Effect of Cardiac Rehabilitation Program Based on Combined Training on VEGF/Endostatin Gene Expression Ratio in Patients with Acute Coronary Syndrome

Background: Coronary artery disease is one of the most common causes of death in the world. With the increase in the incidence of these diseases, surgical and non-surgical interventions followed by cardiovascular rehabilitation programs have become more important. The process of angiogenesis and improvement of blood flow is considered as one of the therapeutic goals in these patients, and vascular endothelial growth factor (VEGF) is known as the most important stimulus and endostatin is known as its most important inhibitory agent. The aim of this study was to investigate the effect of eight-week Cardiac Rehabilitation Program based on combined training on VEGF/Endostatin gene expression ratio in acute coronary syndrome (ACS) patients with Coronary Artery Bypass Graft (CABG). Methods: 30 middle-aged CABG men were selected using purposive sampling based on inclusion criteria. Participants were randomly divided into two groups of control and training. Quantitative Real-time PCR was used to measure VEGF and endostatin gene expression levels. The eight-week combined exercise training was conducted in three sessions in a week, with the supervision of cardiac rehabilitation physician. Dependent t-test and independent t-test were used to data analysis. Results: Significant increase was observed after eight weeks of combined training on VEGF gene expression in CABG patients (P=0.001), but it was not significant on Endostatin gene expression (p=0.38) and VEGF/Endostatin ratio (P=0.62). Conclusion: Eight-week combined cardiac rehabilitation training- as the protocol used in this research- increased the expression of VEGF gene in CABG patients, but there were not any significant changes in Endostatin gene expression and VEGF/Endostatin ratio by this method. Therefore, it can be stated that increase in VEGF gene is one of the results of adaptation to combined exercise activity used in this study, and it seems that physical activity is an important and effective factor in the process of angiogenesis and can play an important role in prevention cardiovascular diseases.