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February 2018

Association of Exercise Preconditioning With Immediate Cardioprotection: A Review

Author Affiliations
  • 1Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, England
  • 2Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, the Netherlands
  • 3Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
  • 4Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
JAMA Cardiol. 2018;3(2):169-176. doi:10.1001/jamacardio.2017.4495

Importance  Exercise reduces the risk of cardiovascular events, including through an underrecognized, clinically useful form of acute cardioprotection accessible after a single episode of exercise, which is called cardiovascular preconditioning.

Observations  Preclinical evidence shows that 1 to 3 episodes of exercise per week will provide strong cardioprotection; gradual, modest cardiovascular risk factor modification or physiological artery remodeling cannot fully explain these benefits. This review highlights preclinical evidence that acute exercise-induced cardiac preconditioning has the ability to activate multiple pathways to confer immediate protection against ischemic events, reduce the severity of potentially lethal ischemic myocardiac injury, and act as a physiological first line of defense.

Conclusions and Relevance  Independent of the protective benefits of long-term exercise training on risk factors and adaptation of the cardiovascular system, cardiovascular preconditioning may contribute to the immediate cardioprotection of exercise. In practical terms, this means that 1 episode of exercise can create clinically relevant cardioprotection.

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