© Springer Nature Singapore Pte Ltd. 2017 139
J. Xiao (ed.), Exercise for Cardiovascular Disease Prevention and Treatment,
Advances in Experimental Medicine and Biology 999,
DOI 10.1007/978-981-10-4307-9_9
Chapter 9
Myocardial Infarction and Exercise Training:
Evidence from Basic Science
Ivana C. Moraes-Silva, Bruno Rodrigues, Hélio J. Coelho-Junior,
Daniele Jardim Feriani, and Maria-Claudia Irigoyen
Abstract 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; nowa-
days, it is a consensus that exercise training (ET) should be part of cardiac rehabili-
tation 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 cardiovascu-
lar 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 patho-
physiology followed by an updated discussion of the most relevant discoveries
regarding ET and MI in basic science.
I.C. Moraes-Silva (*) • M.-C. Irigoyen
Laboratory of Experimental Hypertension, Heart Institute (InCor), University of São Paulo
Medical School, São Paulo, SP, Brazil
e-mail: [email protected]
B. Rodrigues • H.J. Coelho-Junior • D.J. Feriani
Physical Education Faculty, University of Campinas (UNICAMP), Campinas, SP, Brazil