Angina Pectoris
Conditions
Keywords
angina, gene expression, depression, anxiety
Brief summary
Regular exercise is known to produce significant health benefits and to reduce the risk of heart diseases, although how this benefit occurs is not well understood. White blood cells are known to be involved in triggering heart attacks, and which genes are switched on or off in white blood cells determines whether they have beneficial or harmful effects. Previous studies, and studies ongoing in our group, have demonstrated measurement of peripheral blood gene expression (which reflects white blood cell gene expression) is able to distinguish between patients with and without coronary artery disease, or patients who are able to develop good compared with poor coronary collateral arteries. Therefore, the gene expression signature in peripheral blood may provide novel diagnostic or prognostic information, and insight into the pathogenesis of heart disease. We therefore hypothesise that exercise alters peripheral blood gene expression in patients with coronary artery disease and angina. This will identify possible ways that exercise improves angina and reduces the risk of heart disease.
Interventions
BEHAVIORALStructured exercise training
randomised to 12 weeks of exercise training up to three times weekly. Training will be interval training with active recovery, with 3 min intervals conducted 10bpm below angina threshold.
Sponsors
Sheffield Teaching Hospitals NHS Foundation Trust
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
30 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Class I to III angina pectoris (classified according to the Canadian Cardiovascular Society \[CCS\])with documented myocardial ischemia or coronary artery disease on angiography * Ability to read and speak English to a level allowing satisfactory completion of written questionnaires and to understand instruction during the exercise programme.
Exclusion criteria
* Acute coronary syndromes or recent myocardial infarction (\<2 months) * Left main coronary artery stenosis \>25% or high-grade proximal left anterior descending artery stenosis * Known reduced left ventricular function (ejection fraction \<40%) * Significant valvular heart disease * Insulin-dependent diabetes mellitus * Occupational, orthopedic, and other conditions that preclude regular exercise * Patients whose ECG prevents interpretation of an exercise test (LBBB, RBBB, pacemaker implantation). * Patients who already perform greater than 30min continuous exercise three times weekly (self-reported).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Peripheral blood gene expression | baseline |
| peripheral blood gene expression | 12 weeks after exercise training (or conventional care) |
Secondary
| Measure | Time frame |
|---|---|
| Angina status | baseline |
| Angina Status | 24wks after starting 12 week exercise programme (or conventional care) |
| Anxiety Score | baseline |
| Depression Score | 6wks after starting 12 week exercise programme (or conventional care) |
Countries
United Kingdom
Outcome results
None listed