Does exercise training improve the function of vascular smooth muscle? A systematic review and meta-analysis

Liu, Yujia; Sun, Zhenjia; Chen, Tong; Yang, Chen

doi:10.1080/15438627.2021.1917408

Cited by 13 publications

(11 citation statements)

References 65 publications

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“…In accordance with our hypothesis and previous evidence in patients with HF [ 20 ] and CAD [ 75 ], our findings demonstrate that aerobic-based CR programmes do not enhance vascular smooth muscle function in patients with HFrEF. On the contrary, Liu et al [ 94 ], who included studies performed with patients and healthy individuals, as well as different exercise modalities, reported that exercise training is suitable for improving endothelial-independent dilation. However, heterogeneity was high and exercise-induced adaptations were only found in patients with hypercholesterolemia or rheumatoid arthritis.…”

Section: Discussionmentioning

confidence: 99%

“…However, heterogeneity was high and exercise-induced adaptations were only found in patients with hypercholesterolemia or rheumatoid arthritis. In addition, Liu et al [ 94 ] found a greater improvement in endothelial-independent dilation in studies which carried out vigorous aerobic exercise. In contrast with these results, Benda et al [ 43 ] and Isaksen et al [ 48 ], who assessed the effect of HIIT compared to non-exercise on vascular smooth muscle function, found no differences.…”

Section: Discussionmentioning

confidence: 99%

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Effects and Optimal Dose of Exercise on Endothelial Function in Patients with Heart Failure: A Systematic Review and Meta-Analysis

et al. 2023

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Background Exercise-based cardiac rehabilitation (CR) is considered an effective treatment for enhancing endothelial function in patients with heart failure (HF). However, recent studies have been published and the optimal “dose” of exercise required to increase the benefits of exercise-based CR programmes on endothelial function is still unknown. Objectives (a) To estimate the effect of exercise-based CR on endothelial function, assessed by flow-mediated dilation (FMD), in patients with HF; (b) to determine whether high-intensity interval training (HIIT) is better than moderate-intensity training (MIT) for improving FMD; and (c) to investigate the influence of exercise modality (i.e. resistance exercise vs. aerobic exercise and combined exercise vs. aerobic exercise) on the improvement of endothelial function. Methods Electronic searches were carried out in PubMed, Embase, and Scopus up to February 2022. Random-effects models of between-group mean differences were estimated. Heterogeneity analyses were performed by means of the chi-square test and I2 index. Subgroup analyses and meta-regressions were used to test the influence of potential moderator variables on the effect of exercise. Results We found a FMD increase of 3.09% (95% confidence interval [CI] = 2.01, 4.17) in favour of aerobic-based CR programmes compared with control groups in patients with HF and reduced ejection fraction (HFrEF). However, the results of included studies were inconsistent (p < .001; I2 = 95.2%). Higher FMD improvement was found in studies which were randomised, reported radial FMD, or performed higher number of training sessions a week. Moreover, HIIT enhanced FMD to a greater extent than MIT (2.35% [95% CI = 0.49, 4.22]) in patients with HFrEF. Insufficient data prevented pooled analyses for the effect of exercise in patients with HF and preserved ejection fraction and the influence of exercise modality on the improvement of endothelial function. Conclusion Aerobic-based CR is a non-pharmacological treatment for enhancing endothelial function in patients with HFrEF. However, higher training frequency and HIIT induce greater adaptation of endothelial function in these patients, which should betaken into consideration when designing exercise-based CR programmes. Trial registration The protocol was prospectively registered on the PROSPERO database (CRD42022304687).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effects and Optimal Dose of Exercise on Endothelial Function in Patients with Heart Failure: A Systematic Review and Meta-Analysis

et al. 2023

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“…Studies have demonstrated that exercise lowers blood pressure [6,7]. Exercise may regulate blood pressure by improving the function of vascular endothelium [8], vascular smooth muscle [9], and cardiovascular autonomic nervous system [10], but the underlying mechanisms remain to be elucidated. Cardiac chronotropic response, which is a reflection of cardiac autonomic function, refers to the ability of the heart rate to increase appropriately in response to the body's metabolic demands during exercise and return quickly to the base level after exercise [11].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

12-week Brisk Walking Improved Chronotropic Response in Hypertensive Patients

Yan

Luo

et al. 2022

Int J Sports Med

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We investigated the effects of 12-week brisk walking on chronotropic response in hypertensive patients aged 40-69. 77 participants in exercise group underwent 12-week brisk walking, while 66 participants in control group received health education. Chronotropic parameters, resting blood pressure, and physical fitness including peak oxygen consumption (VO2peak) were measured. After 12 weeks, the systolic blood pressure (SBP) was decreased (-6.104 mmHg, 95%CI -8.913 to -3.295 mmHg, P<0.0001), while metabolic chronotropic relationship (MCR) slope and VO2peak were increased (0.073, 95%CI 0.001 to 0.145, P=0.046; 1.756 mL/kg/min, 95%CI 0.891 to 2.622 mL/kg/min, P<0.0001) in exercise group compared to baseline. The chronotropic response index (CRI) at 25-75W load were decreased (-0.210, 95%CI -0.307 to -0.112, P<0.0001; -0.144, 95%CI -0.204 to -0.083, P<0.0001; -0.078, 95%CI -0.135 to -0.022, P=0.007) in control group after 12 weeks. The relative changes (%Δ) of systolic and diastolic blood pressure were negatively correlated with %ΔVO2peak (r=-0.233, r=-0.187), while %ΔMCR and %ΔCRI at 50-75W load were positively correlated with %ΔVO2peak after 12 weeks (r=0.330, r=0.282, r=0.370). %ΔSBP was also positively correlated with %ΔMCR (r=-0.213). In conclusion, 12-week brisk walking reduced SBP by improving chronotropic response in hypertensive patients aged 40-69. The enhanced chronotropic response was associated with enhanced cardiorespiratory fitness.

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“…It should be noted that all pooled studies performed aerobic exercise. On the contrary, Liu et al(100), who included studies performed with patients and healthy individuals, as well as different exercise modalities, reported that exercise training is suitable for improving endothelialindependent dilation. Nonetheless, heterogeneity was high and exercise-induced adaptations were only found in patients with hypercholesterolemia or rheumatoid arthritis.…”

mentioning

confidence: 99%

Effects and optimal dose of exercise on endothelial function in patients with heart failure: a systematic review and meta-analysis

Fuertes-Kenneally

Manresa‐Rocamora²,

Blasco-Peris

et al. 2022

Preprint

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Background Exercise-based cardiac rehabilitation (CR) is considered an effective treatment for enhancing endothelial function in patients with heart failure (HF). Nonetheless, recent studies have been published and the optimal “dose” of exercise required to increase the benefits of exercise-based CR programmes on endothelial function is still not well-known. Objectives (a) To estimate the effect of exercise-based CR on endothelial function, assessed by flow-mediated dilation (FMD); (b) to determine whether high-intensity interval training (HIIT) is better than moderate intensity training (MIT) for improving FMD; and (c) to investigate whether there are differences between resistance exercise (alone or combined with aerobic exercise) and aerobic exercise for enhancing endothelial function. Methods Electronic searchers were carried out in PubMed, Embase, and Scopus up to February 2022. Random-effects models of between-group mean differences were estimated. Heterogeneity analyses were performed by means of the chi-square test and I2 index. Subgroup analyses and meta-regressions were used to test the influence of potential moderator variables on the effect of exercise. Results Most of the included studies performed an aerobic-based CR programme in patients with HF and reduced ejection fraction (HFrEF). We found a FMD increase of 2.74% (95% confidence interval [CI] = 1.69, 3.79%) in favour of CR programmes compared with control groups. Nonetheless, the results of included studies were inconsistent (p < .001; I2 = 94.8%). Higher FMD improvement was found in studies performed with patients with HFrEF compared to patients with HF and preserved ejection fraction, reported radial FMD, or performed higher training frequency. Moreover, HIIT enhanced FMD to a greater extent than MIT (2.65% [95% CI = 0.98, 4.33%]), while no differences were found based on the exercise modality (1.97% [95% CI = − 0.64, 4.58%]). Conclusion Aerobic-based CR is a non-pharmacological treatment for enhancing endothelial function in patients with HFrEF. Nonetheless, training variables such as the aerobic training method (i.e., HIIT and MIT) and training frequency should be considered to properly design exercise-based CR programmes. Registration: The protocol was prospectively registered on the PROSPERO database (CRD42022304687).

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Does exercise training improve the function of vascular smooth muscle? A systematic review and meta-analysis

Cited by 13 publications

References 65 publications

Effects and Optimal Dose of Exercise on Endothelial Function in Patients with Heart Failure: A Systematic Review and Meta-Analysis

Effects and Optimal Dose of Exercise on Endothelial Function in Patients with Heart Failure: A Systematic Review and Meta-Analysis

12-week Brisk Walking Improved Chronotropic Response in Hypertensive Patients

Effects and optimal dose of exercise on endothelial function in patients with heart failure: a systematic review and meta-analysis

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