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Biomedical subjects
Publications and source records attributed to Ehud Goldhammer.
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BACKGROUND: Physical activity may lower the risk for coronary artery disease (CAD) by mitigating inflammation, which plays a key role in the pathophysiology of atherosclerosis. The purpose of this study was to determine the effect of aerobic exercise training on levels of pro- and anti-inflammatory cytokines, IL-1, IL-6, IL-10, INF-gamma, and C-reactive protein (CRP), in CAD patients participating in a cardiac rehabilitation program. METHODS AND RESULTS: Twenty-eight patients, age 64+/-7.1 years, participated in a 12-week aerobic exercise training program at 70-80% of individual maximal heart rate. Training resulted in a significant reduction of all pro-inflammatory cytokines, CRP from 7.5+/-4.2 to 3.9+/-3.5 mg/l, p<0.001, IL-1, 0.33+/-0.23 to 0.51+/-0.12 pg/ml, p=0.014, IL-6, 2.50+/-1.50 to 1.44+/-0.57 pg/ml, p=0.002, INF-gamma, 18.63+/-3.31 to 16.77+/-2.49 pg/ml, p<0.001, as well as a significant increase in the anti-inflammatory, cytokine IL-10, from 1.61+/-1.40 to 2.29+/-2.01 pg/ml, p=0.008. Baseline CRP levels were 36% (p=0.006) higher among diabetes mellitus patients and training was associated with a 40.5% CRP reduction in these patients compared to 19% reduction in non-diabetics, p<0.01. At baseline 72% of patients were in a high risk category (CRP>3 mg/l), 28% in an intermediate (CRP=1-3 mg/l), with none in a low risk category (<1 mg/l). Following exercise training, 11% were in the low risk, 50% in the intermediate and 39% in the high risk category, indicating 46% reduction in the number of subjects in the high risk category. CONCLUSIONS: Aerobic exercise training in CAD patients is an effective mean in inducing reduction in CRP, IL-1, IL-6, INF-gamma levels, and increase in IL-10, thus, possibly improving coronary risk profile.
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PURPOSE: The purpose of the present study was to examine the effect of aerobic exercise training on the immune system in coronary artery disease patients treated with beta-blockers. METHODS: Twenty-five patients (46.1 +/- 2 yr) treated with atenolol, a beta-blocker agent, for 3 months before exercising were divided randomly into two groups: 15 underwent an aerobic exercise training program for 12 wk at 65-70% of their work capacity, whereas the other 10 patients served as controls. RESULTS: After training, levels of CD4 and CD8 cells were significantly (P < 0.05) higher and concomitantly the CD4/CD8 ratio decreased significantly (P < 0.05) in the exercising group compared with the control group. CONCLUSIONS: Data suggest that coronary artery disease patients exercising aerobically at 65-70% of their work capacity gain a statistically significant higher lymphocyte T cell function as compared with their untrained counterparts.
PURPOSE: Deterioration in left ventricular function is a more sensitive marker of myocardial ischemia during exercise than ST segment depression. The current study was designed to evaluate left ventricular function during one-repetition-maximum (1-RM) strength testing and resistance exercise in cardiac patients with moderate left ventricular dysfunction. METHODS: Using echocardiographic methods, left ventricular function was evaluated in 15 patients with left ventricular dysfunction (age, 65 +/- 6.5 years; ejection fraction, 42.1 +/- 5.8). Measurements were performed during 1-RM testing and resistance exercise (20%, 40%, and 60% of 1-RM using 10 to 15 repetitions) on the one-arm biceps curl (BIC) and bilateral knee extension exercises and compared with measurements of left ventricular function during the symptom-limited graded exercise test (SL-GXT). RESULTS: During the knee extension exercise, there was a slight but significant reduction (P< or =.05) in ejection fraction values at the end of 60% 1-RM, as compared with rest and previous workloads. Significant increases in systolic blood pressure and left ventricular end-systolic volume ratio values (P< or =.05) from rest to exercise were observed across test modes and for all workloads. The prevalence of new wall motion abnormalities during knee extension and BIC 1-RM strength testing was comparable with that observed during SL-GXT. The greatest increase in new wall motion abnormalities was seen during 60% 1-RM of knee extension exercise, as compared with prior workloads, BIC exercises, and SL-GXT. CONCLUSIONS: Despite an increase in occurrence of ischemic changes during the highest resistance exercise workloads and with larger muscle mass, the findings are small in magnitude and do not suggest reduced cardiac performance.
BACKGROUND: All-out anaerobic exercise may be dangerous for the older population, due to hypoxia and inappropriate blood pressure response. OBJECTIVES: This study compared and evaluated left ventricular function at peak all-out anaerobic effort in 12 well-trained older (58 +/- 1 years) and 12 young men (22 +/- 1 years). METHODS: Subjects were studied by echocardiography at peak all-out anaerobic exercise, on a cycle ergometer. RESULTS: Seven older subjects experienced ECG abnormalities. Significant (p < 0.05) differences between the older group and the young group, respectively, were noted for: cardiac output (9.8 +/- 0.9 and 15.8 +/- 0.9 l.min(-1)), left ventricular end-systolic pressure-volume ratio (4.7 +/- 0.8 and 4.4 +/- 4.9), left ventricular end-diastolic volume (104.8 +/- 6.9 and 125.7 +/- 6.2 ml), ejection fraction (67.1 +/- 6.0 and 59.8 +/- 5.5%), left ventricular end-systolic pressure volume ratio (4.4 +/- 0.4 and 4.8 +/- 0.3 ratio), and total peripheral resistance (966.0 +/- 84.0 and 660 +/- 82.8 dyn.s(-1).cm(-5)). CONCLUSIONS: Data suggest that during all-out anaerobic exercise, forces opposing ejection were not reduced enough to avoid left ventricular dysfunction and ECG abnormalities in the older subjects. This is attributed to functional changes with age in the myocardium and associated blood vessels, leading to impairment of left ventricular function and blunted inotropic and chronotropic responses to catecholamine. Therefore, an all-out anaerobic-type effort should not be given to an older subject due to the great hazardous potential.