04 Sep 2006

Beneficial effects of physical training in cardiovascular disease

Prof. Oyvind Ellingsen

Topics: Rehabilitation and Exercise Physiology
Session number: 934000
Session title: What do we know in 2006 about the mechanisms of the beneficial effects of physical training?
Authors: Ellingsen, O. Trondheim, Norway

Several recent studies indicate that regular exercise induces a host of physiological responses that may prevent, attenuate or reverse the development of cardiovascular disease.

According to Dr. Stefan Gielen (Leipzig GE) exercise reverses endothelial dysfunction in coronary arteries and other vessels by increasing the production of nitric oxide (NO). Regular exercise training increases the activity of the endothelial isoform of NO-synthase and its regulatory enzyme Akt. This improves the ability of the arteries to dilate and increases oxygen supply to the heart muscle in patients with coronary artery disease. Higher availability of NO also reduces the levels of reactive oxygen species, and exerts local antioxidative effects in the vessel wall. Shortlasting intense bouts of exercise increase the amount and function of circulating endothelial progenitor cells, which may act to regenerate injured vessels.

Data from Dr. Ulrik Wisloff (Trondheim NO) demonstrated that exercise improves contractility and reverses pathological remodelling in heart failure, possibly by enhancing the capacity of the sarcoplasmic calcium pump. A pilot study in heart failure patients indicated that the magnitude of beneficial effects seems to be larger with brief intervals of high intensity compared with longer bouts of moderate intensity.

Larger clinical studies from Professor Panteleo Gianuzzi’s group (Veruno IT) demonstrate that exercise training attenuates and may even reverse progression of chronic heart failure. After the training period patients had higher work capacity and better heart function, which was associated with better quality of life. Conclusion According to Professors William Dafoe (Edmonton CA) and Massimo Piepoli (Piacenza IT) some of the beneficial effects of exercise training in cardiovascular disease may result from reduced levels of stress hormones and inflammatory factors like TNF-a, IL-6 and CRP.

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.