Arterial Prehabilitation
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REVIEW ARTICLE
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Arterial Prehabilitation Can Exercise Induce Changes in Artery Size and Function that Decrease Complications of Catheterization? Amr Alkarmi,1 Dick H.J. Thijssen,2,3 Khalled Albouaini,1 N. Timothy Cable,2 D. Jay Wright,1,2 Daniel J. Green2,4 and Ellen A. Dawson2 1 2 3 4
Liverpool Heart and Chest Hospital, Liverpool, UK Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK Department of Physiology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia, Australia
Contents Abstract. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. Introducing the Concept of Arterial ‘Prehabilitation’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Does Arterial Catheterization Cause Vascular Damage? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Does Exercise Training Enhance Conduit Artery Function in Humans? . . . . . . . . . . . . . . . . . . . . . . . . . . 3.1 Localized Effects of Small Muscle Group Exercise Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.2 Whole Body or Large Muscle Group Exercise Training Effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4. Effects of Exercise Training on Conduit Artery Remodelling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5. Interaction between Functional Change and Structural Change Following Training . . . . . . . . . . . . . 6. Relevance of Functional and Structural Arterial Adaptation to ‘Prehabilitation’ . . . . . . . . . . . . . . . . . 7. Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Abstract
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Coronary angiography and angioplasty are common invasive procedures in cardiovascular medicine, which involve placement of a sheath inside peripheral conduit arteries. Sheath placement and catheterization can be associated with arterial thrombosis, spasm and occlusion. In this paper we review the literature pertaining to the possible benefits of arterial ‘prehabilitation’ – the concept that interventions aimed at enhancing arterial function and size (i.e. remodelling) should be undertaken prior to cardiac catheterization or artery harvest during bypass graft surgery. The incidence of artery spasm, occlusion and damage is lower in larger arteries with preserved endothelial function. We conclude that the beneficial effects of exercise training on both artery size and function, which are particularly evident in individuals who possess cardiovascular diseases or risk factors, infer that exercise training may reduce complication rates following catheterization and
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