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J Appl Physiol (1985). 2015 Oct 15;119(8):934-43. doi: 10.1152/japplphysiol.00053.2015. Epub 2015 Jun 5.

What can we learn about treating heart failure from the heart's response to acute exercise? Focus on the coronary microcirculation.

Author information

1
Division of Experimental Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; and Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland.
2
Division of Experimental Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; and.
3
Division of Experimental Cardiology, Thoraxcenter, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; and d.merkus@erasmusmc.nl.

Abstract

Coronary microvascular function and cardiac function are closely related in that proper cardiac function requires adequate oxygen delivery through the coronary microvasculature. Because of the close proximity of cardiomyocytes and coronary microvascular endothelium, cardiomyocytes not only communicate their metabolic needs to the coronary microvasculature, but endothelium-derived factors also directly modulate cardiac function. This review summarizes evidence that the myocardial oxygen balance is disturbed in the failing heart because of increased extravascular compressive forces and coronary microvascular dysfunction. The perturbations in myocardial oxygen balance are exaggerated during exercise and are due to alterations in neurohumoral influences, endothelial function, and oxidative stress. Although there is some evidence from animal studies that the myocardial oxygen balance can partly be restored by exercise training, it is largely unknown to what extent the beneficial effects of exercise training include improvements in endothelial function and/or oxidative stress in the coronary microvasculature and how these improvements are impacted by risk factors such as diabetes, obesity, and hypercholesterolemia.

KEYWORDS:

HFpEF; coronary microcirculation; myocardial infarction; neurohumoral

PMID:
26048972
DOI:
10.1152/japplphysiol.00053.2015
[Indexed for MEDLINE]
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