Journal
CURRENT OPINION IN CARDIOLOGY
Volume 30, Issue 5, Pages 543-550Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/HCO.0000000000000206
Keywords
exercise; heart failure; physical activity; prevention; remodeling
Categories
Funding
- National Institute of Health [T32-HL007604]
- National Heart, Lung, and Blood Institute's Framingham Heart Study [N01-HC-25195]
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Purpose of review Heart failure prevention is an important public health goal. Increased physical activity and exercise may help to prevent heart failure, as they are associated with reduced heart failure incidence and potentially act through a variety of mechanisms to slow disease progression. Recent findings Increased physical activity, higher cardiorespiratory fitness, and lower sedentary time are associated with reduced heart failure incidence. These associations are consistent for occurrence of heart failure with both preserved and reduced ejection fraction, the common subphenotypes of the condition. Physiologic cardiac and vascular remodeling occurs across the normal range of physical activity in the community, and regular exercise (four to five sessions per week) is necessary to mitigate age-associated reductions in ventricular compliance and cardiac mass. Summary Greater physical activity, less sedentary time, and improved cardiorespiratory fitness are associated with reductions in heart failure risk. Various mechanisms may explain these findings, including: reducing the prevalence of standard and novel cardiovascular risk factors, inhibiting pathologic cardiovascular remodeling, promoting physiologic remodeling, and improving cardiac, neurohormonal, skeletal muscle, pulmonary, renal, and vascular performance. Future research is needed to elucidate the optimal timing, duration, and modality of physical activity and exercise training necessary to prevent the development of heart failure.
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