Beneficial effects of music listening during treadmill exercise in coronary artery disease patients with a history of percutaneous coronary intervention

Background Music has been shown to potently reduce the perception of fatigue and exertion through dissociation and distraction during exercise. Listening to music prior to and during exercise has been shown to increase motivation and effort, leading to improved performance outcomes. Purpose To study the effects of music listening on clinical, ECG and hemodynamic indices measured during exercise in patients (pts) with documented coronary artery disease (CAD) and a history of percutaneous coronary intervention (PCI). Methods Thirty two asymptomatic pts (29M/3F) with CAD and a history of previous PCI (12-36 months) were studied during follow-up treadmill exercise test (Bruce Protocol). All pts maintained good LV function assessed by standard echocardiography. Sixteen pts consisting music group (MG) (mean age 60±9) were openly exposed to instrumental classical music delivered during exercise via high quality audio system connected to speakers. Another group of 16 pts (NMG) (mean age 59±8) was not exposed to music during exercise and acted as a control group. All pts were assessed according to standard hemodynamic and ECG measurements obtained during exercise testing in CAD pts. All pts were asked post-exercise to indicate levels of anxiety-stress felt during the procedure on a Visual Analogue Scale (VAS) (range 0-10 cm). Results All pts achieved >85% of their max predicted heart rate and no pt developed angina symptoms during the test. ST-T segment exercise ECG abnormalities were detected in 4(25%) pts in MG compared to 5(31%) pts in NMG group (p=ns). Twelve (81%) pts in MG and 13 (87%) in NMG group were on a b-blocker during the test. Exercise duration was longer in MG (9.4±1.6 min) compared to NMG (8.0±1.2 min) (p=0.009). In addition, VAS score was lower in M (4.8±1.8 cm) vs NM group (6.2±1.3 cm) (p=0.017) indicating a reduced level of perceived anxiety-stress in MG . Conclusion Music listening improves exercise tolerance during treadmill exercise in pts with CAD and history of PCI. This improvement may be related to a reduction in the perception of anxiety induced by music listening on exercise. Music may be a useful tool to achieve maximal performance and optimize exercise testing diagnosis in cardiovascular pts.