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VOLUME 14 , ISSUE 5 ( September-October, 2013 ) > List of Articles


The Effects of Phase III Cardiac Rehabilitation in Serum and Salivary Hs-CRP and Anthropometric Measurements in Patients with Coronary Artery Disease

Iraj Mirzaii-Dizgah, Boshra Jamshidpour, Behrouz Attarbashi Moghadam, Behnoosh Vasaghi-Gharamaleki, Mostafa Nejatian

Citation Information : Mirzaii-Dizgah I, Jamshidpour B, Moghadam BA, Vasaghi-Gharamaleki B, Nejatian M. The Effects of Phase III Cardiac Rehabilitation in Serum and Salivary Hs-CRP and Anthropometric Measurements in Patients with Coronary Artery Disease. J Contemp Dent Pract 2013; 14 (5):819-824.

DOI: 10.5005/jp-journals-10024-1409

Published Online: 00-10-2013

Copyright Statement:  Copyright © 2013; Jaypee Brothers Medical Publishers (P) Ltd.



Cardiac rehabilitation is a key part in the treatment of coronary artery disease (CAD) by its anti-inflammatory effects. However, the effect of exercise training programs on salivary concentrations of high-sensitivity C-reactive protein (hs-CRP) in patients with coronary artery disease has not been well studied. The objective of this study was to evaluate the effect of phase III cardiac rehabilitation on serum and salivary levels of hs-CRP, in relation to the anthropometric measurements of obesity and the relationship between salivary and serum levels of hs-CRP in CAD male patients.

Materials and methods

Forty male volunteers (45-75 years) with CAD participated in 6 to 8 weeks of moderate intensity aerobic exercise training consisting of 45 minutes sessions of treadmill, stationary bicycle and arm ergometer. Anthropometric measurements of obesity, serum level of hs-CRP, stimulated and nonstimulated salivary level of hs-CRP were measured at the beginning, in the middle and at the end of exercise sessions.


All anthropometric measurements increased (p < 0.05) following cardiac rehabilitation except waist-hip ratio. Serum hs-CRP level reduced by 36% independent to the anthropometric measurements changes. Stimulated and nonstimulated salivary hs-CRP level decreased 68 and 54%, respectively, after 24 sessions of cardiac rehabilitation. Nonstimulated salivary hs-CRP levels correlated to serum levels of hs-CRP at baseline and after 24 sessions (p < 0.05).


Phase III cardiac rehabilitation seems to be effective to improve serum and salivary hs-CRP concentrations independent of anthropometric measurements.

Clinical significance

Nonstimulated salivary hs-CRP measurement could be a surrogate for blood measurement of hs-CRP during cardiac rehabilitation in male patients with CAD.

How to cite this article

Jamshidpour B, Moghadam BA, Vasaghi-Gharamaleki B, Mirzaii-Dizgah I, Nejatian M. The Effects of Phase III Cardiac Rehabilitation in Serum and Salivary Hs-CRP and Anthropometric Measurements in Patients with Coronary Artery Disease. J Contemp Dent Pract 2013;14(5):819-824.

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  1. Relationship of obesity and visceral adiposity with serum concentrations of CRP, TNF-alpha and IL-6. Diabetes Res Clin Pract 2005;69(1):29-35.
  2. Exercise training modulates cytokines activity in coronary heart disease patients. Int J Cardiol 2005;100(1):93-99.
  3. Regular exercise training compared with percutaneous intervention leads to a reduction of inflammatory markers and cardiovascular events in patients with coronary artery disease. Eur J Cardiovasc Prev Rehabil 2008;15(1):107-112.
  4. Relation of C-reactive protein to abdominal adiposity. Am J Cardiol 2010;106(1):56-61.
  5. The novel role of C-reactive protein in cardiovascular disease: Risk marker or pathogen. Int J Cardiol 2006;106(3):291-297.
  6. Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med 2005;352(16):1685-1695.
  7. Effects of aerobic exercise on uric acid, total antioxidant activity, oxidative stress and nitric oxide in human saliva. Int J Sport Med 2008;16(2):128-137.
  8. Detection of Homocysteine and C-reactive protein in the saliva of healthy adults: comparison with blood levels. Biomark Insights 2010;20(5):57-61.
  9. Reduction in C-reactive protein through cardiac rehabilitation and exercise training. J Am Coll Cardiol 2004;43(6):1056-1061.
  10. Cardiac rehabilitation is associated with an improvement in C-reactive protein levels in both men and women with cardiovascular disease. J Cardiopulm Rehabil 2005;25(6):332-336.
  11. Effect of strengthening exercises on serum C-reactive protein after coronary artery bypass graft. Iranian J Publ Health 2008;37(2):93-100.
  12. The effect of cardiac rehabilitation on changes in lipid profile of iranian obes patients with coronary artery disease. Modern Rehabilitation J 2010;2:45-49.
  13. Salivary acute phase proteins as biomarker in oral and systemic disease, acute phase proteins as early nonspecific biomarkers of human and veterinary diseases, francisco veas (Ed.), 2011;ISBN:978-953-307-873-1, InTech, Available from:
  14. Effect of acute exercise on the levels of salivary cortisol, tumor necrosis factor-alpha and nitric oxide. J Oral Sci 2010;52(1):133-136.
  15. Comparison of saliva and blood for human immunodeficiency virus prevalence testing. J Infect Dis 1991;163:699-702.
  16. American Association for Cardiovascular and Pulmonary Rehabilitation; American Heart Association. Medical director responsibilities for outpatient cardiac rehabilitation/secondary prevention programs. A statement for healthcare professionals from the American Association for Cardiovascular and Pulmonary Rehabilitation and the American Heart Association. J Cardiopulm Rehabil 2005;25:315-320.
  17. Relationship between physical activity and inflammation among apparently healthy middleaged and older US adults. Arch Intern Med 2002;162:1286-1292.
  18. Elevated C-reactive protein: another component of the atherothrombotic profile of abdominal obesity. Arterioscler Thromb Vasc Biol 2001;21:961-967.
  19. Associations of visceral adiposity and exercise participation with C-reactive protein, insulin resistance, and endothelial dysfunction in Korean healthy adults. Metabolis 2008;57:1181-1189.
  20. A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention. Int J Obes Relat Metab Disord 1997;21:941-947.
  21. Effects of cardiac rehabilitation and exercise training in obese patients with coronary artery disease. Chest J 1996;109:52-56.
  22. Effects of eight weeks of exercise training and orlistat therapy on body composition and maximal exercise capacity in obese females. Public Health 2006;120:76-82.
  23. Is weight loss the optimal target for obesity-related cardiovascular disease risk reduction? Can J Cardiol 2008;24:25-31.
  24. Long-term changes in exercise capacity, quality of life, body anthropometry, and lipid profiles after a cardiac rehabilitation program in obese patients with coronary heart disease. Am J Cardiol 2003;91(3):321-325.
  25. Braunwald's Heart disease: a text book of cardiovascular medicine. 7th ed. Philadelphia: Elsevier Saunders; 2008;1149-1154.
  26. Recent approaches in saliva as a credible periodontal diagnostic and prognostic marker. AOSR 2012;2(1):40-46.
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