Mr Georg Kojda
Despite several evidenced-based pharmacologic and other interventional approaches to treat the majority of cardiovascular diseases, it appears essential to increase the awareness of patients, physicians and other healthcare pofessionals on the most important lifestyle interventions such as healthy diet and regular physical activity.
In this session a couple of excellent speakers informed a very interested and numerously present audience about the impact of physical activity on quality of life and life expectancy. The first speaker, Dr. Lopez-Lluch from the University of Pamplona, gave a very well respected overview on the the effects of caloric restriction and how such an intervention would interfere with physical activity. His presentation began with the example of rhesus monkeys which had lived their life either on normal diet or on caloric restriction. The latter animals were much better in shape, e.g. their fur, their skin and their complete health status showed less signs of ageing. Dr. Lopez-Lluch said that caloric restriction appeared to be as important as the right mixture of carbohydrates, fat and fibers. Then he showed the audience many examples from studies with rodents demonstrating that the majority of effects induced by regular physical activity are adding benefits to caloric restriction. His well-conducted studies convincingly illustrated the involvement of mitochondrial mitogenesis as an important underlying molecular mechanism. The following speaker, Dr. Kemi from the University of Glasgow, informed about the effects of exercise on the prognosis of heart failure patients. His excellent presentation guided the audience from the analysis of published clinical trials to the molecular mechanisms likely underlying the improvement of cardiac myocyte contractility. He pointed out that exercise is of utmost importance for heart failure patients, because this intervention would largely increase their exercise capacity and thus their quality of life. The session went on with the exquisite speech of Dr. von Hees from the University of Leuven. His presentation concentrated on his recent epidemiologic study including more than 1200 Belgian police officers. He investigated the very important question of how much intensity of exercise is needed to achieve beneficial effects on cardiovascular health. Furthermore, he pointed out that physical fitness – as measured by maximal oxygen consumption (aerobic capacity) – and past physical activity appear to be strong predictors of beneficial effects. In the discussion, the next speaker, Dr. Hambrecht from the University Bremen, made the important comment that we can’t give recommendations for exercise intensity until data from controlled clinical trials are available allowing an evidenced-based estimation of the risk-benefit-ratio. In his outstanding presentation, Dr. Hambrecht focused on the effects of exercise on endothelial function in patients with coronary artery disease. He demonstrated that daily exercise of moderate intensity improves myocardial perfusion and endothelium-dependent vasodilation of large coronary arteries. One of his major points were that daily exercise duration can be devided in 3-6 portions of 10 min and that patients will achieve measurable benefits within only 4 weeks. Finally, comments from the very interested audience shed some light on a serious problem that physicians and other healthcare professionals have to face when they try to motivate patients to exercise: the patients’ marginal willingness and their very limited compliance.
More attention should be paid by physicians and other healthcare professionals to the beneficial effects of non-pharmacologic interventions such as healthy diet and regular physical activity and the importance of life-long adhearance to these interventions.
Exercise cell biology and cardiovascular health, state of the art
This congress report accompanies a presentation given at the ESC Congress 2009. Written by the author himself/herself, this report does not necessarily reflect the opinion of the European Society of Cardiology.
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