Miyachi Masaaki, Yazawa Hiroki, Furukawa Mayuko, Tsuboi Koji, Ohtake Masafumi, Nishizawa Takao, Hashimoto Katsunori, Yokoi Toyoharu, Kojima Tetsuhito, Murate Takashi, Yokota Mitsuhiro, Murohara Toyoaki, Koike Yasuo, Nagata Kohzo
Department of Medical Technology, Nagoya University School of Health Sciences, 1-1-20 Daikominami, Higashi-ku, Nagoya 461-8673, Japan.
Hypertension. 2009 Apr;53(4):701-7. doi: 10.1161/HYPERTENSIONAHA.108.127290. Epub 2009 Mar 2.
The clinical efficacy of exercise training in individuals with heart failure is well established, but the mechanism underlying such efficacy has remained unclear. An imbalance between cardiac hypertrophy and angiogenesis is implicated in the transition to heart failure. We investigated the effects of exercise training on cardiac pathophysiology in hypertensive rats. Dahl salt-sensitive rats fed a high-salt diet from 6 weeks of age were assigned to sedentary or exercise (swimming)-trained groups at 9 weeks. Exercise training attenuated the development of heart failure and increased survival, without affecting blood pressure, at 18 weeks. It also attenuated left ventricular concentricity without a reduction in left ventricular mass or impairment of cardiac function. Interstitial fibrosis was increased and myocardial capillary density was decreased in the heart of sedentary rats, and these effects were attenuated by exercise. Exercise potentiated increases in the phosphorylation of Akt and mammalian target of rapamycin observed in the heart of sedentary rats, whereas it inhibited the downregulation of proangiogenic gene expression apparent in these animals. The abundance of the p110alpha isoform of phosphatidylinositol 3-kinase was decreased, whereas those of the p110gamma isoform of phosphatidylinositol 3-kinase and the phosphorylation of extracellular signal-regulated kinase and p38 mitogen-activated protein kinase were increased, in the heart of sedentary rats, and all of these effects were prevented by exercise. Thus, exercise training had a beneficial effect on cardiac remodeling and attenuated heart failure in hypertensive rats, with these effects likely being attributable to the attenuation of left ventricular concentricity and restoration of coronary angiogenesis through activation of phosphatidylinositol 3-kinase(p110alpha)-Akt-mammalian target of rapamycin signaling.
运动训练对心力衰竭患者的临床疗效已得到充分证实,但其疗效背后的机制仍不清楚。心脏肥大与血管生成之间的失衡与心力衰竭的转变有关。我们研究了运动训练对高血压大鼠心脏病理生理学的影响。6周龄开始喂食高盐饮食的 Dahl 盐敏感大鼠在9周龄时被分为久坐组或运动(游泳)训练组。运动训练在18周时减轻了心力衰竭的发展并提高了生存率,而不影响血压。它还减轻了左心室的向心性,而不降低左心室质量或损害心脏功能。久坐大鼠心脏中的间质纤维化增加,心肌毛细血管密度降低,而运动减轻了这些影响。运动增强了久坐大鼠心脏中观察到的Akt和雷帕霉素哺乳动物靶点的磷酸化增加,而抑制了这些动物中明显的促血管生成基因表达的下调。久坐大鼠心脏中磷脂酰肌醇3激酶的p110α亚型丰度降低,而磷脂酰肌醇3激酶的p110γ亚型、细胞外信号调节激酶和p38丝裂原活化蛋白激酶的磷酸化增加,而运动阻止了所有这些影响。因此,运动训练对高血压大鼠的心脏重塑有有益作用,并减轻了心力衰竭,这些作用可能归因于通过激活磷脂酰肌醇3激酶(p110α)-Akt-雷帕霉素哺乳动物靶点信号通路减轻左心室向心性和恢复冠状动脉血管生成。