The anti-ageing molecule sirt1 mediates beneficial effects of cardiac rehabilitation.
BACKGROUND
An exercise-based Cardiac Rehabilitation Programme (CRP) is established as adjuvant therapy in heart failure (HF), nevertheless it is underutilized, especially in the elderly. While the functional and hemodynamic effects of CRP are well known, its underlying molecular mechanisms have not been fully clarified. The present study aims to evaluate the effects of a well-structured 4-week CRP in patients with stable HF from a molecular point of view.


RESULTS
A prospective longitudinal observational study was conducted on patients consecutively admitted to cardiac rehabilitation. In fifty elderly HF patients with preserved ejection fraction (HFpEF), levels of sirtuin 1 (Sirt1) in peripheral blood mononuclear cells (PBMCs) and of its targets, the antioxidants catalase (Cat) and superoxide dismutase (SOD) in serum were measured before (Patients, P) and at the end of the CRP (Rehabilitated Patients, RP), showing a rise of their activities after rehabilitation. Endothelial cells (ECs) were conditioned with serum from P and RP, and oxidative stress was induced using hydrogen peroxide. An increase of Sirt1 and Cat activity was detected in RP-conditioned ECs in both the absence and presence of oxidative stress, together with a decrease of senescence, an effect not observed during Sirt1 and Cat inhibition.


CONCLUSIONS
In addition to the improvement in functional and hemodynamic parameters, a supervised exercise-based CRP increases Sirt1 activity and stimulates a systemic antioxidant defence in elderly HFpEF patients. Moreover, CRP produces antioxidant and anti-senescent effects in human endothelial cells mediated, at least in part, by Sirt1 and its target Cat.
Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende 43, 84081 Baronissi, Italy.
Giusy
G
Russomanno
Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy.
Graziamaria
G
Corbi
Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende 43, 84081 Baronissi, Italy.
Valentina
V
Manzo
Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy.|Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme, Benevento, Italy.
Nicola
N
Ferrara
Department of Translational Medical Sciences, Federico II University of Naples, Naples, Italy.|Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme, Benevento, Italy.
Giuseppe
G
Rengo
Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende 43, 84081 Baronissi, Italy.|IRCCS MultiMedica, Milan, Italy.
Annibale A
AA
Puca
Cardiac Rehabilitation Unit of "San Gennaro dei Poveri" Hospital, Naples, Italy.
Salvatore
S
Latte
Vascular Physiopathology Unit, IRCCS INM Neuromed, Pozzilli, Italy.
Albino
A
Carrizzo
Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende 43, 84081 Baronissi, Italy.
Maria Consiglia
MC
Calabrese
INSERM U1063, Stress Oxydant et Pathologies Métaboliques, Institut de Biologie en Santé, Université d'Angers, Angers, France.
Ramaroson
R
Andriantsitohaina
Department of Institutional Study and Territorial Systems, University of Naples "Parthenope", Naples, Italy.
Walter
W
Filippelli
Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende 43, 84081 Baronissi, Italy.|Vascular Physiopathology Unit, IRCCS INM Neuromed, Pozzilli, Italy.
Carmine
C
Vecchione
Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende 43, 84081 Baronissi, Italy.
Amelia
A
Filippelli
Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende 43, 84081 Baronissi, Italy.
Valeria
V
Conti
Catalase; Endothelium; Heart failure; Oxidative stress; Rehabilitation; Sirtuin