Exercise and Cardioprotection: A Natural Defense Against Lethal Myocardial Ischemia–Reperfusion Injury and Potential Guide to Cardiovascular Prophylaxis

Abstract

Similar to ischemic preconditioning, high-intensity exercise has been shown to decrease infarct size following myocardial infarction. In this article, we review the literature on beneficial effects of exercise, exercise requirements for cardioprotection, common methods utilized in laboratories to study this phenomenon, and discuss possible mechanisms for exercise-mediated cardioprotection.

Recent Advances in Pharmacological and Non-Pharmacological Strategies of Cardioprotection

“…Several studies have indicated that regular practice of physical exercise constitutes a physiological condition that can potentially stimulate the cardioprotective response [51,52,53]. It is well established that moderate exercise is an effective and economic way to prevent and treat cardiovascular diseases, because exercise induces cardiac hypertrophy and neo-angiogenesis, essential determinants for cardioprotection [51,52,53]. Similar to ischemic preconditioning, the practice of moderate (1 to 3 episodes of exercises per week) and high-intensity exercise can decrease infarct size following myocardial infarction [51,52,53].…”

“…It is well established that moderate exercise is an effective and economic way to prevent and treat cardiovascular diseases, because exercise induces cardiac hypertrophy and neo-angiogenesis, essential determinants for cardioprotection [51,52,53]. Similar to ischemic preconditioning, the practice of moderate (1 to 3 episodes of exercises per week) and high-intensity exercise can decrease infarct size following myocardial infarction [51,52,53]. It has been proposed that moderate exercise induces the intracellular IGF-1-PI3K-Akt, NO, C/EBPβ, and PGC-1α signaling pathways, promoting protection against cardiac ischemic disease, cardiac aging and cardiac metabolic derangement [54].…”

Exercise Training and Cardiac Remodeling

“…Regarding the intensity of exercise, this may influence cardiovascular responses [22]. However, an optimal intensity for cardioprotection is not yet known [5]. In healthy individuals, cardiovascular changes seem to be more significant when subjected to the most intense effort [23].…”

“…In healthy individuals, cardiovascular changes seem to be more significant when subjected to the most intense effort [23]. Although high intensities have shown important outcomes for cardiovascular health, such as improved endothelial function, individuals with CVD need greater care in the assessment and prescription of intense exercise [5].…”

“…Among the cardiovascular benefits of exercise, it is possible to observe blood pressure reductions, resting bradycardia, and greater efficiency of the cardiovascular system [4]. Also, cardioprotective factors are observed with exercise training such as the reduction of the magnitude of myocardial infarction [5], through different mechanisms, such as reduction of the inflammatory process, molecular regulation, as well as control of the pathological cardiac hypertrophy [5]. However, not every exercise stimulus promotes the same responses.…”