Effects of listening to joyful music on endothelial function in rehabilitation of patients after myocardial infarction

Introduction: In the setting of cardiovascular disease the endothelium loses its normal function. Exercise training has been shown to improve endothelial function, however little is known about the role of music in cardiovascular rehabilitation or the effects of listening to favourite music on endothelial function. Objectives: To evaluate the effects of listening to joyfulmusic on the endothelial function, assess through changes of circulating blood markers of endothelial function: the stable end products of nitric oxide (NOx), S-nitrosothiols (RSNO-reservoir for bioavailable nitric oxide), and asymmetric dimethylarginine (ADMA) in patients (pts) after myocardial infarction (MI). Methods: 50pts after MI were studied. At baseline and 3 weeks later, in all pts values of NOx, RSNOandADMAwere evaluated andexercise testwas performed. After the initial study,patients were randomized to music (M,n=20) and control (C,n=30) group. Patients in both groups underwent a supervised 3 weeks aerobic exercise training at residential center. Additionaly to exercise training patients inMgroupwere listening their favoritemusic for half an hour everyday. Results: Baseline values of NOx, RSNO and ADMA were similar in M and C group. After 3 weeks value of NOx increased significantly in M group (from 32.7 ± 9.0 to 49.0 ± 10.5 mmol/l, P<0.001), as well as in C group (from 32.5±12.0 to 42.0±11.0 mmol/l, P<0.005), however increase in NOx was higher in M than in C group (49%vs 30%) compared to baseline values. In both groups, value of RSNO increased after 3 weeks: in M group RSNO increased from 3.2±1.3 to 5.3±1.3 mmol/l (P<0.001) and in C group from 3.1±1.6 to 4.5±1.4 mmol/l (P<0.001). After 3 weeks increase in RSNO was higher inMthan in C group (65% vs 45%), compared to baseline values. Value of ADMA decreased in both groups (ns) after 3 weeks, and this reduction was greater in M than in C group (13.7% vs 8.2%). Conclusion: Listening to joyful music in combination with regular exercise training program leads to more pronounced benefit and improvement of endothelial function than exercise training alone. Therefore, listening to joyful music may be an adjunct method in the rehabilitation of patients after myocardial infarction.