New insights about the putative role of myokines in the context of cardiac rehabilitation and secondary cardiovascular prevention

Abstract

Exercise training prevents the onset and the development of many chronic diseases, acting as an effective tool both for primary and for secondary prevention. Various mechanisms that may be the effectors of these beneficial effects have been proposed during the past decades: some of these are well recognized, others less. Muscular myokines, released during and after muscular contraction, have been proposed as key mediators of the systemic effects of the exercise. Nevertheless the availability of an impressive amount of evidence regarding the systemic effects of muscle-derived factors, few studies have examined key issues: (I) if skeletal muscle cells themselves are the main source of cytokine during exercise; (II) if the release of myokines into the systemic circulation reach an adequate concentration to provide significant effects in tissues far from skeletal muscle; (III) what may be the role carried out by muscular cytokine regarding the well-known benefits induced by regular exercise, first of all the anti-inflammatory effect of exercise. Furthermore, a greater part of our knowledge regarding myokines derives from the muscle of healthy subjects. This knowledge may not necessarily be transferred per se to subjects with chronic diseases implicating a direct or indirect muscular dysfunction and/or a chronic state of inflammation with persistent immune-inflammatory activation (and therefore increased circulating levels of some cytokines): cachexia, sarcopenia due to multiple factors, disability caused by neurological damage, chronic congestive heart failure (CHF) or coronary artery disease (CAD). A key point of future studies is to ascertain how is modified the muscular release of myokines in different categories of unhealthy subjects, both at baseline and after rehabilitation. The purpose of this review is to discuss the main findings on the role of myokines as putative mediators of the therapeutic benefits obtained through regular exercise in the context of secondary cardiovascular prevention.

Treatment models of cardiac rehabilitation in patients with coronary heart disease and related factors affecting patient compliance

“…CR can be divided into three stages: the first stage begins during hospitalization and consists of early mobilization, assessment, and rehabilitation guidance. The second stage is the outpatient rehabilitation period (2-6 weeks after discharge) (Di et al, 2017). Based on the cardiopulmonary function evaluation of patients, individualized exercise prescription is formulated to guide patients in participating in regular rehabilitation exercise in the hospital, while lifestyle and drug treatment are managed simultaneously.…”

Inflammation associated with chronic heart failure leads to enhanced susceptibility to depression

“…Immuno‐inflammatory mechanisms have been implicated in the initiation and progression of HF during the past two decades . Therefore, we analyzed the inflammatory gene expression in the heart.…”

Pathophysiology of Peripheral Arterial Disease (PAD): A Review on Oxidative Disorders

“…Concerning the positive activities of the PE, it was recently proposed that the protective effects of PE could also be attributed to the muscular release of the peptides called “myokines”. These molecules, secreted during skeletal muscle contraction, may trigger specific metabolic pathways in different tissues and organs far from the muscle allowing to communicate with many organs such as visceral fat, bone, liver, and nervous system, among others [ 20 , 21 ].…”