Bernstein, Daniel. Exercise assessment of transgenic models of human cardiovascular disease. Physiol Genomics 13: 217-226, 2003; 10.1152/ physiolgenomics.00188.2002.-Exercise provides one of the most severe, yet physiological, stresses to the intact cardiovascular system and is a major determinant of the utilization of metabolic substrates. The adaptations to exercise are the result of a coordinated response of multiple organ systems, including cardiovascular, pulmonary, endocrine-metabolic, immunologic, and skeletal muscle. With the proliferation of genetically altered murine models of cardiovascular disease, the importance of developing methods of accurate physiological phenotyping is critical. There are numerous examples of transgenic models in which the baseline cardiovascular phenotype is unchanged or minimally changed from the wild type, only to become manifest during the stress of exercise testing. In this review, we cover the basics of the murine cardiovascular response to exercise and the importance of attending to strain differences, compare different exercise methodologies (constant workload treadmill, incremental workload treadmill, swimming) and hemodynamic monitoring systems, and examine the murine response to exercise conditioning. Several examples where exercise studies have contributed to the elucidation of cardiovascular phenotypes are reviewed: the -adrenergic receptor knockouts, phospholamban knockout, dystrophin knockout (mdx), and the mutant ␣-myosin heavy chain (R403Q) transgenic.-adrenergic receptor knockout; skeletal muscle; phospholamban knockout; dystrophin knockout; mutant ␣-myosin heavy chain transgenic OVER THE PAST DECADE, there has been a proliferation of genetically modified animal models of human cardiovascular disease. Despite adaptation of transgenic technology to larger mammals, the mouse remains the most commonly used species for transgenic studies and continues to be the only species in which targeted genetic deletions are possible. The addition of technologies allowing tissue-specific knockouts as well as the ability to turn gene expression on and off again at will enhances our ability to study genetic regulation of the cardiovascular system. Some phenotypes, however, may be extremely subtle. Thus thorough evaluation of genetically altered murine models requires the ability to study all components of murine cardiovascular physiology. The development of techniques allowing the evaluation of mice in an awake, unrestrained state has advanced the study of true resting cardiovascular dynamics and has also allowed the introduction of exercise testing to study cardiovascular response during stressed states. Exercise studies provide valuable information about how the cardiovascular system responds under maximally stimulated conditions, with the possibility of uncovering phenotypes not observed at rest. Given the expense and time involved in creating genetically altered murine models of human cardiovascular disease, it is not unreasonable to suggest that most if not all models s...