Arq. Bras. Cardiol. 2022; 119(5): 747-753

Does Myocardial Injury Occur After an Acute Aerobic Exercise Session in Patients with Refractory Angina?

Carla Giuliano de Sá Pinto Montenegro , Luciana Oliveira Cascaes Dourado , Camila Paixão Jordão , Marcelo Luiz Campos Vieira , Camila Regina Alves Assumpção, Luis Henrique Wolff Gowdak , Alexandre da Costa Pereira, Carlos Eduardo Negrão, Luciana Diniz Nagem Janot de Matos

DOI: 10.36660/abc.20210564

This Original Article is referred by the Short Editorial "Refractory Angina Referral to Cardiovascular Rehabilitation: A Neglected Patient".

Abstract

Background:

It is unclear whether exercise is safe in patients with more advanced forms of coronary artery disease, such as those with refractory angina (RA).

Objective:

We aimed to determine the effect of an acute aerobic exercise session (AAES) on high-sensitivity cardiac troponin T (hs-cTnT) levels in patients with RA.

Methods:

This was a longitudinal, non-randomized, and non-controlled clinical study. Participants were recruited from April 2015 to January 2019. On a visual pain scale from 0 to 10, pain rated up to 3 was considered as the top level allowed to continue exercising. We assessed hs-cTnT at baseline and 3 hours after the AAES. The protocol consisted of 5 minutes of warm-up, 30 minutes of continuous aerobic exercise at heart rate corresponding to the anaerobic threshold or angina threshold obtained in the cardiopulmonary exercise testing, and 5 minutes of cooling down. P values less than 0.05 were considered statistically significant.

Results:

Thirty-two patients with RA were included (61 ± 9 years, 59.4% male). The baseline hs-cTnT concentration was 10.9 ng/L (95% confidence interval: 9.1 to 13.0 ng/L). The hs-cTnT collected 3 hours after the AAES was 11.1 ng/L (95% confidence interval: 9.1 to 13.5 ng/L). No difference occurred in hs-cTnT before and after AAES (p = 0.657).

Conclusions:

A single AAES performed at the angina threshold with corresponding visual pain scale did not alter hs-cTnT in patients with RA, suggesting that no significant myocardial injury was elicited by exercising and that this exercise protocol can be considered safe.