Exercise for Cardiovascular Disease Prevention and Treatment: From Molecular to Clinical, Part 2 (Advances in Experimental Medicine and Biology, 1000)

The book provides an intensive overview on exercise for cardiovascular disease prevention and treatment, from basic research to clinical practice. The volume firstly summarizes the acute and chronic response to exercise. Secondly, evidence for exercise as medicine for the heart based on clinical studies and basic research is summarized. Thirdly, molecular mechanisms mediating the beneficial effects of exercise including IGF-1-PI3K-AKT signalling, NO signalling, C/EBPB-Cited4 signalling, Non-coding RNAs, epigenetic regulators, mitochondria adaption and exosomes are presented. Finally, exercise dosing, prescription and future prospects are provided. This book will provide valuable reference for researchers in cell biology, physiology, as well as physician, physical therapist in cardiology, sport medicine, etc. Contents Part I: Exercise Benefits the Heart: Clinical Evidence Chapter 1: Exercise Benefits Coronary Heart Disease 1 Side-Effect of Lacking Exercise 2 Beneficial Effects of Exercise on Coronary Heart Disease 2.1 Aerobic Exercise 2.1.1 Improved Heart Functions 2.1.2 Increase Exercise Capacity 2.1.3 Reduce Risk Factors of CHD 2.1.4 Reduce the Incidence Rate, Complication, Recurrence Rate, Mortality of CHD 2.2 Resistance Exercise 2.3 Flexibility Exercise References Chapter 2: Exercise Exerts Its Beneficial Effects on Acute Coronary Syndrome: Clinical Evidence 1 Introduction 2 Pathophysiology of Acute Coronary Syndrome 3 Exercise and Cardiovascular System 3.1 Effects of Cardiac Disease on Exercise Performance 3.2 Effects of Exercise on Cardiovascular System 3.2.1 Biological Effects of Exercise in the Healthy People Biological Effects of Dynamic Exercise Biological Effects of Isometric Exercise 3.2.2 Biological Effects of Exercise in Coronary Artery Disease Biological Effects of Dynamic Exercise Biological Effects of Isometric Exercise 3.2.3 Biological Effects of Training Biological Effects of Dynamic Exercise Biological Effects of Isometric Exercise Training 4 Exercise and Acute Coronary Syndrome 4.1 General Concept 4.2 Exercise in Angina Pectoris 4.3 Exercise in Myocardial Infarction 4.4 Exercise-Based Cardiac Rehabilitation 4.4.1 Historical Perspective 4.4.2 Effect of Exercised-Based Cardiac Rehabilitation on Patients with Acute Coronary Syndrome 5 Conclusion References Chapter 3: Exercise-Based Rehabilitation for Heart Failure: Clinical Evidence 1 Exercise Prescription 2 Evidence on Effects of Exercise 2.1 For Heart Failure with Reduced Ejection Fraction 2.1.1 Aerobic Training Effect on Hemodynamics Effect on Skeletal Muscle Health-Related Quality of Life Psychological Factor Mortality and Hospital Readmission Cost-Effectiveness Analysis Effect of Intensity and Volume of Aerobic Training 2.1.2 Resistive Training 2.1.3 Inspiratory Muscle Training 2.2 For Heart Failure with Preserved Ejection Fraction 2.3 For End-Stage Heart Failure References Chapter 4: The Benefits of Exercise Training on Aerobic Capacity in Patients with Heart Failure and Preserved Ejection Fraction 1 Introduction 2 Aerobic Capacity in HFpEF Patients 2.1 What Are the Physiological Mechanisms Related to Reduced Aerobic Capacity in HFpEF Patients? 3 The Effects of Exercise Training in HFpEF Patients 3.1 What Are the Physiological Mechanisms Underlie Increased Aerobic Capacity in HFpEF Patients After Aerobic Exercise Training? 4 Cardiovascular Rehabilitation: A Practical Approach 4.1 Comments 5 Exercise Training Recommendations 5.1 Aerobic Exercise 5.2 Resistance Training 5.3 Safety of Cardiovascular Rehabilitation Program 6 Summary References Chapter 5: Hypertension and Exercise Training: Evidence from Clinical Studies 1 Pathophysiology of Primary Hypertension 2 Anaerobic Exercise Training 2.1 Recommendations for Resistance Training Prescription 3 Aerobic Exercise Training 3.1 Recommendations for Aerobic Exercise 4 Other Modalities of Exercise Training 4.1 Respiratory Training 4.2 Tai chi 4.3 Yoga 4.4 Pilates 5 Exercise Training and Pharmacological Interactions in Hypertension 5.1 Diuretics 5.2 Angiotensin-Converting Enzyme Inhibitors (ACEi) 5.3 Angiotensin Receptor 1 (AT1) Blockers 5.4 Central Alpha 2 Agonists 5.5 Vasodilators 5.6 Calcium Channel Blockers 5.7 Beta-Blockers 6 Conclusions References Chapter 6: Effects of Exercise on Arrhythmia (and Viceversa): Lesson from the Greek Mythology 1 Arrhythmia and Exercise: Can We Accept the Risk? 2 Arrhythmias and Customized Exercise Indications 3 Supraventricular Arrhythmias 4 Current Suggestions and Concluding Remarks References Chapter 7: Exercise and Congenital Heart Disease 1 Introduction 2 Benefit of Exercise in CHD 3 Safety of Exercise in CHD 3.1 Assessment 3.2 Recommendations References Chapter 8: The Positive Effects of Exercise in Chemotherapy-Related Cardiomyopathy 1 Introduction 2 Chemotherapeutic Drugs Involved in Cardiotoxicity 2.1 Anthracyclines 2.2 Trastuzumab 2.3 Other Chemotherapeutic Drugs Causing Cardiotoxicity 3 Screening for Chemotherapy-Induced Cardiomyopathy 3.1 Diagnostic Tools for the Detection of Chemotherapy-­Induced Cardiomyopathy 4 Treatment of Chemotherapy-Induced Cardiomyopathy 5 Benefits of Exercise in Cancer Patients 6 Molecular Basis of Exercise Benefit in Chemotherapy-­Induced Cardiomyopathy 7 Clinical Studies 8 Exercise Prescription 9 Conclusion References Chapter 9: Clinical Evidence of Exercise Benefits for Stroke 1 Benefits of Aerobic Exercise in Post-Stroke Patients 1.1 Cardiorespiratory Fitness 1.2 Cognitive Function 1.3 Functional Performance 1.3.1 Balance 1.3.2 Walking Speed 1.3.3 Endurance 2 Benefits of Strength Exercise 2.1 Improve Muscle Strength and Endurance 2.2 Improve Walking Performance and Balance 2.3 Improve Functional Outcomes 2.4 Other Exercise Benefit Aspects 3 Benefits of Flexibility Exercise 3.1 Increase ROM 3.2 Prevent Contractures 3.3 Increase ADLs 4 Benefits of Neuromuscular Exercise 4.1 Promote Mobility 4.2 Improve Trunk Control 4.3 Improve Balance 5 Benefits of Traditional Chinese Exercise 5.1 Improve Balance and Gait 5.2 Reduce Risk of Falls 5.3 Improve Quality of Life 5.4 Effects on Depression 6 Summary References Chapter 10: Evidence on Exercise Training in Pulmonary Hypertension 1 Introduction 2 Exercise Limitations in Pulmonary Hypertension 2.1 Haemodynamics and Exercise Limitation 2.2 Cardiorespiratory Function and Exercise Limitation 2.3 Muscles and Exercise Limitation 3 Rationale for Exercise Training 4 Evidence on Exercise Training in Pulmonary Hypertension 5 Adaptations to Exercise Training 6 Assessing and Prescribing Exercise in Pulmonary Hypertension 6.1 Cardiopulmonary Exercise Testing 6.2 Six Minutes Walk Test 7 Setting Up a Pulmonary Hypertension Rehabilitation Center 8 Future Recommendations 9 Conclusion References Chapter 11: Peripheral Vascular Disease: The Beneficial Effect of Exercise in Peripheral Vascular Diseases Based on Clinical Trials 1 Introduction 2 Beneficial Effects of Exercise on PAD 2.1 Quality of Life and Exercise 2.2 Exercise Improves Inflammatory/Haemostatic Function 2.3 Enhancement of Walking Efficiency in PAD with Exercise 2.4 Endothelial-Mediated Vessel Dilation Effect 2.5 Increased Capillarity with Training Exercise 3 Exercise Rehabilitation Programs for PAD with Proven Beneficial Effect 3.1 Supervised Exercise Training Programs 3.2 Community-Based Walking Exercise 3.3 Ergometry 3.4 Pole Striding 3.5 Resistance Training 3.6 Systematic Review to Compare Modes of Exercise Training for PAD 4 Beneficial Effect of Exercise in Comparison to Standard Way of Management References Part II: Molecular Mechanisms Chapter 12: The IGF1-PI3K-Akt Signaling Pathway in Mediating Exercise-Induced Cardiac Hypertrophy and Protection 1 Introduction 2 Cardiac Hypertrophy and the Association with Heart Failure Versus Cardiac Protection 2.1 Morphologically Distinct Forms of Cardiac Growth and Hypertrophy: Physiological Versus Pathological 3 Cardiac Enlargement at the Cellular and Molecular Level 3.1 Hypertrophic Stimuli and Signaling Cascades Implicated in Mediating Pathological and Physiological Cardiac Hypertrophy 4 Key Molecular Mechanisms Responsible for Exercise-­Induced Cardiac Growth and Protection 4.1 IGF1-PI3K-Akt Signaling 4.1.1 IGF1R 4.1.2 PI3K 4.1.3 Akt 4.2 Other Factors Contributing to Exercise-Induced Cardiac Hypertrophy and Protection 4.3 IGF1-PI3K(p110α)-Akt Signaling Is Cardioprotective in Preclinical Models 4.3.1 IGF1 and PI3K(p110α) Attenuate Pathological Remodeling Induced by Pressure Overload 4.3.2 PI3K(p110α) Improves Survival in a Setting of DCM 4.3.3 PI3K(p110α) Improves Systolic Function in Mice with MI 4.3.4 Reducing Cardiac PI3K(p110α) Activity Accelerates Disease Progression 4.3.5 Akt Protects the Heart by Promoting Cell Survival and Angiogenesis 5 Therapeutic Strategies Targeting the IGF1-PI3K-Akt Pathway 5.1 Gene Therapy Approaches 5.2 Small Molecules Activating the IGF1-PI3K-Akt Pathway 5.3 PI3K Regulated-microRNAs 6 Summary References Chapter 13: NO Signaling in the Cardiovascular System and Exercise 1 Introduction 2 Nitric Oxide Synthases 3 Intracellular Nitric Oxide Targets and Genetic Approaches 4 Phosphorylation and Regulation of eNOS Activity 5 Nitric Oxide Signaling in the Cardiovascular System: Health And Disease 6 Exercise Training and Nitric Oxide Signaling 7 MicroRNAs That Targets NO Pathway: Relations Between Exercise and Cardiovascular System 8 Nitric Oxide as Target for Development of New Therapies 9 Conclusion References Chapter 14: C/EBPB-CITED4 in Exercised Heart 1 C/EBPB-CITED4 Signaling Pathway 1.1 Introduction of C/EBPB-CITED4 Signaling Pathway 1.2 C/EBPB and Exercise 2 C/EBPB-CITED4 Signaling Is a Novel Pathway in Cardioprotection 2.1 C/EBPB-CITED4 in Mediating Benefits of Exercise in Heart 2.2 C/EBPB-CITED4 Is Important to Cardiac Growth in Pregnancy 2.3 A Regulatory Network Based on C/EBPB-CITED4 Signaling Pathway 2.3.1 MicroRNAs 2.3.2 Other Molecules Related to the C/EBPB Signaling in Heart 3 Conclusion and Prospect References Chapter 15: MicroRNAs Mediate Beneficial Effects of Exercise in Heart 1 Introduction 2 Cardiac Adaptations to Physical Exercise 2.1 Cardiac Growth: Cardiac Hypertrophy and Cardiomyocyte Renewal 2.2 Angiogenesis 3 miRNAs Responsible for Cardiac Adaptations to Exercise 3.1 Cardiac Growth 3.2 Anti-fibrosis 3.3 Angiogenesis 4 miRNAs Mediate Protective Effects of Exercise in CVDs 4.1 Exercise Protects Against Myocardial Infarction 4.2 Exercise Protects Against Cardiac Ischemia/Reperfusion Injury 4.3 Exercise Protects Against Heart Failure 4.4 Exercise Protects Against Diabetic Cardiomyopathy 4.5 Exercise Protects Against Atherosclerosis 4.6 Exercise Protects Against Hypertension 4.7 Exercise Protects Against Pulmonary Hypertension 5 Circulating miRNAs in Response to Exercise 5.1 Circulating miRNAs in Acute Exercise 5.2 Circulating miRNAs in Chronic Exercise 6 Conclusions References Chapter 16: Exercise Training and Epigenetic Regulation: Multilevel Modification and Regulation of Gene Expression 1 Introduction 2 Epigenetics: History and Concepts 3 Epigenetic Mechanisms 3.1 DNA Methylation 3.2 Histone Modifications 3.3 Chromatin Structure, Nucleosomes and Histones 3.4 Acetylation 3.5 Other Histones Modification 3.6 Non Coding RNAs 3.7 Epigenetic Regulation, Exercise and Heart 3.8 Aerobic Exercise 3.8.1 DNA Methylation 3.8.2 Histones Acetylation 3.8.3 MicroRNAs 3.8.4 Resistance Exercise 3.9 Epigenetic Regulation, Exercise and Skeletal Muscle 3.9.1 Methylation 3.9.2 MicroRNAs 3.9.3 Histone Acetylation 3.10 Blood Vessels, Exercise Training and Epigenetics 3.10.1 DNA Methylation 3.10.2 Histone Acetylation 3.10.3 MicroRNAS and Long non Coding RNAS 4 Final Considerations References Chapter 17: Exercise-Induced Mitochondrial Adaptations in Addressing Heart Failure 1 Introduction 2 Mitochondrial Biogenesis 3 Structural Remodeling Involving Mitochondrial Fusion and Fission 4 Mitochondrial Autophagy 5 Conclusion References Chapter 18: Exosomes Mediate the Beneficial Effects of Exercise 1 Introduction 2 Exercise 3 Exosome 3.1 The Introduction of Exosomes 3.2 Exosome Biogenesis 3.3 Exosome Release 3.4 The Effect of Stress on Biogenesis and Release of Exosomes 3.5 Exosome Uptake by Target Cells 3.6 Exosome Isolation, Purification and Identification 4 The Exosomes Induced by Exercise in Cardiovascular Diseases 4.1 Exosome Effect on Cardiovascular Diseases 4.2 The Function of Exosomal miRNA Induced by Exercise in Cardiovascular Diseases 4.3 The Function of HSP Induced by Exercise in Exosome in Cardiovascular Diseases 5 Perspectives and Challenges References Part III: Exercise Dosing and Prescription Chapter 19: Exercise Dosing and Prescription-Playing It Safe: Dangers and Prescription 1 An Brief Introduction to the Principles of Exercise Prescription 2 Scientific Establishment and Implementation of Exercise Prescription 2.1 Pre-participation 2.2 Establishment of Exercise Prescription 2.3 Implementation of Exercise Prescription 3 Aerobic (Cardiorespiratory Endurance) Exercise Prescription and Detailed Exercise Programs 3.1 Frequency of Exercise 3.1.1 Modified for CVD Patients 3.2 Intensity of Exercise 3.2.1 Modified for CVD Patients 3.3 Types (Mode) of Exercise 3.3.1 Modified for CVD Patients 3.4 Exercise Time (Duration) 3.4.1 Modified for CVD Patients 3.5 Exercise Volume 3.6 Progression 3.7 Examples of Detailed Aerobic Exercise Programs 4 Muscular Fitness Exercise Prescription and Detailed Exercise Programs 4.1 Frequency of Resistance Exercise 4.1.1 Modified for CVD Patients 4.2 Types of Resistance Exercise 4.3 Volume of Resistance Exercise (Repetitions and Sets) 4.3.1 Modified for CVD Patients 4.4 Progression and Maintenance 4.4.1 For CVD Patients 4.5 Examples of Detailed Resistance Exercise Programs 5 Flexibility Exercise (Stretching) and Detailed Exercise Programs 6 Neuromotor Exercise 7 Exercise Prescription for Heart Disease 7.1 Inpatient and Outpatient Exercise Program 7.2 Congestive Heart Failure 7.3 Special Considerations 7.3.1 Patients with a Sternotomy 7.3.2 Recent Pacemaker or Implantable Cardioverter Defibrillator Implantation 7.3.3 Patients After Cardiac Transplantation References Annotation The book provides an intensive overview on exercise for cardiovascular disease prevention and treatment, from basic research to clinical practice. The volume firstly summarizes the acute and chronic response to exercise. Secondly, evidence for exercise as medicine for the heart based on clinical studies and basic research is summarized. Thirdly, molecular mechanisms mediating the beneficial effects of exercise including IGF-1-PI3K-AKT signalling, NO signalling, C/EBPB-Cited4 signalling, Non-coding RNAs, epigenetic regulators, mitochondria adaption and exosomes are presented. Finally, exercise dosing, prescription and future prospects are provided. This book will provide valuable reference for researchers in cell biology, physiology, as well as physician, physicaltherapist in cardiology, sport medicine, etc