[Oxidative-reductive balance in patients after acute coronary syndrome that undergo cardiac rehabilitation].

Unlabelled: Cardiac rehabilitation is essential part of acute coronary syndrome (ACS) treatment. Controlled physical activity (both aerobic exercise and muscle-strengthening activities) is the most important part of cardiac rehabilitation (CR). There is a close relationship between regular physical exercise and secondary prevention in patients after ACS. However, influence of physical activity on antioxidative protection mechanisms and free radical reactions is not yet fully known. The aim of study was to evaluate CR effects (the second phase) on oxidative-reductive balance in patients after ACS hospitalised for CR.

Material And Methods: Our study comprised 50 patients (32 male, 18 female), aged 42-75 years (56.42 +/- 8.34) after ACS treated by percutaneous transluminal coronary angioplasty (PTCA), that subsequently underwent the second phase of CR. Interval cycloergometer training was performed five times a week (in total 15 training sessions). In addition to interval training, patients underwent individual breathing exercises, relaxation exercises, isometric exercises of particular muscle groups and general rehabilitation twice a day. Thiobarbituric acid reactive substances (TBARS) level in erythrocytes, total antioxidant status (TAS) of plasma, superoxide dysmutase-1 (SOD-1), catalase (CAT) and glutathione peroxidase (GSH-Px) activity in erythrocytes were determined before and after CR programme. Statistical analysis of physical activity influence on oxidative-reductive balance was performed by Wilcoxon matched pairs test. P < 0.05 was acknowledged as statistically significant.

Results: After rehabilitation programme in patients after ACS following significant results were found: increase in SOD-1 activity compared to baseline values (3624.22 +/- 1003.38 U/gHb vs 3086.71 +/- 683.14 U/gHb; p = 0.007), increase in GSH-Px activity compared to baseline values (41.27+/- 13.87 U/gHb vs. 38.02 +/- 13.98 U/gHb; p = 0.006), decrease in CAT activity compared to baseline values (17.30 +/- 4.87 U/gHb vs. 19.64 +/- 4.36 U/gHb; p = 0.001), increase in TAS level compared to baseline values (2.00 +/- 0.75 mM/L vs. 1.66 +/- 0.71 mM/L; p = 0.003), increase in TBARS level compared to baseline values (0.21 +/- 0.05 microM/gHb vs. 0.19 +/- 0.03 microM/gHb; p = 0.0006).

Conclusions: Improvement of antioxidative protection in patients after ACS was observed after cardiac rehabilitatiom programme. Increase in SOD-1 and GSH-Px activity in erythrocytes and TAS plasma level was found. Increase of TBARS level in erythrocytes in patients after ACS and subsequent cardiac rehabilitation is associated with intensification of free-radical chain reaction related to physical activity.