© Springer Nature Singapore Pte Ltd. 2017 257
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_14
Chapter 14
Cardiac Fibrosis: The Beneficial Effects
of Exercise in Cardiac Fibrosis
Jan Kyselovič and John J. Leddy
Abstract Numerous scientific findings have concluded that individuals who are
active tend to develop less cardiovascular disease than those who enjoy more seden-
tary lifestyles. Animal models have further demonstrated that the beneficial effects
of training on the heart effects of training are related to the signaling pathways of
myocardial hypertrophy and fibrosis. As such, fibroblasts represent a very important
population of cells within the myocardium as they play a crucial role in both cardiac
development and response to injury. Fibroblasts establish and maintain the biochem-
ical, electrical and mechanical environment of the heart through their complex inter-
actions with cardiomyocytes. Cardiac injury disrupts the balance between fibroblasts
and cardiomyocytes and creates a state favouring inflammation and fibrosis.
Although this adaptive response initially serves to increase wound healing, it may
eventually lead to increased cardiac damage and cardiac failure if homeostasis is not
restored. Myofibroblasts are mediators of both the adaptive and maladaptive compo-
nents of this reaction. This review focuses on the beneficial effects of exercise in
cardiac fibrosis as demonstrated in basic research studies. Attention will be given to
the characterisation of the relationship between exercise and cardiac remodelling,
including the cellular and molecular adaptations of the heart in response to exercise
as well as benefits of exercise in preventing or reversing the pathological remodel-
ling of the fibrotic heart. By furthering our understanding of the beneficial and del-
eterious roles of cardiac fibroblasts and myofibroblasts and how these roles are
related to each other in cardiac development and in heart disease, we may be able to
design interventions to prevent the progression of cardiac fibrosis.
Keywords Cardiac fibrosis • Effects of exercise • Molecular pathways
J. Kyselovič (*)
Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University
Bratislava, Bratislava, Slovak Republic
e-mail: [email protected]
J.J. Leddy
Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa,
Ottawa, Canada