Beneficial effects of exercise training on physical performance in patients with vasospastic angina

Jun Sugisawa, Yasuharu Matsumoto, Masashi Takeuchi, Akira Suda, Satoshi Tsuchiya, Kazuma Ohyama, Kensuke Nishimiya, Mina Akizuki, Koichi Sato, Shoko Ohura, Hideki Ota, Shohei Ikeda, Tomohiko Shindo, Yoku Kikuchi, Kiyotaka Hao, Takashi Shiroto, Jun Takahashi, Satoshi Miyata, Yasuhiko Sakata, Kei TakaseMasahiro Kohzuki, Hiroaki Shimokawa

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Aims: In vasospastic angina (VSA), coronary vasomotion abnormalities could develop not only in epicardial coronary arteries but also in coronary microvessels, where calcium channel blockers (CCBs) have limited efficacy. However, efficacy of exercise training for VSA remains to be elucidated. We thus aimed to examine whether vasodilator capacity of coronary microvessels is impaired in VSA patients, and if so, whether exercise exerts beneficial effects on the top of CCBs. Methods: We performed 2 clinical protocols. In the protocol 1, we measured myocardial blood flow (MBF) using adenosine-stress dynamic computed tomography perfusion (CTP) in 38 consecutive VSA patients and 17 non-VSA controls. In the protocol 2, we conducted randomized controlled trial, where 20 VSA patients were randomly assigned to either 3-month exercise training group (Exercise group) or Non-Exercise group (n= 10 each). Results: In the protocol 1, MBF on CTP was significantly decreased in the VSA group compared with the Non-VSA group (138 ± 6 vs 166 ± 10 ml/100 g/min, P = 0.02). In the protocol 2, exercise capacity was significantly increased in the Exercise group than in the Non-Exercise group (11.5 ± 0.5 to 15.4 ± 1.8 vs 12.6 ± 0.7 to 14.0 ± 0.8 ml/min/kg, P < 0.01). MBF was also significantly improved after 3 months only in the Exercise group (Exercise group, 145 ± 12 to 172 ± 8 ml/100 g/min, P < 0.04; Non-Exercise group, 143 ± 14 to 167 ± 8 ml/100 g/min, P = 0.11), although there were no significant between-group differences. Conclusions: These results provide the first evidence that, in VSA patients, exercise training on the top of CCBs treatment may be useful to improve physical performance, although its effect on MBF may be minimal.

Original languageEnglish
Pages (from-to)14-21
Number of pages8
JournalInternational Journal of Cardiology
Publication statusPublished - 2021 Apr 1
Externally publishedYes


  • CT perfusion
  • Coronary vasospasm
  • Exercise capacity
  • Exercise training
  • Microvascular angina

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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