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Arterial Prehabilitation

Can Exercise Induce Changes in Artery Size and Function that Decrease Complications of Catheterization?

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Abstract

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 enhance the success of arteries harvested as bypass grafts. Future research efforts should focus directly on examination of the ‘prehabilitation’ hypothesis and the efficacy of different interventions aimed at reducing clinical complications of common interventional procedures.

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Acknowledgements

Daniel Green was supported by the National Heart Foundation of Australia. Dick Thijssen was supported by the Netherlands Organisation for Scientific Research (NWO-grant 82507010) and is a recipient of the E. Dekker-stipend from the Dutch Heart Foundation. The authors have no conflicts of interest that are directly relevant to the content of this review.

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Authors and Affiliations

  1. Liverpool Heart and Chest Hospital, Liverpool, UK

    Amr Alkarmi, Khalled Albouaini & D. Jay Wright

  2. Research Institute for Sport and Exercise Science, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, UK

    Dick H. J. Thijssen, N. Timothy Cable, D. Jay Wright, Daniel J. Green &  Ellen A. Dawson (Research Fellow)

  3. Department of Physiology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands

    Dick H. J. Thijssen

  4. School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia, Australia

    Daniel J. Green

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  1. Amr Alkarmi
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  2. Dick H. J. Thijssen
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Correspondence to Ellen A. Dawson.

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Alkarmi, A., Thijssen, D.H.J., Albouaini, K. et al. Arterial Prehabilitation. Sports Med 40, 481–492 (2010). https://doi.org/10.2165/11531950-000000000-00000

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