Improved endothelial function and reversal of myocardial perfusion defects after aerobic physical training in a patient with microvascular myocardial ischemia

• Published in: American journal of physical medicine & rehabilitation Vol. 90; no. 1; pp. 59 - 64
• Main Authors: Carvalho, Eduardo Elias Vieira, Crescêncio, Julio Cesar, Elias, Jr, Jorge, Brito, Laura Beatriz Alves, Gallo, Jr, Lourenço, Simões, Marcus Vinicius
• Format: Journal Article
• Language: English
• Published: United States 01-01-2011
• Subjects: Endothelium, Vascular - physiopathology; Exercise; Female; Humans; Microvascular Angina - diagnosis; Microvascular Angina - rehabilitation; Middle Aged; Myocardial Ischemia - physiopathology; Myocardial Ischemia - rehabilitation; Myocardial Perfusion Imaging; Quality of Life; Tomography, Emission-Computed, Single-Photon
• ISSN: 0894-9115; 1537-7385
• DOI: 10.1097/PHM.0b013e3181ddd6bb

The objective of this report is to document the effects of an aerobic training program on myocardial perfusion, and endothelial function abnormalities, and on the relief of angina in a patient with microvascular myocardial ischemia. A 53-year-old female patient exhibited precordial pain on effort and angiographically normal coronaries. Her symptoms had been present for 4 yrs despite pharmacologic treatment for the control of risk factors, with myocardial perfusion scintigraphy revealing an extensive reversible perfusion defect. She was submitted to aerobic training for 4 mos, obtaining significant improvement of the anginal symptoms. Additionally, after the aerobic training program, scintigraphy revealed the disappearance of the myocardial perfusion defect, with a marked improvement of endothelium-dependent vasodilatory response and an improved quality-of-life score. These results suggest that aerobic training can improve endothelial function, leading to a reduction of ischemia and an improved quality-of-life in patients with microvascular myocardial ischemia.