Cardiac rehabilitation with intermittent myocardial ischaemia as a new therapeutic option in refractory angina?

Abstract

Abstract A 72‐year‐old man daily suffered from a refractory angina consecutive to a diffuse coronary artery disease despite optimal medical management. Revascularization could not be performed because of a severe thrombopenia. He was referred to our outpatient cardiac rehabilitation programme where he was candidate for 20 sessions, three times a week, of high‐intensity aerobic interval training involving brief episodes of regressive myocardial ischaemia. After 7 weeks, exercise capacity (+28.5%), VO2 peak (35.7%), and ischaemic threshold increased while clinical status and quality of life improved. No adverse effect was reported. Aerobic interval training with myocardial ischaemia might be a therapeutic alternative in refractory angina.

Keywords

• Coronary artery disease
• Refractory angina pectoris
• Cardiac rehabilitation
• Aerobic interval training
• Myocardial pre‐conditioning