Exercise-specific epigenetic effects on cardiovascular health.

Area of Science:

• Cardiovascular Physiology
• Exercise Science
• Epigenetics

Background:

• Cardiovascular disease (CVD) involves diverse pathologies.
• Exercise is prescribed for CVD prevention, but benefits vary with intensity and duration.
• Ultra-endurance exercise may paradoxically lead to maladaptive cardiac remodeling.

Purpose of the Study:

• To synthesize an epigenetic remodeling framework explaining exercise's dual effects on cardiovascular health.
• To reconcile divergent outcomes of different exercise modalities, intensities, and durations.
• To guide individualized exercise prescriptions for maximizing cardioprotection.

Main Methods:

• Systematic examination of epigenetic pathways (DNA methylation, histone modifications, non-coding RNAs) modulated by exercise.
• Contrast of epigenetic signatures between moderate exercise and ultra-endurance settings.
• Discussion of sex-specific epigenetic mechanisms in ultra-endurance stress.

Main Results:

• Aerobic and resistance training induce cardioprotective epigenetic changes.
• Ultra-endurance exercise is associated with myocardial damage markers and adverse remodeling.
• Emerging evidence suggests sex-specific epigenetic responses to extreme endurance stress.

Conclusions:

• Epigenetic remodeling is a key mechanism balancing cardiovascular adaptation and vulnerability to exercise.
• Current evidence has limitations, including reliance on models and peripheral tissues.
• Future research should address gaps for personalized, risk-stratified exercise prescriptions.