Abstract
Background
Circulating levels of angiopoietin-like 2 (ANGPTL2), a proinflammatory and proatherogenic
protein, are elevated in patients with coronary artery disease (CAD). We hypothesized
that high-intensity intermittent exercise (HIIE), known to be beneficial in patients
with CAD, would reduce circulating ANGPTL2 levels.
Methods
Plasma levels of ANGPTL2 were measured before and 20 minutes, 24 hours, and 72 hours
after an acute exercise session in a crossover study comparing HIIE to moderate-intensity
continuous exercise (MICE) in 14 patients with CAD and 20 age-matched and 20 young
healthy controls.
Results
Pre-exercise ANGPTL2 levels were 3-fold higher in patients with CAD than in age-matched
controls (P < 0.05) and correlated negatively with Vo2max/lean body mass (P < 0.0001). In healthy controls, ANGPTL2 levels were low and not affected by HIIE
or MICE. In patients with CAD, ANGPTL2 levels decreased significantly by 41% after
20 minutes of HIIE, a reduction that was maintained after 24 and 72 hours (P < 0.05). In contrast, although ANGPTL2 levels decreased by 47% after 20 minutes of
MICE, they increased by 104% after 24 hours and returned to baseline values after
72 hours (P < 0.05). A negative correlation was observed between this increase in ANGPTL2 levels
and the mean rate-pressure product (heart rate × systolic blood pressure; index of
myocardial O2 consumption) measured during MICE, suggesting that subclinical ischemia might promote
ANGPTL2 expression.
Conclusions
In patients with CAD, circulating ANGPTL2 levels are acutely reduced after HIIE and
transiently increased after MICE. A sustained reduction in circulating ANGPTL2 levels
could contribute to the chronic beneficial cardiometabolic effects of HIIE in patients
with CAD.
Résumé
Introduction
Les concentrations circulantes de la protéine angiopoïétine-like 2 (ANGPTL2), une
protéine pro-inflammatoire et proathérogène, sont élevées chez les patients souffrant
de maladie coronarienne (MC). Nous avons posé l’hypothèse que l’exercice par intervalles
de haute intensité (EIHI), connu pour être bénéfique chez les patients souffrant de
MC, pourrait réduire les concentrations circulantes d’ANGPTL2.
Méthodes
Les concentrations plasmatiques d’ANGPTL2 ont été mesurées avant, puis 20 minutes,
24 heures et 72 heures après une séance d’exercice à court terme dans une étude transversale
comparant l’EIHI à l’exercice continu d’intensité modérée (ECIM) chez 14 patients
souffrant de MC et 20 témoins en santé appariés selon l’âge, ainsi que 20 témoins
jeunes et en santé.
Résultats
Les concentrations d’ANGPTL2 avant l’exercice étaient 3 fois plus élevées chez les
patients souffrant de MC que chez les témoins appariés selon l’âge (P < 0,05) et corrélaient négativement avec le VO2max/la masse maigre (P < 0,0001). Chez les témoins en santé, les concentrations d’ANGPTL2 étaient faibles
et non affectées par l’EIHI ou l’ECIM. Chez les patients souffrant de MC, les concentrations
d’ANGPTL2 diminuaient significativement de 41 % après 20 minutes d’EIHI, une réduction
qui était maintenue après 24 heures et 72 heures (P < 0,05). En revanche, bien que les concentrations d’ANGPTL2 diminuaient de 47 % après
20 minutes d’ECIM, elles augmentaient de 104 % après 24 heures et revenaient aux valeurs
initiales après 72 heures (P < 0,05). Une corrélation négative était observée entre cette augmentation dans les
concentrations d’ANGPTL2 et le produit moyen de la fréquence et de la pression (fréquence
cardiaque × pression artérielle systolique; indice de consommation du myocarde en
O2) mesuré durant l’ECIM, ce qui montre que l’ischémie sous-clinique favoriserait l’expression
d’ANGPTL2.
Conclusions
Chez les patients souffrant de MC, les concentrations circulantes d’ANGPTL2 sont réduites
à court terme après l’EIHI et augmentées de manière transitoire après l’ECIM. Une
réduction soutenue des concentrations circulantes d’ANGPTL2 pourrait contribuer aux
effets cardiométaboliques bénéfiques à long terme de l’EIHI chez les patients souffrant
de MC.
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References
- Exercise: friend or foe?.Nat Rev Cardiol. 2013; 10: 495-507
- American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise.Med Sci Sports Exerc. 2011; 43: 1334-1359
- Physical activity and cardiovascular mortality risk: possible protective mechanisms?.Med Sci Sports Exerc. 2012; 44: 84-88
- Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials.Am J Med. 2004; 116: 682-692
- Effects of physical activity on life expectancy with cardiovascular disease.Arch Intern Med. 2005; 165: 2355-2360
- Exercise and longevity.Maturitas. 2012; 73: 312-317
- Effects of cardiorespiratory fitness on blood pressure trajectory with aging in a cohort of healthy men.J Am Coll Cardiol. 2014; 64: 1245-1253
- Differential effects of aerobic exercise, resistance training and combined exercise modalities on cholesterol and the lipid profile: review, synthesis and recommendations.Sports Med. 2014; 44: 211-221
- Regular physical exercise corrects endothelial dysfunction and improves exercise capacity in patients with choursonic heart failure.Circulation. 1998; 98: 2709-2715
- Adolph Distinguished Lecture: The remarkable anti-aging effects of aerobic exercise on systemic arteries.J Appl Physiol (1985). 2014; 117: 425-439
- The effects of physical activity on serum C-reactive protein and inflammatory markers: a systematic review.J Am Coll Cardiol. 2005; 45: 1563-1569
- The effect of physical activity or exercise on key biomarkers in atherosclerosis—a systematic review.Atherosclerosis. 2014; 235: 150-161
- Effects of exercise training on chronic inflammation in obesity: current evidence and potential mechanisms.Sports Med. 2013; 43: 243-256
- Diverse roles of ANGPTL2 in physiology and pathophysiology.Trends Endocrinol Metab. 2014; 25: 245-254
- Angiopoietin-like-2: a multifaceted protein with physiological and pathophysiological properties.Expert Rev Mol Med. 2014; 16: e17
- Angiopoietin-like proteins: a comprehensive look.Front Endocrinol (Lausanne). 2014; 5: 4
- Angiopoietin-like 2 promotes atherogenesis in mice.J Am Heart Assoc. 2013; 2: e000201
- Role of endothelial cell-derived Angptl2 in vascular inflammation leading to endothelial dysfunction and atherosclerosis progression.Arterioscler Thoursomb Vasc Biol. 2014; 34: 790-800
- Angiopoietin-like protein 2 and risk of type 2 diabetes in a general Japanese population: the Hisayama study.Diabetes Care. 2013; 36: 98-100
- Angiopoietin-like proteins—potential therapeutic targets for metabolic syndrome and cardiovascular disease.Circ J. 2009; 73: 2192-2197
- Angiopoietin-like protein 2 promotes chronic adipose tissue inflammation and obesity-related systemic insulin resistance.Cell Metab. 2009; 10: 178-188
- Association of serum angiopoietin-like protein 2 and epinephrine levels in metabolically healthy but obese individuals: in vitro and in vivo evidence.Exp Ther Med. 2013; 5: 1631-1636
- Angiopoietin-like protein 2 sensitively responds to weight reduction induced by lifestyle intervention on overweight Japanese men.Nutr Diabetes. 2011; 1: e20
- Interval training for patients with coronary artery disease: a systematic review.Eur J Appl Physiol. 2011; 111: 579-589
- High-intensity interval training in cardiac rehabilitation.Sports Med. 2012; 42: 587-605
- Provocative issues in heart disease prevention.Can J Cardiol. 2014; 30: S401-S409
- A single bout of high-intensity interval exercise does not increase endothelial or platelet microparticles in stable, physically fit men with coronary heart disease.Can J Cardiol. 2013; 29: 1285-1291
- Acute responses to high-intensity intermittent exercise in CHD patients.Med Sci Sports Exerc. 2011; 43: 211-217
- Angiopoietin-like protein 2 is associated with chronic kidney disease in a general Japanese population: the Hisayama Study.Circ J. 2013; 77: 2311-2317
- Muscle as an endocrine organ: focus on muscle-derived interleukin-6.Physiol Rev. 2008; 88: 1379-1406
- The anti-inflammatory effect of exercise.J Appl Physiol (1985). 2005; 98: 1154-1162
- Beneficial health effects of exercise—the role of IL-6 as a myokine.Trends Pharmacol Sci. 2007; 28: 152-156
- Tumor necrosis factor-alpha increases angiopoietin-like protein 2 gene expression by activating Foxo1 in 3T3-L1 adipocytes.Mol Cell Endocrinol. 2011; 339: 120-129
- High-intensity aerobic interval exercise in chronic heart failure.Curr Heart Fail Rep. 2013; 10: 130-138
- High-intensity aerobic interval training in a patient with stable angina pectoris.Am J Phys Med Rehabil. 2010; 89: 83-86
Article info
Publication history
Published online: February 03, 2015
Accepted:
January 27,
2015
Received:
December 16,
2014
Footnotes
See page 1238 for disclosure information.
Identification
Copyright
© 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
