Circulating microRNAs as emerging cardiac biomarkers responsive to acute exercise.

BACKGROUND: Circulating microRNAs (c-miRNAs) are mediators of intercellular communication with great potential as cardiac biomarkers. The analysis of c-miRNAs in response to physiological stress, such as exercise, would provide valuable information for clinical practice and a deeper understanding of the molecular response to physical activity. Here, we analysed for the first time the acute exercise response of c-miRNAs reported as biomarkers of cardiac disease in a well-characterized cohort of healthy active adults. METHODS: Blood samples were collected immediately before and after (0 h, 24 h, 72 h) a 10-km race, a half-marathon (HM) and a marathon (M). Serum RNA from 10-km and M samples was extracted and a panel of 74 miRNAs analysed using RT-qPCR. c-miRNA response was compared with a panel of nine cardiac biomarkers. Functional enrichment analysis was performed. Pre- and post-M echocardiographic analyses were carried out. RESULTS: Serum levels of all cardiac biomarkers were upregulated in a dose-dependent manner in response to exercise, even in the absence of symptoms or signs of cardiac injury. A deregulation in the profiles of 5 and 19 c-miRNAs was observed for 10-km and M, respectively. Each race induced a specific qualitative and quantitative alteration of c-miRNAs implicated in cardiac adaptions. Supporting their discriminative potential, a number of c-miRNAs previously associated with cardiac disease were undetectable or stable in response to exercise. Conversely, "pseudo-disease" signatures were also observed. CONCLUSIONS: c-miRNAs may be useful for the management of cardiac conditions in the context of acute aerobic exercise. TRANSLATIONAL ASPECTS OF THE WORK: Circulating microRNAs could offer incremental diagnostic value to established and emerging cardiac biomarkers, such as hs-cTnT or NT-proBNP, in those patients with cardiac dysfunction symptoms after an acute bout of endurance exercise. Furthermore, circulating miRNAs could also show "pseudo-disease" signatures in response to acute exercise. Clinical practitioners should be aware of the impact caused by exercise in the interpretation of miRNA data.

[Exercise as the cornerstone of cardiovascular prevention]. / Ejercicio, piedra angular de la prevención cardiovascular.

Lack of physical activity in the general population is a public health problem and is recognized as an independent risk factor for the development of coronary disease. The relative risk of inactivity is similar to that of hypertension, hypercholesterolemia and smoking. Consequently, a sedentary lifestyle is associated with a concurrent increase in cardiovascular disease. Engaging regularly in mild-to-moderate physical exercise results in a range of physiological adaptations that are beneficial for health. Various studies have demonstrated that there is an inverse relationship between regular exercise and the risk of coronary heart disease, cardiac events and death. Exercise improves the lipid profile and glycemic control, reduces or prevents hypertension, obesity and stress, and promotes fitness and longevity. However, most evidence for the benefits of exercise comes from observational studies and, although maximum oxygen uptake and the duration of exercise on an exercise stress test are powerful predictors of mortality, there is no agreement on the quantity or intensity of the physical activity needed for primary or secondary prevention. On the other hand, although there is a temporarily increased risk of acute myocardial infarction during exhaustive exercise, the balance of risks and benefits is strongly in favor of the benefits because there is a minimum threshold for the weekly energy expenditure required to reduce cardiovascular risk.

[Cardiovascular prevention and cardiac rehabilitation]. / Prevención cardiovascular y rehabilitación cardiaca.

This article contains a review of the main developments in cardiovascular disease prevention reported during the last year. In addition, the most recent clinical practice guidelines are also discussed. The aims of cardiovascular prevention are to reduce mortality and morbidity in individuals at a high risk and to help those at a low risk to maintain their status. Lifestyle modification and the reduction of modifiable cardiovascular risk factors are key to cardiovascular disease prevention. The implementation of clinical practice guidelines provides the primary means of achieving these goals.