Effects of aerobic exercise combined with Levocarnitine on improving endothelial function and antioxidation in patients with stable angina pectoris of coronary heart disease

Abstract

Objective To investigate the effect of aerobic exercise combined with Levocarnitine in treating stable angina pectoris(SAP) and its effect on vascular endothelial function and serum levels of superoxide dismutase(SOD), total antioxidant capacity(TAC), glutathione peroxidase(GSH-px), malondialdehyde (MDA), and lipid peroxide(LPO). Methods One hundred and fifty patients with SAP were selected in Affiliated Hospital of Yan′an University from september 2017 to september 2018 and randomly divided into control group and observation group(75 cases in each group). Both groups received routine intervention according to the guidelines.The control group was given with intravenous drip of left carnitine(3 g/time and once a day). On basis of the control group, the observation group was treated with regular aerobic exercise therapy.After 8 weeks' treatment for two groups, attack frequency degree of angina pectoris, score of life quality of Seattle angina scale(SAQ), and clinical effect were compared between the two groups.And the vascular endothelial function(plasma endothelin(ET)1, nitric oxide(NO)), flow mediated vasodilation(FMD) of brachial artery and antioxidant effect(serum levels of SOD, TAC, GSH-px, MDA and LPO) were detected. Results After 8 weeks' treatment, frequency of angina pectoris and episode of duration of angina pectoris in the observation group were less((4.19±0.56) vs.(6.22±0.89) time, (4.31±0.50) vs.(5.25±0.71) min), while life quality indexes SAQ score was higher, than those in the control group, and the difference was statistically significant((18.44±2.30) vs.(12.49±1.82) score, (56.31±6.62) vs.(48.05±5.88) score, (14.46±1.99) vs.(9.22±1.10) score, (21.41±2.95))vs.(18.09±2.26) score, (16.14±2.17) vs.(12.05±1.82) score, (all P<0.01)). The total clinical effective rate of the observation group (92% (69 / 75)) was higher than that of the control group (80% (60 / 75)), the difference was statistically significant (χ2=4.485, P=0.034). After 8 weeks′ treatment, level of ET-1, FMD of brachial artery, MDA, and LPO were lower than those in the control group((65.38±7.91) ng/L vs.(77.12±8.56) ng/L, (9.44±1.34)% vs.(12.55±1.81)%, (2.81±0.43) μmol/L vs.(3.90±0.50) μmol/L, (3.14±0.44) μmol/L vs.(4.40±0.63) μmol/L), while NO, SOD, TAC, GSH-px were higher than control group((67.51±7.79) μmol/L vs.(52.17±6.08) μmol/L, (85.25±9.67)U/L vs.(76.01±8.33) U/L, (12.79±1.80) kU/L vs.(9.64±11.05) kU/L, (117.65±15.03) U/L vs.(111.76±14.19) U/L), and the difference was statistically significant (all P<0.01). Conclusion Aerobic exercise combined with Levocarnitine in treating SAP can reduce the attack of angina pectoris, improve the life treatment of patients, and improve the clinical effect, which may be related to the improvement of endothelial function and antioxidant effect. Key words: Aerobic exercise; Levocarnitine; Stable angina pectoris; Vascular endothelial function; Antioxidant