Laughlin M H, Oltman C L, Bowles D K
Department of Veterinary Biomedical Sciences, Dalton Cardiovascular Research Center, University of Missouri, Columbia 65211, USA.
Med Sci Sports Exerc. 1998 Mar;30(3):352-60. doi: 10.1097/00005768-199803000-00004.
Aerobic exercise training induces an increase in coronary blood flow capacity that is associated with altered control of coronary vascular resistance and, therefore, coronary blood flow. The relative importance of metabolic, myogenic, endothelium-mediated, and neurohumoral control systems varies throughout the coronary arterial tree, and these control systems contribute in parallel to regulating coronary vascular resistance to differing degrees at each level in the coronary arterial tree. In addition to this nonuniformity of the relative importance of vascular control systems in the coronary arterial tree, it appears that exercise training-induced adaptations are also distributed spatially, in a nonuniform manner throughout the coronary tree. As a result, it is necessary to examine training-induced adaptations throughout the coronary arterial tree. Adaptations in endothelium-mediated control play a role in training-induced changes in control of coronary vascular resistance, and there is evidence that the effects of training may be different in large coronary arteries than in the microcirculation. Also, there is evidence that the mode, frequency, and intensity of exercise training bouts and duration of training may influence the adaptive changes in endothelial function. Exercise training has also been shown to induce changes in responses of coronary vascular smooth muscle to vasoactive agents and alterations in the cellular-molecular control of intracellular Ca2+ in coronary vascular smooth muscle of conduit coronary arteries and to enhance myogenic reactivity of coronary resistance arteries. Exercise training also appears to have different effects on vascular smooth muscle in large coronary arteries than in the microcirculation. For example, adenosine sensitivity is increased in conduit coronary arteries and large resistance arteries after training but is not altered in small coronary resistance arteries of trained animals. Although much remains to be studied, evidence clearly indicates that chronic exercise alters the phenotype of coronary endothelial and vascular smooth muscle cells and that plasticity of these cells plays a role in adaptation of the cardiovascular system in exercise training.
有氧运动训练可使冠状动脉血流容量增加，这与冠状动脉血管阻力控制的改变相关，进而影响冠状动脉血流。代谢、肌源性、内皮介导和神经体液控制系统的相对重要性在整个冠状动脉树中各不相同，这些控制系统在冠状动脉树的各个水平上以不同程度并行调节冠状动脉血管阻力。除了冠状动脉树中血管控制系统相对重要性的这种不均匀性外，运动训练引起的适应性变化似乎在空间上也是不均匀地分布在整个冠状动脉树中。因此，有必要研究整个冠状动脉树中训练引起的适应性变化。内皮介导控制的适应性变化在训练引起的冠状动脉血管阻力控制变化中起作用，并且有证据表明，训练对大冠状动脉的影响可能与对微循环的影响不同。此外，有证据表明运动训练的方式、频率、强度和持续时间可能会影响内皮功能的适应性变化。运动训练还被证明可引起冠状动脉血管平滑肌对血管活性物质反应的变化，以及冠状动脉血管平滑肌细胞内钙离子细胞分子控制的改变，并增强冠状动脉阻力动脉的肌源性反应性。运动训练对大冠状动脉血管平滑肌的影响似乎也与对微循环的影响不同。例如，训练后冠状动脉主干和大阻力动脉对腺苷的敏感性增加，但训练动物的小冠状动脉阻力动脉对腺苷的敏感性未改变。尽管仍有许多有待研究的内容，但证据清楚地表明，长期运动可改变冠状动脉内皮细胞和血管平滑肌细胞的表型，并且这些细胞的可塑性在运动训练中心血管系统的适应中起作用。
