The Role of Exercise-Induced Molecular Processes and Vitamin D in Improving Cardiorespiratory Fitness and Cardiac Rehabilitation in Patients With Heart Failure

Abstract

Heart failure (HF) still affects millions of people worldwide despite great advances in therapeutic approaches in the cardiovascular field. Remarkably, unlike pathological hypertrophy, exercise leads to beneficial cardiac hypertrophy characterized by normal or enhanced contractile function. Exercise-based cardiac rehabilitation improves cardiorespiratory fitness and, as a consequence, ameliorates the quality of life of patients with HF. Particularly, multiple studies demonstrated the improvement in left ventricular ejection fraction (LVEF) among patients with HF due to the various processes in the myocardium triggered by exercise. Exercise stimulates IGF-1/PI3K/Akt pathway activation involved in muscle growth in both the myocardium and skeletal muscle by regulating protein synthesis and catabolism. Also, physical activity stimulates the activation of the mitogen-activated protein kinase (MAPK) pathway which regulates cellular proliferation, differentiation and apoptosis. In addition, emerging data pointed out the anti-inflammatory effects of exercises as well. Therefore, it is of utmost importance for clinicians to accurately evaluate the patient’s condition by performing a cardiopulmonary exercise test and/or a 6-min walking test. Portable devices with the possibility to measure exercise capacity proved to be very useful in this setting as well. The aim of this review is to gather together the molecular processes triggered by the exercise and available therapies in HF settings that could ameliorate heart performance, with a special focus on strategies such as exercise-based cardiac rehabilitation.

Long-term effect of SARS-CoV-2 infection on cardiovascular outcomes and all-cause mortality

“…At the beginning of the pandemic, epidemiologic studies showed that individuals of advanced age, male gender, and with preexisting illnesses such as cancer or cardiovascular diseases (CVD), metabolic disorders, diabetes, and obesity, were at higher risk of developing complications and severe forms of COVID-19, and were associated with unfavorable outcomes [5] . CVD is one of the leading causes of mortality in the world, whose prevalence is growing due to the aging population and the increase in age-related diseases such as diabetes mellitus, obesity, dyslipidemia, and hypertension, which are risk factors for heart disease [6] . In addition, poor life choices such as inadequate diet and sedentary lifestyle coupled with stress contribute to an even greater number of CVD cases [6] .…”

“…CVD is one of the leading causes of mortality in the world, whose prevalence is growing due to the aging population and the increase in age-related diseases such as diabetes mellitus, obesity, dyslipidemia, and hypertension, which are risk factors for heart disease [6] . In addition, poor life choices such as inadequate diet and sedentary lifestyle coupled with stress contribute to an even greater number of CVD cases [6] . The reason why patients with CVD are generally prone to develop severe forms of infective disorders lies in the already present impaired endothelial function and activity, deteriorated immune response and platelet hyperreactivity [7] , [8] .…”

The Combined Effect of Resistance Training and Vitamin D Supplement on Skeletal Muscle Hypertrophy: A Review

“…However, during this rigorous evaluation, it became evident that certain articles needed to be excluded for specific reasons. For example, 1 article focused primarily on the human heart rather than skeletal muscle (15), which did not align with the objectives of the present study. Additionally, several articles did not directly address the topic of hypertrophy (18,19,29).…”