Despite the striking improvement in the pharmacological treatment of cardiovascular diseases over the last decades, non-pharmacological interventions still have a relevant role and provide clear benefits in terms of clinical results and quality of life. This is the case of exercise training, which was the argument of this seminar.
Dr Vanhees discussed the relationship between aerobic capacity and risk in healthy adults and subjects with known cardiovascular disease and provided convincing evidence that aerobic capacity is significantly correlated with more favourable outcome. He also said that an improvement in aerobic capacity yields relevant prognostic benefit independently of other risk factors (hypertension, obesity, diabetes, etc.) and established prognostic markers, like left ventricular ejection fraction.
The physiological background of the positive effects of aerobic capacity were examined by Dr Wisloff, who provided an overview of the relationship between aerobic capacity and cellular function. In particular, he went through the morphological and cellular correlates of physical training in both normal and failing hearts and concluded that the positive effect of training is largely due to an improved shortening of myocytes and better calcium handling at cellular level.
In his interesting presentation, Dr Seals provided evidence that older adults show similar adaptations to exercise training as younger people. He also emphasized that main mechanisms involved are the increase in maximal stroke volume and cardiac output, higher peak of active blood flow, and the increase in maximal oxygen extraction.
Finally, Dr Geladas discussed the relation between type of training and work capacity. In particular, he examined the physiological correlates of interval versus continuous training in view of different outcomes. He also presented some data on water immersion and dry air exposure as alternative training modalities.