Table Of ContentAdvances in Experimental Medicine and Biology 1000
Junjie Xiao Editor
Exercise for
Cardiovascular
Disease Prevention
and Treatment
From Molecular to Clinical, Part 2
Advances in Experimental Medicine
and Biology
Volume 1000
Editorial Board
IRUN R. COHEN, The Weizmann Institute of Science, Rehovot, Israel
ABEL LAJTHA, N.S. Kline Institute for Psychiatric Research,
Orangeburg, NY, USA
JOHN D. LAMBRIS, University of Pennsylvania, Philadelphia, PA, USA
RODOLFO PAOLETTI, University of Milan, Milan, Italy
More information about this series at http://www.springer.com/series/5584
Junjie Xiao
Editor
Exercise for Cardiovascular
Disease Prevention and
Treatment
From Molecular to Clinical, Part 2
Editor
Junjie Xiao
Cardiac Regeneration and Ageing Lab, School of Life Science
Shanghai University
Shanghai, China
ISSN 0065-2598 ISSN 2214-8019 (electronic)
Advances in Experimental Medicine and Biology
ISBN 978-981-10-4303-1 ISBN 978-981-10-4304-8 (eBook)
DOI 10.1007/978-981-10-4304-8
Library of Congress Control Number: 2017954329
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Contents
Part I Exercise Benefits the Heart: Clinical Evidence
1 Exercise Benefits Coronary Heart Disease ........................................... 3
Lei Wang, Dongmei Ai, and Ning Zhang
2 Exercise Exerts Its Beneficial Effects on Acute
Coronary Syndrome: Clinical Evidence ............................................... 9
Zhuyuan Liu, Huanyu Gu, Qiying Dai, Hongbao Wang,
Jianhua Yao, and Lei Zhou
3 Exercise-Based Rehabilitation for Heart Failure:
Clinical Evidence ..................................................................................... 31
Rongjing Ding
4 The Benefits of Exercise Training on Aerobic Capacity
in Patients with Heart Failure and Preserved Ejection Fraction ....... 51
Danilo Marcelo Leite do Prado and Enéas Antônio Rocco
5 Hypertension and Exercise Training: Evidence
from Clinical Studies .............................................................................. 65
Ivana C. Moraes-Silva, Cristiano Teixeira Mostarda,
Antonio Carlos Silva- Filho, and Maria Claudia Irigoyen
6 Effects of Exercise on Arrhythmia (and Viceversa):
Lesson from the Greek Mythology ........................................................ 85
Caterina Lambiase, Silvia Macerola, Giovanna Bosco,
Elisa Messina, and Pasquale Franciosa
7 Exercise and Congenital Heart Disease ................................................ 95
Junnan Wang and Bin Liu
8 The Positive Effects of Exercise in Chemotherapy-Related
Cardiomyopathy ...................................................................................... 103
Cavarretta Elena, Mastroiacovo Giorgio, Lupieri Annik,
Frati Giacomo, and Peruzzi Mariangela
v
vi Contents
9 Clinical Evidence of Exercise Benefits for Stroke ................................ 131
Peipei Han, Wen Zhang, Li Kang, Yixuan Ma, Liyuan Fu,
Liye Jia, Hairui Yu, Xiaoyu Chen, Lin Hou, Lu Wang, Xing Yu,
Masahiro Kohzuki, and Qi Guo
10 Evidence on Exercise Training in Pulmonary Hypertension .............. 153
Abraham Samuel Babu, Ross Arena, and Norman R. Morris
11 Peripheral Vascular Disease: The Beneficial Effect of Exercise
in Peripheral Vascular Diseases Based on Clinical Trials ................... 173
Basant M. Elnady and Ayman Saeed
Part II Molecular Mechanisms
12 The IGF1-PI3K-Akt Signaling Pathway in Mediating
Exercise-Induced Cardiac Hypertrophy and Protection ..................... 187
Kate L. Weeks, Bianca C. Bernardo, Jenny Y. Y. Ooi,
Natalie L. Patterson, and Julie R. McMullen
13 NO Signaling in the Cardiovascular System and Exercise ................. 211
Tiago Fernandes, Camila V. Gomes-Gatto, Noemy P. Pereira,
Yahya R. Alayafi, Vander J. das Neves, and Edilamar M. Oliveira
14 C/EBPB-CITED4 in Exercised Heart ................................................... 247
Shengguang Ding, Tianyi Gan, Meiyi Song, Qiying Dai,
Haitao Huang, Yiming Xu, and Chongjun Zhong
15 MicroRNAs Mediate Beneficial Effects of Exercise in Heart ............. 261
Yihua Bei, Lichan Tao, Dragos Cretoiu, Sanda Maria Cretoiu,
and Junjie Xiao
16 Exercise Training and Epigenetic Regulation:
Multilevel Modification and Regulation of Gene Expression ............. 281
Ursula Paula Renó Soci, Stephano Freitas Soares Melo,
João Lucas Penteado Gomes, André Casanova Silveira,
Clara Nóbrega, and Edilamar Menezes de Oliveira
17 Exercise-Induced Mitochondrial Adaptations
in Addressing Heart Failure ................................................................... 323
Jubert Marquez and Jin Han
18 Exosomes Mediate the Beneficial Effects of Exercise .......................... 333
Yangxin Li, Chaoshan Han, Juanjuan Wang, Jin Zhou,
Chun Liang, Kasturi Ranganna, and Yao-hua Song
Part III Exercise Dosing and Prescription
19 Exercise Dosing and Prescription-Playing It Safe: Dangers
and Prescription ...................................................................................... 357
Lei Wang, Dongmei Ai, and Ning Zhang
Part I
Exercise Benefits the Heart: Clinical
Evidence
Chapter 1
Exercise Benefits Coronary Heart Disease
Lei Wang, Dongmei Ai, and Ning Zhang
Abstract Coronary heart disease (CHD) is a group of diseases that include: no
symptoms, angina, myocardial infarction, ischemia cardiomyopathy and sudden
cardiac death. And it results from multiple risks factors consisting of invariable fac-
tors (e.g. age, gender, etc.) and variable factors (e.g. dyslipidemia, hypertension,
diabetes, smoking, etc.). Meanwhile, CHD could cause impact not only localized in
the heart, but also on pulmonary function, whole-body skeletal muscle function,
activity ability, psychological status, etc. Nowadays, CHD has been the leading
cause of death in the world. However, many clinical researches showed that exercise
training plays an important role in cardiac rehabilitation and can bring a lot of ben-
efits for CHD patients.
Keywords Coronary heart disease • Exercise • Rehabilitation
1 Side-Effect of Lacking Exercise
Even for normal people, lacking of exercise can cause many negative consequences.
With the atrophy of muscle fibers, the reduction of muscle power and the muscle mass,
the oxidation capacity of muscle decrease at the same time. Research showed that with
the increase of age every year, oxygen consumption decrease by 0.1MET, indicating
that physical fitness level decreases when age increases [1]. Another study showed that
oxygen uptake will have a reduction of 0.2 MET for 1-day bed rest, indicating that bed
L. Wang (*)
Department of Rehabilitation Medicine, Second Medical School of Nanjing University of
Chinese Medicine, Nanjing, China
e-mail: [email protected]
D. Ai
Department of Rehabilitation Medicine, Nanjing Drum Tower Hospital, the Affiliated
Hospital of Nanjing University Medical School, Nanjing, China
N. Zhang
Department of Cardiology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing
University Medical School, Nanjing, China
© Springer Nature Singapore Pte Ltd. 2017 3
J. Xiao (ed.), Exercise for Cardiovascular Disease Prevention and Treatment,
Advances in Experimental Medicine and Biology 1000,
DOI 10.1007/978-981-10-4304-8_1
4 L. Wang et al.
rest has a negative effect on cardiovascular function [2]. So, what about CHD patients?
Lacking exercise can cause tachycardia, orthostatic hypotension and increased risks of
thromboembolism. Elderly patients would have a reduction in muscle groups and
physical function. If VO (maximum oxygen uptake) is too low to complete daily
2max
activities (the impaired ability to cross street safely, go up the stairs, stand up from
chairs or toilet), the quality of life will have a dramatic decline for the elderly.
2 Beneficial Effects of Exercise on Coronary Heart Disease
2.1 Aerobic Exercise
Aerobic exercise, the most studied and recommended modality, with a beneficial
dose-response effect on prognosis [3, 4, 5], consists of movements of large muscle
mass in rhythmic manner for a sustained period. The aerobic exercise includes
everyday activity, for instance, active travel (cycling or walking), heavy household
work, gardening, occupational activity, leisure time activity, or exercise such as
brisk walking, Nordic walking, hiking, jogging or running, cycling, cross-country
skiing, aerobic dancing, skating, rowing or swimming. Similar to all other interven-
tions, its prescription can be adjusted in terms of frequency, duration and intensity
[6]. However, to achieve the most optimized beneficial effect, patients with CHD
should get individualized prescription. So, what beneficial effects can aerobic exer-
cise bring for CHD?
2.1.1 Improved Heart Functions
Aerobic exercise training could increase the diameter and the elasticity of coronary
arteries, improve endothelium function to optimize the structure and function of
coronary arteries, facilitate the establishment of coronary collateral circulation,
compensate adaption of improved blood supply for coronary arteries and stabilize
coronary arteries clots. In addition, it can increase blood flow and reduce new patho-
logical changes. Study showed that long-term regular aerobic exercise can improve
physical function and decrease heart rate, SBP (systolic blood pressure), RPP (heart
rate-blood pressure product), myocardial oxygen consumption, and increase the
threshold of exercise-induced myocardial ischemia during submaximal exercise [7].
Moreover, aerobic exercise training after MI (myocardial infarction) has also been
suggested to improve ventricular function and attenuate ventricular remodeling.
Patients with an initial Q-wave MI and a left ventricular ejection fraction <10% in
the ELVD (Exercise and Left Ventricular Dysfunction) trial received 6 months of
exercise training. There was a resultant increase in both exercise capacity and left
ventricular ejection fraction (34–38%) [8].
