Exercise and the Cardiovascular System: Clinical Science and Cardiovascular Outcomes
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Substantial evidence has established the value of high levels of physical activity, exercise training (ET), and overall cardiorespiratory fitness in the prevention and treatment of cardiovascular diseases. This article reviews some basics of exercise physiology and the acute and chronic responses of ET, as well as the effect of physical activity and cardiorespiratory fitness on cardiovascular diseases. This review also surveys data from epidemiological and ET studies in the primary and secondary prevention of cardiovascular diseases, particularly coronary heart disease and heart failure. These data strongly support the routine prescription of ET to all patients and referrals for patients with cardiovascular diseases, especially coronary heart disease and heart failure, to specific cardiac rehabilitation and ET programs.
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The primary metric of functional capacity is cardiorespiratory fitness (CRF), usually assessed as peak oxygen uptake (VO2).
“The primary metric of functional capacity is cardiorespiratory fitness (CRF), usually assessed as peak oxygen uptake (V˙o2).6”
Aerobic training benefits include subcellular shifts in gene expression, boosted cellular metabolism, greater organ efficiency, and enhanced systemic biological and physiological integration.
“Aerobic benefits include subcellular shifts in gene expression (triggered in part by reduced inflammation), boosted cellular metabolism (improved bioenergetics and insulin sensitivity), greater organ efficiency (including increased cardiac, vascular, pulmonary, muscular, neurologic, and cognitive performance), and enhanced systemic biological and physiological integration.6”
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Self-citationEnhanced left ventricular performance in endurance trained older men.
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Aerobic exercise and other healthy lifestyle factors that influence vascular aging
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The impact of endurance exercise training on left ventricular systolic mechanics
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Can Intensive Exercise Harm the Heart?
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Exercise, body mass index, caloric intake, and cardiovascular mortality
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Self-citationThe Joint Effects of Physical Activity and Body Mass Index on Coronary Heart Disease Risk in Women
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Self-citationShould high-intensity-aerobic interval training become the clinical standard in heart failure?
Arena, R. A., MYERS, J. N., Forman, D. E., Lavie, C. J., & Guazzi, M. (2012) · Heart Failure Reviews · doi:10.1007/s10741-012-9333-z · Cited by 105 · see citing works
Self-citationPandey, A., Patel, M. R., Gao, A., Willis, B. L., Das, S. R., Leonard, D. S., Drazner, M. H., de Lemos, J. A., DeFina, L. F., & Berry, J. D. (2014) · American Heart Journal · doi:10.1016/j.ahj.2014.10.017 · Cited by 98 · see citing works
Impact of Exercise Training on Psychological Risk Factors
Lavie, C. J., Milani, R. V., O’Keefe, J. H., & Lavie, T. J. (2011) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2011.03.007 · Cited by 98 · see citing works
Self-citationExercise training-induced adaptations in the coronary circulation
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Exercise-induced cardiac remodeling
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Increased Coronary Artery Plaque Volume Among Male Marathon Runners.
Schwartz, R. S., Kraus, S. M., Schwartz, J. G., Wickstrom, K., Peichel, G. A., Garberich, R., Lesser, J. R., Oesterle, S. N., Knickelbine, T., Harris, K. M., et al. (2014) · Europe PMC (PubMed Central) · Cited by 82 · see citing works
Self-citationCan Intensive Exercise Harm the Heart?
Levine, B. D. (2014) · Circulation · doi:10.1161/circulationaha.114.008142 · Cited by 81 · see citing works
Exercise Training in Congestive Heart Failure: Risks and Benefits
Keteyian, S. J. (2011) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2011.02.005 · Cited by 80 · see citing works
Response to la Gerche and Heidbuchel
Levine, B. D. (2014) · Circulation · Cited by 78 · see citing works
Exercising for Health and Longevity vs Peak Performance: Different Regimens for Different Goals
O’Keefe, J. H., Franklin, B. A., & Lavie, C. J. (2014) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2014.07.007 · Cited by 73 · see citing works
Self-citationImprovement of systolic and diastolic heart function after physical training in sedentary women
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Potential Benefits of Weight Loss in Coronary Heart Disease
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Obesity Paradox, Cachexia, Frailty, and Heart Failure
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Self-citationMinimal Amount of Exercise to Prolong Life
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Self-citationLavie, C. J., & Milani, R. V. (1996) · The American Journal of Cardiology · doi:10.1016/s0002-9149(96)00614-5 · Cited by 45 · see citing works
Self-citationOptimal Dose of Running for Longevity
Lee, D.-C., Lavie, C. J., & Vedanthan, R. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.11.022 · Cited by 42 · see citing works
Self-citationSafety of Early Enrollment into Outpatient Cardiac Rehabilitation After Open Heart Surgery
Pack, Q. R., Dudycha, K. J., Roschen, K. P., Thomas, R. J., & Squires, R. W. (2014) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2014.11.040 · Cited by 42 · see citing works
O’Keefe, J. H., Lavie, C. J., & Guazzi, M. (2014) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2014.11.004 · Cited by 38 · see citing works
Self-citationFormal Cardiac Rehabilitation and Exercise Training Programs in Heart Failure
Lavie, C. J., Berra, K. A., & Arena, R. A. (2013) · Journal of Cardiopulmonary Rehabilitation and Prevention · doi:10.1097/hcr.0b013e31829f95c9 · Cited by 37 · see citing works
Self-citationZavin, A., Daniels, K. M., Arena, R. A., Allsup, K., Lazzari, A. A., Joseph, J., Schulze, P. C., Lecker, S. H., & Forman, D. E. (2012) · International Journal of Cardiology · doi:10.1016/j.ijcard.2012.06.007 · Cited by 32 · see citing works
Self-citationExercise Training in Heart Failure With Preserved Ejection Fraction
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Self-citationHigh-intensity interval training in patients with cardiovascular diseases and heart transplantation
Lavie, C. J., Arena, R. A., & Earnest, C. P. (2013) · The Journal of Heart and Lung Transplantation · doi:10.1016/j.healun.2013.08.001 · Cited by 19 · see citing works
Self-citationTerminology for Describing the Elastic Behavior of Arteries
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OUTCOME AFTER MYOCARDIAL INFARCTION IN A COHORT STUDY OF CROSS COUNTRY SKIERS IN SWEDEN
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Coronary Artery Plaque and Cardiotoxicity as a Result of Extreme Endurance Exercise.
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Self-citationCritical impact of fitness in the prevention and treatment of heart failure
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Self-citation
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Exercise-induced oxidative stress: Friend or foe?
Powers, S. K., Deminice, R., Ozdemir, M., Yoshihara, T., Bomkamp, M. P., & Hyatt, H. (2020) · Journal of Sport and Health Science · doi:10.1016/j.jshs.2020.04.001 · Cited by 655 · see citing works
Forman, D. E., Arena, R., Boxer, R., Dolansky, M. A., Eng, J. J., Fleg, J. L., Haykowsky, M., Jahangir, A., Kaminsky, L. A., Kitzman, D. W., et al. (2017) · Circulation · doi:10.1161/cir.0000000000000483 · Cited by 319 · see citing works
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Heart in space: effect of the extraterrestrial environment on the cardiovascular system
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Management of cardiovascular diseases in patients with obesity
Lavie, C. J., Arena, R., Alpert, M. A., Milani, R. V., & Ventura, H. O. (2018) · Nature Reviews Cardiology · doi:10.1038/nrcardio.2017.108 · Cited by 218 · see citing works
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Associations of resistance exercise with cardiovascular disease morbidity and mortality
LIU, Y., LEE, D.-C., LI, Y., ZHU, W., ZHANG, R., SUI, X., LAVIE, C. J., & BLAIR, S. N. (2019) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000001822 · Cited by 187 · see citing works
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Nes, B. M., Gutvik, C. R., Lavie, C. J., Nauman, J., & Wisløff, U. (2017) · The American Journal of Medicine · doi:10.1016/j.amjmed.2016.09.031 · Cited by 108 · see citing works
Self-citationModulation of Insulin Sensitivity by Exercise Training: Implications for Cardiovascular Prevention
Iaccarino, G., Franco, D., Sorriento, D., Strisciuglio, T., Barbato, E., & Morisco, C. (2021) · Journal of Cardiovascular Translational Research · doi:10.1007/s12265-020-10057-w · Cited by 106 · see citing works
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Self-citationUsing metabolic equivalents in clinical practice
Franklin, B. A., Brinks, J., Berra, K., Lavie, C. J., Gordon, N. F., & Sperling, L. S. (2018) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2017.10.033 · Cited by 94 · see citing works
Self-citationBakker, E. A., Lee, D.-C., Sui, X., Artero, E. G., Ruiz, J. R., Eijsvogels, T. M. H., Lavie, C. J., & Blair, S. N. (2017) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2017.02.018 · Cited by 76 · see citing works
Self-citationSix-Year Changes in Physical Activity and the Risk of Incident Heart Failure: ARIC Study
Florido, R., Kwak, L., Lazo, M., Nambi, V., Ahmed, H. M., Hegde, S. M., Gerstenblith, G., Blumenthal, R. S., Ballantyne, C. M., Selvin, E., et al. (2018) · Circulation · doi:10.1161/circulationaha.117.030226 · Cited by 56 · see citing works
Kuang, J., McGinley, C., Lee, M. J.-C., Saner, N. J., Garnham, A., & Bishop, D. J. (2022) · PeerJ · doi:10.7717/peerj.12856 · Cited by 45 · see citing works
Arena, R., & Lavie, C. J. (2017) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2017.02.005 · Cited by 31 · see citing works
Self-citationWallen, M. P., Skinner, T. L., Pavey, T. G., Hall, A., Macdonald, G. A., & Coombes, J. S. (2016) · Transplantation Reviews · doi:10.1016/j.trre.2016.07.004 · Cited by 30 · see citing works
Jensen, S. B. K., Lundgren, J. R., Janus, C., Juhl, C. R., Olsen, L. M., Rosenkilde, M., Holst, J. J., Stallknecht, B. M., Madsbad, S., & Torekov, S. S. (2019) · BMJ Open · doi:10.1136/bmjopen-2019-031431 · Cited by 20 · see citing works
Cardiorespiratory fitness and the incidence of chronic disease
Kokkinos, P., Narayan, P., Myers, J., & Franklin, B. (2018) · Journal of Clinical Exercise Physiology · doi:10.31189/2165-6193-7.2.37 · Cited by 14 · see citing works
- Authors
- Lavie, C. J., Arena, R., Swift, D. L., Johannsen, N. M., Sui, X., Lee, D.-C., Earnest, C. P., Church, T. S., O’Keefe, J. H., Milani, R. V., & Blair, S. N.
- Affiliations
- Pennington Biomedical Research Center (US)
- ORCID
- Venue
- Circulation Research
- Published
- 2015-07-03
- Volume
- 117
- Issue
- 2
- Pages
- 207-219
- ISSN
- 0009-7330 (ISSN-L)
- 1524-4571
- PMC
- PMC4493772
- OpenAlex
- W1947201748
- Cited by
- 782
- References
- 139
- Citations by year
- 2026: 57 · 2025: 81 · 2024: 75 · 2023: 61 · 2022: 78 · 2021: 82 · 2020: 63 · 2019: 70 · 2018: 64 · 2017: 76 · 2016: 56 · 2015: 15 · 2014: 2 · 2013: 1
- FWCI
- 16.76
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Circulation Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (R01AG006945)
- Topics
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
- Keywords
- exercise training, cardiorespiratory fitness, cardiovascular disease prevention, coronary artery disease, heart failure, cardiac rehabilitation, exercise physiology, physical activity, exercise prescription
- MeSH terms
- Cardiac Rehabilitation, Aging, Cardiac Output, Cardiovascular Diseases, Cardiovascular Physiological Phenomena, Exercise Therapy, Female, Humans, Inflammation, Male, Obesity, Physical Fitness, Risk Factors, Stress, Psychological, Stroke Volume, Exercise, Prescriptions, Sedentary Behavior, Vascular Stiffness
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