Scheuer J
Circulation. 1982 Sep;66(3):491-5. doi: 10.1161/01.cir.66.3.491.
Physical training is thought to be a stimulus for coronary vascular growth and coronary collateral development. This report is a summary of knowledge in the area. Studies in experimental animals with normal hearts indicate that physical training promotes increased myocardial capillary density and also causes enlargement of the surface coronary vessels. The physiologic effect of these changes on coronary vascular reserve and protection of segments of the heart against myocardial ischemia has not been established. Physically trained dogs and pigs do not appear to be protected against the effects of coronary occlusion, in that the ischemic area appears to be as large in trained animals as in untrained animals for any given coronary lesion. One study in physically trained rats appears to show protection against myocardial infarction, but whether this is related to coronary vascular changes has not been established. Experiments in dogs subjected to chronic narrowing or gradual occlusion demonstrate that physical training in these models does promote collateral blood flow as measured by retrograde flow in open-chest experiments. Studies using the microsphere technique in closed-chest animals confirms increased collateral flow to ischemic areas in some animals, but the magnitude of the increases appears to be small and varies greatly from animal to animal. Studies in athletes suggest that myocardial blood flow is lower at any submaximal level of training in athletes than in sedentary persons. Studies in patients with coronary artery disease have generally failed to show an increase in coronary blood flow or in perfusion of ischemic areas after physical training programs, but the techniques used might not have been sensitive enough to detect changes. The evidence in the experimental animals is sufficiently promising to indicate that the search should be continued to define physical training programs that will most stimulate myocardial vascularity and coronary collaterals in humans.
体育锻炼被认为是冠状动脉血管生长和冠状动脉侧支发育的一种刺激因素。本报告是该领域知识的总结。对正常心脏实验动物的研究表明，体育锻炼可促进心肌毛细血管密度增加，还会导致冠状动脉表面血管扩张。这些变化对冠状动脉储备以及保护心脏部分区域免受心肌缺血影响的生理作用尚未明确。经过体育锻炼的狗和猪似乎并未受到冠状动脉阻塞影响的保护，因为对于任何给定的冠状动脉病变，训练动物的缺血区域似乎与未训练动物的一样大。一项对经过体育锻炼的大鼠的研究似乎显示出对心肌梗死有保护作用，但这是否与冠状动脉血管变化有关尚未明确。对慢性狭窄或逐渐阻塞的狗进行的实验表明，在这些模型中，体育锻炼确实能促进侧支血流，这在开胸实验中通过逆行血流来测量。在闭胸动物中使用微球技术的研究证实，一些动物缺血区域的侧支血流有所增加，但增加的幅度似乎较小，且不同动物之间差异很大。对运动员的研究表明，在任何次最大训练水平下，运动员的心肌血流量都低于久坐不动的人。对冠状动脉疾病患者的研究通常未能显示体育锻炼计划后冠状动脉血流量或缺血区域灌注增加，但所采用的技术可能不够灵敏，无法检测到变化。实验动物中的证据很有前景，表明应继续探索，以确定最能刺激人类心肌血管生成和冠状动脉侧支的体育锻炼计划。
