The impact of cardiomotor rehabilitation on endothelial function in elderly patients with chronic heart failure

Abstract

Background To explore the effects of cardiac exercise rehabilitation on peripheral blood endothelial progenitor cells (EPC) in elderly patients with chronic heart failure. Methods 80 elderly patients with chronic heart failure were selected from March 2017 to March 2019 and randomly divided into two groups (N = 40). The control group was treated routinely and walked freely for 30–60 min every day. The patients in the exercise rehabilitation group developed a cardiac exercise rehabilitation plan. Then, cardiac function and peripheral blood B-natriuretic peptide (BNP) levels in the two groups were compared. The cell viability, proliferation, apoptosis, and invasion ability of EPCs were detected. The levels of the PI3K/AKT pathway and eNOS and VEGF were compared. Results There were no significant differences in all indexes between the two groups before treatment (P > 0.05), and both improved significantly after treatment (P < 0.05). After treatment, LVEF and LVFS in the exercise rehabilitation group were significantly higher than those in the control group (P < 0.05), and LVEDD and LVESD were significantly lower than those in the control group (P < 0.05). The BNP level in the exercise rehabilitation group was significantly lower than that in the control group (P < 0.05). The cell viability, proliferation, invasion ability of EPC, and the levels of PI3K, AKT, eNOS, and VEGF mRNA and protein in the exercise rehabilitation group were significantly higher than those in the control group. Apoptosis rate was significantly lower than those in the control group (P < 0.05). Conclusions Visceral exercise rehabilitation can improve cardiac ejection and myocardial function in elderly patients with chronic heart failure, and can promote the vitality, proliferation, and invasion of peripheral blood EPC, and promote the expression of eNOS and VEGF by upregulating the PI3K/AKT pathway to promote angiogenesis and endothelial function.

Exercise Training Effects on Circulating Endothelial and Progenitor Cells in Heart Failure

“…The effect of exercise training on EPCs and CECs has been previously assessed in patients with chronic HF. During the last two decades many researchers have investigated the impact of a multi-session exercise training program on EPCs in HF [ 85 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 ]. The first investigators who evaluated the effect of a regular aerobic exercise training program were Sarto P. et al [ 90 ].…”

“…Functional capacity assessed by peak VO2 and angiogenetic markers such as VEGF were also improved after the training program [ 85 ]. In another interesting study, Chen J. et al [ 97 ] evaluated the effects of exercise training on cardiac function, B-natriuretic peptide (BNP) levels, cell viability, proliferation, apoptosis, and invasion ability of EPCs, eNOS, and VEGF in 80 elderly patients with chronic HF. The training group performed cardiac exercise rehabilitation for 12 weeks, 3–5 times a week while the control group only performed simple exercises at the bedside or indoors and walked freely for 30–60 min per day [ 97 ].…”

“…In another interesting study, Chen J. et al [ 97 ] evaluated the effects of exercise training on cardiac function, B-natriuretic peptide (BNP) levels, cell viability, proliferation, apoptosis, and invasion ability of EPCs, eNOS, and VEGF in 80 elderly patients with chronic HF. The training group performed cardiac exercise rehabilitation for 12 weeks, 3–5 times a week while the control group only performed simple exercises at the bedside or indoors and walked freely for 30–60 min per day [ 97 ]. Through their results, it was shown that exercise training improved myocardial function and promoted angiogenesis and endothelial function via the improvement of the vitality, proliferation, and invasion of peripheral blood EPCs, and the expression of eNOS and VEGF through the upregulation of the PI3K/AKT pathway [ 97 ].…”

“…The training group performed cardiac exercise rehabilitation for 12 weeks, 3–5 times a week while the control group only performed simple exercises at the bedside or indoors and walked freely for 30–60 min per day [ 97 ]. Through their results, it was shown that exercise training improved myocardial function and promoted angiogenesis and endothelial function via the improvement of the vitality, proliferation, and invasion of peripheral blood EPCs, and the expression of eNOS and VEGF through the upregulation of the PI3K/AKT pathway [ 97 ].…”

Endothelial Function Assessment by Flow-Mediated Dilation Method: A Valuable Tool in the Evaluation of the Cardiovascular System

“…More advanced methods include the assessment of glycocalyx using atomic force microscopy [ 23 ], the assessment of endothelial progenitor cells in peripheral blood [ 24 ], or the study of endothelial cells carried out in cell culture [ 25 ].…”