Exercise training in chronic heart failure: mechanisms and therapies

Piepoli, Massimo F

doi:10.1007/s12471-012-0367-6

Cited by 45 publications

(43 citation statements)

References 38 publications

(32 reference statements)

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“…New integrative therapeutic strategies in neurocardiology can offer different perspectives for vagal nerve stimulation on renal denervation practice in neurologic patients [66][67][68][69][70]. Our data aims to strengthen the need of careful cardio-vascular monitoring of these fragile patients, by including in routine clinical protocols, autonomic activity markers as reliable predictors for potentially lifethreatening, but preventable events.…”

Section: Therapeutic Perspectivesmentioning

confidence: 92%

Cortical lateralization and cardiac autonomic control. Insights from insular stroke and epilepsy

Constantinescu¹,

Detante²,

Matei³

et al. 2017

Arch Clin Cases

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Autonomic nervous system dysfunction is a common complication of stroke. Human studies and experimental data showed a hemispheric lateralization of autonomic activity concerning the forebrain and particularly the insular cortex. Insular cortex involvement is associated with more pronounced autonomic imbalance leading to life threatening arrhythmias and sudden death. We present two case reports of insular infarction in young patients without any cardiac comorbidity, illustrating a specific lateralized function of insula and its influence on the sympatho-vagal balance that implied differentiated therapeutic management after stroke. The right insular stroke was associated to sympathetic activation and left insular stroke was associated to parasympathetic predominance. The same lateralization of autonomic function with opposite effects on sympatho-vagal balance was also reported in two insular epilepsy cases, illustrating the fact that, beyond the controlling network, the cortical modulation of the autonomic nervous system is asymmetric. Identifying high risk patients prone to develop neurogenic cardiac complications, by better understanding of dysautonomia pathophysiology and consequent implementation of prophylactic and therapeutic interventions may significantly reduce mortality rate in stroke and epilepsy.

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Section: Therapeutic Perspectivesmentioning

confidence: 92%

Cortical lateralization and cardiac autonomic control. Insights from insular stroke and epilepsy

Constantinescu¹,

Detante²,

Matei³

et al. 2017

Arch Clin Cases

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“…Furthermore, physical training can have beneficial effects on neurohumoral, inflammatory, metabolic and central hemodynamic responses and on endothelial, skeletal muscle and cardiovascular functions in CHF patients (9). Regular physical training is closely associated with increases in myocardial perfusion and metabolism and the normalization of the sympathetic-parasympathetic balance, which decrease oxidative stress.…”

Section: Introductionmentioning

confidence: 99%

Aerobic exercise improves the inflammatory profile correlated with cardiac remodeling and function in chronic heart failure rats

Nunes¹,

Alves²,

Kessler³

et al. 2013

Clinics

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OBJECTIVE:The aim of the present study was to evaluate the effect of 8 weeks of aerobic exercise training on cardiac functioning and remodeling and on the plasma levels of inflammatory cytokines in chronic heart failure rats.METHODS:Wistar rats were subjected to myocardial infarction or sham surgery and assigned to 4 groups: chronic heart failure trained (n = 7), chronic heart failure sedentary (n = 6), sham trained (n = 8) and sham sedentary (n = 8). Four weeks after the surgical procedures, the rats were subjected to aerobic training in the form of treadmill running (50 min/day, 5 times per week, 16 m/min). At the end of 8 weeks, the rats were placed under anesthesia, the hemodynamic variables were recorded and blood samples were collected. Cardiac hypertrophy was evaluated using the left ventricular weight/body weight ratio, and the collagen volume fraction was assessed using histology.RESULTS:The chronic heart failure trained group showed a reduction in left ventricular end-diastolic pressure, a lower left ventricular weight/body weight ratio and a lower collagen volume fraction compared with the chronic heart failure sedentary group. In addition, exercise training reduced the plasma levels of TNF-α and IL-6 and increased the plasma level of IL-10.CONCLUSION:An 8-week aerobic exercise training program improved the inflammatory profile and cardiac function and attenuated cardiac remodeling in chronic heart failure rats.

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“…In this respect, vagal stimulation, exercise training, electrical neurostimulation, music therapy, and -recently-renal denervation have become interesting options in the treatment of angina pectoris, heart failure, and hypertension [21][22][23][24][25][26]. Various patient groups (psychological distress, atrial fibrillation, heart failure, post-CABG) may benefit when the appropriate mechanisms of the interrelation between the nervous system, brain and heart become elucidated [27].…”

mentioning

confidence: 99%