SEARCH · PubMed Health

Results for “Exercise training”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 469 records · Page 26Linked to original sources

PubMed1997

Contractile responsiveness of coronary arteries from exercise-trained rats.

The purpose of this study was to determine whether exercise training alters vasomotor reactivity of rat coronary arteries. In vitro isometric microvessel techniques were used to evaluate vasomotor properties of proximal left anterior artery rings (1 ring per animal) from exercise-trained rats (ET; n = 10) subjected to a 12-wk treadmill training protocol (32 m/min, 15% incline, 1 h/day, 5 days/wk) and control rats (C; n = 6) restricted to cage activity. No differences in passive length-tension characteristics or internal diameter (158 +/- 9 and 166 +/- 9 micron) were observed between vessels of C and ET rats. Concentration-response curves to K+ (5-100 mM), prostaglandin F2alpha (10(-8)-10(-4) M), and norepinephrine (10(-8)-10(-4)) were unaltered (P > 0.05) in coronary rings from ET rats compared with C rats; however, lower values of the concentration producing 50% of the maximal contractile response in rings from ET rats (P = 0.05) suggest that contractile sensitivity to norepinephrine was enhanced. Vasorelaxation responses to sodium nitroprusside (10(-9)-10(-4) M) and adenosine (10(-9)-10(-4) M) were not different (P > 0.05) between vessels of C and ET rats. However, relaxation responses to the endothelium-dependent vasodilator acetylcholine (ACh; 10(-10)-10(-4) M) were significantly blunted (P < 0.001) in coronary rings from ET animals; maximal ACh relaxation averaged 90 +/- 5 and 46 +/- 12%, respectively, in vessels of C and ET groups. In additional experiments, two coronary rings (proximal and distal) were isolated from each C (n = 7) and ET (n = 7) animal. Proximal coronary artery rings from ET animals demonstrated decreased relaxation responses to ACh; however, ACh-mediated relaxation of distal coronary rings was not different between C and ET groups. NG-monomethyl-L-arginine (inhibitor of nitric oxide synthase) blocked ACh relaxation of all rings. L-Arginine (substrate for nitric oxide synthase) did not improve the blunted ACh relaxation in proximal coronary artery rings from ET rats. These studies suggest that exercise-training selectively decreases endothelium-dependent (ACh) but not endothelium-independent (sodium nitroprusside) relaxation responses of rat proximal coronary arteries; endothelium-dependent relaxation of distal coronary arteries is unaltered by training.

Acetylcholine↗

PubMed1996

Increased glucose transport-phosphorylation and muscle glycogen synthesis after exercise training in insulin-resistant subjects.

BACKGROUND: Insulin resistance in the offspring of parents with non-insulin-dependent diabetes mellitus (NIDDM) is the best predictor of development of the disease and probably plays an important part in its pathogenesis. We studied the mechanism and degree to which exercise training improves insulin sensitivity in these subjects. METHODS: Ten adult children of parents with NIDDM and eight normal subjects were studied before starting an aerobic exercise-training program, after one session of exercise, and after six weeks of exercise. Insulin sensitivity was measured by the hyperglycemic-hyperinsulinemic clamp technique combined with indirect calorimetry, and the rate of glycogen synthesis in muscle and the intramuscular glucose-6-phosphate concentration were measured by carbon-13 and phosphorus-31 nuclear magnetic resonance spectroscopy, respectively. RESULTS: During the base-line study, the mean (+/-SE) rate of muscle glycogen synthesis was 63 +/- 9 percent lower in the offspring of diabetic parents than in the normal subjects (P < 0.001). The mean value increased 69 +/- 10 percent (P = 0.04) and 62 +/- 11 percent (P = 0.04) after the first exercise session and 102 +/- 11 percent (P = 0.02) and 97 +/- 9 percent (P = 0.008) after six weeks of exercise training in the offspring and the normal subjects, respectively. The increment in glucose-6-phosphate during hyperglycemic-hyperinsulinemic clamping was lower in the offspring than in the normal subjects (0.039 +/- 0.013 vs. 0.089 +/- 0.009 mmol per liter, P = 0.005), reflecting reduced glucose transport-phosphorylation, but this increment was normal in the offspring after the first exercise session and after exercise training. Basal and stimulated insulin secretion was higher in the offspring than the normal subjects and was not altered by the exercise training program. CONCLUSIONS: Exercise increases insulin sensitivity in both normal subjects and the insulin-resistant offspring of diabetic parents because of a twofold increase in insulin-stimulated glycogen synthesis in muscle, due to an increase in insulin-stimulated glucose transport-phosphorylation.

Adult↗

PubMed1996

Exercise training alters kinetics of antioxidant enzymes in rat tissues.

Michaelis-Menten constant (Km) and maximum velocity (Vmax) of catalase (CAT), glutathione peroxidase (GSH-Px) and glutathione reductase (GR) in various tissues of exercise-trained old rats were compared with the age matched sedentary control. Exercise training increased the maximum velocity (Vmax) for CAT in the brain (350%), liver (33%), lung (34%), muscle (25%) and testes (21%); for GSH-Px (using t-butyl hydroperoxide as a substrate) in the liver (22%), lung (25%), and testes (52%); for GSH-Px (using GSH as a cosubstrate) in the brain (64%) and liver (100%), and for GR in testes (50%). This increase in Vmax indicates the potential activation of these enzymes in the specific tissues. Exercise training differentially altered the affinities of enzyme (Km) for CAT, GSH-Px and GR to their substrates. These studies suggest that exercise training provided a beneficial role by activation of antioxidant enzymes in specific tissues of aged rats. Thus, exercise training aids in coping with oxidative stress in old age.

Animals↗

PubMed2003

Eccentric exercise training in patients with chronic obstructive pulmonary disease.

The oxygen cost of eccentric exercise is lower than that of concentric exercise at similar work-loads. In this study, the response to eccentric cycle exercise training (EET) in addition to general exercise training (GET) on exercise performance and quality of life was investigated in 24 patients with severe chronic obstructive pulmonary disease (COPD). All patients had a normal resting PaO2 and an arterial oxygen saturation (SaO2) below 90% at Wmax, achieved during a maximal incremental concentric cycle exercise test. The patients participated in a comprehensive inpatient pulmonary rehabilitation programme of 10 weeks. They were randomly assigned either to GET (GET group: mean FEV 38% predicted) or to GET and additional EET (GET/EET group: FEV1 45% predicted). During EET, the patients were able to cycle eccentrically for 15 min continuously at a mean of 160 (69%) of Wmax whereas the Borg dyspnoea score did not exceed 3.0 and SaO2 did not fall below 90%. Parameters of cardiocirculatory fitness and gas exchange improved in the GET/EET group but no further improvement in exercise capacity occurred compared to GET. It is concluded that eccentric cycle exercise is a safe and attractive training modality for patients with severe COPD and can be performed at a high intensity without the patient becoming out of breath or needing supplemental oxygen.

Exercise Therapy↗

PubMed1993

Home-based and worksite-based exercise training for patients with coronary artery disease.

In the era of thrombolysis, exercise training for patients with ischemic heart disease should be reserved for enhancement of functional capacity and psychological well-being rather than improvement of prognosis. Low to moderate intensity exercise training enhances functional capacity to the same extent that group-based exercise training does and can be performed safely at home. The physical demands of occupational work have decreased to the point where patients with ischemic heart disease who manifest neither treadmill-induced myocardial ischemia nor left ventricular dysfunction can perform virtually any occupational task.

Ambulatory Care↗

PubMed1990

Interval versus continuous exercise training after coronary bypass surgery: a comparison of training-induced acute reactions with respect to the effectiveness of the exercise methods.

In order to improve endurance by exercise on a bicycle ergometer, both the interval method (I) (exertion and recovery phases alternate each minute) and the continuous method (constant exertion) can be employed. We examined the effects of both methods on the following parameters: heart rate, blood pressure, rate-pressure product, glucose, lactate, and catecholamine levels, and physical performance. Two groups of nine male patients were trained daily on a bicycle ergometer for 3.5 weeks. These patients had undergone coronary bypass surgery 24 and/or 26 days before the training started. The training heart rate was set at 86% of the individual maximum heart rate. In the last week of training, the exercise intensity in both patient groups, following either I or C regimen, was 20:121 W and 83 W respectively. The exercise training lasted 20 minutes with the following findings: (1) there were no significant differences in blood pressure, rate-pressure product, rates of glucose and catecholamines, and (2) there was a significantly higher rate of lactate in the second ten minutes of the I training. Before and after the training period, the patients were subjected to a multistage bicycle ergometer exercise test (sitting). The following results obtained after the training favor the I method: (1) patients' physical performance increased (+0.63 vs. +0.26 W/kg; p less than 0.001); (2) heart rate was lower at rest (-9 vs. -4 beats/min; p less than 0.04) and at 75 W (-12 vs. -2 beats/min; p less than 0.02); (3) rate-pressure product was lower at rest (-1675 vs. -291; p less than 0.04) and at 75 W (-2810 vs. -735; p less than 0.05); (4) rate of lactate was lower at 75 W (-0.83 vs. -0.33 mmol/l; p less than 0.04); (5) catecholamines were not lowered by I or C training, and no differences between the two groups could be observed. Exercise training according to the I method involves both the aerobic and anaerobic capacity of the organism, whereas exercise training according to the C method involves only oxidative capacity. After coronary bypass surgery, the I method is better suited to increase physical performance and is more effective in economizing the cardiac function.

Adult↗

PubMed1992

Effects of exercise training and diabetes on cardiac myosin heavy chain composition.

This study determined whether the beneficial effects of exercise training on the diabetic heart previously observed are associated with alterations in ventricular myosin heavy chain (MHC) isoform composition. Diabetes was induced in rats by i.v. streptozotocin. Trained rats were run on a treadmill for 60 min/day, 27 m/min, 10% grade. After 10 wks, ventricular MHC isoenzyme protein composition was analyzed for MHC composition using gel electrophoresis. alpha-MHC and beta-MHC mRNA were determined by Northern and slot blot hybridization techniques. Both protein and mRNA analyses indicated that sedentary control rats exhibited a predominance of alpha-MHC. Sedentary diabetics exhibited a shift to beta-MHC. Exercise trained diabetic rats showed a predominance of beta-MHC. The results indicate that treadmill exercise training of diabetic rat does not prevent the diabetes-induced shift in MHC composition towards the beta-MHC isoform, thus it is unlikely that the beneficial effects of exercise training on the diabetic heart, previously shown, are due to a normalization of the myosin isoform composition.

Animals↗

PubMed1986

The effect of exercise-training on resting metabolic rate in lean and moderately obese individuals.

Two experiments have been performed to establish whether exercise-training has an influence on resting metabolic rate (RMR). In a first study, RMR was measured in a cohort of 59 individuals comprising 20 trained and 39 non-trained subjects. The absolute level of RMR in trained subjects exceeded by 11 percent that observed in the non-trained individuals (P less than 0.01). When comparing regression lines of RMR versus FFM between the two groups, the intercept with the Y axis (RMR values) was also significantly higher in trained subjects (P less than 0.01). The second experiment was conducted to find out whether the trend for an elevated RMR noted in athletes could be reproduced in obese persons engaging in an exercise-training program. Eight moderately obese women were submitted to an 11-week training programme, including 5 hours of aerobic exercise per week performed at a mean intensity of about 50 percent VO2 max. The results showed that exercise-training induced a significant rise in RMR which corresponded to 8 percent of pretraining value in kcal/kg FFM/min (P less than 0.01). Thus, data reported here suggest that aerobic exercise-training is associated with an elevated RMR per unit of fat free mass in both lean and moderately obese individuals.

Adult↗

PubMed2006

Exercise training improves insulin-induced and insulin-like growth factor-1-induced vasorelaxation in rat aortas.

Improved vasorelaxant response is one of the beneficial effects of exercise training on vascular function. The mechanism for this response is, however, poorly understood. The aim of this study was to investigate the effects of exercise training on insulin-induced and insulin-like growth factor-1 (IGF-1)-induced vasorelaxation. Fourteen 6-week-old male Wistar rats were randomly divided into sedentary control and exercise groups. For 12 weeks, the exercise group ran on a treadmill 60 min/day, 5 days/week. After exercise training, insulin-induced and IGF-1-induced vasorelaxant responses were evaluated by measuring the isometric tension of aortic rings. The vasorelaxant role of phosphatidylinositol 3-kinase (PI3K) and nitric oxide synthase (NOS) was examined by applying inhibitors, such as wortmannin (an inhibitor of PI3K) and N(omega)-nitro-L-arginine methyl ester (L-NAME, a NOS inhibitor). In addition, we examined the vascular response to the NO donor, sodium nitroprusside (SNP). We found that: (1) exercise training significantly enhanced both insulin-induced and IGF-1-induced vasorelaxation in rat aortas; (2) this vasorelaxant effect disappeared after the use of wortmannin or L-NAME; (3) there was no significant difference in SNP-induced vasorelaxation between control and exercise groups. Our findings indicate that exercise training enhances insulin-induced and IGF-1-induced vasorelaxant responses which are mediated through the PI3K-NOS-dependent pathway.

Animals↗

PubMed1988

Strategies for increasing early adherence to and long-term maintenance of home-based exercise training in healthy middle-aged men and women.

Two studies were undertaken to compare strategies for the adoption and maintenance of moderate-intensity, home-based exercise training. In the study of adoption, 52 men and women who had served for 6 months as controls for a study of moderate-intensity, home-based exercise training received 30 minutes of baseline instruction. They were then randomized to receive continuing instruction and support through 10 staff-initiated telephone contacts of 5 minutes each every 2 weeks, or to receive no telephone contacts. In subjects receiving telephone contacts, peak oxygen uptake increased significantly after 6 months, whereas no increase was observed in subjects receiving no staff support (p less than 0.05). In the maintenance study, 51 men and women who had significantly increased their peak oxygen uptake by 6 months of moderate-intensity, home-based exercise training were randomized to undergo daily self-monitoring and receive adherence instructions, or undergo weekly self-monitoring only, during a second 6-month period of training. Subjects performing daily self-monitoring reported completing significantly more exercise training sessions during the 6 months of training than subjects performing weekly self-monitoring; functional capacity in both groups remained higher than before training (p less than 0.05). Taken together, these studies suggest that brief baseline instruction followed by continuing telephone contact with staff can be used to help people adopt a moderate-intensity, home-based exercise training program that can be maintained by simple self-monitoring strategies.

Behavior↗

PubMed2003

Regional differences in effects of exercise training on contractile and biochemical properties of rat cardiac myocytes.

Myocardial function is enhanced by endurance exercise training, but the cellular mechanisms underlying this improved function remain unclear. A number of studies have shown that the characteristics of cardiac myocytes vary across the width of the ventricular wall. We have previously shown that endurance exercise training alters the Ca2+ sensitivity of tension as well as contractile protein isoform expression in rat cardiac myocytes. We tested the hypothesis that these effects of training are not uniform across the ventricular wall but are more pronounced in the subendocardial (Endo) region of the myocardium. Female Sprague-Dawley rats were divided into sedentary control (C) and exercise trained (T) groups. T rats underwent 11 wk of progressive treadmill exercise. Myocytes were isolated from the Endo region of the myocardium and from the subepicardial (Epi) region of both T and C hearts. We found an increase in the Ca2+ sensitivity of tension in T cells compared with C cells, but this difference was larger in the Endo cells than in the Epi cells. In addition, we found a training-induced increase in atrial myosin light chain 1 (aMLC1) expression that was larger in the Endo compared with Epi samples. We conclude that effects of exercise training on myocyte contractile and biochemical properties are greater in myocytes from the Endo region of the myocardium than those from the Epi region. In addition, these results provide evidence that the increase in aMLC1 expression may be responsible for some of the training-induced increase in myocyte Ca2+ sensitivity of tension.

Animals↗

PubMed1992

Resistive exercise training in cardiac patients. Recommendations.

Resistive exercise training has recently gained popularity in cardiopulmonary rehabilitation programmes. Improvement in muscular strength is important to facilitate return to daily vocational and recreational activities after a cardiac event. Resistive exercise has been shown to be haemodynamically safe for selected individuals with cardiovascular impairment, even at relatively high workloads. This form of training may enhance muscular strength and endurance, body composition, blood lipid and lipoprotein levels, and cardiovascular endurance, although further research is needed in cardiac populations. Patients should be clinically screened and perform a symptom-limited maximal graded exercise test prior to resistive training. Patients who have characteristics associated with an increased risk of cardiac event during exercise should avoid heavy resistive training. Free weights, cuff and hand weights, isotonic/isokinetic machines, elastics, and other resistive modalities may be used for exercise of major muscle groups in cardiopulmonary rehabilitation. Resistive training workloads may be determined by gradual acclimatisation or 1 repetition maximum testing. Heart rate, blood pressure, rate-pressure product and rating of perceived exertion should be determined during lifting movements. Circuit weight-training has been recommended and has been reported to improve strength, lean body mass, self-efficacy, and may decrease risk factors for coronary artery disease. Nonsustained isometric or combined dynamic/isometric exercises have also been recommended for cardiac patients since many vocations involve lifting/pushing movements or frequent isometric muscle contraction. There appears to be considerable benefit and minimal risk of resistive exercise training for patients with cardiovascular impairment. This mode of exercise may allow patients to perform daily strength tasks safely, more efficiently, and with greater self-confidence.

Adaptation, Physiological↗

PubMed1977

The effect of exercise training on heart rate during coitus in the post myocardial infarction patient.

The effect of interval exercise training on the peak coital heart rate in post myocardial infarction patients was studied. Sixteen men (ages 46-54) underwent a 16-week bicycle ergometer training program 12 to 15 weeks following their first myocardial infarction. Portable ECG tape recorders were used to record the ECG during coitus twice before and twice after the training program. The maximum minute oxygen consumption (VO2max) was measured in each subject during bicycle ergometer ECG examinations before and after the training program. A control group of six post myocardial infarction patients who were not trained was evaluated in the same manner. The exercise-trained group had an average increase in VO2max of 11.5%(2.7 to 3.0 L/min) and an average decrease in peak coital heart rate of 5.5%(127/min to 120/min). The control group demonstrated a 2% increase in VO2max and no significant change in peak coital heart rate. The increase in aerobic capacity (VO2max) and the consequent reduction in peak coital heart rate in our trained group suggests the potential value of exercise training in improving sexual function in the patient with angina during coitus.

Angina Pectoris↗

PubMed1987

Cardiovascular adaptations to exercise training in the elderly.

Maximal O2 uptake (VO2max) and left ventricular function decrease with age. Endurance exercise training of sufficient intensity, frequency, and duration increases VO2max in the elderly. The mechanisms underlying the increased VO2max in the elderly are enhanced O2 extraction of trained muscle during maximal exercise leading to a wider arteriovenous O2 difference, and higher cardiac output in the trained state. However, increased cardiac output during true maximal exercise has not been documented in elderly subjects. Endurance exercise training results in a lower heart rate and rate pressure product during submaximal exercise at a given intensity. However, no improvement in left ventricular function has been reported in the elderly after exercise training. Highly trained master athletes exhibit proportional increases in the left ventricular end-diastolic dimension and wall thickness suggestive of volume-overload hypertrophy compared with age-matched sedentary controls. The magnitude of left ventricular enlargement is similar to that in young athletes. The failure of exercise training to alter the age-related deterioration of left ventricular function in the elderly may reflect an insufficient training stimulus rather than the inability of the heart to adapt to training in elderly subjects.

Adaptation, Physiological↗

PubMed1987

The effect of 7 years of intense exercise training on patients with coronary artery disease.

The purpose of this study was to evaluate the effects of long-term exercise training on maximal aerobic exercise capacity, evidence of myocardial ischemia and plasma lipid-lipoprotein concentrations in patients with coronary artery disease. Nine men with coronary artery disease, aged 57 +/- 2 years, who had completed 12 months of supervised intense exercise training were restudied after 6 additional years during which they continued to exercise. The first 12 months of training resulted in a 44% increase in maximal oxygen consumption (VO2max) from 25.0 +/- 1.3 to 35.9 +/- 1.5 ml X kg-1 X min-1 (p less than 0.001). The VO2max after 6 additional years (total 7 years) of intense training was 36.8 +/- 2.4 ml X kg-1 X min-1. Plasma high density lipoprotein (HDL)-cholesterol concentration increased from 38 +/- 3 to 45 +/- 4 mg X dl-1 at 12 months and rose further to 53 +/- 5 mg X dl-1 at 6 years of follow-up (p less than 0.05). The atherogenic index (total cholesterol/HDL-cholesterol ratio) decreased from 5.8 +/- 0.4 to 4.9 +/- 0.4 by 12 months (p less than 0.01) and to 4.1 +/- 0.4 after 6 additional years of training (p less than 0.05). Although the maximal heart rate-pressure product was 14% higher after 12 months of training, maximal ST segment depression was significantly less, 0.27 +/- 0.06 versus 0.19 +/- 0.04 mV (p less than 0.05); this improvement was maintained after 6 years of additional training. These data provide evidence that the beneficial effects of a program of intense exercise training can be maintained for long periods in some motivated patients with coronary artery disease who continue to exercise.

Blood Pressure↗

PubMed1998

Effect of smoking cessation on exercise performance in female smokers participating in exercise training.

We evaluated in a randomized prospective trial the possible effect of smoking cessation on exercise performance in middle-aged female smokers who underwent vigorous exercise training as an adjunct to a cognitive-behavioral smoking cessation treatment program. A total of 109 subjects met the criteria for this substudy; of these, 51 were in the contact control (nonexercising) group and 58 were in the exercise training group. Both groups had a graded maximal exercise stress test performed on a bicycle ergometer before and after 12 weeks of treatment. All subjects participated in a 12-session, group-based, cognitive-behavioral treatment program for nicotine dependence. Subjects in the contact condition participated in 3 supervised health education lectures per week but did not engage in regular exercise. Subjects in the exercise group trained 3 times a week, averaging 83% of maximum heart rate achieved on their baseline exercise test. On the 12-week exercise stress test, the exercise group did significantly better than control in all aspects of exercise performance. Those who quit showed a further increase in their exercise test duration (p <0.001) and had a greater increase in calculated peak oxygen consumption expressed as fat-free weight (p = 0.031). In conclusion, women who undergo a vigorous exercise training program and quit smoking demonstrate improved exercise performance over those who continue to smoke.

Adult↗

PubMed1999

Effects of exercise training on responsiveness of the mesenteric arterial bed to phenylephrine and KCl in male rats.

1. We aimed to determine whether there are any changes in responsiveness of the mesenteric arterial beds to phenylephrine (Phe) and KCl in exercise-trained rats, and whether vascular endothelium and/or vascular smooth muscle play a role in these changes. 2. Adult male rats were subjected to a swimming schedule every day for 28-33 days. Studies were performed in vitro using Krebs perfused mesenteric arterial beds. 3. Maximum perfusion pressure responses to KCl and Phe of the mesenteric arterial beds from exercise-trained rats were significantly lower than those from sedentary controls. However, these differences disappeared after blocking the nitric oxide synthase by NG-nitro-L-arginine (L-NOARG). 4. 3-[(3-cholamidopropyl)-dimethylammonio]-1-propanesulphonate (CHAPS, 3 mg ml(-1), 2 min infusion) caused a significant increase in maximum perfusion pressure responses to KCl to the same extent in both exercise-trained and sedentary control rats. CHAPS caused about a 4.5 fold leftward shift of the curve with no change in maximum response to Phe for the mesenteric arterial beds from sedentary control rats, but not for those obtained from exercise-trained rats. However, these differences were abolished in the presence of L-NOARG. 5. Indomethacin did not alter the dose-response curves to KCl or Phe in either swimming or control groups. 6. These results suggest that there was a lower vascular responsiveness to KCl and Phe in exercise-trained rats at rest. The decrease in reactivities to KCl or decrease in sensitivity to Phe after having endothelium impairment by CHAPS of the mesenteric arterial beds of exercise-trained rats were due to an increase in both spontaneous release and upregulation of phenylephrine-stimulated release of nitric oxide from both the vascular endothelium and the vascular smooth muscle cells, and may not be a consequence of an increase in vasodilator prostaglandins by the vascular bed.

Adrenergic alpha-Agonists↗

PubMed2004

Percutaneous coronary angioplasty compared with exercise training in patients with stable coronary artery disease: a randomized trial.

BACKGROUND: Regular exercise in patients with stable coronary artery disease has been shown to improve myocardial perfusion and to retard disease progression. We therefore conducted a randomized study to compare the effects of exercise training versus standard percutaneous coronary intervention (PCI) with stenting on clinical symptoms, angina-free exercise capacity, myocardial perfusion, cost-effectiveness, and frequency of a combined clinical end point (death of cardiac cause, stroke, CABG, angioplasty, acute myocardial infarction, and worsening angina with objective evidence resulting in hospitalization). METHODS AND RESULTS: A total of 101 male patients aged < or =70 years were recruited after routine coronary angiography and randomized to 12 months of exercise training (20 minutes of bicycle ergometry per day) or to PCI. Cost efficiency was calculated as the average expense (in US dollars) needed to improve the Canadian Cardiovascular Society class by 1 class. Exercise training was associated with a higher event-free survival (88% versus 70% in the PCI group, P=0.023) and increased maximal oxygen uptake (+16%, from 22.7+/-0.7 to 26.2+/-0.8 mL O2/kg, P<0.001 versus baseline, P<0.001 versus PCI group after 12 months). To gain 1 Canadian Cardiovascular Society class, 6956 dollars was spent in the PCI group versus 3429 dollars in the training group (P<0.001). CONCLUSIONS: Compared with PCI, a 12-month program of regular physical exercise in selected patients with stable coronary artery disease resulted in superior event-free survival and exercise capacity at lower costs, notably owing to reduced rehospitalizations and repeat revascularizations.

Aged↗