Exercise and heart failure: an update

Cattadori, Gaia; Segurini, Chiara; Picozzi, Anna; Padeletti, Luigi; Anzà, Claudio

doi:10.1002/ehf2.12225

Cited by 158 publications

(133 citation statements)

References 87 publications

(126 reference statements)

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“…Importantly, exercise training has not only been shown to reduce the risk of CHF but also to be beneficial to patients already diagnosed with CHF (14).…”

Section: Adenovirus-mediated Overexpression Ofmentioning

confidence: 99%

Extracellular superoxide dismutase, a molecular transducer of health benefits of exercise

2020

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Extracellular superoxide dismutase (EcSOD) is the only extracellular scavenger of superoxide anion (O 2 .-) with unique binding capacity to cell surface and extracellular matrix through its heparin-binding domain. Enhanced EcSOD activity prevents oxidative stress and damage, which are fundamental in a variety of disease pathologies. In this review we will discuss the findings in humans and animal studies supporting the benefits of EcSOD induced by exercise training in reducing oxidative stress in various tissues. In particularly, we will highlight the importance of skeletal muscle EcSOD, which is induced by endurance exercise and redistributed through the circulation to the peripheral tissues, as a molecular transducer of exercise training to confer protection against oxidative stress and damage in various disease conditions.

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“…Importantly, exercise training has not only been shown to reduce the risk of CHF but also to be beneficial to patients already diagnosed with CHF (14).…”

Section: Adenovirus-mediated Overexpression Ofmentioning

confidence: 99%

Extracellular superoxide dismutase, a molecular transducer of health benefits of exercise

2020

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“…1 The overall prevalence of cardiovascular disease in patients is~2% of the population. 1 The overall prevalence of cardiovascular disease in patients is~2% of the population.…”

Section: Introductionmentioning

confidence: 99%

Skeletal muscle wasting in chronic heart failure

2018

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Patients suffering from chronic heart failure (CHF) show an increased prevalence (~20% in elderly CHF patients) of loss of muscle mass and muscle function (i.e. sarcopenia) compared with healthy elderly people. Sarcopenia, which can also occur in obese patients, is considered a strong predictor of frailty, disability, and mortality in older persons and is present in 5–13% of elderly persons aged 60–70 years and up to 50% of all octogenarians. In a CHF study, sarcopenia was associated with lower strength, reduced peak oxygen consumption (peak VO2, 1173 ± 433 vs. 1622 ± 456 mL/min), and lower exercise time (7.7 ± 3.8 vs. 10.22 ± 3.0 min, both P < 0.001). Unfortunately, there are only very limited therapy options. Currently, the main intervention remains resistance exercise. Specialized nutritional support may aid the effects of resistance training. Testosterone has significant positive effects on muscle mass and function, and low endogenous testosterone has been described as an independent risk factor in CHF in a study with 618 men (hazard ratio 0.929, P = 0.042). However, the use of testosterone is controversial because of possible side effects. Selective androgen receptor modulators have been developed to overcome these side effects but are not yet available on the market. Further investigational drugs include growth hormone, insulin‐like growth factor 1, and several compounds that target the myostatin pathway. The continuing development of new treatment strategies and compounds for sarcopenia, muscle wasting regardless of CHF, and cardiac cachexia makes this a stimulating research area.

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“…129 Chronotropic incompetence has a major role in the limitation of the cardiac output response, in addition to the impairment of the stroke volume increase. [135][136][137][138] A flattening oxygen consumption trajectory during exercise has been recently introduced as a new measurement of disease severity and a prognostic determinant and its value was independent from LVEF in a first study. 131 Cardiac and extracardiac comorbidities have a major role in patients with HFpEF.…”

Section: Diagnosis and Prognosis: Role Of Exercise Testing And Cardiamentioning

confidence: 99%

“…[132][133][134] They may influence exercise capacity and limit the value of cardiopulmonary exercise testing or the 6-min walk test distance for the assessment of the patients with HFpEF. [135][136][137][138] A flattening oxygen consumption trajectory during exercise has been recently introduced as a new measurement of disease severity and a prognostic determinant and its value was independent from LVEF in a first study. 139 Two-dimensional speckle tracking echocardiography can evaluate LV global longitudinal strain, which can detect LV systolic dysfunction at an earlier stage than EF and whose impairment is associated with a worse outcome.…”

Section: Hf With Preserved Ef Diagnosis and Prognosis: Role Of Exercimentioning

confidence: 99%

Highlights in heart failure

et al. 2019

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Heart failure (HF) remains a major cause of mortality, morbidity, and poor quality of life. It is an area of active research. This article is aimed to give an update on recent advances in all aspects of this syndrome. Major changes occurred in drug treatment of HF with reduced ejection fraction (HFrEF). Sacubitril/valsartan is indicated as a substitute to ACEi/ARBs after PARADIGM-HF (hazard ratio [HR], 0.80; 95% confidence interval [CI], 0.73 to 0.87 for sacubitril/valsartan vs. enalapril for the primary endpoint and Wei, Lin and Weissfeld HR 0.79, 95% CI 0.71-0.89 for recurrent events). Its initiation was then shown as safe and potentially useful in studies in patients hospitalized for acute HF. More recently, DAPA-HF trial showed the beneficial effects of the sodium-glucose transporter type 2 (SGLT2) inhibitor dapaglifozin vs. placebo, added to optimal standard therapy [HR, 0.74; 95% CI, 0.65 to 0.85;0.74; 95% CI, 0.65 to 0.85 for the primary endpoint]. Trials with other SGLT 2 inhibitors and in other patients, such as those with HF with preserved ejection fraction (HFpEF) or with recent decompensation, are ongoing. Multiple studies showed the unfavourable prognostic significance of abnormalities in serum potassium levels. Potassium lowering agents may allow initiation and titration of mineralocorticoid antagonists in a larger proportion of patients. Meta-analyses suggest better outcomes with ferric carboxymaltose in patients with iron deficiency. Drugs effective in HFrEF may be useful also in HF with mid-range ejection fraction. Better diagnosis and phenotype characterization seem warranted in HF with preserved ejection fraction. These and other burning aspects of HFpEF research are summarized and reviewed in this article.A multiparametric approach is often proposed for risk stratification of HF patients. The prognostic accuracy of the metabolic exercise test data combined with cardiac and kidney indexes risk score was found as superior to the HF Survival Score and Seattle HF model risk scores in a cohort of 6112 1106 D. Tomasoni et al.

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Exercise and heart failure: an update

Cited by 158 publications

References 87 publications

Extracellular superoxide dismutase, a molecular transducer of health benefits of exercise

Extracellular superoxide dismutase, a molecular transducer of health benefits of exercise

Skeletal muscle wasting in chronic heart failure

Highlights in heart failure

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