Beneficial Effects of Baduanjin Exercise on Left Ventricular Remodelling in Patients after Acute Myocardial Infarction: an Exploratory Clinical Trial and Proteomic Analysis


Author: Shuai Mao1 2 3, Xiaoxuan Zhang1 2, Minggui Chen1 2, Chuyang Wang4, Qubo Chen4, Liheng Guo1 2, Minzhou Zhang5 6, Aleksander Hinek3

Affiliation: <sup>1</sup> State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China.

<sup>2</sup> Department of Critical Care Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China.

<sup>3</sup> Translational Medicine, Hospital for Sick Children, Toronto, M5G 0A4, Canada.

<sup>4</sup> Biological Resource Center, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China.

<sup>5</sup> State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China. minzhouzhang@aliyun.com.

<sup>6</sup> Department of Critical Care Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510120, China. minzhouzhang@aliyun.com.
Conference/Journal: Cardiovasc Drugs Ther
Date published: 2020 Aug 6
Other:
  Special Notes: doi: 10.1007/s10557-020-07047-0.   ,  Word Count: 275  
    PMID: 32761487 DOI: 10.1007/s10557-020-07047-0



Abstract



Background: The beneficial effects of physical exercise on cardiac remodelling improvement after myocardial infarction have already been suggested. However, the results of previous clinical trials have not been consistent. Moreover, the putative molecular mechanisms leading to the clinically observed effects of physical exercise still remain elusive.



Aim: We aimed to evaluate whether the well-defined and strictly controlled traditional Chinese Qigong Baduanjin exercise (BE) would attenuate the adverse left ventricular (LV) remodelling in patients with ST-elevation myocardial infarction (STEMI).



Methods: A total of 110 clinically stable STEMI patients, following successful revascularization of their infarcted coronary arteries, were randomized and enrolled in two groups: 56 were subjected to a 12-week BE-based cardiac rehabilitation programme (BE group), and the remaining 54 were exposed to the usual physical exercise (control group) for the same time period. The primary outcome was the change from baseline to 6 months in the echocardiographic LV end-diastolic volume index (ΔLVEDVi). Proteomic analysis was also performed to uncover associated mechanisms.



Results: Compared with the control group, the BE group showed significantly lower ΔLVEDVi (-5.1 ± 1.1 vs. 0.3 ± 1.2 mL/m2, P < 0.01). Proteomic analysis revealed BE-induced variations in the expression of 80 proteins linked to regulation the of metabolic process, immune process, and extracellular matrix reorganization. Furthermore, correlation analyses between the validated serum proteomes and primary endpoint demonstrated a positive association between ΔLVEDVi and MMP-9 expression, but a negative correlation between ΔLVEDVi and CXCL1 expression.



Conclusion: This is the first study indicating that BE in STEMI patients can alleviate adverse LV remodelling associated with beneficial energy metabolism adaptation, inflammation curbing, and extracellular matrix organization adjustment.



Keywords: Baduanjin exercise; Cardiac rehabilitation; Left ventricular remodelling; Myocardial infarction; Proteomic study.