2 41
regulation) of Nrf2 with respect to different mode of exercises such as acute
exercise stress (AES), endurance exercise stress (EES) and moderate exercise
training (MET), and outline the importance of ‘OPTIMAL’ Nrf2 sustenance for
the healthy regulation of redox homeostasis under diverse challenges in the car-
diac system (Fig. 13.3). Different modes exercise protocols and their effects are
summarized in Table 13.1.
6 Benefits of Acute Exercise on Nrf2 Antioxidant Signaling
Exercise is recognized for maximal oxygen uptake by tissues to elevate and improve
the metabolism, thereby enhance myocardial fitness [ 141 ]. However, the expansion
of cardiac fitness correlates well with the degree of the physical action [ 142 ]. In
examining the underlying mechanisms for exercise-induced benefits in myocardial
health, it has been demonstrated that ROS can activate redox-sensitive transcription
factors, including Nrf2, NF-κB and strengthen the antioxidant signaling [ 96 , 120 ,
143 – 146 ]. Prior studies indicated that impairment of the Nrf2-related antioxidant
Fig. 13.3 Effects of metabolic and physical stresses on patho(physio)logical cardiac aging.
Metabolic and chronic conditions such as obesity, diabetes, hypertension, inflammation, etc. pro-
mote hyper-oxidative condition, and structural and functional (systolic/diastolic) remodeling leads
to accelerating aging of the myocardium. While endurance exercise stress exacerbates oxidative
stress and cardiac remodeling, acute or moderate exercise training preserves cardiac health and
prevents remodeling by maintaining myocardial defense system through stabilizing Nrf2-
antioxidant signaling
13 Cardiac Agingfi– Bene ts offiExercise, Nrf2 Activation andfiAntioxidant Signaling