The aging heart and exercise training

N. Ferrara, P. Pisanelli, M. Voza, P. Abete, D. Leosco, A. Filippelli, F. Rossi, F. Rengo

Research output: Contribution to journalArticle


Aging process is responsible for significant structural and functional changes of the cardiovascular system. These modifications involve an increment of connective tissue matrix, a reduced number and increased size of myocytes. From the ultrastructural point of view, the aging heart is characterized by a modification of myofilaments, and by an alteration of calcium homeostasis. In addition, it is very important to underline the agerelated β-adrenoreceptor and post-receptor pathway modifications. Moreover, in an experimental model, we have recently shown an age-related reduction of ischemic preconditioning. This phenomenon is characterized by a reduced electro-mechanical dysfunction after a prolonged ischemic period, when preceded by brief and repeated episodes of myocardial ischemia. We have also demonstrated that the age-related reduction in ischemic preconditioning was related to a decrease in norepinephrine release in response to myocardial ischemia. It is generally accepted that physical activity can reverse the morphological, metabolic and functional changes of the aging heart. It can also reverse the age-related prolongation of isometric contraction and action potential duration, and the decrease of Ca-ATPase of the sarcoplasmic reticulum. Exercise training may also increase cardiac output and modify age-induced alterations in collagen characteristics. Physical activity reverses the age-related adenylate cyclase depression and inhibitory G-protein α-subunit (Gi alpha) increase and improves lusitropy by isoproterenol in papillary muscles from aged rats. In addition to this anti-aging effect, various factors have been implicated in the beneficial effect of physical activity including a lipid-lowering effect, increased insulin sensitivity, reduced arterial pressure, increased coronary vasodilatatory capacity and coronary perfusion, correction of endothelial dysfunction, and the reduction of heart rate and sympathetic activity. Several epidemiological studies indicate that physical activity offers partial protection against primary or secondary events of coronary heart disease and associated mortality among middle aged and older men. In the Goteborg study, the most active men, after 20 years of follow-up, had a relative risk of death from coronary heart disease of 0.72 (95 % confidence interval = CI: 0.56-0.92). In the British heart study, light, moderate and vigorous activity reduced mortality and heart attacks in older men by 0.61 (95% CI: 0.48-0.86), 0.50 (95% CI: 0.31-0.79), 0.65 (95% CI: 0.45-0.94), respectively. In the Honolulu heart program, the risk of coronary heart disease was reduced in physically capable elderly men with the distance walked. Studies on animal models and humans demonstrated that physical activity can modify cardiovascular changes induced by aging. In particular, it has been demonstrated that exercise training restores ischemic preconditioning in the aging rat heart by safeguarding norepinephrine release in response to myocardial ischemia. Similarly, this mechanism seems to be preserved in elderly patients with acute myocardial infarction who have high physical activity scores. In an experimental study, we have provided that first global analysis of aging-induced gene expression changes in the rat heart and its modulation induced by exercise training using a gene chip technology according to very restrictive selection criteria. Our results suggest that exercise is able to counterbalance the changes in transcript levels induced by aging in the rat heart, completely reversing the age-related effects on the expression profile of some genes. These date confirm, at molecular level, the role of exercise training as an anti-aging agent.

Original languageEnglish
Pages (from-to)145-156
Number of pages12
JournalArchives of Gerontology and Geriatrics
Issue numberSUPPL. 8
Publication statusPublished - 2002


  • Cardiovascular aging
  • Gene chip technology
  • Physical activity of elderly

ASJC Scopus subject areas

  • Ageing
  • Medicine(all)

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    Ferrara, N., Pisanelli, P., Voza, M., Abete, P., Leosco, D., Filippelli, A., Rossi, F., & Rengo, F. (2002). The aging heart and exercise training. Archives of Gerontology and Geriatrics, 35(SUPPL. 8), 145-156.