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Exercise increased the growth of new muscle cells and blood vessels in the weakened muscles of people with heart failure, according to two new studies

Exercise increased the growth of new muscle cells and blood vessels in the weakened muscles of people with heart failure, according to two new studies. 
"If you have heart failure, exercise training can improve your health status, increase your ability to exercise and reverse patterns of muscle damage that are common in heart failure," said Axel Linke, M.D., assistant professor of medicine at the University of Leipzig, Germany, and a co-author on both studies.
In chronic heart failure, the heart can't pump enough blood to other organs in the body.
"In addition to getting out of condition because it becomes difficult to exercise, people with heart failure have cellular-level changes in their muscles that make them weaker, more prone to fatigue, and in later stages results in actual muscle shrinkage," he said.
In one study (abstract 3797), researchers investigated whether exercise training could activate progenitor cells, a pool of immature cells in skeletal muscle that can divide into various mature cells as needed for muscle repair.
Compared with healthy people, those with heart failure have about a 50 percent reduction in the number of progenitor cells in their muscles, Linke said.
Researchers examined biopsies of the vastus lateralis, the largest quadricep muscle in the outer thigh, in 50 men, average age 56, with moderate to severe heart failure -- a level at which any exercise is uncomfortable. Researchers took the biopsies before and after a six-month period in which 25 men remained inactive and the other 25 participated in an individualized, physician-supervised endurance exercise program.
Study participants rode a stationary bicycle at least 30 minutes a day (usually divided into two sessions) at about half their peak exercise capacity.
At the end of the six-month study, levels of progenitor cells stayed the same in the inactive group but changed significantly in the exercisers:
  • Total number of progenitor cells (identified by c-kit+ protein marker on the cell surface) increased by 109 percent.
  • Progenitor cells differentiating into muscle cells (identified by c-kit/MEF2+ marker) increased by 166 percent.
  • Progenitor cells actively dividing to form new cells and repair muscle damage (identified by c-kit/Ki67+ protein marker) significantly increased six-fold.
"With exercise, the number of progenitor cells became almost normal, the cells started to divide again, and they began to differentiate into myocytes (muscle cells). And that's exactly what patients with heart failure need -- replacement of muscle cells," Linke said.
Participants in the exercise program also felt better and increased their exercise capacity 20 percent during the six-month study, Linke said.
Whether exercise can induce similar changes in heart muscle is not known, researchers said.
"We also have c-kit+ cells in the heart but we don't know whether they are similar to those in skeletal muscle," Linke said.

https://www.sciencedaily.com/releases/2007/11/071107170759.htm
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