Aerobic exercise improves ventricular remodeling by promoting macrophages to phagocytose dying cardiomyocytes in heart failure model

Abstract

Heart failure (HF), the terminal stage of various forms of cardiovascular disease, is a severe disorder characterized by pathological cardiac fibrosis, ventricular remodeling, and reduced heart function. Chamber remodeling is the basic pathological mechanisms of HF. Aerobic exercise training (AET) as one of the non-pharmacological treatments of cardiac rehabilitation, has become one of the important therapeutic means for the long-term management of chronic HF, but how AET can improve the process in HF has not been well clarified. This study aims to determine the role of AET in pathological cardiac remodeling in HF and its potential mechanisms. We identified AET promoting the clearance of apoptosis cardiomyocytes by boosting interactions of cardiomyocytes-macrophages in HF. Lgmn was associated with the efferocytosis elevation of macrophages by AET. In addition, AET, improving the ventricular remodeling and strengthening heart function ultimately, upregulation of the anti-inflammatory mediators and downregulationof the proinflammatory mediators by boosting the expression of Lgmn in chronic repair stage of HF.Our results link AET to efferocytosis elevation of macrophages in the chronic repair stage of heart injury and identify AET as a significant prevention and therapeutic of ventricular remodeling in HF to mediate proper inflammation resolution and cardic function increase.