Exercise for Cardiovascular Disease Prevention and Treatment From Molecular to Clinical, Part 1

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And there is not enough mass of evidence in scientific journals that could in more

detail describe the course of the process of neoangiogenesis in relatively “healthy”

heart. Our work often reflects the formation of new blood vessels in skeletal muscle,

which could have a common signaling pathways and morphological manifestations

as in both cases we are dealing with cross-striated muscles.

Other source of information are papers dealing with neoangiogenesis in heart

suffering from cardiovascular disease. It is known that chronic diseases of the car-

diovascular system such as hypertension lead to remodeling of the heart wall, which

runs in many ways similar to a physiological adaptation after regular workout.

Nevertheless, one must be extremely cautious and restrained with this approach.

That is why presented results of today are at best preliminary and they must be con-

firmed in studies designed specially to give evidence of link between random (but

strictly defined) type of exercise and beneficial neoangiogenesis (or arteriogenesis)

within the injury-undisturbed wall of heart. When confirmed, only then one could

speculate about the real gains of this process on performance of heart and of the

whole organism consequently.

Exercise also induces preconditioning whereby the heart is more resistant to

injury even long after the exercise has ceased. The proverbial “triggers” that induce

cardioprotective signaling are clearly multi-factorial, and include neural, endocrine,

and paracrine factors, as well as autocrine signaling and adaptations that arise from

within the heart itself [ 4 ].

Important remark must be said to the “unpopularity” of neoangiogenesis. And in

most cases, it is indeed well deserved reputation. Neoangiogenesis has been associ-

ated with increased aggressiveness of malignant tumors [ 71 , 72 ] and with diseases

as (diabetic) retinopathy [ 73 , 74 ] or atherosclerotic plaque progression [ 75 , 76 ].

VEGF as a common molecule of several signaling pathways is involved in many

pathological conditions as a tumorigenesis and/or atherosclerosis. Only relatively

small step lies between useful angiogenesis in heart and pathological formation of

new vessels, mainly if we will have ambitions to interfere into this process affecting

one or several molecular pathways. Are we ready to play with fire?

As was said above; there is no question exercise affects condition of the heart in

a positive way, but pathways behind are far more complex as we originally thought.

Acknowledgment This study was supported by Grant of the Slovak Research and Development
Agency No. APVV-0434-12 “Morphological characterization of reparative and regenerative mech-
anisms in myocardium during chronic diseases”.

References

1. Pagidipati NJ, Gaziano TA (2013) Estimating deaths from cardiovascular disease: a review of
   global methodologies of mortality measurement. Circulation 127(6):749–756


2. Eckel RH, Jakicic JM, Ard JD, et al (2013) AHA/ACC guideline on lifestyle management to
   reduce cardiovascular risk: a report of the American College of Cardiology/American Heart
   Association task force on practice guidelines. J am Coll Cardiol 63 (25 Pt B):2960-2984

7 Physical Exercise Can Spur Beneficial Neoangiogenesis andflMicrovasculature...