Effects of exercise training on neurovascular control and skeletal myopathy in systolic heart failure

Author(s)

Negrao, Carlos E. ^{[1, 2]} ; Middlekauff, Holly R. ^[3] ; Gomes-Santos, Igor L. ^[1] ; Antunes-Correa, Ligia M. ^[1]

Affiliation

^[1] Univ Sao Paulo, Sch Med, Heart Inst InCor, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Sch Phys Educ & Sport, Sao Paulo - Brazil

^[3] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med Cardiol & Physiol, Los Angeles, CA 90095 - USA

• Document type: Review article
• Source: AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY; v. 308, n. 8, p. H792-H802, APR 15 2015.
• Web of Science Citations: 19

Abstract

Neurohormonal excitation and dyspnea are the hallmarks of heart failure (HF) and have long been associated with poor prognosis in HF patients. Sympathetic nerve activity (SNA) and ventilatory equivalent of carbon dioxide (VE/VO2) are elevated in moderate HF patients and increased even further in severe HF patients. The increase in SNA in HF patients is present regardless of age, sex, and etiology of systolic dysfunction. Neurohormonal activation is the major mediator of the peripheral vasoconstriction characteristic of HF patients. In addition, reduction in peripheral blood flow increases muscle inflammation, oxidative stress, and protein degradation, which is the essence of the skeletal myopathy and exercise intolerance in HF. Here we discuss the beneficial effects of exercise training on resting SNA in patients with systolic HF and its central and peripheral mechanisms of control. Furthermore, we discuss the exercise-mediated improvement in peripheral vasoconstriction in patients with HF. We will also focus on the effects of exercise training on ventilatory responses. Finally, we review the effects of exercise training on features of the skeletal myopathy in HF. In summary, exercise training plays an important role in HF, working synergistically with pharmacological therapies to ameliorate these abnormalities in clinical practice. (AU)

• FAPESP's process: 10/50048-1 - Cellular and functional bases of exercise in cardiovascular diseases
• Grantee: Carlos Eduardo Negrão
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 13/15651-7 - Effects of Aerobic Exercise Training Associated with Inspiratory Muscle Training on Skeletal Myopathy in Patients with Heart Failure
• Grantee: Lígia de Moraes Antunes Corrêa
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 14/13690-8 - Role of exercise training on prevention of cardiotoxicity provoked by doxorubicin
• Grantee: Igor Lucas Gomes dos Santos
• Support Opportunities: Scholarships in Brazil - Post-Doctoral