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Basic science behind the cardiovascular benefits of exercise
  1. Mathew G Wilson1,2,3,
  2. Georgina M Ellison4,
  3. N Tim Cable2,5,6
  1. 1Department of Sports Medicine, ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  2. 2Research Institute of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
  3. 3Research Institute of Sport and Exercise Sciences, University of Canberra, Canberra, Australia
  4. 4Faculty of Life Sciences & Medicine, Centre of Human and Aerospace Physiological Sciences & Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
  5. 5Department of Sport Sciences, Aspire Academy, Doha, Qatar
  6. 6Department of Sports Science, Exercise and Health, University of Western Australia, Australia
  1. Correspondence to Professor Mathew G Wilson, ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, PO Box 29222, Doha 29222, Qatar; mathew.wilson{at}


Cardiorespiratory fitness is a strong predictor of cardiovascular (CV) disease and all-cause mortality, with increases in cardiorespiratory fitness associated with corresponding decreases in CV disease risk. The effects of exercise upon the myocardium and vascular system are dependent upon the frequency, intensity and duration of the exercise itself. Following a prolonged period (≥6 months) of regular intensive exercise in previously untrained individuals, resting and submaximal exercising heart rates are typically 5–20 beats lower, with an increase in stroke volume of ∼20% and enhanced myocardial contractility. Structurally, all four heart chambers increase in volume with mild increases in wall thickness, resulting in greater cardiac mass due to increased myocardial cell size. With this in mind, the present paper aims to review the basic science behind the CV benefits of exercise. Attention will be paid to understanding (1) the relationship between exercise and cardiac remodelling; (2) the cardiac cellular and molecular adaptations in response to exercise, including the examination of molecular mechanisms of physiological cardiac growth and applying these mechanisms to identify new therapeutic targets to prevent or reverse pathological remodelling and heart failure; and (3) vascular adaptations in response to exercise. Finally, this review will briefly examine how to optimise the CV benefits of exercise by considering how much and how intense exercise should be.

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