercise test, patients were allocated into exercise-phase ST depression group （exercise group, n＝90）, 54 male and 36 female, age between 35～80, recovery-phase ST depression group （recovery group, n＝61）, 26 male and 35 female, age between 45～74, and negative exercise test group （negative test group, n＝17）, 11 male and 6 female, age between 35～80. Based on results of coronary angiography, they were categorized into marked stenosis group, slightly stenosis group and angiographical normal group. Clinical characteristics of three groups, relations between stress test and coronary angiography, and echocardiographic parameters were compared. Results The patients in exercise-phase ST depression group were older and there were more diabetes in this group. The high density lipoprotein cholesterol （HDLC） level was lower, and the creatine and cystatin C levels were higher than other two groups （P<0.05）. There were more exercise-phase ST depression in marked stenosis group than other two groups （P＜0.05）. Recovery phase ST depression group showed higher percentage of slight stenosis compared with exercise-phase group （P<0.01）. Exercise-phase ST depres sion was more sensitive to find out one, two or three vessels lesions than recovery phase ST depression. Echocardiographic left ventricular end diatolic volume was lower than other two groups （P<0.05）. Conclusions Patients with recovery-phase ST depression had less coronary risk factors and more slight stenosis in coronary arteries. Diagnosis of coronary artery disease in recovery-phase ST depression patients should be individualized and considered based on risk factors assessment.

Abstract:Aim The evaluation of the clinical feasibility of disruption of intracoronary plaques was conducted by angioplasty with high intensity, low frequency ultrasound. Methods 30 cases of coronary heart disease with stenosis ≥75% in one blood vessel were divided into Ultrasonic dissolved group and PTCA group randomly. Comparison of stenosis degree and ST segment in routine ECG and exercise tests before and after the treatment were conducted. Results Ultrasound was found to have dissolved atherosclerotic plaques in 15 cases. The residual stenosis was 43.0%±15.5% after the treatment, representing a decrease of 43.5%±17.7% compared with that before the treatment (40.1%±15.3% vs 84.7%±4.7%,p<0.05). In 5 out of these 15 patients, the residual stenosis was less than 30%. ST segment in ECG was markedly lifted up after the treatment in 15 patients. There were remarkable differences between the time needed for exercise-induced angina pectoris, the time for exercise-induced decrease in ST segment for 0.1 mV and the maximal range of decrease in ST segment before and those after the treatment (p<0.01). The residual stenosis was significantly more severe in ultrasonic group compared with PTCA group(43.0±15.5% vs 20.9±2.9%, p<0.01). Conclusions Angioplasty with high intensity, low frequency ultrasound can be used as a new approach for treating serious stenosis and improving blood flow of the coronary artery.

Abstract:Aim The evaluation of the clinical feasibility of disruption of intracoronary plaques was conducted by angioplasty with high intensity, low frequency ultrasound. Methods 30 cases of coronary heart disease with stenosis ≥75% in one blood vessel were divided into Ultrasonic dissolved group and PTCA group randomly. Comparison of stenosis degree and ST segment in routine ECG and exercise tests before and after the treatment were conducted. Results Ultrasound was found to have dissolved atherosclerotic plaques in 15 cases. The residual stenosis was 43.0%±15.5% after the treatment, representing a decrease of 43.5%±17.7% compared with that before the treatment (40.1%±15.3% vs 84.7%±4.7%,p<0.05). In 5 out of these 15 patients, the residual stenosis was less than 30%. ST segment in ECG was markedly lifted up after the treatment in 15 patients. There were remarkable differences between the time needed for exercise-induced angina pectoris, the time for exercise-induced decrease in ST segment for 0.1 mV and the maximal range of decrease in ST segment before and those after the treatment (p<0.01). The residual stenosis was significantly more severe in ultrasonic group compared with PTCA group(43.0±15.5% vs 20.9±2.9%, p<0.01). Conclusions Angioplasty with high intensity, low frequency ultrasound can be used as a new approach for treating serious stenosis and improving blood flow of the coronary artery.

Abstract:Aim To explore the objective evidence of ischemic preconditioning (IP) in patients with stable angina (SA).Methods sixteen patients with SA underwent two times of treadmill exercise tests(TET) at the interval of 10 minutes according to Bruce protocal. The appeared rate and time of chest pain, maximal value and duration of ST segment depression, arrhythmias occurred during TET were analysed for different two tests. Results 9 patients (56.3%) complained of chest pain in the first test, however, only 4 of them (25%) did in the second one (P<0.01). The occurred time of chest pain was 2.24±0.2 min in the first test, 3.8±0.4 min in the second one (P<0.05). The maximal value of ST segment depression decreased from 0.18±0.07 mV in the first test to 0.12±0.04 mV in the second one (P<0.01), and duration of ST segment depression was down from 6.42±0.8 min in the first test to 4.1±0.5 min in the second one (P<0.01). The rate of arrhythmia decreased from 43.8% in the first test to 18.8% in the second one (P<0.01). Conclusions The present data demonstrated that transient ischemia of myocardium could result in ischemic preconditioning phenomenon, and protected heart from more serious damage at the definite interval of time.