Laboratory of Experimental Hypertension, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, SP, Brazil.
Physical Education Faculty, University of Campinas (UNICAMP), Campinas, SP, Brazil.
Adv Exp Med Biol. 2017;999:139-153. doi: 10.1007/978-981-10-4307-9_9.
In 2016, cardiovascular disease remains the first cause of mortality worldwide [1]. Coronary artery disease, which is the most important precursor of myocardial infarction (MI), is the main component of total cardiovascular mortality, being responsible for approximately seven million of deaths [1]. In approximately 20% of infarcted patients, MI is recurrent in the first year after the event [2]. Moreover, among cardiovascular disease, coronary artery disease accounts for the most increased index of life years lost due to morbidity and/or mortality [1]. Sedentarism highly contributes to cardiovascular disease burden, especially for coronary artery disease, and is also one of the MI risk factors [3]. For many years, it was recommended to avoid physical activity after a cardiovascular event; nowadays, it is a consensus that exercise training (ET) should be part of cardiac rehabilitation programs. There is increasing evidence confirming that, when adequately prescribed and supervised, ET after MI can prevent future complications and increase the quality of life and longevity of infarcted patients [4, 5]. ET after MI follows international specialized guidelines; however, there are different protocols adopted by several societies worldwide in cardiac rehabilitation [6], and there is still lack of information on which type and regimen of exercise may be the ideal after MI, as well as how these exercises act to promote beneficial effects to cardiovascular and other organic systems. Thus, experimental studies are important contributors to elicit mechanisms behind clinical results, and to test and compare different ET protocols. Therefore, exercise prescription can be optimized, individualized, and safely practiced by patients. In this chapter, we present a brief review of MI pathophysiology followed by an updated discussion of the most relevant discoveries regarding ET and MI in basic science.
2016 年，心血管疾病仍然是全球死亡的首要原因[1]。冠心病是心肌梗死（MI）最重要的前身，也是总心血管死亡率的主要组成部分，约占死亡人数的 700 万[1]。在大约 20%的梗死患者中，MI 在事件发生后的第一年复发[2]。此外，在心血管疾病中，冠心病导致因发病和/或死亡而丧失生命年的指数增加最多[1]。久坐不动极大地增加了心血管疾病的负担，特别是对冠心病而言，也是 MI 的危险因素之一[3]。多年来，人们建议避免在心血管事件后进行身体活动；如今，运动训练（ET）应该成为心脏康复计划的一部分，这已成为共识。越来越多的证据证实，在适当的规定和监督下，MI 后的 ET 可以预防未来的并发症，并提高梗死患者的生活质量和寿命[4,5]。MI 后的 ET 遵循国际专业指南；然而，全球心脏康复领域有不同的协议[6]，并且对于哪种类型和方案的运动可能是 MI 后理想的运动，以及这些运动如何作用以促进心血管和其他有机系统的有益效果，仍缺乏信息。因此，实验研究是阐明临床结果背后机制以及测试和比较不同 ET 方案的重要贡献者。因此，可以通过患者来优化、个体化和安全地进行运动处方。在这一章中，我们简要回顾了 MI 的病理生理学，随后更新讨论了基础科学中关于 ET 和 MI 的最相关发现。
