The Role of Exercise-Based Cardiac Rehabilitation After Myocardial Infarction on Cholesterol Transfer to HDL

Int J Mol Sci. 2025 Jan 6;26(1):419. doi: 10.3390/ijms26010419.

Abstract

High-density lipoprotein (HDL) is associated with decreased incidence of cardiovascular events, and its functionality also influences prognosis. Exercise is an important tool to improve prognosis in the post-infarction (MI) population, but the role of exercise on HDL functionality is poorly understood. Sixty-two patients with acute MI were randomized in a supervised exercise program for 12-14 weeks (exercise group-EG) or a control group (CG). The main objective of the study was to analyze the role of exercise on esterified cholesterol (EC) and unesterified cholesterol (UC) transfer to HDL. For the total population, the baseline mean rate of EC transfer to HDL was 2.53 ± 0.83 and at the end of follow-up, it was 2.74 ± 0.64 (p = 0.03). The figures for UC were, respectively, 4.08 ± 1.2 and 4.4 ± 1.06 (p = 0.02). The difference (follow-up minus baseline) for EC was 0.15 ± 0.84 for the control group and 0.27 ± 0.69 for the exercise group (p = 0.53); for UC, the figures were 0.28 ± 1.14 and 0.35 ± 0.96 (p = 0.80), respectively, for the control and exercise groups. In post-MI patients, 12-14 weeks of supervised exercise did not improve HDL functionality.

Keywords: HDL functionality; acute myocardial infarction; cardiac rehabilitation; supervised exercise.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Cardiac Rehabilitation* / methods
  • Cholesterol / blood
  • Cholesterol / metabolism
  • Cholesterol, HDL* / blood
  • Cholesterol, HDL* / metabolism
  • Exercise / physiology
  • Exercise Therapy* / methods
  • Female
  • Humans
  • Lipoproteins, HDL / blood
  • Lipoproteins, HDL / metabolism
  • Male
  • Middle Aged
  • Myocardial Infarction* / metabolism
  • Myocardial Infarction* / rehabilitation

Substances

  • Cholesterol, HDL
  • Cholesterol
  • Lipoproteins, HDL

Grants and funding

This work was supported by the State of Sao Paulo Research Foundation (Fundação de Amparo à Pesquisa do Estado de São Paulo—FAPESP) (grant #: 2014/01021-4 and 2023/10447-4). Dr Nicolau, Dr. Negrao, and Dr. Rondon are recipients of a scholarship from the National Council of Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico –CNPq) (grant # 303448/2021-0, 304697/2020-6, and 315459/2023-9).