Unraveling new mechanisms of exercise intolerance in chronic heart failure: role of exercise training.
Heart Fail Rev
; 18(1): 65-77, 2013 Jan.
Article
en En
| MEDLINE
| ID: mdl-22684340
ABSTRACT
Despite remarkable progress in the therapeutic approach of patients with chronic heart failure (CHF), exercise intolerance remains one of the hallmarks of the disease. During the past two decades, evidence has accumulated to underscore the key role of both endothelial dysfunction and skeletal muscle wasting in the process that gradually leads to physical incapacity. Whereas reverse ventricular remodeling has been attributed to aerobic exercise training, the vast majority of studies conducted in this specific patient population emphasize the reversal of peripheral abnormalities. In this review, we provide a general overview on underlying pathophysiological mechanisms. In addition, emphasis is put on recently identified pathways, which contribute to a deeper understanding of the main causes of exercise tolerance and the potential for reversal through exercise training. Recently, deficient bone marrow-related endothelial repair mechanisms have received considerable attention. Both acute exercise bouts, as well as exercise training, affect the mobilization of endothelial progenitor cells and their function. The observed changes following exercise training are believed to significantly contribute to improvement of peripheral endothelial function, as well as exercise capacity. With regard to skeletal muscle dysfunction and energy deprivation, adiponectin has been suggested to play a significant role. The demonstration of local skeletal muscle adiponectin resistance may provide an interesting and new link between the insulin resistant state and skeletal muscle wasting in CHF patients.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Tolerancia al Ejercicio
/
Debilidad Muscular
/
Terapia por Ejercicio
/
Insuficiencia Cardíaca
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Heart Fail Rev
Asunto de la revista:
CARDIOLOGIA
Año:
2013
Tipo del documento:
Article
País de afiliación:
Bélgica