Key Points
- To examine evidence for structural adaptations within the coronary circulation of healthy adult hearts in response to exercise and training.
- Synthesized findings from temporal studies investigating coronary vascular remodelling and capillary proliferation during exercise.
- Evaluated in vivo hemodynamic intervention models utilizing vasodilator, inotropic, and chronotropic manipulations across the cardiac vascular tree.
- Exercise training induces active capillary proliferation that is masked by concurrent transformation of capillaries into small resistance arterioles under 30 μm in diameter.
- Vascular expansion occurs throughout resistance and large coronary arteries, primarily driven by shear stress, wall tension, and myocardial stretch and compression.
- Hemodynamic forces produce distinct regional effects across the vascular tree, mediated temporally by endothelial factors including nitric oxide and growth factors.
Structured PICO
Does exercise and training induce structural adaptations of the coronary circulation in the healthy adult heart?
PPopulationHealthy adult heart
IInterventionExercise and training
OOutcomeStructural adaptations of the coronary circulation (coronary vascular remodelling)surrogate
Exercise training induces significant coronary vascular remodeling, including capillary proliferation and arteriolarization, driven by hemodynamic and mechanical stimuli.
Limitations
- Technical difficulties of measuring haemodynamic parameters in the heart in vivo