Cardiovascular Functional Cell Injury and Cardiovascular Diseases: Mechanistic Insights and Exercise Interventions

Cardiovascular diseases (CVDs) are a leading cause of mortality worldwide and substantially impair physical health, psychological well-being, and quality of life. Cardiovascular functional cells, including cardiomyocytes, cardiac fibroblasts (CFs), vascular smooth muscle cells (VSMCs), vascular endothelial cells (ECs), and immune cells, play essential roles in maintaining cardiovascular homeostasis. Accumulating evidence demonstrates that injury to cardiovascular functional cells drives the initiation and progression of CVDs. Specifically, cardiomyocyte injury is associated with mitochondrial dysfunction and ferroptosis; CF dysfunction promotes cardiac fibrosis; VSMC dysfunction drives pathological phenotypic switching; endothelial dysfunction induces inflammation and oxidative stress; and aberrant immune cell activation promotes M1 macrophage polarization and functional imbalance of B cells and T cells. Growing evidence indicates that exercise attenuates CVD progression by alleviating cardiomyocyte injury, suppressing aberrant CF activation, restoring VSMC function, improving vascular EC dysfunction, and modulating aberrant immune cell activation. This review summarizes the composition and functions of cardiovascular functional cells, examines the roles of cardiovascular functional cell injury in CVDs, presents clinical evidence for the beneficial effects of exercise on CVDs, and discusses the potential mechanisms by which exercise alleviates CVDs through ameliorating injury to cardiovascular functional cells, thereby providing a theoretical basis for the cardiovascular benefits of exercise.