Does appropriate endurance exercise training improve cardiac function in patients with prior myocardial infarction?

Adachi, Hiromasa; Koike, Atsushi; Obayashi, Tohru; Umezawa, Shigeo; Niwa, Akira; Marumo, Fumiaki; Hiroe, Michiaki

doi:10.1093/oxfordjournals.eurheartj.a014715

Cited by 57 publications

(50 citation statements)

References 36 publications

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“…On the other hand, shorter intervals of 30 s and 60 s, for instance, failed to show any further improvement in the VO2max in HIIT compared to MCT (Table 1, 2). More recently, high-intensity continuous training has yielded an improvement in the cardiac function in patients with previous myocardial infarction (42). According to a recent report by Arena et al, the optimal exercise prescription for patients with CHF and CAD may be composed of an intensity (-85-90% HRpeak), interval length (4 minutes), number (bout) (4), intensity of recovery between intervals (50% HRpeak) and duration of recovery (3 minutes) (43).…”

Section: Intensity Duration and Number Of Bouts Of Hiit Exercisementioning

confidence: 99%

Review of High-intensity Interval Training in Cardiac Rehabilitation

2016

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For the secondary prevention of cardiovascular disease, comprehensive cardiac rehabilitation is required. This involves optimal medical therapy, education on nutrition and exercise therapy, and smoking cessation. Of these, efficient exercise therapy is a key factor. A highly effective training protocol is therefore warranted, which requires a high rate of compliance. Although moderate-intensity continuous training has been the main training regimen recommended in cardiac rehabilitation guidelines, high-intensity interval training has been reported to be more effective in the clinical and experimental setting from the standpoint of peak oxygen uptake and central and peripheral adaptations. In this review, we illustrate the scientific evidence for highintensity interval training. We then verify this evidence and discuss its significance and the remaining issues.

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Section: Intensity Duration and Number Of Bouts Of Hiit Exercisementioning

confidence: 99%

Review of High-intensity Interval Training in Cardiac Rehabilitation

2016

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“…Shorter low-intensity exercise protocols also attenuate postischemic myocardial injuries, as 1-3 consecutive days of exercise result in both enhanced postischemic recovery and reduced infarct size (17,23,24,68). In addition to protocol duration, it seems that training intensity may also represent a crucial factor in exercise-induced cardioprotection (1,44,60), and a growing body of evidence from both human and animal studies suggests a greater effect of high-intensity aerobic training (HIT) compared with moderateintensity training (MIT) on cardiovascular, muscle, and metabolic adaptations (38,49,61,64,66). Among the putative mechanisms that have been proposed to explain exerciseinduced cardioprotection, several studies have focused on the exercise-associated increase in myocardial antioxidant capacity (29,56) and improvement of Ca 2ϩ homeostasis (20,23,24,34,65).…”

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confidence: 99%

High-intensity training reduces intermittent hypoxia-induced ER stress and myocardial infarct size

Bourdier

Flore

Sanchez³

et al. 2016

American Journal of Physiology-Heart and Circulatory Physiology

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Chronic intermittent hypoxia (IH) is described as the major detrimental factor leading to cardiovascular morbimortality in obstructive sleep apnea (OSA) patients. OSA patients exhibit increased infarct size after a myocardial event, and previous animal studies have shown that chronic IH could be the main mechanism. Endoplasmic reticulum (ER) stress plays a major role in the pathophysiology of cardiovascular disease. High-intensity training (HIT) exerts beneficial effects on the cardiovascular system. Thus, we hypothesized that HIT could prevent IH-induced ER stress and the increase in infarct size. Male Wistar rats were exposed to 21 days of IH (21-5% fraction of inspired O2, 60-s cycle, 8 h/day) or normoxia. After 1 wk of IH alone, rats were submitted daily to both IH and HIT (2 ϫ 24 min, 15-30m/min). Rat hearts were either rapidly frozen to evaluate ER stress by Western blot analysis or submitted to an ischemia-reperfusion protocol ex vivo (30 min of global ischemia/ 120 min of reperfusion). IH induced cardiac proapoptotic ER stress, characterized by increased expression of glucose-regulated protein kinase 78, phosphorylated protein kinase-like ER kinase, activating transcription factor 4, and C/EBP homologous protein. IH-induced myocardial apoptosis was confirmed by increased expression of cleaved caspase-3. These IH-associated proapoptotic alterations were associated with a significant increase in infarct size (35.4 Ϯ 3.2% vs. 22.7 Ϯ 1.7% of ventricles in IH ϩ sedenary and normoxia ϩ sedentary groups, respectively, P Ͻ 0.05). HIT prevented both the IH-induced proapoptotic ER stress and increased myocardial infarct size (28.8 Ϯ 3.9% and 21.0 Ϯ 5.1% in IH ϩ HIT and normoxia ϩ HIT groups, respectively, P ϭ 0.28). In conclusion, these findings suggest that HIT could represent a preventive strategy to limit IHinduced myocardial ischemia-reperfusion damages in OSA patients.obstructive sleep apnea; intermittent hypoxia; ischemia-reperfusion; high-intensity aerobic training; endoplasmic reticulum stress NEW & NOTEWORTHYWe demonstrated that intermittent hypoxia induced cardiac proapoptotic ER stress and increased infarct size, which were prevented by high-intensity aerobic training. These results strengthen the need for early identification of patients with sleep apnea at risk for cardiovascular complications and suggest that exercise can be used as a new preventive strategy for these patients.

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“…Physical exercise has positive effects on left ventricular function both in humans [20] and rats [6] in some but not all studies [10], at least if physical exercise is started several weeks after the myocardial infarction. The reason why physical exercise improves left ventricular function and survival is not clear.…”

Section: Discussionmentioning

confidence: 99%

Physical Exercise Increases Survival after an Experimental Myocardial Infarction in Rats

et al. 1998

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To directly evaluate the effect of physical exercise on survival, 80 rats were randomly assigned to either sedentary life (n = 40) or physical exercise 7 days/week during 6 weeks (n = 40), starting 2 weeks after coronary ligation. All animals were followed daily for 183 days. Size of myocardial infarction was determined by planimetry of serial histologic sections of the left ventricle. Physical exercise had no effect on survival in the total treatment group. However, rats with large myocardial infarctions, randomized to physical exercise, had significantly (p = 0.03) better survival (50%) after 6 months than control rats (17%) with large infarctions.

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Does appropriate endurance exercise training improve cardiac function in patients with prior myocardial infarction?

Cited by 57 publications

References 36 publications

Review of High-intensity Interval Training in Cardiac Rehabilitation

Review of High-intensity Interval Training in Cardiac Rehabilitation

High-intensity training reduces intermittent hypoxia-induced ER stress and myocardial infarct size

Physical Exercise Increases Survival after an Experimental Myocardial Infarction in Rats

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